I've never been able to understand advocates of homeopathy. I just have difficulty understanding how otherwise intelligent people can fall for the bad science, the logical fallacies, and the magical thinking necessary to believe that homeopathy is anything other than glorified water, an elaborate, ritualized placebo. I can understand how such an idea may have taken hold 200 years ago, when Samuel Hahnemann first dreamed up the concept that "like cures like" and that diluting these "like" remedies to an extent that, even a few years after the principles of homeopathy were formalized it was obvious, thanks to Avagadro, that the dilutions involved in homeopathy were such that not a single molecule of active compound was likely to be left. After all, back then diseases were thought to be due to an imbalance of humors, and the germ theory of disease was over 50 years away. Moreover, "conventional" medicine was often worse than the disease, involving, as it often did, bleedings, purgatives with heavy metals like antimony or arsenic, and all sorts of other horrors. By comparison, for many conditions, doing nothing (which, let's face it, is what homeopathy is in effect doing) produced better results.
But how to explain the persistence of homeopathy, which can best be described as sympathetic magic and magical thinking now, 200 years later, when it requires believing things that science dos not support and, indeed, that would require that much of what we know about science to be horrendously incorrect? That's why I thoroughly enjoyed Ben Goldacre's takedown of a particularly credulous defense of homeopathy. Unfortunately, Goldacre's takedown has inspired a particularly idiotic retort from a man named Denis MacEoin:
Goldacre's article was laden with his usual sarcasm. In it, he paraded his superior knowledge and accused homeopaths of "killing patients" and being "morons". As a fellow sceptic I understand where he is coming from; I identify with his pro-science stance, and have as little time for unscientific nostrums as he, but I came away from this piece with a feeling of embarrassment, a conviction he doesn't know what he's talking about, just like Whipple.
Ah, yes. The old "I'm a skeptic, too" ploy, a.k.a. the "I'm a scientific person, too" gambit. Inevitably, when you see someone like MacEoin starting off with a statement like this, you know what's coming next, don't you? Of course you do:
The homeopathy community has its fair share of fools and charlatans, and many practitioners and gurus come from the counter culture. I have as little patience for them and their metaphysical weirdness as does Ben. But I'm also aware of an entirely rational world of doctor homeopaths, and many non-doctors who prefer to work alongside conventional medicine and would sooner die than manufacture a remedy from moonshine and call it "Luna". By tarring all homeopaths with the same brush, Goldacre does both them and their patients a disservice.
No he doesn't. What possible advantage can come from homeopaths working "side-by-side with "conventional" doctors? There's certainly no advantage to scientific medicine. The only "advantage" accrues to purveyors of unscientific nostrums (like homeopaths), who purposely encourage such associations with real medicine because they bring an unjustified air of respectability to their quackery.
Of course, the really hilarious part of MacEoin's critique of Goldacre is when he pulls the old "you're not a homeopath" gambit:
I said he doesn't know what he's talking about, and I meant it. I am sure he has not acquired any homeopathic qualifications, and I'm confident he has not sat in with an experienced homeopath for a year or so or worked at a homeopathic NHS hospital. He has read a few books and set himself up as the arbiter of things homeopathic. That is not a good basis for critical understanding.
No, Mr. MacEoin, you don't have to be a homeopath to recognize unscientific, illogical, and downright wrong thinking when you see it. By your reasoning, it would appear, no one who's not a homepath or has "acquired homeopathic qualifications" (does that mean qualifications diluted into nothingness?) can criticize homeopathy. Come on. I don't claim that no one who's not a physician or hasn't studied medicine for a suitable length of time can criticize modern medicine. Why do homeopaths insist that anyone who isn't a homeopath or hasn't studied homeopathy with homeopaths can't criticize homeopathy?
Because anyone who's a homeopath has swallowed the whole woo-filled belief system and anyone who's spent as much time hanging out with homeopaths and studying homeopathy as MacEoin has also likely done the same, that's why.
