Respectful Insolence

He’s ba-ack.

Has it really only been two weeks? A mere two weeks since everybody’s favorite advocate of The One Quackery to Rule Them All promised the woo-friendly readers of the “health” section of that wretched hive of scum and quackery, The Huffington Post that he would “provide further specific evidence of the unscientific attitude and actions from those individuals and organizations who are leading the campaign against homeopathy.” Like pretty much every skeptic who’s made any sort of name for himself, no matter how minor, in having fun taking down the pseudoscientific nonsense known as homeopathy, I fervently hoped that I would make the list of the two prominent skeptics whom Ullman blames more than anyone else for a “disinformation campaign against homeopathy.” Of course, given that homeopathy is based on disinformation mixed with magical thinking (sympathetic magical thinking, to be precise), one would think that Ullman would try to dilute the disinformation (with succussion between each step, of course) and use it as a remedy. In any case, skeptics everywhere waited with bated breath to find out who would receive the honor of being named an enemy of homeopathy by the ultimate woo-meister homeopath himself. (And even homeopaths don’t come woo-ier than Ullman.)

They need wait no more. Yesterday, the answer was revealed in a post on HuffPo entitled Disinformation on Homeopathy: Two Leading Sources:

Two of the leading antagonists to homeopathy are James Randi (U.S.) and Tracey Brown (UK). This short article is not meant to be exhaustive on the disinformation campaign against homeopathy, but providing profiles of these leading antagonists to homeopathy will hopefully shed light on the nature of their information and how trustworthy they may or may not be.

Losing out to Randi is, obviously, not a disgrace at all. Randi is, after all, Randi, an icon of the skeptical movement whose contributions to skepticism and critical thinking are legion. In contrast, I had no idea who Tracey Brown is when I read this. It turns out that I should have, given that Brown is the managing director of the U.K. science advocacy group Sense About Science. As you may recall, Sense About Science has been relentless about countering pseudoscience in the U.K. and is known for its campaign to Keep Libel Laws Out of Science. No wonder Ullman would dislike Brown so!

Before he starts, Ullman tries to assure us that he’s not launching ad hominem attacks:

Please know that this review and critique of Mr. Randi and Ms. Brown is not an ad hominem attack on these two individuals. I have a great amount of respect for Mr. Randi as an entertainer and magician, and Ms. Brown is a highly-competent public relations professional. They may also be quite lovely people too, but whether they are nice or lovely or entertaining or competent is not the point of this article. Instead, this article reviews their actions, their priorities and the organizations that they have represented, all of which are reasonable and appropriate areas for critique and are not personal attacks on who they are.

Not surprisingly, much of what follows, in addition to the usual misinformation and pseudoscience that Ullman likes to promote, consists of ad hominem attacks. For example:

James Randi is not just a homeopathic and alternative medicine skeptic, he is also a climate change denier (Randi.org).

And:

If James Randi had serious concerns about fraud and deception in medicine and science, one would think that he would not be silent on the rampant chicanery considerable fraud regularly committed by conventional medical and “scientific” researchers and by Big Pharma companies. However, Randi is a great magician, and he is clearly a recognized expert at misdirection.

The advantage of Randi’s climate change position is that he stands with and by Big Oil and Big Corp. To quote the church lady, “How convenient.”

So, let’s see. Ullman’s claim that he’s not launching ad hominem attacks is followed by portraying Randi as being a pharma shill who also stands with “Big Oil” and “Big Corp.” Does any of this have anything to do with Randi’s criticisms of homeopathy? No, it does not. Even if all of this were true (and it is not), it would be irrelevant to the scientific and skeptical arguments made against homeopathy. Ullman’s simply trying to poison the well with ad hominem attacks, his denials that that’s what he’s doing notwithstanding.

I’ve criticized Randi myself for the huge mistake he made in falling for the talking points of anthropogenic global warming denialists. However, from my perspective, Randi’s mistake was primarily one of omission. He basically wrote an opinion without having studied the issue, and it showed. It showed badly. However, just because Randi made a mistake about AGW doesn’t mean he’s mistaken about all science. He knows homeopathy cold and has demonstrated it again and again. Yet, instead of addressing Randi’s arguments about homeopathy, Ullman spends most of his time whining about the Million Dollar Challenge and bringing up unrelated topics, like AGW, finishing up with a truly vile and despicable cheap shot at Randi based on his personal life that puts the lie to Ullman’s pre-emptive denial that he’s engaging in ad hominems.

Ullman’s even worse when it comes to Tracey Brown, whose past connections to the Communist Party he gleefully recounts, later referring to her as a pharma shill. Truly, I must say that I’ve never seen an ad hominem calling a person, in essence, a Commie pinko and a corporate shill at the same time! Either inconsistency doesn’t bother Ullman, or he’s so eager to attack Brown that he seemingly can’t make up his mind whether she’s a Commie or a Capitalist flack defending corporate interests.

All of this was then followed by this strange attack:

In 2010, SAS and a collaborating organization, the Merseyside Skeptics Society, gained significant media attention by promoting demonstrations that ridiculed homeopathy by asserting that “there is nothing in homeopathic medicine.” Although the Merseyside Skeptics Society is also called “Skeptics at the Pub,” one would think that the media would easily recognize the low level of discourse that would emerge from a group with this name, but not when professional public relations people are pulling some strings.

Come on, now. This is just silly. Skeptics in the Pub meetups are nothing more than informal ways for skeptics to get together and talk skepticism. I’ve been to several such meetups myself, both locally and in other cities when I’m traveling. Notice how he denigrates the Merseyside Skeptics not because they made bad arguments against homeopathy. He can’t. So instead he basically does the equivalent of mocking the Merseyside Skeptics because they hold Skeptics in the Pub meetings.

Ullman’s blatant ad hominems aside, though, does he offer any substantive arguments in support of homeopathy or refuting criticisms of homeopathy? What do you think? Of course he doesn’t. He can’t. Instead, he lays down howlers like this:

The demonstrators each imbibed an entire bottle of a homeopathic medicine to “prove” that there is nothing in it and, strangely enough, to show that they could not commit suicide by ingesting it. It is a tad ironic that these demonstrators equated the ability to commit suicide with a drug as a way to prove that it provides therapeutic action! And these demonstrations were further shown to be “unclear on the concept” of homeopathy, because ingesting a whole bottle of a homeopathic medicine would not prove or disprove anything. At best, it may be akin to using a nail instead of a needle to attempt to disprove acupuncture (clearly, this is garbage in, garbage out thinking).

Actually, it’s Ullman who’s “unclear on the concept,” particularly given his most inapt analogy. After all, if homeopathic remedies have any action whatsoever, then it should be possible to increase the dose to the point of causing toxicity. If, no matter how much homoepathic remedy you take, nothing happens, then that’s an incredibly strong indication that there really is nothing there. Of course, basic physics and chemistry are more than enough to demonstrate that in homepathic dilutions above around 12C or so, it’s incredibly unlikely that there’s a single molecule of the active compound.

In addition, Ullman complains about how the British documentary series Horizon recruited James Randi to investigate Jacques Benveniste’s infamous experiments on homeopathy and to try to replicate the experiments of Madeleine Ennis. These experiments have been held up by homeopaths as “evidence” for the memory of water, but in reality what other scientists and the producers of Horizon, along with James Randi’s help, demonstrated is that Benveniste’s and Ennis’ experiments were fatally flawed and could not be replicated. The details are presented in this transcript of the show. One notes that it is very different from the description that Ullman provides. Particularly ironic is this statement:

When Professor Ennis was ultimately sent the protocol, she was shocked at what she received. This protocol was not her experiment (Ennis, 2004). In fact, it was clearly a study that was a set-up to disprove homeopathy.

Well, not exactly. Science and scientific experiments are designed primarily to falsify, not to prove, hypotheses. That’s where Ullman gets it wrong. He wants an experiment to “prove” homeopathy. That’s not science. Trying to falsify the key concepts behind homeopathy is. If homeopathy can stand up to such hypothesis testing, then that’s an indication that the hypotheses that represent the central concepts of homeopathy might have some validity. They didn’t.

Ullman is also very unhappy about the British House of Commons report on homeopathy last year. I wrote about this report when it came out; it was very good for a governmental report. To discredit it, he relies on, of course, more ad hominems. He attacks Evan Harris, the MP who was a driving force behind the report and points out that he was defeated in his next election “by a 20-something-year-old candidate who had no previous political experience,” implying that it was the report on homeopathy that led to his defeat, a highly unlikely proposition. If anything, the report on homeopathy didn’t have as much of an effect on government policy as it deserved to.

Not surprisingly, in the end, Ullman concludes his post with a rather prolonged and equally pathetic rant against medical “fundamentalism,” which is pure irony, given that it is homeopaths who are the most fundamentalist of all. They never deviate from their pseudoscience, no matter how much evidence shows it to be nothing more than magical thinking sprinkled with a dash of pseudoscience. He even concludes with a typical crank prediction that his pseudoscience will triumph:

Thomas Kuhn, the great physicist and philosopher of science and author of the seminal “Structure of Scientific Revolutions,” asserted that “paradigm shifts” seem only outrageous or revolutionary to those people who have invested themselves in the old paradigm… but to all others, the paradigm shift is a natural evolutionary development to virtually everyone else. The deniers of homeopathy are simply “too invested” personally and professionally in the old medical and scientific paradigm, while the rest of us consider the maturation of medicine and science as long overdue.

It has been said that dinosaurs tend to yell and scream the loudest before their fall… and it seems that we are all witnessing evolution at work.

It is not a coincidence that you could find almost exactly the same text on a creationist blog, on a quack blog (well, actually, it already is), or on the blog of an anthropogenic global warming denialist. All cranks believe that someday they’ll be vindicated by science. It’s very rare that they’re right, and in the case of Dana Ullman the odds of his being right about homeopathy being vindicated are equivalent to the odds of finding a single molecule of the original homeopathic remedy in a 100C dilution.

Comments

  1. #1 Denice Walter
    October 4, 2011

    I think of homeopathy as the lynch pin of woo. A lot rides on it.

    If folks buy this idea, they’ll be likely to buy a whole lot more of spurious nonsense sold by charlatans, so it is defended at all costs. It exemplifies the life energy-vibration-resonance theme they so love.

    On a lighter note ( if anything can be lighter than the insubstantial):

    The idiots I survey have become involved in the People’s Protests anti-GMO, anti-nuclear energy, anti-Wall St ( see NaturalNews; ProgressiveRadioNetwork). Dana will work that too I suspect.

  2. #2 Mu
    October 4, 2011

    The Kuhn quote makes perfect sense if you replace denier with promoter. Medicine has moved on since Hahnemann, starting with germ theory and taking off from there. Just some folks are too vested in their 18th century paradigms to get the message.

  3. #3 RS
    October 4, 2011

    If the mind is a biological organ rather than a window onto reality, there should be truths that are literally inconceivable, and limits to how well we can ever grasp the discoveries of science.

    My belief in the advances of modern medicine is not a simple truth. Despite decades of scientific research, the reality is that there is no objectively “best” care for most ailments.

    I do not believe in homeopathy, but I do respect those with different beliefs. So do NOT be too upset about losing out to Randi!

  4. #4 Science Mom
    October 4, 2011

    There there Orac, perhaps you will make DUllman’s next list. Your disappointment is palpable; go to a pub and knock one back with some fellow sceptics in DUllman’s honour and all will be right again.

  5. #5 G Bell
    October 4, 2011

    Great article, to bad juvenile language and attitudes slip in and out of your otherwise objective perspective.

  6. #6 Composer99
    October 4, 2011

    Giving Ullman the benefit of the doubt, he seems to share along with many cranks & denialists the inability to understand what an ad hominem argument is and what makes it a logical fallacy.

    The fact that he, David-Barton-like, lies about not employing ad hominem arguments right after insisting he isn’t about to use them, makes me, for one, less likely to give him the benefit of the doubt.

  7. #7 daijiyobu
    October 4, 2011

    Dana Ullman “waaaaah-waaaaaah.”

    -r.c.

  8. #8 Dana Ullman
    October 4, 2011

    It is quite quite remarkable that you are actually defending the basophil research created and conducted by Wayne Turnbull! The reason that I consider you and your ilk to be “medical fundamentalists” and “deniers” is that you take out the electron microscope to any minor problem in a study’s design or implementation when the study has a positive result, but then, you go deaf-dumb-blind to “junk science” studies that show a negative result.

    I have never yet read a single criticism of the BBC’s (or 20/20′s) study from a “skeptic”, despite the fact that many skeptics have read Professor Ennis’ critique of that study (which clearly verified how junky it was).

    Please continue in your deaf/dumb/blindness because it simply verifies that unscientific attitudes behind your platitudes.

    Then, when you actually wrote that Randi “know homeopathy cold,” you’ve simply proven how little you and he knows about homeopathy. How embarrassing for you both.

  9. #9 Eric Lund
    October 4, 2011

    If folks buy this idea [homeopathy], they’ll be likely to buy a whole lot more of spurious nonsense sold by charlatans, so it is defended at all costs.

    QFT. Anybody who paid attention in high school chemistry should be able to figure out that homeopathy is nonsense–all you need to remember is the order of magnitude of Avogadro’s number, a fact which nobody is openly disputing. Debunking many other forms of woo involve some combination of knowing facts which woo-pushers are deliberately trying to obscure or having some familiarity with medical science. For instance, take the vaccines-cause-autism crowd. We know this idea is false because, for example, autism rates did not decline after the putative causal agent thimoserol was removed from vaccines. But this is not something taught in high schools; on the contrary, this would be a superficially plausible idea (at least to a layman) were it not for the medical studies showing that this hypothesis is false (the one counterexample that I know of being the fraudulent, since-retracted Wakefield study). The anti-vax crowd have been trying to drown out this inconvenient fact.

  10. #10 Just Sayin'
    October 4, 2011

    Before he starts, Ullman tries to assure us that he’s not launching ad hominem attacks:

    …by launching an ad hominem attack.

    Ullman’s even worse when it comes to Tracey Brown, whose past connections to the Communist Party he gleefully recounts, later referring to her as a pharma shill,

    A Pinko Commie LibrulTM who’s also a shill for Big BiznissTM??? That’s a new one! But he also loses crank points for not calling her a Kenyan Anti-colonialist MuslinTM conspiring with Obama to impose Sharia law on good god-fearin’ Murrcans.

  11. #11 Dangerous Bacon
    October 4, 2011

    “A Pinko Commie Librul who’s also a shill for Big Bizniss???

    I thought that was a specialty of The Joos.

    Ullman: ” I have a great amount of respect for Mr. Randi as an entertainer and magician, and Ms. Brown is a highly-competent public relations professional.”

    See, this could explain why Orac didn’t make the Homeopathic Enemies List. Ullman is trying to suggest that big-time debunkers of homeopathy are out of their depth when they criticize his woo. It’d be harder to do this with Orac, Edzard Ernst or any number of scientists who’ve derided homeopathic nonsense.

    Bottom line: it’s pretty embarassing that an “entertainer and magician” and “public relations professional” have a sound grasp of science when Dana Ullman MPH is so sorely lacking.

  12. #12 Moopheus
    October 4, 2011

    “After all, if homeopathic remedies have any action whatsoever, then it should be possible to increase the dose to the point of causing toxicity.”

    If homeopathic theory were true, wouldn’t it be possible to dilute a solution to the point of toxicity? Does a homeopath ever say, don’t dilute past a certain point, it’s bad? That would be an interesting challenge to a homeopath: make a solution so dilute it produces a negative effect.

  13. #13 Ken
    October 4, 2011

    There are, what – five, six different explanations from homeopaths for how it “works”, right? Water memory, silica, vibrations, quantums, doctrine of signatures, a couple of others, all disagreeing. Doesn’t that mean that most of the disinformation is coming from the homeopaths themselves?

  14. #14 herr doktor bimler
    October 4, 2011

    Thomas Kuhn, the great physicist
    The what?
    I know he had a Ph.D in physics, but he shifted to history (and always considered himself a historian) before he did anything with it.

    It has been said that dinosaurs tend to yell and scream the loudest before their fall…
    By whom?

  15. #15 Beamup
    October 4, 2011

    @ Moopheus:

    According to homeopaths, only beneficial effects can ever be produced. If a remedy would normally produce an effect (e.g. lowering body temperature to treat a fever) and that would be detrimental (e.g. using it for hypothermia because one of the other 500 symptoms that remedy treats is shivering) then it just doesn’t happen.

    Magic indeed.

  16. #16 James Randi
    October 4, 2011

    There seems to an impression that I’m a climate-change denier. Anyone who reads BOTH the posts I wrote on the subject will see that I only doubted that present means of evaluating such world-wide and aged data was possible with enough accuracy to say that the climate change was anything but a transient phenomenon, but I also firmly stated that I was not speaking from any stance of expertise. I received two sorts of response to my first SWIFT article, one from those who applauded my denial of AGW, and one from an equal number who congratulated me for accepting it…!

    The tests of homeopathy that we – Sir John Maddox of Nature Magazine, Walter Stewart from the US National Institutes of Health, and I – did at the Benveniste Lab at Clamart, France, were double-blinded and totally negative. Those were tests that I designed, a simple yes-or-no on whether the homeopathic community could tell – BY ANY MEANS – the difference between plain water and homeopathically-prepared water. They could not, and Ullman has chosen to ignore those…

    Why?

