Given that this is the last weekday before the end of 2011 and this quite probably will be my last post of the year (that is, unless something so compelling pops up over the weekend that it tempts me more than I can resist), I wondered what would be a good topic. Then, readers started sending me a link to the perfect topic, and I agreed that it represents a loose end that I should try to take care of before the year is up. So take care of it I will.
Right before Christmas, a homeopath named Judith Acosta, who bills herself as a "licensed psychotherapist, classical homeopath, and crisis counselor in private practice," wrote a post entitled A Personal Case for Classical Homeopathy: Part I, which I duly deconstructed. The post appeared on--where else?--that wretched hive of scum and quackery, The Huffington Post, a.k.a. Huffpo. It took her less than a week, and yesterday Acosta posted the second part of her incursion into pure woo, entitled, appropriately enough, A Personal Case for Classical Homeopathy: Part II. In part I, Acosta used her own personal anecdote of how she thought classical homeopathy had cured her of troublesome ovarian cysts that doctors supposedly couldn't do anything about. it took a hell of a long time, and her symptoms waxed and waned, but eventually they got better, almost certainly with no help from the magic water whose praises she sang. As I pointed out, she got better on her own, but her homeopath took credit for it, at every exacerbation calling the exacerbation evidence that his magic water was working.
Convenient, isn't it?
In any case, part II picks up where part I left off, but first Acosta has to justify her belief in homeopathy by first admitting that she knows it sounds crazy:
After the debate with my last articles on this topic, I find I couldn't agree with the critics more. Homeopathy is strange and sounds magical. When I try to explain it to people -- despite years of study and personal/professional experience -- I wind up sounding like my worst woo-woo nightmare, stumbling over words like "energy," "resonance" and "organism."As I stumble, my husband patiently awaits my sound byte, still anxiously hoping I can give him a way to explain what I do to save him from sounding just as ridiculous.
Acosta's poor husband. He married a psychotherapist, someone with a perfectly respectable profession, who later turned into a homeopath. He must be a good man, sticking with her and trying to understand even though, based on what Acosta says, he seems puzzled by and disapproving of the whole thing. As well he should be, given that homeopathy is pure quackery and most homeopathic remedies are diluted to nonexistence, leaving just water. Acosta tries to explain using, as quackery apologists often do, not with science, but with metaphor. The first metaphor she tries is a musical metaphor, because her husband is a musician:
"In homeopathy, you can think of both the human being (or any living creature for that matter) and the remedy as pieces of music. A person comes in for treatment and the disease or pathology is presenting as a song, out of tune with the rest of the person when in a healthy state. We look for a remedy that most closely matches the totality of that pathology's song. When we give it to the patient, the remedy cancels the disease. A song for a song. Like cures like."
Eyebrow is lowered. I am momentarily reprieved. "Is it phase cancellation?"
"I'm not sure because it's not an opposing frequency, it's a similar one. But maybe the amplitudes are opposing."
Eyebrow is raised. I realize that I'm back to where I started.
Given that her metaphor is woo-filled nonsense, that's not surprising. Pathology is a song, and homeopaths are trying to match the totality of the pathology's song? Seriously? Wouldn't it be better to understand the pathology on a scientific basis and use that understanding to design therapies to correct (or at least alleviate) the pathology? Not in a homeopath's world! After all, there is no scientific evidence to support the concept of "like cures like" as a general principle in medicine, any more than science supports the concept that diluting a remedy somehow makes it stronger, the latter principle violating multiple laws of chemistry and physics.
Having failed in her first metaphor, Acosta begins a second, followed by the "individualization" gambit that is so frequently used as an excuse for the failure of various alternative medicines to demonstrate efficacy in randomized, controlled clinical trials. Here's the metaphor:
See yourself as a being of a million small crystals, each one with a frequency. When you become ill, some of those crystals change frequency and begin to vibrate or sing out of tune. When we choose a remedy, we choose it to best match those crystals that have fallen out of tune. When delivered, it shatters those sick crystals, leaving only the healthy ones behind.