Of course, MacEoin isn't a doctor or a homeopath, just a homeopathy booster. So by his own logic, why should we take his blatherings seriously about either medicine or homeopathy? (No doubt, if he ever learns of my post, he'll dismiss my "sarcasm" about homeopathy because I'm not a homeopath, either.) Not surprisingly, next MacEoin posts a blatant appeal to other ways of knowing, using a claim that randomized clinical trials are not the proper way to determine if homeopathy "works":
There has never been a proper trial of homeopathy. There have been countless trials based on the methodology applied to orthodox medicines, as if homeopathy is a form of orthodox medicine. Some have been positive, most negative. This proves nothing, because what they have tested was never homeopathy in the first place.
In orthodox trials, all patients in the "real" group are given the same drug for the same length of time. Homeopaths do not work like that. For one condition, they may select one of a dozen or more remedies, chosen after long and detailed interviews. They see patients repeatedly over the course of months or years, refining and changing prescriptions, and watching a steady development that follows a strong internal logic. It is a long process. But this is how homeopathy works: mangling it for the chance to jump on the clinical trial bandwagon is not science. No scientist of repute carries out tests of A by running trials of B. All the vaunted meta-analyses that proclaim the ineffectiveness of homeopathy are scientifically illiterate, as Ben Goldacre seems to be in this instance.
Repeat after me: The stupid, it burns. Think about it. If there's never been a "proper trial" of homeopathy, then on what basis is MacEoin so confident that it works?
His whine is nothing more than a claim that science can't analyze homeopathy. It's nothing more than a blatant appeal to "other ways of knowing." Besides if you search PubMed, you'll find that studies of "individualized" homeopathic treatments have been done. They're generally of very low quality, and, as with the rest of homeopathy, it's the low quality studies that "find" an effect. In any case, I reject utterly the contention that randomized clinical trials are not up to the task of determining whether homeopathy "works" or not. Moreover, it's up to the homeopaths, not the skeptics, to provide evidence that homeopathy does anything that can be differentiated from the effect of a placebo or, if they are going to claim that the standard methodology of scientific medicine is not the proper set of tools to study homeopathy, to provide a credible alternative method and to give us an explanation why that's a bit more convincing than MacEoin's lame and petulant rant.
Finally, particularly hilarious is MacEoin's whine about the criticism of his silly article that filled the comments:
I put up a short article designed to provoke some sort of rational debate about a contentious scientific subject. I expected criticism, but I also expected reason, balance, and informed debate. I received the criticism in bucketloads, but none of the other things. Instead of a reasoned discussion, there is -- if you will scroll down -- little but invective, vitriol, spleen, and anger. I do not think I have read a single comment here that has been anything but bellicose, with vituperative language, ignorance parading as knowledge, and arrogance masquerading as scientific insight. This has not been a rational debate, and anyone who thinks it has should read back carefully. I am all too aware of what it is: this is the language, long familiar to me, of religious intemperance, the voice of orthodoxy screaming for the blood of heretics -- and, let me tell you, it is rank.
Well, I recognize MacEoin's language as the voice of pseudoscience, magical thinking, and superstition whining like a whipped puppy when it isn't taken seriously by science, and it is pathetic. Moreover, there were plenty of serious responses in the comments; MacEoin, like most boosters of woo, decided to concentrate only on the most sarcastic ones in order to play the poor, ridiculed martyr. Never mind that he richly deserved every bit of ridicule he got. Here's a word of advice for him: If you want a rational debate, post a rational argument, rather than the fallacy of special pleading.
OTHER GOOD TAKEDOWNS OF MACEOIN'S RUBBISH:
- Quacking About Ducks
- They're still arguing over the effectiveness of water
- Homeopathy Again - Ultra Sigh
ADDENDUM: Oh, goody. Everybody's favorite homeopath, Dana Ullman (who should be familiar as a persistent pro-homeopathy commenter in this thread, for example), has shown up in the thread over at MacEoin's post. Another commenter has him pegged perfectly:
...I also observe that debating with you is like arguing with a particularly dense piece of Teflon, so I will not bother, but anyone who has the emotional reserves and wishes to see how someone remarkably like you tried ineffectually to defend your book against criticism could start by reading the posts of "JamesGully" here;
http://forums.randi.org/showthread.php?p=2783078&highlight=jamesgully+holmes#post2783078
This reminds me of an article Freeman Dyson wrote about paranormal phenomena in which he concluded that conventional science may not ever have the correct methodology to study the paranormal and prove it invalid. Talk about moving the goalposts.