    James Randi.

  17. #17 Black-cat
    October 4, 2011

    Ullman has either never taken a critical thinking class or thinks that his readers have never taken a critical thinking class and won’t understand what an ad hominem attack is. Most woo followers have never taken basic chem, freshman human physiology, or microbiolgy. They don’t have a fundamental understanding of the basic sciences and have no critical thinking skills. I’ve talked with women with stage 3 breast cancer that have refused all treatment except for surgery and spend thousands of dollars on bogus remedies, and think that they can arm themselves with the school of google and know just as much as their oncologists. I have actually been told this by someone who has never taken a freshman life science class. Most of them are taking homeopathy remedies.

    Ullman and his ilk are very dangerous people. I don’t know how they can live with themselves.

  18. #18 Krebiozen
    October 4, 2011

    @ Moopheus and Beamup,
    I have seen several claims by homeopaths that there are high potency (i.e. highly diluted) remedies that would make even a hardened skeptic very ill. Andy Lewis has taken them up on this and has taken not only an overdose of homeopathic remedies, but a continued course of homeopathic sugar pills of which he he was told:

    The lachesis is supposed to be particularly nasty. It is made from a snake venom (Bushmaster) and is supposed to induce horrific symptoms. Previous provers have reported paralysis of the arms and lots of pain. But because my pills do not actually contain any snake venom, I feel pretty confident I will be OK.

    http://www.quackometer.net/blog/2010/01/1023-my-personal-homeopathic-overdose.html

  19. #19 Chris
    October 4, 2011

    Mr. Randi:

    They could not, and Ullman has chosen to ignore those…

    Why?

    Because he is an idiot.

    Plus he makes his money selling his books, and he can’t let facts get in the way of a paycheck.

  20. #20 Tybo
    October 4, 2011

    Poor Kuhn. First he was abused by the post-modernists, then the cranks.

  21. #21 James Randi
    October 4, 2011

    There seems to an impression that I’m a climate-change denier. Anyone who reads BOTH the posts I wrote on the subject will see that I only doubted that present means of evaluating such world-wide and aged data was possible with enough accuracy to say that the climate change was anything but a transient phenomenon, but I also firmly stated that was not speaking from any stance of expertise. I received two sorts of response to my first SWIFT article, one from those who applauded my denial of AGW, and one from an equal number who congratulated me for accepting it…!

    The tests of homeopathy that we – Sir John Maddox of Nature Magazine, Walter Stewart from the US National Institutes of Health, and I – did at the Benveniste Lab at Clamart, France, were double-blinded and totally negative. Those were tests that I designed, a simple yes-or-no on whether the homeopathic community could tell the difference between plain water and homeopathically-prepared water. They could not, and Ullman has chosen to ignore those…

    Why?

    James Randi.

  22. #22 Beamup
    October 4, 2011

    @ Krebiozen:

    Just goes to show that homeopaths can’t even agree on how their magic is supposed to work. Much like Ken’s point on mechanism, but about effects instead.

  23. #23 Orac
    October 4, 2011

    Then, when you actually wrote that Randi “know homeopathy cold,” you’ve simply proven how little you and he knows about homeopathy. How embarrassing for you both.

    I can’t speak for Randi, but that’s a risk I’m willing to take. By the way, Randi showed up in the comments here. A great honor for me, and an opportunity for you to try to use something other than ad hominems as arguments. Try actually addressing the substance.

  24. #24 Denice Walter
    October 4, 2011

    @ Eric Lund:

    I have found that along with the cargo cult science, our woo-meisters are usually also selling the cult of personality- their own. Their own promptings may assuage the doubts of the more sceptical amongst their followers .

    Whether it is a real doctor like Weil or an untrained alt med proselytiser like Adams, he usually will present himself as a paragon of virtue, “ahead of the curve” ( Oh how I hate that expression!), a revolutionary, somehow brighter and more insightful than thousands of professionals and scientists, a role model to be emulated. Some recruit folks for their projects and communities ( e.g. Ecuador). Or instruct about how corrupt medicine, corporations, or government are.

    The ones I follow have brancched out into other fields beyond health : psychology, economics, and politics. As a person with formal education in the first two, I often find their pronouncements hilarious. Doesn’t mean that they can’t harm people. ( e.g. counselling/financial advice)

  25. #25 Matthew Cline
    October 4, 2011

    After all, if homeopathic remedies have any action whatsoever, then it should be possible to increase the dose to the point of causing toxicity.

    I’ve seen the claim that homeopathy works by providing information to the body, which the body then uses to heal itself, and increasing the dose is along the lines of increasing the volume at which the same information is provided. So just like if someone giving directions to you by shouting at the top of their lungs isn’t going to result in you getting lost, increasing the dose isn’t going to make the body heal itself wrong.

  26. #26 TBruce
    October 4, 2011

    “ahead of the curve” ( Oh how I hate that expression!)

    In my experience, if you’re “ahead of the curve”, you end up in the ditch.

    BTW, Ullman should be ashamed of himself for that wretched article.

  27. #27 SplatterPatterns
    October 4, 2011

    #17, Black-cat, October 4, 2011 4:52 PM,

    Mostly depends on the woo to preferred currency exchange rate, don’t it?

  28. #28 Agent Smith
    October 4, 2011

    Ullman,

    Despite your bizarre notice at the start of the article, your whole premise is a exercise in poisoning the well.

    Why does it matter who is promoting the anti-homeopathic, pro-science views? James Randi and the Merseyside Skeptics Society could be Satan and his agents for all I care. The source of the argument is utterly irrelevant consideration.

    Scientific claims about reality rise and fall on their respective evidence, not on their source. This is something homeopaths don’t seem to quite understand yet.

  29. #29 Narad
    October 4, 2011

    I’ve seen the claim that homeopathy works by providing information to the body, which the body then uses to heal itself, and increasing the dose is along the lines of increasing the volume at which the same information is provided. So just like if someone giving directions to you by shouting at the top of their lungs isn’t going to result in you getting lost, increasing the dose isn’t going to make the body heal itself wrong.

    And in this conception, what would different potencies represent? More detailed instructions in the frequency rather than amplitude domain? Sweet Jesus, WHAT IF THE DIRECTIONS ARE WRONG? (There are “prescription-only” homeopathic nostrums, yes?)

  30. #30 Do'C
    October 4, 2011

    The reason that I consider you and your ilk to be “medical fundamentalists” and “deniers” is that you take out the electron microscope to any minor problem in a study’s design or implementation when the study has a positive result, but then, you go deaf-dumb-blind to “junk science” studies that show a negative result.

    It would be difficult to better demonstrate sniveling about burden of proof within a scientific context.

  31. #31 lilady
    October 5, 2011

    I think Ullman has hit a new low…even for him, with this smear campaign against Mr. Randi. Fortunately, many of the comments directed at him at the Ho-Po site have called him out on his tactics…and his homeopathy “cures”.

    When is the Ho-Po going to show some integrity and stop giving these snake oil salesman a forum and a marketplace to sell their books and their magic potions, lotions, pills and treatments to gullible people?

    Yes, Mr. Ullman, Randi has your number and you are just a low life sleazy practitioner of the dark art of homeopathy. I hope you are enjoying all the negative feedback that your latest article at the Ho-Po has generated…I know I am.

  32. #32 WMDKitty
    October 5, 2011

    Um… Orac? I just stumbled across this:

    http://www.change.org/petitions/pathogenic-viruses-do-not-exist

    And wondered what you’d make of it.

  33. #33 Chris
    October 5, 2011

    Um, WMDKitty, is that a joke? For a lark you should send it to Dr. Racaniello at http://www.virology.ws/ .

  34. #34 delurked lurker
    October 5, 2011

    It seems to be hard to argue coherently with anyone who understands the philosophy of Homeopathy, but I think that may be part of the problem in that many people who go to them have no knowledge of basic biology so are unable at first glance to detect the obvious fraud being perpetrated by homeopathic practitioners.

    BTW wow….. J.R. posted here. Been a fan ever since he came to Australia and got the most hostile interview ever televised, by a man called Don Lane. Don Lane was a fan of a British kook called Dorris Stokes who claimed to talk to the dead and he went feral on James. James earned my admiration for his cool under fire and has been an inspiration to me ever since. If any of you can track down that interview its well worth a watch.

    A true skeptic is a true skeptic. To be a true skeptic means that you need to view both sides of an argument, unfortunately when it comes to AGW all logic seems to get thrown out of the window. Now an intelligent person can sort through the dross on both sides of the argument and get to the nitty gritty on the valid opposing views. IMHO this is exactly what James has done on AGW. The issue has however ceased to become a scientific argument and is now a political one, which is why I think the logic has been removed.

    If I never see an AGW debate used in this forum again I will be a happy man as this will prove to be a true skeptic forum. Mind you I have my doubts ;)

    Feel free to prove my doubts unfounded.

  35. #35 Se Habla Espol
    October 5, 2011

    @Dana Ullman

    Then, when you actually wrote that Randi “know homeopathy cold,” you’ve simply proven how little you and he knows about homeopathy. How embarrassing for you both.

    Ullman, Randi’s expertise lies in understanding and exposing how people get fooled. It’s true that he doesn’t specialize in how homeopaths’ marks get fooled, nor in the homeopaths’ techniques — those are just minor details.

    Since the essence, if not the whole, of homeopathy is fooling the marks, Randi probably is more of an expert in homeopathy than you or (nearly) any homeopath you can come up with.

  36. #36 Todd W.
    October 5, 2011

    @Dana Ullman

    I doubt you’ll actually post again, and even if you do, I doubt you’ll really answer my question/challenge, but if you think that there is some good, scientific evidence out there that vindicates homeopathy, go ahead and share it here. Give us a link to a journal article that shows a homeopathic remedy working significantly better than placebo.

  37. #37 palindrom
    October 5, 2011

    deluded lurker@34 –

    Well, I’d hate also to turn this into another AGW back-and-forth, but I wanted to respond quickly to this:

    The issue has however ceased to become a scientific argument and is now a political one, which is why I think the logic has been removed.

    This is most unfortunately true in the public sphere, but among scientists with expertise in the issue, it’s not the case. The denialist PR campaign would like you to think that there is a substantial number of serious experts out there who disagree, but there simply isn’t.

  38. #38 DLC
    October 5, 2011

    Dana Ullman, meet Lorenzo Romano Amedeo Carlo Avogadro di Quaregna e di Cerreto.( http://en.wikipedia.org/wiki/Amedeo_Avogadro) The Count, a noted physicist and mathematician in his day, is the fellow responsible for Avogadro’s law, and the eponymous constant, Avogadro’s number. His work, while not directly relating to Homeopathy, does have considerable impact on it. To Wit: beyond a dilution of the level of Avogadro’s constant, no portion of active principle can still be present within said substance. Thus, no possible portion, not even a molecule, of substance other than water can be in a homeopathic dilution of the generally “approved” level of 30c. Now, given that there can never be a negative amount of substance, it can be fairly demonstrated that homeopathic remedies are nothing but water, or sugar pills. No doubt you will fall back on your ever-favorite claim that I simply do not understand homeopathy — but any such claim would be plainly false.
    And in any case, even if I knew nothing of Homeopathy, you sir are the one making the claim, and it is you who must substantiate the claim. So, provide us with some evidence. Go on, we’ll wait. Credible double-blind, peer reviewed studies only, please.

  39. #39 palindrom
    October 5, 2011

    lilady@31 –

    You asked:

    When is the Ho-Po going to show some integrity and stop giving these snake oil salesman a forum and a marketplace to sell their books and their magic potions, lotions, pills and treatments to gullible people?

    I expect that’s a rhetorical question; the real answer is probably “Whenever it stops generating enough clicks to be worthwhile”, or, in other words, “probably never”.

    HP’s regular science articles, which I follow closely when they touch on my own field, are generally pretty clueless also. There’s usually a commenter who asks “When is HP going to get a science section?”, to which I usually reply something like “Be careful what you wish for.”

  40. #40 Matthew Cline
    October 5, 2011

    If homeopathic theory were true, wouldn’t it be possible to dilute a solution to the point of toxicity? Does a homeopath ever say, don’t dilute past a certain point, it’s bad?

    If I recall correctly, Samuel Hahnemann thought that remedies could be successed (shaken) to the point where they’d be too powerful. I think his concern was that taking a vial of liquid remedy miles on horseback would shake it up too much and make it too strong.

  41. #41 Skepticat_UK
    October 5, 2011

    Thanks for this, Orac. I can never be bothered to read Dullman’s articles on Huffpo and it’s much funnier reading your responses anyway. His reasoning that ‘Tracey is a commie pinko Big Pharma shill therefore whatever she says against homeopathy is disinformation’ is on a par with his argument that homeopathy must work because Her Majesty the Queen and a bunch celebrities use it.

    The man’s a buffoon.

  42. #42 Gray Falcon
    October 5, 2011

    Question for Ullman: Since you actually sell homeopathic remedies, doesn’t that make your own statements about them suspect, at least according to your standards?

  43. #43 Reuben
    October 5, 2011

    Just use what Jenny McCarthy has told you to use… Google “How Does Homeopathy Work?” and click on the top response. Let hilarity ensue.

  44. #44 Daniel J. Andrews
    October 5, 2011

    After all, if homeopathic remedies have any action whatsoever, then it should be possible to increase the dose to the point of causing toxicity.

    I believe this is exactly backward, and that Dana has a good point in that skeptics don’t understand how homeopathy works. So instead of skeptics taking a whole bottle of homeopathic sleeping pills, they should take one sleeping pill, dissolve it in water, dilute it a large number of times (don’t forget to tap/bump it each dilution), and then ingest a single drop. Then we’ll see skeptics keeling over into comas and death. ;-)

  45. #45 Heliantus
    October 5, 2011

    @ Matthew Cline

    So just like if someone giving directions to you by shouting at the top of their lungs isn’t going to result in you getting lost,

    Err, actually…
    I have a strong desire to run away whenever someone is yelling in my general direction. That may not help me getting the right directions (assuming they are yelling the right directions).
    I believe a proper term for this would be sensory overload.

  46. #46 Dangerous Bacon
    October 5, 2011

    “@Dana Ullman

    I doubt you’ll actually post again”

    The pattern so far has been for him to scoot in, drop a turd pearl of stereotypical woo silliness, and then duck out as fast as possible to avoid any evidence-based contamination of his thought processes.

  47. #47 puppygod
    October 5, 2011

    @Daniel J. Andrews

    I believe this is exactly backward, and that Dana has a good point in that skeptics don’t understand how homeopathy works. So instead of skeptics taking a whole bottle of homeopathic sleeping pills, they should take one sleeping pill, dissolve it in water, dilute it a large number of times (don’t forget to tap/bump it each dilution), and then ingest a single drop. Then we’ll see skeptics keeling over into comas and death. ;-)

    No, no, you got it backwards. It’s not allopathy! They should start not with sleeping pill, but with coffee. Dilute it to C100 and then Bamf! One drop and you keel over snoring. Two drops, and you never wake up… :3

  48. #48 Jarred C
    October 5, 2011

    @ Daniel J. Andrews:

    I believe this is exactly backward, and that Dana has a good point in that skeptics don’t understand how homeopathy works. So instead of skeptics taking a whole bottle of homeopathic sleeping pills, they should take one sleeping pill, dissolve it in water, dilute it a large number of times (don’t forget to tap/bump it each dilution), and then ingest a single drop. Then we’ll see skeptics keeling over into comas and death. ;-)

    That’s still not correct. The idea in homeopathy is that like cures like; if a substance would cause an ailment at a high dose, then the same substance (or a different substance with the same effect) at homeopathic doses will cure the ailment. The lower the dose, the more powerful the cure.

    Using your example, taking a homeopathic dose of a sleeping pill will cause you to wake up. If you wanted to cause a drowsy effect, you would need homeopathic doses of caffeine. It’s impossible to create a coma with homeopathic doses of caffeine, or to create convulsions with homeopathic doses of a sleeping pill, because homeopathy always cures, and a cure can never be bad. And remember, we’re talking cures here, not poisons like the medical establishment and big pharma dish out. Or something.

    And remember: allopathic medicine is bad, because it only treats the symptoms and never deals with the real issues that are causing the symptoms. Exactly like homeopathy. So if anyone is against allopathic medicine for that reason, they should also be against homeopathic medicine.

  49. #49 Collin
    October 5, 2011

    @3. That’s not what it means to respect a belief.

    When Catholics gather in a church and say they’re consuming the body and blood of Christ, that’s a respectable, private, symbolic ritual. They don’t think it’s real; they’re just putting on a show for their deity. (I don’t like the idea of a deity that expects a lie as worship, but someone who argues the same way as I do from another point of view could just as well say that my form of worship is a lie. Since reality isn’t involved, there’s no point in arguing. That’s what respect is about.)

    Homeopaths are not being symbolic. They’re claiming their ritual makes something real, selling it as real medicine, and running brainwashing campaigns to silence everyone who points out how Orwellian they are. That’s not respectable.

  50. #50 Chrisj
    October 5, 2011

    He attacks Evan Harris, the MP who was a driving force behind the report and points out that he was defeated in his next election “by a 20-something-year-old candidate who had no previous political experience,” implying that it was the report on homeopathy that led to his defeat, a highly unlikely proposition. If anything, the report on homeopathy didn’t have as much of an effect on government policy as it deserved to.