Admittedly, it is a metaphor, and as such, still leaves a great deal unexplained. I can understand the frustration of allopaths and critics with the obvious absence of hard, linear facts that are repeatable regardless of the person or place. Compared to current pharmaceutical philosophy, making scientific "sense" of homeopathy is like trying to play ordinary billiards in a quantum pool hall.
Wow. I must admit, it sure sounds impressive. It is, of course, a pair of fetid dingo's kidneys. Crystals? Why not look at living organisms as what they are, a collection of cells and chemicals? As for the bit about choosing a remedy to "best match those cyrstals that have fallen out of tune," I had a hard time not laughing out loud when I read that. As it is, I did chuckle a bit. How do homeopaths figure out which "crystals" fall out of tune? By asking a bunch of questions? How do they figure out what homeopathic remedy will work to destroy those out of tune crystals? They use a principle based on a prescientific understanding of how the human body functions, the pathology of disease, and how medicines work.
Yet, despite homeopathy being based on sympathetic magic combined with a prescientific understanding of human physiology, Acosta has the unbridled chutzpah to portray homeopathy as being so very, very advanced compared to "allopathic" medicine. "Allopathic" medicine is all Newtonian, don't you know? And homeopathy is quantum! Somehow, I suspect that Acosta has little understanding of what, exactly, quantum theory even actually says. Like Deepak Chopra, to Acosta "quantum" means whatever she wants it to mean, as long as it can sound as though it justifies homeopathy. But she "understands" the frustration of scientists and "allopaths"! We're so far behind her and her homeopathy that it's not surprising that we can't understand! She really appears to believe that, too. She also appears to believe the whole "individualization" schtick:
The problem is that homeopathy is aimed at treating the individual with a single remedy, chosen specifically for him or her. It is not for treating masses of people with the same pill. Twenty people could have the "same" flu, but each one would need a different remedy (not necessarily Oscillococcinum) and be rightly cured because each one would manifest illness in a way that is utterly unique to him-/herself. We always treat the person, not the disease. As such it is exceedingly difficult, if not impossible to replicate homeopathic treatment the way pharmaceutical companies try to do in drug trials.
Whenever I see a homeopath (or any promoter of alternative medicine) make a statement like that, it's hard not to suspect that what is really going on is that the homeopath is "making it up as he goes along." Strike that. It's more than suspecting. Homepaths are making it up as they go along, as are most alternative medicine practitioners. the reason I say that is that there is no science to guide them, no commonly agreed upon guidelines, only this cult of extreme "individualization." the result is that any homeopath can treat any patient any way he wants, and it's all good. Nothing is incorrect, and nothing is correct. Whatever a homeopath wants goes. The best part (to the homepath) is that it's the perfect excuse to explain why, in the best designed clinical trials, homeopathic remedies do not have an effect any greater than placebo effects. Randomized clinical trials are too rigid! Their woo can't be studied by RCTs!
Or at least so homeopaths say.
Acosta finishes with another anecdote. This time, it's not her but rather her dog. This is another favorite ploy of alt-med aficionados, in which they claim that animals aren't subject to placebo effects. This is not exactly true Animals, such as dogs, can be exquisitely sensitive to their owner's or handlers' behavior and manner. Dogs, especially, are sensitive to what their owners want and expect and behave accordingly; they also respond very favorably to attention and loving care. In this case, Acosta claims that a homeopathic bee venom concoction resulted in the inflammation in her dog's eye disappearing within minutes. Even potent medicines that really work (like steroids) do not work that quickly. Within hours, maybe, but not within minutes. A far more likely explanation is a bit of misdiagnosis with confirmation bias.
What we're left with here is nothing more than another, even less convincing, anecdote, all gussied up with verbiage about "vibrations," "crystals," and "individualization." There's no science, no objective evidence, nothing but stories.
