I had been planning on either discussing a study or analyzing another cancer cure testimonial, but things have been (mostly) too serious around the ol’ blog the last few days. What with depressing posts about the return of whooping cough thanks to antivaccine idiocy, more evidence that Andrew Wakefield is a despicable human being, and evidence that there are equally despicable ideas prevalent in “complementary and alternative medicine” (CAM), I was starting to enter one of my periodic periods of depression brought on by contemplating the sheer scope of human gullibility and stupidity. I needed a break, or at least something that could turn my despair at human idiocy into laughter. Fortunately, ss I was rooting about for potential topics for tomorrow, what should I see in my e-mail in box but an e-mail from my good blog bud Mark Hoofnagle over at Denialism Blog. The e-mail contained a link that made me laugh out loud when I read it because it is one of the best distillations of the utter ridiculousness of homeopathy that I’ve ever seen. True, it’s not quite as ridiculous as the article I once found about homeopathic plutonium a couple of years ago or Aqua Nova (click on the link if you haven’t figured out what it is already). When I read it, I decided instantly that, even though Mark had already blogged about it and even though it was a nearly four year old article about homeopathy, I had to pile on too, particularly after I saw that everyone’s favorite homeopathic apologist, Dana Ullman, had graced the comments with his IQ-draining presence. After all, if I haven’t seen it, it’s new to me and possibly new to you too.
Maybe, if we’re lucky enough, Dana’ll show up over here too.
The article is over at Hpathy.com and entitled On The Treatment of Burns. Like Mark, I know a thing or two about burns. You can’t get through a general surgery residency without learning to care for burns, and the residency program where I trained was home to the main burn unit in northeast Ohio. During my rotations there, I dealt with numerous burn patients, with burns large and small. Some patients had burns over greater than 75% of their bodies. Doing split-thickness skin grafts became marathon endurance sessions in the operating room, particularly the children, for whom we had to keep the temperature set very high, leaving the operating room team drenched in sweat by the end of the case. So, having some knowledge about how burns are treated, I wanted to see how homeopaths treat burns.
My regular readers should be very familiar now with at least one principle of homeopathy, namely that diluting a remedy makes it stronger. That particular principle of homeopathy usually brings the most ridicule, violating, as it does, several laws of physics and chemistry, as well as not making any sense from an intuitive, common-sense point of view either. The other principle of homeopathy, which we discuss less is the principle of “like cures like.” In other words, to treat a symptom, homeopaths choose remedies that cause that very symptom in healthy individuals. As with the idea that dilution strengthens a remedy, it concerns homeopaths not in the least that there is no physiological or biological rationale to think that such a principle is true, much less generalizable to an entire system of medicine. With that background knowledge now, I bet you can see where this is going, and, predictably, it’s straight off the deep end:
How do you treat a burn? Almost everyone, if you ask them for the first response required in the treatment of a burn, will tell you, “Put it in cold water…”.
In my first year of homoeopathic training a general discussion led the lecturer to describe a treatment for burns. He explained that he had been dining with a friend who had burnt herself and had immediately, to his horror, held the burnt area of her hand in the heat of a candle for a little while. The friend had then explained to him that the normal treatment of using cold water was ineffective, but that the application of heat to a burn meant that it would not blister, and although it did hurt more on the initial application it healed far more quickly and painlessly thereafter. This she demonstrated a little while later when he saw to his amazement that the burned area was not even red and she was experiencing no pain.
Surgeons and doctors out there can probably guess what this idiot did. Can you? Yes, my guess is that this homeopath, by holding the burnt area of his hand in the flame longer, converted a first degree burn to a third degree burn (full thickness) or a deep second degree (partial thickness) burn. And it’s true: Full thickness and deep partial thickness burns don’t blister. They don’t hurt either, because the nerve endings have been seared away. The reason we put cold water on a burn is to stop the process of thermal injury; what this homeopath did was to accelerate it so that the burn went all the way through the skin. Now, in the case of a tiny burn, as from a candle, a person can get away with this. Basically, the full-thickness burn in the skin dries up and forms a scab under which new skin forms. However, doing this in the case of a larger full thickness burn would be disastrous, leading to more scarring, a longer healing time, and possibly even the need for a skin graft. As one of the commenters pointed out, it’s not a good idea to convert a superficial burn to a deep one because they hurt less!
Only someone who has no knowledge of burn physiology would be able to propose such a treatment. What a lot of people don’t know about burns is that it is the more superficial burns that can often be the most painful and nasty-looking, even though they are generally not as serious. For example, first degree burns are very superficial and will heal on their own. However, because they don’t burn away nerve endings they are often very painful. They also look incredibly nasty when healing, because they will often blister up. However, underneath the blister, the underlying skin usually heals without incident. In fact, it’s usually best not to break the blister, because it’s an excellent biological dressing.