    Dr Harris lost his seat partly as a result of gerrymandering, but also partly as a result of a vigorous (not to mention vicious) hate campaign waged against him by religious organisations, pseudo-scientists, and the usual anti-science crowds. I wouldn’t be surprised to find that homeopaths and other woo-meisters in the constituency were handing out the leaflets (although I’m not aware of them producing any themselves), and/or telling their clients that they should vote against him. So sadly it might have had some effect. Not as much as the anti-abortionists, tabloid readers and others, but still some.

    (Links are to people commenting on the hate campaign, as the campaign itself had no website that I know of.)

  51. #51 W. Kevin Vicklund
    October 5, 2011

    They don’t think it’s real; they’re just putting on a show for their deity.

    Actually, they claim they do believe it’s real. You’re thinking of Protestants.

  52. #52 dhogaza
    October 5, 2011

    Reuben, #42:

    Brilliant google foo, there …

  53. #53 Antaeus Feldspar
    October 5, 2011

    When Catholics gather in a church and say they’re consuming the body and blood of Christ, that’s a respectable, private, symbolic ritual. They don’t think it’s real; they’re just putting on a show for their deity.

    I could understand why someone might believe that’s what Catholics believe, and some Catholics may privately believe that, but it’s not an accurate representation of actual Catholic belief. Catholics believe that consecration transmutes the substance of Communion wafers and wine into the body and blood of Christ, while the “accidentals” (basically, all the physical aspects of the wafers and wine) are unchanged.

    Some may point out that this is a completely unfalsifiable assertion, and it is, but as Collin points out, it’s really between Catholics and their God. It’s quite different from homeopathy, whose proponents keep claiming that it should be awarded all the status of a science despite it never being able to meet the tests of a science.

  54. #54 WMDKitty
    October 6, 2011

    @chris (#33?) — Hell if I know. I hope it’s a joke, but let’s face it — Poe’s Law. As absurd as that petition is, I guarantee there is at least one crackpot out there who believes the claims.

    As it stands, it’s… mind-numbingly stupid.

  55. #55 Chris
    October 6, 2011

    Joke or not, have you met Dochniak? That is why my sense of sanity is a bit off.

  56. #56 David
    October 6, 2011

    I read through this commentary and then Ullman’s original article, and the two are little related: even is one correctly faults Ullman for ad hominems, Orac fails to address specific points that Ullman brings up. It appears that the bulk of this commentary is itself an ad hominem (prior disrespect of the writer leading to evasion of his most salient arguments and references to specific studies) and scientific uncharitability (regarding the arguments of the other side in the worst light rather than the best).

    More specifically:
    “[Ullman:] In fact, it was clearly a study that was a set-up to disprove homeopathy.
    [Orac:] Well, not exactly. Science and scientific experiments are designed primarily to falsify, not to prove, hypotheses.”

    Ullman is probably not referring to the philosophy-of-science issue of whether experiments are meant to prove or falsify the subject matter (and the Popperian theory of falsification is regardless not the final word on science: for instance, there is not simple experiment that could be set up to falsify conventional medicine — it would require a massive array of different experiments backed by theoretical arguments — yet this doesn’t make conventional medicine unscientific). Rather, from the context Ullman is clearly referring to the study’s being set up intentionally to disprove homeopathy by altering or eliminating aspects of the experiment that were originally introduced to maximize the likelihood of a positive result (reading him thus doesn’t even require charitability, just honesty).

    I believe that skeptics have got themselves so convinced that homeopathy cannot be real due to the simplistic argument that the dilutions contain no original substance (surely there are better arguments against homeopathy! — ones that do not rest on ignoring novel, accumulating experimental and theoretical research published in high-level conventional science journals about clathrates, stable water clusters, etc. (this material is easy to source by searching for original research articles using these keywords), that suggests that it is not absurd that — though not-at-all yet clear whether — there might just be a reasonable physical basis for homeopathy) that interlocutors sympathetic to homeopathy, and even conventional researchers who perform experiments that may be interpreted as having anything to do with homeopathy, are rejected a priori (what may be termed the “meta-ad-hominem argument against homeopathy”). As neither Orac or Randi manage an article without ad hominems (and I personally read them charitably by ignoring those in favour of assessing the meat of their arguments), I would suggest that cherry picking an opponent’s article for ad hominems, then uncharitably misinterpreting other points, while finally ignoring the strong ones that cannot so easily be rebutted, doesn’t advance the dialogue — in the unlikely case they are genuinely interested in one (voila: a double ad hominem to seal it off!!).

  57. #57 igor
    October 6, 2011

    @Chris: there’s more where that came from and all along the same lines of mind numbing willful ignorance. This one purports to ask a question, when it is obvious from the contect that it has no interest in any honest answer.

    http://proliberty.com/observer/20091243.htm

  58. #58 Ender
    October 6, 2011

    @David – your understanding of falsification is flawed, ‘conventional medicine’ is not an applicable subject for falsification, but individual treatments and elements within it are falsifiable and have been tested against that standard.

    You are right about what Ulmann was referring to, however he was wrong, the experiment was not altered and no aspects of it was eliminated, it was merely a scientific attempt at falsification of the hypothesis that was successful. The hypothesis was falsified.

    “I believe that skeptics…”

    This is also an incorrect statement. There is no unified group called “skeptics” who all have the same reasons for their beliefs. Some skeptics do not believe homeopathy works because they are up to date on the evidence that shows it doesn’t work. Others because they understand the science of why it shouldn’t work, and know that there is not enough convincing evidence that it does work to overthrow our understanding of science. Others simply take the word of scientists who should know what they are talking about. Still others don’t believe because they believe in some other treatment, say Reiki or others, and there is no room for both treatments in their worldview. And as you say, some of them are caught up in their understanding of dilution and have not looked into it further.

    Thing is, this isn’t relevant. It’s like when people say “Religious people only believe because they’re weak minded” or “Atheists only don’t believe because they want to do selfish things forbidden by religion/they are moral perverts” – Yes, these things are true for some subsection of the population named, you’re already failing by failing to indicated which subsection and just generalising but most of all the motivations of those who accept the truth is irrelevant to whether it’s true or not

    It’s just a way of poisoning the well, or sociologically engaging someone’s arguments by showing that “they” are have the wrong reasons or the wrong motivations for their beliefs and therefore are wrong, as if this had any logical validity at all.

  59. #59 Orac
    October 6, 2011

    I believe that skeptics have got themselves so convinced that homeopathy cannot be real due to the simplistic argument that the dilutions contain no original substance (surely there are better arguments against homeopathy!

    Actually, the fact that homeopathic dilutions don’t contain any remaining remedy is a pretty damned strong argument against homeopathy.

  60. #60 Igor
    October 6, 2011

    Actually, the fact that homeopathic dilutions don’t contain any remaining remedy is a pretty damned strong argument against homeopathy.

    Next thing these skeptics tell me is that this cup full of water I’m drinking doesn’t contain any apple joice in it. Such negativity, if Jesus could turn it into wine then homeopaths can ensure its apple juice.

    Incidentally, how long does one keep their mind open waiting for the implausible to become definitve proof (or at least something resembling reality)? Because if david is willing to demonstrate such openness then perhaps I can sell him my paper explaining how the superstring theory explains the vibration coefficient of the Dihydrogen Monoxide molecules in vitro? I have no use for the nobel Prise, so I’ll let him have it for 50 bucks and a coffee enema.

  61. #61 JKW
    October 6, 2011

    The reason that I consider you and your ilk to be “medical fundamentalists” and “deniers” is that you take out the electron microscope to any minor problem in a study’s design or implementation when the study has a positive result, but then, you go deaf-dumb-blind to “junk science” studies that show a negative result.

    @Dana Ullman – My my, that’s a whole shovel full of emotion-fueled drivel. There was definitely a shaky finger being pointed at the screen after the post button was clicked.

  62. #62 Igor
    October 6, 2011

    I wonder if he even realizes that an EM and the supporting computer equipment is not something one can easily “take out to any minor problem.” Perhaps he is thinking of a homeoelectronic microscope, which gets smaller and more effecient to transport every time one uses it.

  63. #63 Denice Walter
    October 6, 2011

    Usual argument:

    But but but… the water has *memory*: it remembers the vibration of the diluted substance and re-resonates at that exact frequency transforming the water into a healing vibration that will fix the out-of-tune symptomatology.

    People have memory. Computers have memory. Even some high quality synthetic materials used in sporting clothes have memory. Water does not have memory. Argument over.

  64. #64 Ender
    October 6, 2011

    @Collin – your understanding of Catholics is flawed.

    “When Catholics gather in a church and say they’re consuming the body and blood of Christ, that’s a respectable, private, symbolic ritual. They don’t think it’s real; they’re just putting on a show for their deity.

    That’s not true. It’s a respectable, private, non-symbolic ritual. They do think it’s real, but not a physical or detectable change, instead a spiritual one (‘substance’ actually in the Platonic manner, but spiritual is a close enough analogy)

    (I don’t like the idea of a deity that expects a lie as worship

    Neither do Catholics. Your ignorance of their beliefs has lead you into disliking “a fact” about their beliefs that is not true.

  65. #65 Mojo
    October 6, 2011

    @Jarred C:

    That’s still not correct. The idea in homeopathy is that like cures like; if a substance would cause an ailment at a high dose, then the same substance (or a different substance with the same effect) at homeopathic doses will cure the ailment.

    Not quite: the basic “like cures like” principle of homoeopathy is that a patient exhibiting particular symptoms can be cured by a remedy that causes similar symptoms in a healthy person. Look at some reports of “provings” on the internet – you’ll find that they are carried out using the diluted remedies (as recommended by the prophet Hahnemann in the Organon). The diluted remedy itself is what is supposed to cause the symptoms.

  66. #66 Mojo
    October 6, 2011

    @Orac:

    Actually, the fact that homeopathic dilutions don’t contain any remaining remedy is a pretty damned strong argument against homeopathy.

    But not as strong an argument as the fact that the effects vanish in the best quality trials. See, for example, Linde K, Melchart D. Randomized controlled trials of individualized homeopathy: a state-of-the-art review. J Altern Complement Med. 1998 Winter;4(4):371-88:

    “In the 19 placebo-controlled trials providing sufficient data for meta-analysis, individualized homeopathy was significantly more effective than placebo (pooled rate ratio 1.62, 95% confidence interval 1.17 to 2.23), but when the analysis was restricted to the methodologically best trials no significant effect was seen.”

  67. #67 David
    October 6, 2011

    @Ender: (1) I actually happen to agree with you, that’s why I specifically said that to falsify conventional medicine as a whole would require a huge array of trials (and if that were done then in principle it can certainly be subject to falsification, at least in the sense that if, say, all individual medical treatments were falsified then the whole of medicine at its state at that time would de facto have been falsified): the same then applies to homeopathy! In other words: If conventional medicine (as opposed to individual treatments therein) is not applicable for falsification, then why is homeopathy treated to “definitive” televised investigations or trials?
    (2) When I said “skeptics” I was referring to the likes of Orac and Randi, not generalizing at large. Please read my commentary charitably as I do others’, otherwise you risk producing such effete retorts also in future.

    @Orac: My point is that the argument that there is no substance in homeopathic remedies is good but not decisive as you frequently present it to be (rhetorically, I understand, but you do not allow Ullman the right of rhetoric!), given contrary evidence even from research outside of the field of homeopathy.

    @Mojo: Classic cherry picking, and of an older and smaller meta-analysis at that. I won’t indulge you with quotes from other meta-analyses that tried but failed to eliminate significance even under worst-case scenario subgroup analyses, as those surely must be false.

    “… but the greatest of these is charity.”

  68. #68 RobNYNY1957
    October 6, 2011

    I think it’s also an important point that the claims of homeopathy, like a lot of pseudosciences, seemingly work best where the symptons are most subjective (both on the part of the patient and the prescriber)) and where the placebo effect is strongest. Rabies is a pretty objective condition, and you either get the treatment or you die (with I believe two exceptions in medical history). Of course, thousands of treatments must have been tried over the centuries, but apparently with no placebo effect. This is one reason why I think you don’t hear as much much about homeopathic or acupuncture treatment for that sort of disease.

    The tragic part arises where pseudoscience is applied in cases where non-subjective illnesses occur, especially when the pseudoscience is used instead of, rather than in addition to, evidenced-based medicine.

  69. #69 Igor
    October 6, 2011

    to falsify conventional medicine as a whole would require a huge array of trials (and if that were done then in principle it can certainly be subject to falsification

    I think you once again misunderstood what it means to be falsifiable. A field in and of itself, save for extreme and unlikely discoveries, is not falsifiable. Medicine is a collection of individual theories which are falsifiable in the event an observation makes such theories untenable. Moreover, medical theories often rely on theories in other fields such as biology, physics, chemistry, etc. Falsifying a theory about the basic principles of chemistry, however improbable, would have devastating effect on a wide range of medical theories (i.e. we are not carbon based life forms. You appear to be attributing some sort of unifying theory to the field of medicine when it is simply not so.

    Homeopathy, on the other hand, presents us with several basic hypothesis (I’m being generous here) and can be easily falsified since it promotes a universal way to cure any malady, real or imagined. Except many previous controlled studies have been discredited by its proponents by modifying their claims as to how it works rendering it unfalsifiable and non-scientific. To the extent Homeopathy was presented as a testable hypothesis, it has been tried many times and found wanting, despite its proposed mechanism’s implausibility in contravening fundamental principles of chemistry, biology and physics.

    Why else has the medical field made such drastic improvements in slightly over a century, while homeopathy’s basic principle remained virtually unchanged in 150 years?

    My point is that the argument that there is no substance in homeopathic remedies is good but not decisive as you frequently present it to be

    Orac went to great length many times in describing the problems associated with homeopathy as anything other than a discredited and implausible hypothesis. A careful reading of his posts indicates that Avogadro’s number is only one of homeopathy’s many failings. It has no explanatory power as to why like substances should cure like, why hitting something against a surface alters the remedy in some drastic manner, how it accounts for the perceived ability of water to remember a particular substance, but forget millions of other substances it came into contact with during its earthly existence, etc. In addition, the evidence is simply not there, and to the extent proponents of homeopathy rely on anecdotal evidence, it rarely extends past curing self limiting conditions. In fact, there are no verifiable instances of it ever curing anything severe, despite claims that it can cure anything.

    (rhetorically, I understand, but you do not allow Ullman the right of rhetoric!), given contrary evidence even from research outside of the field of homeopathy.

    Ullman only has rhetoric. He ignores direct questions, cites studies which say something completely different than what he claims (I’m not even talking about finer points, explicit language) and when called out upon these major flaws accuses the other side of conspiring against him with corporate interests (while conveniently ignoring that homeopathy has become big business). While this does not in itself discredit homeopathy, it does discredit Ullman. Incidentally, care to cite the research outside the field of homeopathy supporting it? You can’t use anything that starts with “Q”.

  70. #70 Jarred C
    October 6, 2011

    Mojo,

    Not quite: the basic “like cures like” principle of homoeopathy is that a patient exhibiting particular symptoms can be cured by a remedy that causes similar symptoms in a healthy person. Look at some reports of “provings” on the internet – you’ll find that they are carried out using the diluted remedies (as recommended by the prophet Hahnemann in the Organon). The diluted remedy itself is what is supposed to cause the symptoms.

    Ahh.. ok, so the homeopathic dose is supposed to cause the symptom. Reading on the ‘net reveals this (paraphrased):
    In a healthy person, the substance used in the remedy will cause the symptoms we’re looking to cure. In an unhealthy person, these symptoms will instead energize the vital force of the body. In doing so, the vital force is able to expel the natural disease (or dis-ease?). When the dosing stops, the vital force returns to it’s normal state.

    It’s much more difficult to wrap my brain around this, compared to how I originally thought it worked.

  71. #71 Antaeus Feldspar
    October 6, 2011

    The reason that I consider you and your ilk to be “medical fundamentalists” and “deniers” is that you take out the electron microscope to any minor problem in a study’s design or implementation when the study has a positive result, but then, you go deaf-dumb-blind to “junk science” studies that show a negative result.

    Subtracting the emotive language, what Dana Ullman is actually complaining about is that the burden of proof is being placed on the side making the extraordinary claim, and extraordinary proof is being required. Does he really not realize that that is the way it works??

    Look at that CERN experiment where the results seem to indicate they have particles travelling faster than the speed of light. Are the scientists saying, “hey, we got this result that totally overturns physics as we know it, so you just better accept with no hesitation that we have overturned physics”? No, they’re saying “Hey, everybody out there – please double-check our work, figure out if this is some sort of experimental error, because we’ve got to be absolutely sure there’s no easy explanation before we draw this amazing game-changing conclusion from it!”

  72. #72 Jarred C
    October 6, 2011

    Why else has the medical field made such drastic improvements in slightly over a century, while homeopathy’s basic principle remained virtually unchanged in 150 years?

    I’ve seen similar questions before. I’ve seen answers to such a question; answer which have been said genuinely and as a troll. The answers are something similar to this: “Because the medical field is wrong, and constantly has to fix it’s ‘wrongness.’ It’s always wrong, which is why it’s always fixing things. It will continue to be wrong, and it will continue to have to “fix” things, only to be wrong about that, and fox those. While _____ (fill in the blank) has never changed because it’s been correct since the beginning.