And stories alone do not constitute convincing evidence in medicine.
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I was impressed with the homeopath's false assertion that homeopathy is too individualized to test by science.
I was thinking of psychology -- as a refutation of sorts -- which is a science, and deals with that most individual of things, minds.
Yet, on the other extreme, naturopaths claim "science" subset homeopathy:
e.g., "the medical science of homeopathy" (see http://www.joyoflifefm.com/services.html by Bastyr grad. and Colorado ND Kanevski).
But it's all the same science-ejected homeopathy.
-r.c.
You are all welcome to come and join me and reply to the two comments that I have posted in response to the long-awaited Part II. Notice that I keep asking some innocuous questions of Ms. Acosta and she hasn't replied. Her two buddies Dr. Nancy Malik and Dana Ullman have used copypasta to discuss the history of homeopathy and the "unique to each patient ploy" of treating with homeopathy medicine.
One ridiculous poster added to the hilarity and inanity, by posting a "my dog was saved by homeopathy" anecdote.
I fail to see how homeopathy, no matter how they define it, is not amenable to RCT.
They claim they can succesfully treat disease [X]. They further claim that every treatment must be individualized, thus giving the exact same water to everyone won't work. So why not just have them actually do their homeopath thing and then, I dunno, measure the outcomes?
Of course, when that fails, they will claim that of course it did because observing the outcomes via science messed with the quantum states of their nostrums and the wave function collapsed before being able to do its magic joo-joo.
Contra Accosta, making scientific sense of homeopathy is actually very simple.
It's rank quackery.
See? Easy-peasy.
I also see a rather gaping flaw in the homeopaths' assertions of the necessity of individualization, which is that, even granting the existence of subtle variations between individuals, all humans share almost every physiological phenomenon in common, which in my layman's opinion is precisely why standardized treatments tend to work.
"I also see a rather gaping flaw in the homeopaths' assertions of the necessity of individualization"
But of course it's a necessity. Convince the mark patient that everyone is different, and it explains why Oscillococcinum or whatever the magic water du jour is didn't cure him the first time, and that he'll have to keep coming back to the homeopath to try different remedies until the condition resolves on its own one works. It's not just homeopaths who promote this grotesquely exaggerated picture of individuality. Lots of people who are heavily into woo explain away the failures of alt med therapies in this fashion, and recommend investing in a smorgasbord of supplements/cleanses in a grand experiment to see what might work. Clinical trials? Bah, they're meaningless, since we're all different.
Homeopaths like to use the "individualized treatment" dodge to argue that homeopathy is inherently unsuited to scientific investigation. In fact, it would be quite trivial to test these claims. Divide your patients with a particular complaint randomly into 3 groups. All are interviewed by the homeopathic physicians who make individualized recommendations and deliver the appropriately formulated preparations to a researcher, who prepares the medications as follows: group 1 gets the individualized treatment; group 2 gets a uniform "standardized" homeopathic preparation, and group 3 gets a vehicle placebo, all administered by a researcher who doesn't know which is which. Then see who gets better. Of course, the scientific prediction is that there will be no statistically significant difference.
Bummer. I was hoping for something interesting WRT her dog. The description "eye bulging out of the socket" is alarming. But....if you know something about dog breeds, there are dogs with a tendency towards bulging eyes like pugs. Not only do they have protuberant eyes, their almost nonexistent muzzles and very flat faces mean that those bulging eyes have little protection from bumps and scratches from their environment.
So a minor irritation could cause quite a shocking result. Similarly, a minor problem could resolve rather quickly. (after all it was HOURS between when she first noticed it and when it was homeopathically treated)
The above is speculation of course. I'm glad that she a) consulted a "allopathic" vet first and b) that it wasn't anything more serious.
Once, I read a (pseudo) scientific study on homeopathy, which had all the pretense of a true medical study - with control groups and so on. I call it "pseudoscientific", because it was sponsored by Boiron. Unfortunately, it's French and I don't know if it was traslated into English, but if anyone cared to look into it, here is the title: "Thérapeutique homéopathique. T. 1, Possibilités en pathologie aiquë, 1992", by Jacques Jouanny.