Homeopath that the writer is, he has no evidence to present, no science. He does, however, have a couple of more anecdotes, for example:
The theory was tested more thoroughly when, about year later, whilst working in a fish and chip shop, I slipped and my left hand plunged into the chip fryer up past the wrist. I ran (screaming!) into the kitchen and turned on the hot tap. The plug was in the sink and the sink began to fill. At the same time a couple of concerned customers had run into the kitchen to see if they could help. One of them noticed that I was running the hot tap and tried to ‘help’ by explaining that I had turned on the wrong tap and attempted to turn off the hot and on the cold. In my pain I had to prevent them and also explain what I was doing. This meant that my hand remained in the water for a longer period than it would perhaps, had I been left alone (this is relevant later…).
The next day, my hand had no evidence of the burn whatsoever! The customers who had witnessed the incident were amazed!
What happened here? It looks to me as though he probably only had his hand momentarily in the fryer. He pulled it out right away, not having left it in long enough to get more than a first degree burning (which no doubt hurt like hell) and the thin layer of hot oil, because it was thin, rapidly cooled once his hand was out of the fryer. The warm water soothed it and also further cooled it, even though it was warm water. In other words, he was very, very lucky. I highly doubt that the outcome would have been so good if his hand had stayed in the fryer a few seconds. If his hands were wet before he slipped, that might also have helped because the water on the skin would instantly vaporize upon coming in contact with the hot oil and temporarily form a thin later of gas around his hand, which could have helped insulate him from the extreme heat, at least over the span of a second. In any case, my guess is that he would have done the same or even better if he had used cool water.
The third anecdote involves the homeopath’s daughter, who scalded her hand with “double boiled water” (whatever that is). Whether he meant water from a double boiler or water that had been boiled twice, I don’t know, but in any event apparently her friend’s dog had started humping her leg while she was pouring water into a cup. (Folks, you can’t make stuff like this up.) She told her dad that she had tried the “hot water thing” but that it hadn’t worked. Her dad, being the homeopath that he was, gave her Caust 200C, which is a 10400-fold dilution of whatever Caust is, a dilution that is many, many orders of magnitude greater than the estimated number of molecules in the known universe. To everyone’s relief, it apparently made the daughter less hostile to the dog, but to no one’s surprise it did absolutely nothing for the burn. In any case, he includes a photo of the rather impressive blister his daughter developed and described her course after that:
I was concerned as the blister was ‘impressive’, although after the initial hot water treatment she was in very little pain. She described the sensation as a ‘discomfort’ rather than ‘pain’. There had been criticisms of my treatment of it, with various people suggesting that she should have taken it to hospital to have it ‘treated properly’. I sought support or advice from ‘Homoeopathy’ but could only find instructions to ‘immerse the part in cold water and seek medical attention’, in addition to the obvious remedies.
She heroically and carefully kept the blister whole and continued to ensure that it did not become dry.
In addition to the hot water I gave her a bottle of Canth 30c, in medicinal solution, from which she took a teaspoonful daily for a few days, after succussing the bottle 6 times.
Ultimately the blister started leaking, and his daughter pulled the skin of the blister off, and–guess what?–the skin underneath had healed! Is this a surprise? Nope. Remember what I said about the blister being an excellent biological dressing? This is exactly what I meant. I’ve often said that homeopathic treatment resembles the correct treatment of a condition by coincidence only. This was nothing more than one such coincidence. Leaving the blister intact and letting the second degree burn heal on its own were exactly the right moves. Homeopathy had nothing to do with it, although I do like the little bit of detail about succussing (shaking) the homeopathic remedy exactly six times. Nothing like a little magic to make the woo go down. I say “magic” because homeopaths will oh so solemnly tell you that just diluting a remedy isn’t enough. It has to be “potentized” by being succussed at each dilution step in order to imbue the potion with its magic powers. Actually, they don’t put it that way, exactly. That’s just my translation of homeopathic woo-speak.
At least now I know where the myth I sometimes hear that cold water is bad for a burn came from. It appears to have come from Samuel Hahnemann himself! It’s right there in an excerpt from a treatise on burns written by Hahnemann in 1816. We skeptics often joke about how homeopathy is nothing more than water, and indeed it is. However, it’s more than that in that it is an entire system of magical thinking applied to medicine. We often assume that homeopathy isn’t dangerous because it’s water, or that it’s only dangerous when people use it to treat or prevent serious diseases instead of science-based medicine. However, the homeopathic treatment of burns is an example of homeopathy being dangerous on its own, particularly for those who are so deluded to heat a burn with a candle and convert a superficial or partial thickness burn into a deep or full thickness burn. It’s also the ultimate example of treating the symptoms instead of the physiology in that the severity of injury is increased by turning a superficial or partial thickness burn into a deep or full thickness burn in order to decrease the amount of pain. In other words, if homeopathic principles are followed in burns, in order to decrease symptoms, you increase the severity of the injury.