    There’s a really good post on this exact line of thinking on the fark forums (not mine).

    http://www.fark.com/comments/6555276/71673482#c71673482

    Link goes directly to the comment in the thread. Link is Safe For Work (SFW).

  73. #73 Narad
    October 6, 2011

    Rabies is a pretty objective condition, and you either get the treatment or you die

    Oh, tish-tosh.

  74. #74 Igor
    October 6, 2011

    @Jared: I meant it as a rhetorical question. Years of lurking around scienceblogs and holocaust denier blogs have taught me that adherents of a faith-like conviction will often simply explain the reality in a way that conforms with their position. I can jokingly come up with a crazy explanation for almost anything, imagine if one is truly dedicated to the cause and armed with a handy post hoc rationalization?

    But don’t say universe doesn’t have a sense of humor. My Wife’s mother and sister are crazy homeopaths. Do you know how long it takes to throw out all those sugar pills they hid around our apartment in case the cat gets sick? Fortunately they know better by now then peddle this stuff to me.

  75. #75 herr doktor bimler
    October 6, 2011

    This is one reason why I think you don’t hear as much much about homeopathic or acupuncture treatment for [rabies].

    A similar question sometimes occurs to me.

  76. #76 Igor
    October 6, 2011

    @Narad: What infuriates me the most is the inherent dishonesty an many alte-med denialist creeds. These people have severe cognitive dissonance when willfully misrepresenting the facts or exhibiting disregard for the veracity of the information and at the same time accusing the establishment of corruption.

    Te article cites Dr. Charles W. Dull, an esteemed lecturer at U.Penn. A cursory search reveals a publication by our esteemed doctor from 1894 on traumatic injuries. Nowhere does the article mention that they are using someone as authority on modern epidemiology who lived 100 years ago. I bet I could make ups a doctor with a ridiculous name from a fictitious university and someone out there will eat it up as long as the good doctor supports the right nonsense.

  77. #77 David
    October 6, 2011

    @Igor: I agree that medicine is not a unified field, and as such unfalsifiable (I was making the point that even if it were in principle falsifiable it would take a wide array of evidence, and you make the stronger claim that would not falsifiable even then — philosophers of science aren’t all united about your interpretation but this is of no consequence at the moment). My point is that homeopathy is likewise not a unified discipline, and while you argue that falsifying it at its foundations (the unknown or impossible mechanism of action, the law of similars, etc.) is sufficient, I would argue that only serious engagement with the subject matter on the order, e.g., of observing the clinical work of a competent homeopath for several weeks, studying its theory of disease and remedy patterns, etc. can adequately inform one about homeopathy. I don’t expect anyone to commit to so much investigation, but in its absence the proper stance against homeopathy is not that of passionate, public certainty. (In that vein, I laughed when Orac said that Randi knows homeopathy cold: it’s like saying that I know magic cold because I can show Randi’s tricks are mere sleight of hand!)

    For example, saying that homeopathy hasn’t progressed in 150 (actually 200) years betrays ignorance: by 1843 there were about 100 remedies in use in homeopathy, now there are thousands, of which around 1000 are well characterized. There have been significant theoretical developments as well. The basic principles haven’t changed precisely because homeopathy is based around unifying healing principles which, by your own admission, conventional medicine lacks.

    I agree that many things in homeopathy seem absurd. I will further admit that many things in homeopathy still seem absurd to me, many years after I’ve been convinced by too much first-hand evidence that they are real despite that. Meanwhile, a fair reading of the official clinical evidence is that there might be an anomaly worth exploring further, rather than clear-cut evidence against homeopathy, and I’ve tired of arguing with skeptics about specific studies because they never acknowledge that perhaps the evidence for an anomaly, while hardly impressive, doesn’t fit neatly into their world view. Theoretical possibilities about mechanism of action include clathrates and stable-water clusters.

    For those who asked: besides countless case reports of serious illnesses in the homeopathic literature, which we won’t count, here are a couple of first-hand examples of severe illnesses treated homeopathically, that may or may not count in your view as verified clinical reports.

    1) Long-term first-hand (5-10 years) observation of several severe autists treated homeopathically (including one girl better classified as mentally insane as she used to scream, run, and hit 24/7 when not sedated, and one adult autist — basically not the sort subject to spontaneous remission except extraordinarily) who recovered (gained the ability to communicate verbally and express emotions, albeit retaining developmental difficulties; normalized abnormal behaviour and because socially competent and relatively independent). This is not a small subset out of a massive pool, but a subset of a marginally larger set.

    2) Case of quintuple thrombotic stroke, post-operative complication due to rare clinical situation requiring the use of blood-clotting Factor VII which was administered in too-high a dose (not a medical mistake, but due to inability to judge required dosage in a very unusual clinical situation). Due to post-operative status, thrombolytic therapy couldn’t be performed, i.e. medically speaking nothing could be done and it would take weeks for the clots to resorb, meanwhile causing permanent damage. Symptoms: left-arm paralysis, left-sided neglect, total amnesia (though possibly ascribable to confusion), total cortical blindness, fixed pupils. Intensive treatment with a mixture of homeopathic remedies (as is required in such extreme situations) was begun right away under presumption of thrombotic stroke, even before confirmation by CT scan. Administered round-the-clock for several days in liquid form as a drop in the mouth, initially every 2 minutes round-the-clock, gradually tapering down over several days to several daily doses, remaining on this for a couple of weeks. Results: left arm regained full function after two hours, eyesight fully regained over 3-4 days, left-sided neglect resolved over one week, memory returned after 2 days (perhaps insignificant as may have been confusion), pupillary responsiveness regained after 2 hours (probably insigificant in itself as it a general indicator of lowered consciousness and not in itself a result of the stroke). Neurologist and hematologist each independently and spontaneously expressed disbelief at the extent and pace of recovery. Normally recovery from such a situation, if it occurs at all, takes weeks to years at best.

    These are just the very tip of the iceberg of the world in which I live, in which ‘placebo’ is no longer the best explanation — possible, but unlikely. I will emphasize that I come from a cultural and educational background shared by many of you here, but due to life circumstances was once compelled to take the time to explore homeopathy beyond the armchair.

    For any surgeon/ICU specialist/paramedic brave enough to experiment with saving lives in situations in which nothing further can be done, of course on top of all applicable medical treatment: the following mixture prepared as a liquid mixture (water or water/alcohol mixture of any proportion) from at least one drop or pellet or each remedy represents probably the only situation — acute trauma (mainly car accidents, heart attacks, thrombotic and hemorrhagic strokes, post-surgical bleeding) — in which a standardized, non-individualized mixture in the hands of someone knowing no homeopathy using crude technique can produce noticeable clinical results where nothing else will (as in the above hospital situation, or in the field during transport to medical care):

    Arnica montana + Aconitum napellus + Calendula officinalis + Carbo vegetabilis + Hypericum perfoliatum + Natrum sulphuricum + Apis mellifica + Cactus grandiflorus + Latrodectus mactans + Opium.

    These can be obtained each in 30c potency (definitely ultra-Avogadro!). Give literally every few seconds in critical situations (near-death), every few minutes in hyper-acute situations, slowly tapering down inter-dose frequency with improvement, eventually down to a few daily doses for a few days before discontinuing.

    I will not be responding to attacks about the ethics of peddling dangerous quackery (this information is meant for those ‘nothing to lose’ situations when the alternative is certain demise or severe disability) or about the merit of the above cases as evidence, as this is an endless argument that I’ve been through too many times before — I am just sharing a piece of my reality in the interest of showing that it is such real-life experience — or, if you prefer, mere anecdotal experience — that informs proponents of homeopathy. Yes, many of them are New Age quacks, but this doesn’t necessarily imply anything about homeopathy as such (since we seem to agree that ad hominem arguments are off the table and under the belt), just as the many narrow-minded, moronic doctors out there do not discredit medicine as such.

  78. #78 Mojo
    October 6, 2011

    @David:

    Classic cherry picking, and of an older and smaller meta-analysis at that. I won’t indulge you with quotes from other meta-analyses that tried but failed to eliminate significance even under worst-case scenario subgroup analyses, as those surely must be false.

    I bet you won’t!

    Actually, Linde & Melchart (1998) is the only review of trials of individualised homoeopathy. I chose it because homoeopaths object to trials of non-individualised homoeopathy (if they don’t give the right results).

    But if you want larger and more recent reviews, how about:

    Linde, K; Scholz, M; Ramirez, G; Clausius, N; Melchart, D; Jonas, WB (1999), “Impact of Study Quality on Outcome in Placebo-Controlled Trials of Homeopathy”, Journal of Clinical Epidemiology 52 (7): 631–6 (“We conclude that in the study set investigated, there was clear evidence that studies with better methodological quality tended to yield less positive results”);

    Cucherat, M; Haugh, MC; Gooch, M; Boissel, JP (2000), “Evidence of clinical efficacy of homeopathy. A meta-analysis of clinical trials. HMRAG. Homeopathic Medicines Research Advisory Group”, European journal of clinical pharmacology 56 (1): 27–33 (“Studies of high methodological quality were more likely to be negative than the lower quality studies”);

    or Shang, Aijing; Huwiler-Müntener, Karin; Nartey, Linda; Jüni, Peter; Dörig, Stephan; Sterne, Jonathan AC; Pewsner, Daniel; Egger, Matthias (2005), “Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy”, The Lancet 366 (9487): 726–732 (“In both groups, smaller trials and those of lower quality showed more beneficial treatment effects than larger and higher-quality trials. When the analysis was restricted to large trials of higher quality, the odds ratio was 0·88 (95% CI 0·65—1·19) for homoeopathy (eight trials) and 0·58 (0·39—0·85) for conventional medicine (six trials)”)?

    Got anything larger and more recent?

  79. #79 Denice Walter
    October 6, 2011

    @ Igor:

    They need to point an accusatory finger at “corrupt” doctors, scientists, corporations, and governmental officials to distract the marks from looking at their own activities. Lately, it seems I hear more “calling out” than alt med hard sell.

    As for cognitive dissonance, it implies actual cognition is going on. But seriously: I think that at least some of them buy their own bill of goods- both promo and pseudoscience: thinking that they know more than real doctors and would use their own protocols.

    However, I wonder if one were so unfortunate as to develop the same cancer as did Mr Jobs would they continue faithfully or defect- i.e go Gonzales or Whipple?

  80. #80 Alan Kellogg
    October 6, 2011

    Orac,

    Thanks for the trip back to the recent past, going through a certain recent thread reminded me of a number of things.

    Dana’s inability to understand how the world works for example, coupled with his adherence to magical thinking in a world where magic is a non-starter from the get go.

    Dana, homeopathy is magical thinking from the very start, and since magic has been shown to not work in this realm we call reality, you’re going to have no luck persuading anybody withh a moitie of sense.

  81. #81 Phoenix Woman
    October 6, 2011

    Narad @ 72: That’s downright horrifying. Even I, a frickin’ liberal arts major, understand how fricking horrifyingly wrong that all is. Do these whale.to folk have no shame? At all?

  82. #82 herr doktor bimler
    October 7, 2011

    by 1843 there were about 100 remedies in use in homeopathy, now there are thousands, of which around 1000 are well characterized.

    Diluted magnetic monopoles? Diluted Berlin Wall?
    The same German supplier also deals in Lux Solis britannicae, i.e. a preparation of English sunlight, which I would have thought was already quite homœopathic enough.

  83. #83 Dangerous Bacon
    October 7, 2011

    “I’ve tired of arguing with skeptics about specific studies because they never acknowledge that perhaps the evidence for an anomaly, while hardly impressive, doesn’t fit neatly into their world view.”

    Your science can’t measure my woo!”

    Classic.

    “For any surgeon/ICU specialist/paramedic brave enough to experiment with saving lives in situations in which nothing further can be done, of course on top of all applicable medical treatment: the following mixture prepared as a liquid mixture (water or water/alcohol mixture of any proportion) from at least one drop or pellet or each remedy represents probably the only situation — acute trauma (mainly car accidents, heart attacks, thrombotic and hemorrhagic strokes, post-surgical bleeding) — in which a standardized, non-individualized mixture in the hands of someone knowing no homeopathy using crude technique can produce noticeable clinical results”

    We’re way ahead of you.

  84. #84 Cedric Katesby
    October 8, 2011

    @JamesRandi

    There seems to an impression that I’m a climate-change denier.

    Yes, there is. Many people who are long-time supporters of you are in dismay at your position.

    Anyone who reads BOTH the posts I wrote on the subject will see that I only doubted that present means of evaluating such world-wide and aged data was possible…

    Yes, you doubt. You are overwhelmed by the hardness of it all. It’s all so big. It’s all so complicated. It’s all so very not easy to understand. Science is…hard. So you doubt. Yet that by itself would not make you a denier.

    As a wise man said, “doubting” the science behind anthropogenic global warming (AGW) does not per se make one a denialist. However, you went out of your way to dig up and promote climate denialist nonsense.

    You could have gone to NASA…but you didn’t.
    You decided to recycle a handful of long debunked climate denier talking points that you found on the Univerity of Google. You didn’t invent them. You found them and happily repeated them. Your arguments used against the current AGW scientific consensus were bad arguments, they were chock full of logical fallacies and misunderstanding of the science. And they all came as a set McHappy Meal of AGW Denialism. All of your arguments were the usual suspects of Climate Denier talking points. You used all the standard ones. That’s no accident.

    Orac said However, from my perspective, Randi’s mistake was primarily one of omission. He basically wrote an opinion without having studied the issue, and it showed. It showed badly.

    No, Randi didn’t “ommit” anything. He studied the popular talking points very carefully and copied them faithfully from whatever blog he decided to use. He could have looked at the peer-reviewed evidence. He chose not to. He could have asked the scientific community. He chose not to. He could have send an email to Orac or Phil Plait or any other upstanding member of the science blogging community out there who would have been delighted to set him straight on the issue but he chose not to.

    Yet even after all the richly-deserved criticism, nothing changed. Mr Randi issued a cringe inducing not-pology and then later allowed his website to hop into bed with more climate deniers.

    James Randi needs to clear the air on this and make a genuine effort to support good science. No hemming and hawing. No wringing of hands. Science denialism is still science denialism no matter who gets sucked into it.
    Even James Randi.
    I say this as a long time James Randi fan. I wish Randi and Penn & Teller would do the right thing and proudly abandon their denialist postion and make a very big deal about it in the process. A couple of glossy videos would be nice. Maybe even a few interviews with NASA scientists or something.

    …but I also firmly stated that was not speaking from any stance of expertise.

    Ah, the Michelle Bachmann defence. Awful.

    “Later, in an interview with Sean Hannity, a Rush Limbaugh wannabe without even Rush’s occasional entertainment value, Bachmann pulls the “I’m not a doctor” gambit coupled with the “I’m just telling you what this woman said” gambit.”

    Awful. Truely awful.

  85. #85 David
    October 8, 2011

    @Mojo: While some homeopaths object to non-individualized trials because they do not reflect the practice of classical homeopathy, the non-individualized trials of homeopathy happen to be the most rigorous ones out there because it is more difficult to investigate individualized homeopathy (much higher cost and difficulties of organizing large-enough ones, objected to on such bases as that there is no one-to-one correspondence between diagnosis and treatment). Therefore though I don’t expect non-individualized trials to produce impressive clinical results, I am looking at the collective evidence from the better trials of anything resembling homeopathy (i.e. anything where a result would be against our current understanding of science, whether it is clinically relevant or not, including also non-clinical experiments (in vitro, physical measurements of homeopathic water, etc.)) simply in order to see whether there is any effect at all (as even a small but robust effect is sufficient to suggest that something is going on to start). From among the clinical studies the various meta-analyses generally agree that the effect is smaller, but is not eliminated, when better studies are looked at. To me this reads as: “there may be an anomaly here” rather than “this is clear proof that there is nothing here”. I don’t know how it is possible to derive the conclusion that “there is definitely nothing here” from the studies you yourself listed (now that you didn’t cherry pick). This is true even when Shang et al. is taken into consideration. But I must note that this study is so below par that it isn’t worth quoting (I’d say the same thing if it showed a positive result): First, it pits “homeopathy” against “conventional medicine” the latter of which Igor pointed out is not a unified entity. Second, it omitted reporting the subset of studies chosen (this information was publicized weeks later after heavy pressure, after the media storm had died out, what makes me suspect that the withholding of the information was deliberate), which proved to be critical given the tiny number of final studies chosen. More about this at:

    http://www.ncbi.nlm.nih.gov/pubmed/18834714

    http://www.ncbi.nlm.nih.gov/pubmed/19371564

    @herr doktor bimler: there are no magnetic monopoles, in nature or in homeopathy. The two ‘single-pole’ magnetic remedies are made by exposing water to one pole of a magnet for a prolonged period, similarly to the manner of preparation of other remedies from magnetic or radiation sources (x-ray, gamma emissions from positronium decay, x-rays, and electromagnetic radiation). There is nothing inherently absurd about this, nor about a piece of Berlin wall prepared homeopathically (whether or not it differs from a random piece of cement of the same sort is a separate question, but there is no reason it cannot be tested and used similarly to more mundane substances, and for that matter compared to generic freshly prepared cement). In other words, these preparations are inherently only slightly more far-fetched than a homeopathic preparation of salt or gold, and it is even on the latter ones on which we disagree.