Anyway, when I read it, one thing struck me - they claimed that patients who took their homeopathic remedy recovered from acute diarrhoea faster than the control group - but it still took 5 or 6 days! Loperamide, anyone? Or even simple carbo medicinalis?
Even taken literally, that metaphor makes no sense.
Maybe she's thinking of Autotune. However it still fails. If pathology is a song, then Autotune is a malignancy.
I prefer the panacea: "Needs more cowbell."
Oh dear - she really means this, doesn't she? I'm getting a mental image of homeopaths whacking patients with a tuning fork to see which body part is out of tune, then turning on a karaoke machine and singing a song in the right key to correct it. (The high notes in "Don't Stop Believin" work on almost everybody.) :)
@TBruce - hahaha,you're right. I forgot about the Cowbell Protocol!
I still remember with fondness the commenter who claimed here that he successfully treated his gout with homeopathic remedies, I forget his name now. Remember that gout is a disorder characterized by a variable course of flare-ups and remissions for no obvious reason when considering his tale.
He had to try several different remedies before he found one that worked. Each time he had a flare-up of gout, the remedy that last worked didn't work this time, and he had to try lots of different remedies again, until he found the right remedy for this bout of gout. Each flare-up of gout was subtly different, and required a different remedy, you see. His gout had damaged one of his toes so badly that he admitted he would require joint replacement surgery eventually.
Obviously, to most of us at least, the remedies were doing absolutely nothing, and he was simply attributing the remissions in symptoms to whatever remedy he happened by chance to be trying at that time, yet he still swore his anecdotes were evidence of homeopathy's efficacy, and considered us all idiots for not seeing the truth...
Sorry, couldn't resist: http://www.youtube.com/watch?v=fyV2cPLuFuA
I posted a third time on Part II...it is still in moderation along with seven other comments. I suspect that most of the eight "being moderated comments"...will just "disappear".
Since my science courses didn't cover crystals in my body being out of tune, I'll skip making any educated guesses about that.
Where would one find crystals in your body? Teeth and bones are a likely place. Then there are pathological crystals like kidney stones, gall stones and gout. ...but somehow I don't think those are the "crystals" being referred to.
I played quantum pool with Einstein once, in a previous life. He managed to beat me by getting the 8-ball into the corner pocket and the side pocket simultaneously! In the ensuing celebration he threw the cue ball into the air and it landed on my foot and hit me in the head (simultaneously)! Then I had to go to the Homeopathic Hospital, where I was cured with one millilitre of sumpnerother.
I admit I have an absence of hard, linear facts that are repeatable (not to mention quadratic or exponential facts), but whatcha gonna do?
If it's necessary for homeopathy to deliver a 'personalised' 'remedy' to each of their clients, then pharmacists might as well pull all those commercially-prepared nostrums off their shelves right now...
If homeopathy has any effect at all, debatable, it works by increasing hydration and/or the placebo effect. All the crap about vibrations and harmonics and energy flow are words used to fill the space that would occupied by the simple and honest statement that there is not one shred of evidence for any actual mechanism or effect beyond what can be explained by the placebo effect.
Sugar pills can produce some very profound effects in patients, particularly if the story and theatrics are right. It is inconsistent even when well delivered and the mechanism is unclear but I have no problem with doctors using the placebo effect when nothing else works.
Of course science works hard to root out and exclude the placebo effect as an obscuring source of noise in an experiment. I would like to see more research of the placebo effect. A complete understanding of the placebo effect might lead to an understanding of how people can effect their own brain chemistry. It might be helpful in understanding the brains roll and possible control over depression and pain.