Here's a wrod of advice: If you want a rational debate, post a rational argument, rather than the fallacy of special pleading.
The funny thing is, he DID get a lot of rational responses along with a seasoning of sarcasm and derision (entirely deserved, in my opinion). He chose to ignore them.
Kind of reminds me of Monty Python's Piranha Bros. sketch:
"He used... sarcasm. He knew all the tricks, dramatic irony, metaphor, bathos, puns, parody, litotes and... satire. He was vicious."
At least Denis didn't get his head nailed to the floor (apart from metaphorically)
Because obviously it's entirely rational to spend your entire career learning about and prescribing treatments which have never actually been tested.
I'm not a medical doctor, so help me with this...
Isn't this the way conventional medicine deals with patients as well?
Damn, clinical trials won't work either. :-(
Bob
Shouty crackers much of Comment is Free may be, but occasionally the commenters come good and this is a great example (it ranks up there with the destruction of the Barefoot Doctor)
As they point out, MacEoin isn't a homeopath (neither is Jeanette Winterson, but apparently you don't have to qualified to promote it, just to criticise) but his wife is, he's written for the journal Society of Homeopaths and he used to be Vice Chair of the Friends of Homeopathy. Not that that in any way means he might have a conflict of interest, of course *cough*.
If "There has never been a proper trial of homeopathy", how does he know it works?
Never hire a homeopath to paint your kitchen. He'll spend years changing the colors, adjusting hues and tints in the base paint, all the while telling you how great your kitchen looks -- and he'll bill by the hour.
Posted by: Watt de Fawke | November 24, 2007 12:03 PM
You forgot to mention that all different paints will be transparent. Hans Christian Anderson once wrote story about homeopathy, entitled "The Emperor's New Clothes".
Off topic so apologies. I (pv) have just posted the comment above, yet it is attributed to someone by the name of Watt de Fawke (I presume a take on "what the fuck"). Is this something on my computer or something weird to do with ScienceBlogs? I've Googled the name and the only entries for a Watt de Fawke link to comments (not mine) on other ScienceBlog forums. Very strange.
"I've never been able to understand advocates of homeopathy. I just have difficulty understanding how otherwise intelligent people can fall for the bad science, the logical fallacies, and the magical thinking necessary to believe that homeopathy is anything other than glorified water, an elaborate, ritualized placebo."
Cult: Homeopathy
Founder or Leader: Dr.Samuel Hahnemann
True Believers and Followers: Melanie Hahnemann, Past and Present Practitioners
Popular Slogan: Similia Similibus Curentur
Mystery - Irrational Belief: Dynamization - Potentization
Pecuniary Interest: Selling Medicines, Tuition for a fee
A small nitpick, as usual concerning historical accuracy, the principle "like cures like" can already be found in the work of Paracelsus in the 16th century.
I see the headlines of the future! Orac admits conventional medicine is useless!
Ah, quote mining is such fun.
Orac,
But how to explain the persistence of homeopathy, which can best be described as sympathetic magic and magical thinking now, 200 years later, when it requires believing things that science dos not support and, indeed, that would require that much of what we know about science to be horrendously incorrect?
The cynical answer: consider that many of these same folks who believe in homeopathy also believe the federal government is covering up evidence of ET life, that Kennedy was killed by the CIA/Russians/mafia/other group du jour, that the rise in gas prices is really just an oil-company conspiracy, and the Bush administration let the 9/11 atrocities occur (or even actively participated in them) because they wanted an excuse for a Mideast war. The stupid of 9/11 Truthers burns like solar plasma.
The less-cynical answer: I don't know why, or how, or from whence, but maybe there is something to homeopathy, on some level. By every law of science, reason, logic, and chesmitry, homeopathy can't possibly work. And yet, I know a couple, husband and wife, who are both very intelligent, well-informed folks. They take full advantage of modern medicine. They watch their budget and they don't burn money on frivolous or useless things. Yet they also have a regular chiropractor and I've heard them talking about the efficacy of "homeopathic" remedies. The only thing I can figure out is either the "homeopathic" treatments they use aren't the same as the woo-ish nonsense you so rightly sneer at ... or somehow, some way, despite all the science and reason and logic that says it shouldn't, it works.