    @Dangerous Bacon: I didn’t say I wasn’t going to present RCT evidence or consider it irrelevant, but that I’ve never even once in many years had a skeptic acknowledge that some of the studies may actually be interpreted in a somewhat positive light (again, not as proof for homeopathy, but as incompatible with the certainty that homeopathy is obviously rubbish) – somehow there is always a criticism pulled out of a hat, or outright disregard of the better studies, whereas the Shang et al. study is quoted liberally by many who’ve never even bothered reading it and honestly criticizing its many faults. In this vein, your dismissal of my sharing of real homeopathic ER experience in favour of quoting satire irrelevant to the discussion is proof that you will wave aside anything that may somehow interfere with your predetermined notion of the real.

  86. #86 Vic
    October 8, 2011

    Homeopathy can’t possibly work! It’s not established medical science. It would be in all the journals if it did! Doctors are the only ones who know how to cure what ails you. How dare they! They don’t have enough proof. And they never will because they can’t afford it, ha ha. And nobody will fund them because there’s no money in it for the only people who can afford large studies, big pharma. Listen, I’ve taken homeopathic medicine for years. It works. My wife fell and hurt her back and hip so bad she needed surgery and therapy. Incredibly, she fully recovered with homeopathic medicine, no surgery, no therapy. You don’t want to believe me, that’s up to you. It’s too incredible? I agree. Don’t believe me. Do your research and keep an open mind.

  87. #87 novalox
    October 8, 2011

    @vic

    Moving your fact-free idiotic rants to another post, troll?

  88. #88 Krebiozen
    October 8, 2011

    Why is it that when anyone comes here and demands

    Do your research and keep an open mind.

    they clearly have not looked at the research (often claiming incorrectly, like Vic, that there isn’t any because it’s too expensive) and are too closed minded to consider the possibility that they are wrong?

  89. #89 Militant Agnostic
    October 8, 2011

    Viv

    Do your research and keep an open mind.

    And I am sure that you are keeping an open mind to the possibility that you are wrong and you are keeping an open mind to the possibility that a huge body of scientific evidence is correct and your limited personal experience is wrong. We know you have not “done your research” with an open mind because you have not found or chosen to ignore the systematic reviews that show the better quality of the study the less likely it is to find a positive affect for homeopathy.

  90. #90 Chris
    October 8, 2011

    I suspect that Vic, our new troll, has absolutely no idea what homeopathy is. And it looks like he making everything up.

    I wonder if he is not a coy reincarnation of a previous troll.

  91. #91 Matthew Cline
    October 9, 2011

    @David:

    My point is that homeopathy is likewise not a unified discipline … I would argue that only serious engagement with the subject matter on the order, e.g., of observing the clinical work of a competent homeopath for several weeks, studying its theory of disease and remedy patterns, etc. can adequately inform one about homeopathy.

    There isn’t enough documented information about the varying schools of homeopathy to learn about it in-depth via reading? Or is the field of homeopathy so dis-unified that there are no schools, and the only way to really learn about it is from an individual practicioner?

  92. #92 Militant Agnostic
    October 9, 2011

    @David

    observing the clinical work of a competent homeopath for several weeks

    Competent Homeopath is an oxymoron. How can someone be competent at something that is at its core ineffective nonsense.

  93. #93 David
    October 9, 2011

    @Mattew Cline: I suggest that observation is the best approach because one cannot read everything about homeopathy in text form. And, no, there isn’t enough information in printed form: if this were the case in medicine then medical students wouldn’t need to do rounds. How is this different from the need to watch a surgery in person in order to be fully convinced that the person did better as a result of it, if you were a ‘surgery skeptic’? Or to listen to a piano instead of reading about how it sounds? The clinical research is part of the data that needs to be considered, not all of it. 40 years ago if one wanted to know what worked in conventional medicine one didn’t have RCTs to rely on (and today still many treatments, certainly most if not all surgical procedures, havne’t been RCT-certified), yet it couldn’t be said that conventional medicine was rubbish. This brings us back always to the issue that homeopathy is incredible on theoretical grounds, and from this springs my suggestion that one needs to include adequate first-hand clinical observation in one’s research, because abstract evidence removed from one’s immediate experience is insufficient.

    @Militant Agnostic: You’re one of those with whom no cogent exchange is possible. (Your nickname even betrays your incoherent attitude: one can be a militant atheist or skeptic, not a militant someone-who-isn’t-even-sure!)

  94. #94 Matthew Cline
    October 9, 2011

    @David:

    And, no, there isn’t enough information in printed form: if this were the case in medicine then medical students wouldn’t need to do rounds.

    We’re not trying to become homeopaths, but become “adequately informed”, as you put it. You don’t need to become a medical doctor in order to discuss conventional medicine in an informed manner.

    How is this different from the need to watch a surgery in person in order to be fully convinced that the person did better as a result of it, if you were a ‘surgery skeptic’?

    If a “surgery skeptic” needed a first-hand view of surgery being performed to change their mind, then they’re doing skepticism wrong.

  95. #95 herr doktor bimler
    October 9, 2011

    one needs to include adequate first-hand clinical observation in one’s research, because abstract evidence removed from one’s immediate experience is insufficient.

    So homeopathy is only convincing under conditions designed to optimise the opportunities for self-delusion, retrospective bias, selection bias, and various other well-known cognitive errors? OK.

  96. #96 herr doktor bimler
    October 9, 2011

    if one wanted to know what worked in conventional medicine one didn’t have RCTs to rely on

    The thing is that a few clever-clogs have dragged mainstream medicine kicking and screaming into the domain of science, forcing them to relinquish the use of leeches and phlebotomy (and various more recent equivalents). Homeopathy is one of several forms of medicine that have successfully resisted that transformation.

  97. #97 David
    October 9, 2011

    @Matthew Cline: I understand becoming a homeopath is not necessary for investigating homeopathy, but becoming “adequately informed” about homeopathy is more involved than becoming adequately informed about medicine. Without trying, an ordinary person is exposed to medical anecdotes say dozens of times a year. So the opinion of the average person about medicine is formed of much anecdotal data. That’s why there are few surgery skeptics out there despite the lack of RCT evidence for surgeries’ effectiveness, but if surgery were not part of our culture and one had no fund of anecdotal experience to draw on, then it would be perfectly feasible to require first-hand experience.

    Now, how many homeopathy patients have you spoken with in your lifetime? (I don’t even mean ones that are overly enthusiastic and therefore illegitimate sources of such information in your mind, but ones that tried it, experienced positive results, and moved on with their lives; and I would recommend speaking not only with ones that self-medicated for a flu but also with ones who had a course of treatment for a chronic ailment.) My suggestion of clinical observation is precisely to make up for the lack of such exposure to homeopathy in our culture. An alternative to observing with a homeopath might be to interview several-dozen patients.

    None of this proves anything about homeopathy, but it is the minimum a thorough skeptic would have to do to become adequately informed about homeopathy anywhere to near the level that one is naturally informed about conventional medicine. I hope this makes my point clearer.

  98. #98 David
    October 9, 2011

    @herr doktor bimler: Homeopathy is also convincing under RCTs. The fact that better studies produce weaker results doesn’t indicate that bigger studies yet will produce weaker results yet: perhaps the weaker results are actually the more precise results (i.e. such studies home in on the true result). Those weak results are still valid statistically, except that the skeptic says: “Extraordinary results require extraordinary proof,” or conversely dismisses the results as “clinically insignificant,” i.e., tacitly admitting that there might be an anomaly (since clinical significance and statistical significance are independent of each other), but quickly dismissing its clinical significance so as to sweep the anomaly under the carpet.

    The medicine of the 1960s was not full of blood-leaching: it was medicine at a high level of scientific development despite the absence of RCTs. So your comparison is, as your conskeptics like to say, a “straw man argument.”

  99. #99 Krebiozen
    October 9, 2011

    David,

    40 years ago if one wanted to know what worked in conventional medicine one didn’t have RCTs to rely on (and today still many treatments, certainly most if not all surgical procedures, havne’t been RCT-certified), yet it couldn’t be said that conventional medicine was rubbish.

    There certainly were RCTs 40 years ago, though I take your point that many widely used treatments at that time had not been subjected to RCTs, and that is still true to some extent. It has been interesting to see some previously routine treatments abandoned as RCTs have shown them to be ineffective (a dated and far from complete list) though it does sometimes take a year or two for these findings to filter into clinical practice.

    The real point here is that the first crude double-blinded placebo-controlled RCT of homeopathy was in 1835 in Nuremberg, and there have been many RCTs since. The best designed RCTs show homeopathy has no effect over placebo, but this has had no effect whatsoever on clinical practice.

  100. #100 Matthew Cline
    October 9, 2011

    @David:

    I understand becoming a homeopath is not necessary for investigating homeopathy, but becoming “adequately informed” about homeopathy is more involved than becoming adequately informed about medicine. Without trying, an ordinary person is exposed to medical anecdotes say dozens of times a year. So the opinion of the average person about medicine is formed of much anecdotal data.

    Yes, their opinion on the effectiveness of conventional medicine is formed by such anecdotes, but any understanding of how the various procedures works or about the theories behind those procedures isn’t going to be reliable.

    but it is the minimum a thorough skeptic would have to do to become adequately informed about homeopathy anywhere to near the level that one is naturally informed about conventional medicine.

    Okay, as an example, lets consider vaccines, something that’s common in developed nations. On the one hand, people who’s only knowledge about vaccines is from anecdotes aren’t going to know anything about them beyond that they prevent you from catching infectious diseases. On the other hand, if there were someone from a place where vaccines were rarely or never used, and I wanted this person to understand about vaccines, I wouldn’t have them interview vaccinated people, or watch vaccines being administered, or watch vaccines being manufactured, but give them some books on vaccines (or have the books read to the person if they’re not literate). This hypothetical person not having any anecdotal or direct experience with vaccines would be no hindrance to their understanding of vaccines.

  101. #101 David
    October 9, 2011

    @Matthew Cline: The “average person” I was referring you includes you and me, as we come to the discussion of medicine and homeopathy with our respective life backgrounds, and we share experience of medicine but not of homeopathy (i.e. I presume that your exposure to homeopathy is limited). This influences your prior belief in the possibility that homeopathy is real, irrespective of theoretical considerations, because you already assume due to cultural exposure that medicine is real but that homeopathy is not, even prior to any proper investigation of the matter.

    I’m not sure the example of vaccines is good, as this is one field in which clinically speaking their effectiveness in preventing illnesses isn’t anecdotally discernible at all. Yet even then, if you had a culture in which medicine and the theory behind vaccination was considered rubbish, then upon reading about vaccines one might still want to “see it for himself,” and if there was a way of doing so (say by participating in a large-scale study as an assistant to the professional investigators) it would be a legitimate way of overcoming skepticism. I am suggesting that the homeopathy skeptic is in a similar position, and has to go to great lengths to properly investigate the matter (or, lacking the initiative to do so, remain agnostic on the matter, which is a viable position that I respect).

    In contrast most medical anecdotes have to do with obvious relationships between symptoms and their alleviation through medical treatment, so such anecdotal data readily influences our prior beliefs.

  102. #102 Matthew Cline
    October 9, 2011

    Okay, I think we’re talking at cross purposes. I’m talking about understanding the methods and theories of a particular type of medicine, regardless of whether or not one agrees with what one understands. You’re talking about what it would take to convince a skeptic that s/he’s wrong, and are saying that in some circumstances mere “book learning” will be insufficient to convince the skeptic of the truth of something, so direct experience and/or anecdotal information is required.

  103. #103 Mephistopheles O'Brien
    October 9, 2011

    David,

    Homeopathy is also convincing under RCTs.

    Got any data supporting that? The studies I’ve looked at magnified trivial differences out of all proportion or didn’t have real controls.

  104. #104 Krebiozen
    October 9, 2011

    David,

    None of this proves anything about homeopathy, but it is the minimum a thorough skeptic would have to do to become adequately informed about homeopathy anywhere to near the level that one is naturally informed about conventional medicine. I hope this makes my point clearer.

    It makes your position very clear. I agree with Herr Doktor Bimler – what you describe are ways of maximizing the chances that a person investigating homeopathy will be misled by cognitive and other biases. RCTs are ways of minimizing such biases. What you describe as “informed” I would describe as “biased”. You seem to be arguing that it is only fair to start assessing homeopathy with a similar level of cognitive bias as we have in favor of conventional medicine, which I think is foolish.

    I have a comment in moderation that explains how clinical practice has changed in response to RCTs, and links to a list of examples. You don’t see large numbers of conventional doctors defending a practice that has been demonstrated to be ineffective by RCTs on the grounds that, “perhaps the weaker results are actually the more precise results” or that that intervention is somehow immune to RCTs, or the other special pleading we see from homeopaths.

    In contrast, alternative medicine, and homeopathy is the prime example, never changes in response to clinical trials.

  105. #105 Mojo
    October 9, 2011

    @Krebiozen:

    In contrast, alternative medicine, and homeopathy is the prime example, never changes in response to clinical trials.

    The first review I cited in this thread (the one of trials of individualized homoeopathy) touched on this in a section headed “Problems with randomized clinical trials of individualized homeopathy”:

    “The motivation for doing trials seems less to be innovation or self-critical evaluation of performance (which is generally considered to be the motivation for good research) but rather justification in front of a hostile scientific establishment.”

  106. #106 lilady
    October 9, 2011

    “This influences your prior belief in the possibility that homeopathy is real, irrespective of theoretical considerations, because you already assume due to cultural exposure that medicine is real but that homeopathy is not, even prior to any proper investigation of the matter.”

    I have a few questions for David about the use of homeopathic medicine that even a layperson can understand.

    How do homeopathy practitioners actually treat a deep vein thrombus or cardiac arrhythmias?

    How do various homeopathic medicines prescribed for a deep vein thrombus or cardiac arrhythmias work…you know, the pharmacokinetics of a particular homeopathic medicine?

    How would a homeopathic physician know the appropriate dose for a patient with a DVT or cardiac arrhythmias?

    Are there any blood tests to determine therapeutic, sub-therapeutic or hyper-therapeutic serum levels of the prescribed homeopathic medicine?

    I suggest that David answer these questions before we proceed further along with comparisons of homeopathic medicine treatments for DVT and cardiac arrhythmias versus treatments prescribed by a medical doctor.

    David, I don’t expect you to read any super technical physician’s prescribing information…you might want to check Wikipedia “Warfarin” for some simple answers to these questions. Please provide any citations from Wikipedia or any other source about the homeopathic treatment of these disorders.

  107. #107 Chris
    October 9, 2011

    David:

    but becoming “adequately informed” about homeopathy is more involved than becoming adequately informed about medicine.

    All you need is to be somewhat competent in high school chemistry to understand why homeopathy is not based on reality. Here is the process, somewhat simplified: Make Your Own Homeopathic Remedies.

    The dilution of 1/1000000000000000000000000000000000000000000000000000000000000 is one molecule in the amount of water that would fill a sphere with the circumference of the earths orbit (and encompass the sun). And way above Avogadro’s Number (something you should have learned about in high school).

    Now explain to us how something so diluted is supposed to work.

  108. #108 Chris
    October 9, 2011

    David, Andre Seine has the claim that homeopathy works better for rabies than real medicine. Do you know what evidence he uses for that claim? I asked Mr. Ullman several times and the only response I got was that it was going to be in a book.

    Now, the most common dilutes is 30C, which is a 1/1000000000000000000000000000000000000000000000000000000000000 dilution. That means one molecule of remedy in a solvent that would have to be contained in a sphere the size of Earth’s orbit (and encompass the sun). This is something that is way past Avogadro’s Number (something one learns in high school chemistry). Please explain how a solution that is all solvent (water, alcohol, sugar pill) has any physiological affect on a body?

    And can you give a well documented case of homeopathy treating a non-self-limiting disease, without any other intervention? This would be something like rabies, Diabetes Type 1, or even syphilis (no antibiotics, but one of Hahnemann’s “miasm”), etc. Make sure it is not an anecdote from a homeopath, but verified by a non-biased third party. Just list the journal, title, and date of that case study that is indexed in PubMed.

  109. #109 TBruce
    October 9, 2011

    David:

    To the average scientifically literate person, homeopathy is about as plausible as a perpetual motion machine. Do you believe that the best way to find out about perpetual motion is to observe an “inventor” or “promoter” of such a machine for several weeks?

  110. #110 Dangerous Bacon
    October 9, 2011

    David: “Without trying, an ordinary person is exposed to medical anecdotes say dozens of times a year. So the opinion of the average person about medicine is formed of much anecdotal data. That’s why there are few surgery skeptics out there despite the lack of RCT evidence for surgeries’ effectiveness, but if surgery were not part of our culture and one had no fund of anecdotal experience to draw on, then it would be perfectly feasible to require first-hand experience.”

    One enormous difference between homeopathy and surgery is that the latter has a rational basis. It relies on well-understood facts about human anatomy, physiology and surgical technique. So even in cases where RCTs have not been done (and are not feasible on practical/ethical grounds), observation and clinical experience are acceptable as tools for evaluating surgical outcomes, in addition to research and quality assurance tools. On the other hand, as homeopathy does not have a rational basis, sound research backing or quality assurance oversight, its reliance on anecdotes is insufficient.

    Homeopathy had its chance to “become part of the culture” of health care in this country. It failed, along with a lot of other nonsense that has thankfully fallen into the dustbin of medical and scientific history.

    We don’t need to waste more time collecting anecdotes about homeopathy, any more than we need to interview patients who are convinced that their recoveries are due to the balancing of the four humors, or to listen to alchemists who just know that they’ve found the philosopher’s stone.