I've clearly been spending too much time with Orac. I had to cut my comment into three parts to get it to fit in HuffPo's pathetic commenting format! As a former New Ager (I got better), I wanted to comment on the fact that I think she sounds like she might just be having doubts about her magical thinking, at least she's still concerned about how others perceieve her beliefs. Her apologetics are the kind I used to use when I was in the long process of waking up to reality. Now, because I'm a creative type and not a scientist (y'all got that covered magnificently) I wanted her to put on her psychologist hat for a minute and focus on her feelings and motivations and see if any of my story resonated for her . . . resonated like a feeling though, not like a crystal.
Come on Ms. Acosta, sounds like you're just about there!
These posts read like the kind of tortured arguments I was making during my last years as a magical thinker. In those days was all about apologetics (mostly for my own benefit) and lots of qualifiers like, "I know it sounds crazy" and "I cringe when I hear myself say this but . . ." I thought I was offering my wisom to others, but I was really just trying to keep reality at arm's length and feel a sense of control.
So, what is it that keeps you in magic land? For me it was a very real, existential fear of death and a rather large ego that was just plain offended by the concept of not existing. Combine that with parents who shielded me from the actuality of death by not letting me go to funerals or accompany them when we had to put some of our animals down, and you ended up with someone who was very anxious about something that is just a normal (if undesirable) part of life.
All through my years of new-age, magical-thinking (from my late teens to my mid forties), my bound and gagged, skeptical self struggled to rationalize every new fad that came along through an almost sadistic torture of quantum physics.
It took me ten years to return to reality (from age 36 to 46). This began when I had the good fortune to work for three successive owners of Whole Life Expo, a large New Age conference and consumer show. This allowed me the chance to meet all my heroes in person, and that was the beginning of my disillusionment. In the New Age, becomming "dis-illusioned" (gotta use that hyphen like with the Alties do with "dis-eased") is frequently a major goal of a spiritual path. On the woo road, one wants to be free of this mundane, limiting world with all its scary, random-ass, totally-beyond-your-control occurences. Alt Med goes hand-in-hand with the New Age because Homeopathy, Chi and other forms of sympathetic magic feel like control. Wrap them in sciency jargon, add the grandma effect, that's when a practitioner actually sits and listens to you (where Science Based Medicine [SBM] is definitely deficient) and Alt Med is the go-to woo for the worried well or those with non life-threatening chronic conditions that SBM has little to offer in the way of treatments.
I know what it's like to cling to confirmation bias out of fear and anxiety. I know what it's like to rationalize the veracity of the most ridiculous modalities or theories because you want them to work so badly. I even employed the stereotype of the cold, unfeeling scientist toiling away in a meaningless universe to convince myself to hate Carl Sagan. That's like hating puppies. I also know what it's like to be horribly embarrassed about being so very vocal and so very wrong for so many years, about so very many things.
Well, I've blathered on long enough (too much time at respectfulinsolence.com) and perhaps I'm projecting, but you're the only homeopath that posts here that doesn't sound totally, utterly convinced. That, and your style of apologetics sounds so much like me just a few years back that I offer my story as a bit of reality-based grit under your protective shell. I realize now that while I did my best to ignore all the grit that got into my tightly closed armor, it made and impression anyway and eventually made it so uncomfortable that I had to get out. When I did finally emerge, I found the pearl that I had been desperately trying to make for all those years had existed all along.
Now my motto is: When the real universe is this awesome, who needs magic?
Should you actually end up in a discussion with a homeopathic believer, I hope you'd point them towards FairDeal Homeopathy - the only honest homeopaths on the web. :-)
www.fdhom.co.uk
I love the "fair deal homeopathy" site.
Off topic, but following links from yesterday's blog led me to this year-old dose of Respectful Insolence about "Mothering" magazine:
http://scienceblogs.com/insolence/2011/01/mothering_a_bastion_of_quacke…
Some sad comments there by a mom whose postpartum depression had been exacerbated by all the earth-mother woo in that fine publication. And this reminded me of a tiny snippet of Simpsons, pictured here:
http://simpsons.wikia.com/wiki/File:Fretful_Mother_Magazine.jpg
Happy New Year, everyone!