Usually water is pH neutral, but somehow the Stupid of Homeopathy is around a pH of -12. It Burns.
I think there are thoughtful, intelligent people who have a lapse in their education involving science. Someone who seems rational tells them to try such and such during a cold, and when a cold comes along they give such and such a go, and voila! In a few days or a week, they are feeling better!
A friend suggested a cold "remedy." She swore by it. She is smart, well read, thoughtful. I checked it out at my grocery store. It was a homeopathic thing. Ugh.
Some of these homeopathic things have good advertising that's professional, national, and involve large amounts of money. They look like the ads for Robitussin. I think that's why reasonable people fall for it. It looks like everything else advertised for colds, flu, etc., so it must be legit. Since most bugs are limited, they get better anyway, and some of the initial response is the placebo effect, so they think it works. They don't think very deeply about it.
Do these homeopathies work? I don't think so. But people want to do something to try to feel better, and homeopathy gives them something to do, until their condition worsens and they have to go to an MD, or it resolves on its own.
"There has never been a proper trial of homeopathy"
Well, there have been some. If by "proper", he means "supportive", he is pretty much right.
Of course, we don't have proper trials of, say, eating copper wire to cure gout, or tying your shoes three times in a row to ward off heart disease.
At some point, you decide whether there is a rational reason to test something. Part of medical research is having a plausible method of action, which homeopathy obviously does not.
The Amara of Ethiopia have the following treatment for rabies:
When a person is bitten by a possibly rabid animal, they throw him in a river or stream so the running water can wash away the demons.
Lo and behold, in the vast majority of cases when a person is bit by an animal and they do this, the person does not develop rabies!
In the small number of cases where a person does develop the symptoms of rabies, they do take him or her to a Western practitioner, who is unable to do much of anything.
People's conclusion: Clearly folk medicine is more effective than biomedicine!
I believe you've overlooked the most obvious explanation: It doesn't work, they just think it does. The fact that they believe in it is not even weak evidence for it, no matter how allegedly intelligent they are. We humans have a tremendous capacity for self-deception.
I've never quite understood how homeopathy advicates get away with saying, in effect: "Homeopathy works - our magic sugar pills are potentised by repeated succussion and dilution" on the one hand, and yet still blythely assume that because they are basically giving out sugar pills wiith no active ingredients, they can't be harmful.
Wouldn't it be fun if the FDA took them at their word (i.e. that homeopathic remedies ARE powerful), and made them explain how they are safe?
It works for other CAM modalities too. What are the risks of accupuncture? How do we know it's safe? What could go wrong if your accupuncturist messed up your Chi?
On a lighter note - soomeone posted a link to this cartoon at PZ's blog, and this one in particular tickled me good:
http://cectic.com/016.html
Orac,
What is the proper term for someone who has "swallowed the whole woo-filled belief system"?
I think they're a "cultist", are they not?
Proof is in the pudding guys!! I'll still be healing desperately ill people when this (yet another) attack on homeopathy has died down. Should we help the suffering or squabble over what might or might not work? Come on. Iatrogenic disease is the biggest killer on earth. Homeopathy heals people. Period
So long as no one actually bakes said pudding according to the recipe and tastes it under controlled conditions, apparently.
Now, if I had access to a truly marvelous pudding recipe, I'd want as many people as possible to taste it. In order to convince people to taste it, I'd have to prove to them that it was actually better than their standard puddings. I mean, I could just claim that it was better, but advertising is rarely a reliable guide to truth.
On the other hand, if I claimed to have access to a truly marvelous pudding recipe, but rather than providing proof that it was any good I resorted to advertising, I think people would have cause to be sceptical.
Knowing what might or might not work is a necessary precondition for helping the suffering. Treating people with things that don't work doesn't tend to help, oddly enough.
Making such patently false statements doesn't exactly enhance your credibility.
Then prove it.