    “…becoming “adequately informed” about homeopathy is more involved than becoming adequately informed about medicine.”

    A restatement of “your science can’t adequately measure my woo.” Special pleading, fail.

  111. #111 Chris
    October 9, 2011

    “…becoming “adequately informed” about homeopathy is more involved than becoming adequately informed about medicine.”

    It means disregarding chemistry one learns in high school!

  112. #112 Bronze Dog
    October 9, 2011

    The big problem: Science is designed to transcend cultural biases through the same processes it uses to filter out our other forms of bias and self-deception. There’s nothing about a proper scientific experiment that would stop homeopathy from performing.

    Oh, and Dangerous Bacon’s comment about surgery having a rational basis is a good point: We know what organs, blood vessels, and so forth are. We know quite a bit about how those body parts interact with each other. Any proposed surgical procedure has to be compatible with this knowledge. Medical researchers and surgeons don’t devise new procedures by randomly reconnecting tubes. They make hypotheses based on what we know about the involved organs and previous surgical procedures.

    Homeopathy, however, isn’t based on demonstrated knowledge. It’s based on “laws” that were simply made up by magical thinking. Just like astrology, for example.

  113. #113 Militant Agnostic
    October 9, 2011

    @Militant Agnostic: You’re one of those with whom no cogent exchange is possible. (Your nickname even betrays your incoherent attitude: one can be a militant atheist or skeptic, not a militant someone-who-isn’t-even-sure!)

    This is the first time I have encountered argumemtum ad pseudonym, which is a subset of the ad hominem fallacy. What a humourless git.

    The existence of clathyrates hardly overturns everything we know about chemistry and physics and does not provide a mechanism for homeopathy unless you are using underpants gnome logic. Clathyrates do not even form at the temperatures and pressures at which homeopathic preparations are prepared. The invocation of clathyrates as mechanism is another example of the cargo cult science that is typical of alt med.

  114. #114 David
    October 9, 2011

    @Matthew Cline: Theoretical considerations and practical experience are related, as in the case of homeopathy the theoretical basis is insufficient for considering it favourably (I’m not in any way claiming that we understand how homeopathy works, only that it works and that there are reasonable explorations being undertaken of how it might work). So insisting on trying to understand how homeopathy works isn’t going to lead anywhere because there is still nothing like a satisfactory explanation of mechanism of action, but it is also not necessary for homeopathic therapeutics (which is based on observation of clinical states and their adjustment through the action of homeopathic remedies [whose mechanism of action is not understood], rather than manipulation of biochemical pathways). I think the theory that you’re looking for is the homeopathic theory of disease, for which a book like The Science of Homeopathy is a good start.

    @lilady: With your questions you’re trying to fit homeopathy into the medical paradigm; of course homeopathy doesn’t fit it. Homeopathy doesn’t work through saturating the blood with a certain level of medication, nor does it treat DVT or cardiac arrhythmias directly, but treatment with homeopathy can and has resolved such conditions because it shifts the overall state of the organism. I cannot tell you by what mechanism, only that there would are changes observed for the better in energy, mood, sleep quality, etc. in addition to changes in the local physical symptoms, and the latter usually doesn’t happen until the former (general) improvement has set in. Such questions are answered in an introductory textbook such as The Science of Homeopathy, which is outdated in the section on proposed mechanisms of action (it was written 30 years ago) but has excellent explanation on therapeutics.

    @Chris: Homeopathy doesn’t contradict high-school chemistry, as high-school chemistry says nothing about the impossibility of there being other mechanisms than chemical ones for action on living organisms.
    The requirement of supplying “one case… verified by an outside source” is of course problematic as any case from the literature I’ll bring you will be objected to, so you’d have to be willing to consider the homeopathic literature, and then there are countless examples, starting from the ones I mentioned in a previous comment above, through to exploring homeopathic journals. In the field there are numerous such examples (again, such as the case I mentioned of a quintuple post-operative thrombotic stroke that was recovered from completely in one week without the use of thrombolytics) above which was verified by a hospital neurologist and hematologist who had no ties whatsoever to homeopathy): I assure you they didn’t rush to write it up as an anecdotal report, and I think I don’t need to explain to you why that is so. Such cases don’t typically make it to the conventional medical literature, though perhaps somewhere there is one.

    @Mojo: Saying that studies are being done not primarily to advance homeopathic practice but to address criticisms is of course true: lots is being done to advance homeopathic practice within the profession, but RCTs are not that useful for those who don’t doubt the efficacy of homeopathy, because unlike in conventional medicine once one observes enough times that the law of similars can be applied successfully for different ailments and with different remedies, and RCT is not very useful because (1) the combinations of remedies and diagnoses is practically endless, or at least in the 10,000s, and (2) at any rate every case has to be individualized based on the patient’s presenting symptoms which are different from any other patient’s once the fine details that homeopaths explore in their anamnesis are taken into consideration. What is more useful than RCTs is: expanding information about new remedies; improving educational standards; exchanging ideas about clinical techniques; etc., and in all these domains the homeopathic profession is very active. RCTs have use in investigating standardized homeopathic preparations (non-classical homeopathy), where individualization isn’t necessary.

    @Krebiozen: Regarding your suggestiong that by learning about homeopathy more intensively one would develop a cognitive bias toward it: that’s not necessarily the case, perhaps one would actually reaffirm the prior negative cognitive bias! It sounds from what you say as if investigating homeopathy more in depth is somehow guaranteed to distort a person’s view of reality in favour of homeopathy. The idea that we are somehow better positioned to read studies by being totally ignorant is ridiculous: obviously the more we know about the subject matter the better. We all roughly know how a doctor performs diagnosis, but how many of you have any inkling about homeopathic diagnosis? At least one commenter above demonstrated complete ignorance of its basics. To learn that one can start by reading books, but there is little substitute for direct experience of the sort that would mimic the direct experience we’ve all had with medicine.

    Finally, to those of you who say that homeopathy doesn’t have a rational basis and is unworthy of further consideration, we have no common language so shouldn’t waste time debating each other.

  115. #115 David
    October 9, 2011

    @Militant Agnostic: My pseodonym-analysis is the sort of retort that a comment that demonstrates no consideration of the arguments of the other side deserves: it was not an ad hominem attack but an analysis of your overall stance. Since you weren’t born with that pseudonym I presumed it represented your attitude of complete inconsideration of the arguments of the other side, and what preceded the signature didn’t encourage any other interpretation.

    This doesn’t stop me from addressing a cogent argument when you present one, as now (even if it’s peppered with invectives): given that clathrates (not clathyrates as you misspelled twice so I presume you’re not an expert on them, as I’m not) are a novel research subject and the parameters influencing them haven’t been conclusively demonstrated, I don’t think you need to rush to denounce them as a possible explanation. And even clathrates that don’t form at the right temperatures and pressures violate the known laws of chemistry, so they may still have relevance. All I am making is the minimal claim that there are several novel research avenues that make the notion that homeopathy is a prior absurd simply untrue — nowhere did I make the claim that clathrates are the explanation for homeopathy.

  116. #116 Lawrence
    October 9, 2011

    David – since homeopathy, per its own definition, consists of nothing but water, please inform us to how exactly “water” is supposed to treat anything other than dehydration?

  117. #117 Chris
    October 9, 2011

    Lawrence:

    consists of nothing but water,

    Or alcohol or milk sugar… I think David should really answer my questions.

  118. #118 herr doktor bimler
    October 9, 2011

    clathrates and stable-water clusters

    These stable-water clusters, do they overcome the homeopathic dilution by propagating and forming identical copies of themselves like so many nanobots during the whacking-the-water-with-a-Bible stage of the process, then break down again when they are no longer wanted so they do not transform the entire ocean into copies of themselves?

    I can’t see how a magical-thinking alternative to medicine is made any more convincing by hypothetical explanatory mechanisms that are themselves a form of magical thinking.

    For water to retain a stable long-term memory it must be in a physical state that has lower energy than water without a memory. Yet the oceans do not spontaneously fall into that state. There seems to be a paradox here.

  119. #119 The Christian Cynic
    October 9, 2011

    @110: Be grateful if it’s your first run-in with that particular strand of idiocy. It’s not even my first encounter with it on this blog (see here for an example).

  120. #120 Narad
    October 9, 2011

    This is the first time I have encountered argumemtum ad pseudonym

    YOU’RE MIXING LATIN AND GREEK! AIEEE! Argumentum ad cognomen?

  121. #121 Militant Agnostic
    October 9, 2011

    David did it ever occur to you that I chose my nym for humorous effect?

    Although I may not have pulled the correct spelling of clathrates out of my memory, I can assure that as petroleum engineer, I know rather more about them then you do. The extraneous y probably snuck in because in the oil patch we refer to them as hydrates or often as f*cking hydrates. They are hardly a novel concept (known since 1810) and have not overturned our understanding of chemistry. The invocation of clathrates is really no different than the invocation of quantum entanglement. Both are attempt by the woo to use an oddball scientific concept that most people don’t understand to support something unconnected that is highly implausible. It is pure Underpants Gnome logic. In case you do not understand the South Park reference, the business plan of the underpants gnomes was

    Step 1 – steal underpants
    Step 2 – ?????
    Step 3 – Profit!

    Chris @113

    Or alcohol or milk sugar…

    Methanol injection is used to prevent the formation of hydrates/clathrates in wellbores and at wellhead chokes since heating is not an option for these. Ethanol would have same effect so using alchohol would destroy any clathrates formed during the whacking with a bible.

  122. #122 Matthew Cline
    October 9, 2011

    @Krebiozen:

    It makes your position very clear. I agree with Herr Doktor Bimler – what you describe are ways of maximizing the chances that a person investigating homeopathy will be misled by cognitive and other biases. RCTs are ways of minimizing such biases. What you describe as “informed” I would describe as “biased”. You seem to be arguing that it is only fair to start assessing homeopathy with a similar level of cognitive bias as we have in favor of conventional medicine, which I think is foolish.

    I don’t think that’s what David’s saying. As far as I can tell, he’s saying that we skeptics already have a negative cognitive bias against homeopathy, that it’s impossible (or at least extremely difficult) to counter this bias simply by trying to think rationally, and thus the best way to deal with the bias is to interview homeopathy users and watch homeopaths working. This will, according to him, negate the negative bias we have against homeopathy, thus letting us evaluate the evidence with an unclouded mind.

    @David:

    Theoretical possibilities about mechanism of action include clathrates and stable-water clusters.

    No, it doesn’t, since:

    1) With a whole bunch of homeopathic remedies, the water is applied to sugar pills before the user gets them. How do these stable-water clusters transfer their “memory” to the sugar?

    2) Even when taken directly as a liquid, these water clusters will have to pass through the intestines into the blood stream. But water does that by passing through proteins in the surface of the cells of the intestinal walls, and a water cluster passing through one of those would break it up into it’s individual water molecules. If they manage to bypass that by being absorbed in a similar manner to, say, aspirin, then they’re acting like molecules, and should be subjectable to chemical analysis.

  123. #123 Militant Agnostic
    October 9, 2011

    To form a clathrate, you have to have something inside the “cage” for the “cage” to from around. How is this supposed to happen when there is no non-polar molecule for the cage to form around? Also, the water methane hydrate is able to form because the methane molecule is very small. The complex organic molecules that are the basis of most homeopathic remedies are based are huge compared to methane. This is just like the misuse of quantum – find some science that is weird and counter-intuitive and then “take it to the fair” as the Irish say. Clathrates are anon-starter as far as a mechanism for homeopathy.

    But then what do I know, I MISPELLED A WORD ON THE INTERNET!!!

  124. #124 herr doktor bimler
    October 9, 2011

    Clathrates are anon-starter

    I thought “anon-starter” was the word for one’s first pseudonym for the WWW, before changing to a more appropriate one.

    The argument seems to be
    (1) People are still researching clathrates and “stable-water clusters”.
    (2) Therefore they are phenomena that we do not understand.
    (3) Therefore they are possible explanations for another phenomenon that we do not understand and does not exist.

  125. #125 Dangerous Bacon
    October 9, 2011

    This business about needing to observe a homeopath in action to overcome my “cognitive biases” reminds me of the ancients who were convinced of the validity of alchemy by watching alchemists work, or talking to people who’d seen it succeed. Of course none of those observations or discussions carried any validity (the alchemists or observers were either in on a scam or self-deluded, much as homeopathic practitioners and their patients have always been).

    Militant Agnostic: “But then what do I know, I MISPELLED A WORD ON THE INTERNET!!!”

    David misspelled “a priori” in his last post, so now I must ignore both of you.* :(

    *a message board I participate in recognizes something called Gaudere’s Law, which states that any post complaining about another poster’s spelling or grammar will itself contain a spelling or grammar mistake.

  126. #126 Chemmomo
    October 9, 2011

    David,
    Describe just one physical property of matter that is strengthened upon dilution and then we can start talking about mechanisms for homeopathy.
    Oh, and if you want to analyze my pseudonym: yes, the first for letters refer to my field.

  127. #127 TBruce
    October 10, 2011

    Analyze MEEEEE!!!!!

    TBruce, of course, is a cross between a Therapod and a Great White Shark.

    I wish.

  128. #128 herr doktor bimler
    October 10, 2011

    The two ‘single-pole’ magnetic remedies are made by exposing water to one pole of a magnet for a prolonged period, similarly to the manner of preparation of other remedies from magnetic or radiation sources (x-ray, gamma emissions from positronium decay, x-rays, and electromagnetic radiation). There is nothing inherently absurd about this, nor about a piece of Berlin wall prepared homeopathically

    This puts paid to my intended second career in satire. I hope you are satisfied!

  129. #129 lilady
    October 10, 2011

    @ Bronze Dog:

    “Homeopathy, however, isn’t based on demonstrated knowledge. It’s based on “laws” that were simply made up by magical thinking. Just like astrology, for example.”

    I lived many years under the astrological sign of “Leo” and now find myself living under the sign of “Cancer” due to the addition of the new astrological sign “Ophiuchus”. Now why did they have to add a new astrological sign to mess up the astrological charts? It only adds to the confusion and I am left with lingering doubts about the decisions and choices I made based on auspicious days for the Leo charts.

    Perhaps decisions I made about my education and my profession would have been different if I knew that I was a true “Cancer” and maybe I could grasp the “science” behind homeopathy…instead of relying on high school chemistry and college organic and inorganic chemistry classes.

    @ David…I have a comment directed at you for the treatment of DVT and cardiac arrhythmia. Yes, it is based on the “medical paradigm” and it is stuck in moderation.

  130. #130 Krebiozen
    October 10, 2011

    David,

    It sounds from what you say as if investigating homeopathy more in depth is somehow guaranteed to distort a person’s view of reality in favour of homeopathy.

    That is essentially what I am suggesting, as that is the nature of cognitive biases, especially when combined with a placebo used to treat an illness that is self-limiting or that has a variable course. Hopefully an educated sceptic would be more aware of these biases than most people, and would not be taken in by them, but I know from personal experience that it is easy to fool yourself in these areas.

    Here is an example to clarify what I mean.

    A commenter spent some time on this blog not long ago arguing in favor of homeopathy. He claimed that homeopathy was successful in treating his gout, but observed that each time his gout flared up, the remedy that he had successfully treated it with the last time didn’t work, and he had to go through several remedies before he found one that worked (there are over 200 possible homeopathic remedies for gout). He surmised that he suffered from several different types of gout, and that he could identify which he was suffering from by additional symptoms. With trial and error he could always find a remedy that would work, though sometimes it took weeks or even months. He also casually commented that gout had damaged one of his toes so badly he required surgery to replace the joint.

    Now I know that gout is an illness that has an unpredictable course. It flares up and subsides in an apparently random fashion. Flare-ups can last days, weeks or even months. I also know that gout is gout, it is caused by crystals of urate forming in joints due to elevated levels of urate in the blood. There are no different sub-types of gout, though there may be different underlying precipitating factors, such as a genetic predisposition and diet.

    With that knowledge it seems clear to me that this person was suffering from untreated gout, with exacerbations that lasted for random periods. His careful recording of symptoms and trying to match these with his homeopathic materia medica to find the correct remedy for each bout of gout was clearly delusional. Predictably his untreated gout had caused joint damage that could have been prevented by conventional treatment. Even when this was pointed out to him he still continued to insist that homeopathy was successful in treating his gout.

    I think that homeopaths are following similarly delusional activities. They are looking for patterns in random or multifactorial data and, as humans do, they think they find them. If a remedy doesn’t work it can easily be explained away; they must have wrongly identified the constellation symptoms that are specific for a particular remedy, and different remedies are tried until one “works”. It’s an elaborate system of chasing rainbows, and I find the lack of insight into this that you display, and that I have seen so many times in other homeopathy apologists, really rather strange.

  131. #131 herr doktor bimler
    October 10, 2011

    there are over 200 possible homeopathic remedies for gout

    Back @77, David argued that contrary to criticism, homeopathy has indeed moved on from Hahnemann’s original statements:

    saying that homeopathy hasn’t progressed in 150 (actually 200) years betrays ignorance: by 1843 there were about 100 remedies in use in homeopathy, now there are thousands, of which around 1000 are well characterized.