The problem is that homeopathy is aimed at treating the individual with a single remedy, chosen specifically for him or her. It is not for treating masses of people with the same pill.
This is why there are no companies manufacturing homeopathic remedies by the ton and selling thousands of identical bottles of little white pills. Oh, wait...
Seems like any oxymoron to me.
@ palindrom: I hoping you aren't departing the blog for now..you'll be missing the "festivities".
Anyway, Happy New Year.
If it's all about personalization, what about all the mass-made pills made by 'Big Homeopathy' (e.g. Boiron)?
Meanwhile, our understanding of the properties and effects of the substances used or that could be used in such preparations has also advanced. I daresay if someone seriously looked for 'like to cure like' now, without reference to existing preparations, they'd come up with different choices than what's being used. So, woo voodoo.
We've heard this many times. Take some herbal remedy, soak your feet in some bath, take an enema, undergo various woo-therapies, etc, and if you feel better, it is the remedy.
If you feel worse, it is the remedy leaching the toxins out of your system so you'll feel worse before you get better.
Feel better, feel worse, either way it is 'proof' the remedy works.
But if you want to go by that analogy, since Newtonian mechanics is identical to quantum mechanics except under certain conditions, wouldn't the analogy lead to the conclusion that "allopathy" works just as well as homeopathy, except under certain conditions?
Homeopaths should stick to metaphor and magic to explain it, as any attempt to try and justify it by science is doomed to failure - it is not just scientifically implausible, it cannot work without some sort of vital force/innate energy.
Can someone please explain to me how, if individualization is absolutely necessary for homeopathy to "work," homeopaths like DUllmann can harp on and on about various "mechanisms" like that silly Indian study that found contaminants in homeopathic nostrums and called it a miracle of the water? If it's a chemical residue, then observed dose-response should be at play, but if it's not then it's still a standardized "memory of water" based on the resonance of whatever original stuff was in there. In either case, if you assert a physical mechanism, how do you get away claiming no CRTs can prove the stuff when these same sorts of factors are testable with scientific medicine with analogous physical reactions? I know the answer is they can't see the huge gaping hole in their logic there, but I'm hoping there is more there than just pure cognitive dissonance.
Wow--can't spell tonight. Definitely should be DUllman with one "n". I wouldn't want to dilute the power of his name by including an extra one there.
Wow--can't spell tonight. Definitely should be DUllman with one "n". I wouldn't want to dilute the power of his name by including an extra one there.
Yes, it's a common claim that the individualisation aspect of homeopathy makes it impossible to test by clinical trial. The claim is, of course, tosh. But strangely, when a result is found that favours homeopathy the individualisation problem is forgotten.
The individualisation must also be ignored when treating animals. After all, they wouldn't give a pet dog a 2 hr consultation interview. But then ...
@Acleron:
According to Dana Ullman, it's not that homeopathy must always be individualized, but that it usually needs to be individualized. Thus, for any non-individualized study, if the result is positive then it's an exception to the rule that validates homeopathy, while if the result is negative it doesn't count against homeopathy because it wasn't individualized. Heads I win, tails it's a tie.
What she says actually makes sense...after 3 glasses of wine...
Tina S, Dana is a guy. Dana is a name that is appropriate for both boys and girls.
You guys sure like to talk about things you have little knowledge or experience with.
You guys sure like to talk about things of which you have little knowledge or experience.
One does not have to eat an entire egg to know it's bad. No one needs experience or in-depth knowledge of homeopathy to know it's bunkum; they really only have to understand the principle that supposedly lies beneath all homeopathy and understand enough of physics to realize why that principle does not in fact work.
Paula certainly has very little knowledge of chemistry, physics or biology.
Paula, I did actually know that Dana Ullman is a guy. You just have to check his wiki page to see is full name is Gregory Dana Ullman. He also has pictures of himself on his own websites.