    For this argument to work, we need evidence that these 900 or so new additions to the homeopathic material medica work better for treating conditions than whatever combinations of the 100 original remedies that would have prescribed for them in Hahnemann’s day. If the homeopaths are confirming this progress with RCTs, then great! If not, where is the progress?

  132. #132 David
    October 10, 2011

    @Militant Agnostic: I wouldn’t trumpet the profit motive as pertaining to homeopaths… we both know who is the winner in that category.

    Regarding clathrates, I stand thoroughly corrected: the reference to clathrates should have been to “clathrate-like” non-random aggregations of intermixed water and alcohol (so it’s just a variety of the ‘water cluster’ hypothesis):
    http://www.nature.com/nature/journal/v416/n6883/full/416829a.html

    Clustering in ultra-pure water has also been observed:
    http://www.sciencedirect.com/science/article/pii/S0375960109010330

    This is an active field of research and I believe at this point it is hard to deny that this phenomenon exists under some conditions. I don’t know what the significance of these, if any, is for homeopathy, but neither does any of you. Again, I’m only making the minimal claim that it is not absurd for water to be able to encode information non-chemically, and that the assumption that liquid water is entirely randomally distributed is actively being questioned in current scientific discourse.

    There is no point dwelling on mechanism of action any more because clearly there is no satisfactory theory to date so if you’re looking for a winner in this arm of the debate, I’m not it. But as I’ve emphasized again and again, my stance on homeopathy is empirically based, which is why I keep referring to the need for real-life experience, without which a skeptic cannot get the full picture and will inevitably persist in skepticism on rationalist grounds (which in themselves are entirely justified). I don’t expect to convince anyone who hasn’t witnessed homeopathy first-hand, and I would consider someone who simply believed without such experience gullible.

    @Krebiozen: It’s correct that many clinical osbervations are erroneous ones, i.e. of the post hoc ergo propter hoc variety (and the example you give sounds like it may fall into that category), but once many solid as opposed to questionable associations are observed, it may become difficult to dismiss them. For example, my own first experience with homeopathy involved trying a different remedy about once a month for over a year in order to address a discrete, stable, objective symptom (two patches of atopic dermatitis of several months’ duration), with zero success every time, followed (on say the 11th remedy) by a disappearance of the lesions, concurrent with an improvement in energy and mood, over two weeks starting the day following the first dose of that remedy, a change that persisted thereafter. This was hardly enough evidence, but intriguing enough to start. Since then I’ve seen countless such associations, also in longstanding or life-long chronic conditions ranging from the psychological to the very objectively physical. Of course logically speaking this could all be due to placebo, but the odds of that are rather spectacular. I’ll use the Kantian division into the speculative and practical realm: speculatively speaking I can never know that it’s not placebo, but practically speaking I can. So if this doesn’t qualify homeopathy as a science (as I’m sure it will not under some definitions thereof) then so be it. I’ll point out, however, that the same sort of practical clinical thinking occurs in medicine all the time: medications are tested out for their effect on specific individuals, often off-label (i.e., without any experimental backing), the difference being that we have more faith in principle in medications working than in homeopathic remedies working in principle. The idea that we can simply know the truth from studies (the utopian form of Evidence Based Medicine), and the categorical dismissal of anecdotal evidence, is simply a remnant of the logical-positivist tradition in philosophy, which was discredited already by the time that it began being applied to medicine in the form of RCTs.

    @Matthew Cline: (1) I believe sugar pellets never dry out completely due to their hygroscopic nature and the fact that humidity is never 0% in a natural environment, so the ‘dry’ form of homeopathic remedies is still water based. If this is not the case then of course any theory would have to account for information storage in sugar as well.
    (2) Homeopathic remedies are taken by mouth without needing to swallow them: they don’t work by post-digestive absorption into the blood stream but by direct diffusion in mucosa of the mouth.

  133. #133 herr doktor bimler
    October 10, 2011

    There is nothing inherently absurd about this

    Homœopathic preparation of Vacuum: the hidden cost is revealed!!

  134. #134 Dangerous Bacon
    October 11, 2011

    Poor David still doesn’t realize that he has it backwards.

    In actual scientific endeavors, anecdotes are a starting point in investigation. Theories with a logical basis need to be generated, rigorous experiments/trials devised, medical treatments evaluated on a large scale, repeated and appropriately monitored to assure efficacy and safety. What David wants us to do is take anecdotes that he thinks constitute “spectacular” evidence, tosses out a dubious and highly speculative mechanism to explain it and says we then have no business doubting him.

    This is the same trap that worthies like Lionel Milgrom have fallen into (Lionel is the star of “quantum” homeopathy). Their observations (contrary to lots of negative observations) has convinced them homeopathy works; all they then need is something to legitimize its ridiculous basis.

    Before we can even begin to think about radically reorganizing chemistry and physics, it is necessary to cast a critical eye on anecdotes involving homeopathy and supposed alleviation of chronic medical conditions, which David claims to have seen “countless” times. Take his own “atopic dermatitis”, which like many other chronic conditions typically has a relapsing and recurring course. If there’s a period of improvement, why of course it was the homeopathy that did it (not standard medical treatment, lifestyle changes or the natural history of the disorder). We’ve seen these false assumptions for myriad other quack remedies and treatments used on lots of ailments that wax and wane, are assumed to be effective, but in the end are revealed to be nothing more than placebo.

    So unfortunately, David is stuck with a hopeless bias towards antiquated quackery, which he attempts to justify with a non-demonstrated association with a dubious speculative mechanism, followed by a variation on the old altie refrain, “you can’t prove me wrong”.

    David has nothing to back his claims but credulousness, though to give him credit he has that in great quantity.

  135. #135 Krebiozen
    October 11, 2011

    David,

    It’s correct that many clinical osbervations are erroneous ones, i.e. of the post hoc ergo propter hoc variety (and the example you give sounds like it may fall into that category), but once many solid as opposed to questionable associations are observed, it may become difficult to dismiss them.

    I don’t understand why you think you can tell a post hoc fallacious “questionable” association from a “solid” association. The only reliable way I know is to use a clinical trial of some sort, otherwise you are liable to fool yourself. On an anecdotal level all such associations are questionable.

    I’ve seen countless such associations, also in longstanding or life-long chronic conditions ranging from the psychological to the very objectively physical. Of course logically speaking this could all be due to placebo, but the odds of that are rather spectacular.

    How do you calculate the odds of this being due to placebo? How do you know what would have happened if the patient had not taken the remedy? There are many “longstanding or life-long chronic conditions ranging from the psychological to the very objectively physical” that often spontaneously resolve for no apparent reason. Have you ever seen homeopathy apparently cure an illness that never spontaneously resolves without treatment and does not have a variable course?

    Here’s another example, that I think is instructive. Dr. Benjamin Rush, one of the Founding Fathers of the United States, believed that bloodletting could cure almost all illnesses. “The effect of bloodletting is as immediate and natural in removing fever, as the abstraction of a particle of sand is to cure an inflammation of the eye, when it arises from that cause”, he wrote. Sometimes he would remove 5 pints of blood or more over the course of as many days. Rush’s experience was extensive, he treated thousands of patients, and took his faith in bloodletting to his grave.

    We now know that draining a weak and sick person of a large proportion of their blood is likely to worsen their condition or even kill them (except in rare conditions that involve iron overload). We know that from clinical trials that followed patients who were bled, and patients who were not. Those who escaped bloodletting were ten times more likely to survive than those who did not. An experienced physician like Rush fooled himself into believing that an actively harmful treatment like bloodletting was beneficial for serious diseases; it is much easier for someone to fool themselves into believing that homeopathy, which does nothing at all, is beneficial for minor, fluctuating or self-limiting illnesses.

    Rush was wrong. His personal experience deceived him. He mistook questionable associations for solid ones, and somehow managed to ignore the fact that many of his patients died as a result of his treatment. Are you able to consider the possibility that your personal experience may have deceived you? Is it possible that you grossly overestimate your ability to distinguish questionable from solid associations, like Rush, one of whose contemporaries accused him of the, “most insolent pretension to superiority ever set up by mortal man”?

  136. #136 Militant Agnostic
    October 11, 2011

    Again, I’m only making the minimal claim that it is not absurd for water to be able to encode information non-chemically, and that the assumption that liquid water is entirely randomally distributed is actively being questioned in current scientific discourse.

    None of this explains how only the desired information and none of the information form deleterious chemicals is retained through repeated dilutions, storage and shipping and absorption into the body. Also none of this explains how this encoded information has the desired effect. It is simply a desperate grasping at straws.

    As to your profit tu quoqe what needs to be compared is ROI. Boiron spends a pittance on research and has virtually no input costs. Although the ratio of marketing spending to research spending for “Big Pharma” is appalling the ratio for Boiron is an order of magnitude worse.

  137. #137 Vicki
    October 11, 2011

    David–

    I would argue that to have a proper understanding, you need to talk to ordinary homeopathic patients, including those who have been ill, tried homeopathic remedies, gotten no measurable effect, and moved on with their lives (either living with their illnesses, getting conventional treatment, or recovering on their own). “Talk only to people who say it worked” is selection bias. If you were correct, the selection bias would mean that you’d find only the people who could be cured by homeopathic treatments, and who were lucky enough to get the “correct treatment.” If you’re wrong (which I think you are) the selection bias means you’ll find only those who got better on their own, or who were also being treated in some other way and are crediting the homeopathy.

    If I take pills for something, and at the same time undergo a course of physical therapy and stop eating dairy products, and I feel better a month later, I don’t know what fixed the problem. Maybe it was the pill, maybe the diet change, maybe the PT, maybe time and luck, maybe even something I’m not thinking about.

    A friend of mine had a weird blood pressure problem, which resolved after several months, within an hour she had a pot of a particular kind of tea. (She had drunk a lot of tea of other kinds during those months.) It seems unlikely that there is something in pu-erh and no other tea that was curative, but she keeps drinking pu-erh and I see no reason to try to dissuade her, since there’s no harm in it and she isn’t urging all her friends to start drinking pu-erh instead of other teas, coffee, etc.

  138. #138 Denice Walter
    October 11, 2011

    @ Krebiozen:

    And woos hold up Rush as “proof” that the medical profession today is hopelessly flawed- somehow forgetting the intervening 200+ years that have elapsed.

  139. #139 David
    October 11, 2011

    @all:

    Given that we can agree that anecdotes are starting points for investigation, I am suggesting precisely that you start your investigation there, because of the pre-existing bias against homeopathy that you otherwise carry with a degree of confidence that is not justified by the degree of your exposure to the subject matter. This much you refuse to do, and instead you prejudge the result of your investigation or bring up the spectre of being irretrievably seduced into believing something that’s not real (this reminds me of the “I’m a simple soul” response that I got from Randi years ago in a brief email exchange).

    Speaking with people who have experienced benefits from homeopathy doesn’t set up selection bias because I am not asking you to believe them (besides, I didn’t specify that you couldn’t equally speak to those who sincerely tried homeopathy but to no avail): I am asking you to collect anecdotal data to gain an adequate impression of the subject matter. For example, you may discover different people reporting similar patterns of reactions to remedies despite lack of knowledge of what to expect from a remedy; some very sensitive people who react to any remedy they take are able to detect which remedy they are given (double-blind) by reporting the symptoms they experience; etc.

    I don’t know how precisely to calculate the odds of an apparent cause-effect relationship being real (presumably actuarial analysis can begin to quantify such situations), but once clear associations pile up again and again, the modern, scientifically educated person can begin to put together a picture of the world even from personal experience providing it is extensive enough, and then put it together with evidence meant to eliminate personal bias. I would be truly alarmed if virtually all RCTs of homeopathy came out negative, and may well cease to believe in homeopathy; but as it stands more often than not they come out at least mildly positive, despite the one-to-one model of conventional medicine not fitting the individualized nature of homeopathy when practiced optimally, and even when the better studies are looked into (please do not quote Shang et al. until you have considered criticisms of it as I referenced in an earlier comment; other meta-analyses couldn’t eliminated the positive results even when restricting to better studies).

    While the current RCTs are wholly inqdquate to serve as practice guidelines (again, this would be no different from conventional medicine up to about the 1960s), they do give me confidence that my collected observations as a whole are not entirely deluded, despite occasional specious inferences.

  140. #140 Chris
    October 11, 2011

    David:

    Homeopathy doesn’t contradict high-school chemistry, as high-school chemistry says nothing about the impossibility of there being other mechanisms than chemical ones for action on living organisms.

    That is the most stupid answer I have ever seen! Now you are just making stuff up. From now on you need to cite the scientific literature.

    I want cites for a well documented case of homeopathy treating a non-self-limiting disease, without any other intervention. This would be something like rabies, Diabetes Type 1, or even syphilis (no antibiotics, but one of Hahnemann’s “miasm”), etc. Make sure it is not an anecdote from a homeopath, but verified by a non-biased third party. Just list the journal, title, and date of that case study that is indexed in PubMed.

  141. #141 TBruce
    October 11, 2011

    David:

    I have seen several individuals make various things disappear and reappear right in front of my eyes. I’m talking about cards, coins, small animals, airplanes, cars and people. I can’t for the life of me figure out how they do it. Okay, they are amateur and professional magicians. If I believed that these conjurers could actually make things disappear and reappear, nothing I saw would change my mind. I could interview hundreds of people from the same shows, and would still believe that these things actually disappeared.

    However, I am confident that what I thought I saw was not what actually happened. I am sure that every one of those magicians used sleight of hand or special effects to fool me. I can be sure that there is not a conjurer out there who can actually make things disappear by mind power alone.

    There’s no shame in being fooled. It happens to everyone. This is what scientific investigation guards against. The shame comes when we insist that what we thought we saw was real, despite all evidence to the contrary, and without the humility to recognize that we can be fooled.

  142. #142 Krebiozen
    October 11, 2011

    David,

    I have had an interest in alternative medicine since I was a child, and over the years I have spoken to dozens of people who have tried homeopathy, both by seeing a homeopath and by simply buying OTC remedies. The vast majority found no benefits from it. A couple of people (including my sister) swear by it, though it is obvious to me that there have been many times when it hasn’t helped them. I see nothing that makes me think there is anything worth investigating further, even if I hadn’t read many studies of homeopathy that suggest to me it is nothing more than a placebo.

    I am a bit bemused by your insistence that you, or anyone, can somehow, “begin to put together a picture of the world even from personal experience providing it is extensive enough, and then put it together with evidence meant to eliminate personal bias”. If the history of medicine has taught us anything it is that this idea is utterly wrong. Take a look at this list of clinical practices that have changed after clinical trials showed they were unsafe or ineffective. Many of these were in use for years by clinicians who thought they were safe and effective, based on their clinical observations. They were wrong, in some cases very badly wrong.

    The first and best known example on that list is of the use of anti-arrhythmic drugs in people having heart attacks. Some doctors were so sure that this was beneficial for their patients that they objected to RCTs using a placebo arm on the grounds that they would be denying those patients life-saving treatment. The results of one study (CAST) showed that after one year, “95% of placebo-treated patients vs 90% of active drug-treated patients remained alive (P = .0006)”. If those doctors were unable to notice a doubling in the death rate due to a drug they prescribed, and indeed believed it was helping their patients, I have little faith that homeopaths can accurately assess the effects of their treatments on mostly minor complaints.

    This is why science-based medicine is so important, because “the spectre of being irretrievably seduced into believing something that’s not real” is not a spectre, it is very real and can have profound effects on people’s lives. In the case of anti-arrhythmic drugs that spectre cost an estimated 20,000 to 70,000 people their lives every year in the USA alone until clinical trials revealed the truth.

    This is nothing to do with “being a simple soul”, it is to do with cognitive biases and more importantly being unable to gather enough evidence to make a reasoned judgment.

    Let’s look at one of the best pieces of evidence for the efficacy of homeopathy, according to one website I found. It’s a clinical trial of homeopathy for childhood diarrhea. It found that patients given a placebo had diarrhea that lasted for an average of 4.1 days, while in those given homeopathy it only lasted 3.3 days, a difference of less than 16 hours. How could anyone casually observing those children given the homeopathic remedy, and without using a control group, make any accurate assessment of whether that remedy worked or not?

    The most positive clinical trials of homeopathy show results of a similar magnitude that you simply could not detect unless you did a clinical trial of some sort. It is blindingly obvious to me that what you claim to be able to do, putting together evidence meant to eliminate personal bias, is impossible.

    One last thing:

    you may discover…some very sensitive people who react to any remedy they take are able to detect which remedy they are given (double-blind) by reporting the symptoms they experience

    If you know anyone who can do this I suggest you direct them to James Randi’s million dollar challenge, as it would count as a paranormal ability that could win Randi’s prize. Has this been documented anywhere? If this can be done reliably under controlled conditions with a truly homeopathic remedy (i.e. 12C or greater dilution) I would gladly change my mind about homeopathy and look forward to seeing a scientific revolution unfold.

  143. #143 Dangerous Bacon
    October 11, 2011

    “some very sensitive people who react to any remedy they take”

    This screams of “placebo effect”.

    “…are able to detect which remedy they are given (double-blind) by reporting the symptoms they experience; etc.”

    Never heard of any controlled trials where this magical ability was confirmed, but no doubt you can supply us with the details.

    “…despite the one-to-one model of conventional medicine not fitting the individualized nature of homeopathy when practiced optimally, and even when the better studies are looked into”

    David, you really, really need to make up your mind. Either (as you have claimed), quality research backs the efficacy of homeopathy (do some more reading, it does not), or “conventional medicine” cannot pretend to judge homeopathy because of its “individualized nature” (in other words, “your science cannot measure my woo”).

    We’ve been over basic fallacies of woo here many, many times, for everything from parasite-zapping to John of God. There are a bunch of convinced devotees for every sort of quackery under the sun. Going out to interview all of them and pairing their testimonials with a smattering of pseudo-science is not the way to vindicate their beliefs.

    A question for you – given how myriad forms of alternative medicine seem to qualify as worthwhile given your criteria, which other ones do you strongly believe in, or is homeopathy the One True Woo? I’d really like to know.

  144. #144 LW
    October 11, 2011

    “some very sensitive people who react to any remedy they take are able to detect which remedy they are given (double-blind) by reporting the symptoms they experience”

    James Randi has a million dollars just waiting to be claimed by the first such person to present himself or herself for testing.

  145. #145 Militant Agnostic
    October 11, 2011

    some very sensitive people who react to any remedy they take are able to detect which remedy they are given (double-blind) by reporting the symptoms they experience

    You have not provided even ordinary evidence for this extraordinary claim. I doubt that you made it up, but it is highly probable you are repeating something someone else made up.

    You are convinced you cannot be fooled and that you do not have the cognitive biases that everyone else has. You remind of Targ and Putoff, the physicists who were taken in by Uri Geller. They were so convinced that they could not be fooled that they were willing to believe he had powers that defied the laws of physics even after conjurers like James Randi showed how easy it was to duplicate Geller’s tricks. Another case was Adrian Conan Doyle who was convinced Harry Houdini had paranormal powers even after Houdini explained how he did something.

  146. #146 Krebiozen
    October 12, 2011

    My comment at #142 has now emerged from moderation – DB, LW and MA made similar points while it was in limbo. I decided to take a closer look at the homeopathic study I mentioned in that comment. You can find a full text version here. It is a meta-analysis of three previous studies in an attempt to achieve statistical significance.

    The first thing I noticed was that the children in the homeopathy group were on average 3 months older, their average height was over an inch (3cm) greater, their average weight was 1.3 pounds (0.6kg) greater and they were on average 7 weight for height percentile points higher than those in the placebo group. Three of these were statistically significant at the 95% level and the last was nearly statistically significant (94%). In combination that suggests to me that the children given homeopathy were healthier to begin with, and likely to recover from diarrhea more quickly.

    One of the studies included in the meta-analysis has been criticized on other grounds as well (PMID: 7478845) but it seems very strange that the homeopathy group was older, taller and heavier than the control group. Have I misinterpreted this?

  147. #147 Mojo
    October 12, 2011

    @David

    A couple of days ago I tried to post links to discussion of the Lutdke & Rutten paper (an article called “Fun with homeopaths and meta-analyses of homeopathy trials” by David Gorski on the Science Based Medicine blog) and of the Rutten & Stolper paper (“I know I said life was too short…” and “Homeopathy paper published” on the Hawk/Handsaw blog) you cited, but it seems to have been held up in moderation because of the links. If you Google ‘ludtke rutten’ and ‘rutten stolper’ the commentaries should be on the first page of results.

  148. #148 David
    October 12, 2011

    @Chris: I addressed your demand for a decisive case-study before. I gave an example from my own experience that was verified by two third-parties, but they didn’t rush to publish it, and if they didn’t it wouldn’t have made it any more believable. Any non-self-limiting condition may spontaneously remit even if extraordinarily rarely. You would still demand RCT evidence, and I wouldn’t blame you, as clinical evidence is only meaningful in the context of significant collected experience. It took quite a few dramatic results before I began to believe claims of homeopathy that I hadn’t myself verified.

    @Krebiozen: If you consider your exposure to homeopathy anecdotes sufficient then that’s fine. But you haven’t presented a clear case against homeopathy, just that you haven’t seen convincing positive evidence and are satisfied that this means there won’t be any. But then you quote positive evidence which you don’t explain away, so I’m a bit confused. Overall it seems that you’re saying: “Despite a minority of positive anecdotes and a small majority of positive yet weak RCT evidence, and because of a majority of negative ancecdotes and sufficient negative RCTs, I am unconvinced” — this is a cogent position to hold. I would argue that if you were exposed to homeopathy practiced at a high level you might change your mind through anecdotes or a deeper understanding of the practice, but at least you are clear and honest in your position. What I don’t think you can do is project that onto me and claim that my experience must be deluded, when my position is based on lots of positive anecdotal evidence coupled with reference to the same RCT data. (I am not promoting relativism here, just suggesting that the reality as far as we can assess it is not as crisp as either of us would like it to be.)

    With regard to determining whether a remedy works without a study: besides the fact that reactions are not all average and subtle but often distributed all the way between clear non-reactors and clear reactors to a remedy, there is much more involved in assessment of remedy response than the pathological outcome measure. For example, there is in acute cases usually a clear shift in temperament following the administration of the remedy (less lethargy/restlessness, more calmness/energy, etc.) even before the actual symptom shifts, and the remainder of the illness, even if no shorter (and in some cases giving a correct remedy will temporarily promote, e.g., diarrhea or vomiting), will be milder. This of course resembles placebo responsiveness, but then the study you quote, which is meant to address that, disagrees and suggests that there is an actual difference.

    @TBruce: the example of magic is only applicable if you assume that all the people whom you speak with about homeopathy have somehow been misled into their beliefs. This is certainly possible, which is why I suggest that personal experience is important. While some are gullible, I do trust that just as you know you have been misled by magic (without needing an RCT to prove this) you would know if that were the case elsewhere.

    @Dangerous Bacon, Militant Agnostic, etc.:
    Studies of non-individualized homeopathy are easier to perform and are more rigorous statistically speaking, but I don’t expect them to produce impressive or even clinically meaningful results as much as in cases of individualized homeopathy. So conventional science can judge whether the homeopathic effect is real in principle (this means that statistical significance without clinical significance would be considered a positive result), yet doesn’t do a good job with clinical significance of individualized treatment because RCTs were not designed for testing individualized treatment and study designs have yet to evolve sufficiently to address that question and the fact that homeopathy doesn’t address the individual symptom but the overall state of the organism so more multidimensional outcome measures need to be developed.

    Regarding my claim that some people can tell apart remedies: The person able to do what I mentioned (a friend with whom I’ve run tests myself, not hearsay) is not subject to the placebo effect because she responds with specific symptoms which differ depending on the identity of the remedy (which I’ve given in double-blind fashion), not non-specifically. It would certainly be an interesting experiment to run formally, though I doubt that positive results would make much of an impression(there would also be the issue of how to quantify the pattern-match between her description and the pre-existing remedy picture), any more than positive results in highly rigorous studies of certain psychic phenomena have made an impression outside of a small circle of believers (I don’t want to open a can of worms and let’s not pursue this further, nor am I a believer in psychic phenomena, but the existing evidence on that — much greater and more rigorous than on homeopathy — is quite intriguing yet ignored by mainstream science and the public for the reason of no mechanism of action).

    As for the James Randi $1M challenge: I am surprised that you would consider a foundation whose authority is critically dependent on maintaining the status quo an unbiased party in administering such a challenge. But the existence of the challenge gives the foundation a lot of public clout, which I believe is its raison d’etre. Patently, Randi is at least as invested in his position as the average homeopath would be in his, yet somehow he is hailed as a hero of the skeptical community and an authority in scientific circles. Given that Randi holds the reins he can refuse a challenge that may produce real results (that screams SELECTION BIAS to me), or find some fault with it somewhere along the way. I have been privy to his email negotiations with homeopathic proposed challenges on a couple of occasions, in which he backed out citing some objection (which he has the full right to do without explanation, as it’s his challenge, and this is the fault in this whole enterprise), so don’t have much trust in him based on my — yes — anecdotal experience. He’s a great magician and is doing good public service (especially since he debunks many things that ought to be debunked along the way), but I don’t think he’s in search of some higher truth beyond his set worldview.

  149. #149 Igor
    October 12, 2011

    Homeopathy doesn’t contradict high-school chemistry, as high-school chemistry says nothing about the impossibility of there being other mechanisms than chemical ones for action on living organisms.

    And my claim that I can fly doesn’t contradict basic physics either. After all, physics says nothing about the impossibility of there being other mechanism than physical for action affecting flight.

  150. #150 Prometheus
    October 12, 2011

    I’ve heard for so long that one of reasons homeopathy can’t be effectively studied by science is that it is “individualised”. When I was offered – in a local “whole foods” market – the opportunity to have a “free” evaluation by a licensed homeopath, I thought it worth the time just to see how this “individualisation” process worked.

    I first asked the homeopath if a complete evaluation could be done in a public market and was assured that an actual physical examination was not required to prescribe therapy. I was then asked what my symptoms were, and I was admonished to be as thorough as possible and to omit no symptom, no matter how trivial or unrelated it might seem.

    As I related my list of aches and complaints – all fairly typical for my age and sex, if my friends and co-workers are any guide – the homeopath would occasionally interrupt me and ask direct questions, such as “Do you ever have problems remembering things?” and “Do you have less energy now than you did in your twenties and thirties?”. All told, this lasted about twenty minutes.

    Afterwards, the homeopath wrote up a list of suggested remedies which included Rhus tox (homeopathic poison ivy) for my joint and back pains and Lachesis (snake venom? – my recollection is that Lachesis was one of the Fates) for my complaint of not having enough time in the day to do all I had to do (a question he asked directly).

    So, the homeopath “prescribed” two remedies (which he “just happened” to be selling at his kiosk) based on my symptoms of joint and back pain and my complaint of being pressed for time (by grants and papers to write, a class to prepare for, etc.). I assume, based on the way the “examination” was conducted, that anyone with my set of symptoms – which would encompass nearly everyone I know – would be given the same “prescription”.

    Compare this with a real doctor, who would listen to symptoms, perform an examination and, if indicated, get lab tests and then – based on all that information – prescribe a treatment (or not) based on the signs and symptoms I presented.

    Maybe I’m missing something, but I don’t see how the homeopath was more “individualised” than a real doctor. Maybe one of the homeopathy apologists can explain it to me.

    Prometheus

  151. #151 lilady
    October 12, 2011

    @ Krebiozen: Terrific link that you provided about how RCTs have changed the practice of medicine.

    I was especially delighted to see the citation about the first ever RCT conducted in 1948 to test streptomycin for treatment of tuberculosis versus the “bed rest” standard of treatment offered in TB sanatoriums at the time.

    I worked as a clinic nurse caring for TB patients and as a tuberculosis disease case manager in the office of TB Control at my country health department and know only too well how RCTs, improved diagnostic sputum testing, DNA fingerprinting for the presence of multi-drug resistant TB, DOT (directly observed therapy), prophylactic treatment of latent TB disease and the development of additional antibiotics (INH, Rifampin, PZA) have positively impacted on the disease incidence morbidity and mortality of tuberculosis.

    Yesterday the WHO released the 2011 Tuberculosis Report with this statement:

    11 October 2011 | Geneva | The World Health Organization (WHO) reports for the first time that the number of people falling ill with tuberculosis (TB) each year is declining. New data, published today in the WHO 2011 Global Tuberculosis Control Report, also show that the number of people dying from the disease fell to its lowest level in a decade. Yet, current progress is at risk from under-funding, especially efforts to combat drug-resistant TB.

    * More on this story
    * Access the WHO 2011 Global Tuberculosis Report here

    Thanks so much for your excellent posting about RCTs…it’s a “show-stopper”.

  152. #152 Matthew Cline
    October 14, 2011

    @Prometheus:

    So, the homeopath “prescribed” two remedies (which he “just happened” to be selling at his kiosk)

    I thought that homeopaths were supposed to make a single remedy for the totality of all symptoms, not multiple remedies, each for a single symptom.

    Maybe I’m missing something, but I don’t see how the homeopath was more “individualised” than a real doctor.

    I’m guessing the response would be that he’s an incompetent homeopath, or even not a true homeopath, referencing the fact that he gave you multiple remedies instead of one. As for individualization, I believe that some (or even many) homeopaths give different remedies based upon the personality of the patient, so if you want a full-blown individualization experience you should find one of them.

  153. #153 Krebiozen
    October 15, 2011

    @lilady
    I’m glad you liked the RCT link, and thanks for the interesting info about TB. I live in a part of London where TB is on the rise, including resistant strains.

  154. #154 Krebiozen
    October 15, 2011

    @David,

    My examples that demonstrate that humans are incapable of adequately interpreting anecdotal evidence of effects far greater than those claimed for homeopathy seem to have passed you by. I don’t think I’m projecting anything onto you. I’m simply assuming that you are a normal human, without any supernormal abilities.

    I haven’t seen any convincing anecdotal or RCT evidence that homeopathy works. Looking at all the evidence I think it is entirely consistent with homeopathy (including the consultation process) being nothing but an elaborate placebo. There is no anecdotal evidence that I have experienced personally, or that I have read or been told about, or RCT evidence in the literature that makes me think otherwise.

    If homeopathy had a very large effect size, and instantly cured a specific disease without fail, for example, then anecdotal evidence might be convincing, but that isn’t what we see. It only seems to work for self-limiting or variable illnesses of the sort we know are prone to placebo effects, and the effect sizes in larger, well-designed trials are small or non-existent which suggests that they are due to biases. Perhaps you are unaware of the problems that can arise with RCTs in general and small studies in particular. I suggest you read some of the posts here for some insight into this.

    Several years ago I was taken in by the idea that if so many people use homeopathy it must be effective. I have since become a sceptic. Unless I see some extraordinary evidence my position is that homeopathy is a placebo.

    Regarding the study I referred to, I picked a small metastudy that was cited on a homeopathy site as being among the strongest evidence available for the efficacy of homeopathy using individualized remedies. My intention was to demonstrate that the effect size claimed is far too small for anyone to notice anecdotally in the way you describe. You may not have noticed that I did discuss the shortcomings of this study in my next comment #146 and referred to an in-depth critique of one of the studies in it.

    In this case I suggest that the randomization process was flawed, or failed, as there was a clear difference between the treatment and control groups, with the treatment group being significantly older, taller and heavier than the placebo group. This is entirely sufficient to explain the difference between the two groups.

  155. #155 David
    October 16, 2011

    @Krebiozen:

    I agree, having reviewed it, that the study you quoted on diarrhea is unimpressive: I don’t share your certainty that the difference in group composition explains the difference in results, but as one cannot know there is sufficient reason to dismiss the results.

    There is another short series of studies, which is rather more difficult to dismiss, and is the sort of data that for me suggests an anomaly, albeit one requiring further study:

    http://www.bmj.com/content/321/7259/471.full.pdf

    There are many voices high up on the in conventional medicine that see the move away from clinical judgement as problematic, so I am not alone:

    http://www.nejm.org/doi/full/10.1056/NEJMp1107278

    While I accept that humans are routinely incapable of making unbiased judgement, I also submit that training in clinical judgement, combined with careful observation over a long time, can reveal the truth despite such limitations, which can be transcended at times. In the case of homeopathy there are patterns that emerge upon detailed observation of the effects of remedies, and the strength of cumulative evidence grows greater over time, that it would be unreasonable for me to dismiss my collected observations at this point; but if reality at some point in future ever starts to present me with a different picture, I will conceivably change my mind after some time, and this much I owe to science.

  156. #156 Chris
    October 16, 2011

    Allergic rhinitis? Are you serious?

    How about something that is non-self-limiting? Perhaps type 1 diabetes or rabies?

    How about showing that one homeopathic remedy can be distinguished by another without the labels? Basically take a bottle of Boiron Natrum Muriaticum tablets and one of Boiron Nux Vomica tablets, spill them out on the table, mix them. Then you get to separate them into the proper piles.

    Do you have a method of doing that?

  157. #157 Militant Agnostic
    October 16, 2011

    In the case of homeopathy there are patterns that emerge upon detailed observation of the effects of remedies, and the strength of cumulative evidence grows greater over time, that it would be unreasonable for me to dismiss my collected observations at this point

    You sound just like a certain anti-vaccination pediatrician, (who caters to the woo-addled)who post here. It would be much more reasonable to consider that the overwhelming evidence against homeopathy is in fact correct and you are mistaken.

  158. #158 Chemmomo
    October 16, 2011

    David, as I’ve noticed you’ve come back to respond to other comments, I have several questions for you.
    First, I notice that you’ve entirely ignored my comment (from Oct 9) which I’ll repeat as a question now: can you name just one physical property of matter that is strengthened upon dilution?

    Next, you said:

    Speaking with people who have experienced benefits from homeopathy doesn’t set up selection bias because I am not asking you to believe them

    If you’re not asking us to believe them, what’s the point of talking to them?

    Then, you complain that we have a “pre-existing bias against homeopathy” you assume “is not justified by the degree of your exposure to the subject matter.” Has it not occurred to you that many of us who comment here actually read scientific literature? Have you not noticed that some of the commenters are practicing medicine professionally, while others have advanced degrees in science? Why is it that you think the bias is on our side? Why don’t you see your own bias here? Is it really that inconceivable to you that other people, who have had more education in science and statistics than you have, might disagree with your interpretation of things?

    Lastly, you complained to Krebiozen that “But you haven’t presented a clear case against homeopathy.” But there’s a problem with this, David: you have not presented a clear case for homeopathy. And you know what? It’s your case to build.

The site is undergoing maintenance presently. Commenting has been disabled. Please check back later!