Regulating the magic that is homeopathy: The sabotage of poor reporting and false balance

Well, it's over.

I'm referring to the two day hearing held by the FDA in Bethesda seeking public comment regarding how it should modernize its regulation of homeopathic products. Actually, as I discussed before (as did Jann Bellamy over at my favorite other blog, Science-Based Medicine), in fact it's arguable wither there is currently much, if any, actual regulation of homeopathic remedies. Oh, sure, sometimes when a foolish company or true believer tries to market something as unremittingly dangerous as a homeopathic asthma nasal spray, the FDA takes notices. However, for the most part, the FDA turns a blind eye to homeopathic products because back in the 1930s, an update to the law authorizing the FDA to regulate food, drugs, and cosmetics defined anything that is listed in the Homeopathic Pharmacopoeia of the United States (HPUS) as a drug. Unfortunately, for whatever historical reason, the FDA seems to have interpreted that part of the law, at least for the last few decades, as meaning that anything in the HPUS is automatically FDA approved and that manufacturers of products within the HPUS don't have to demonstrate efficacy and safety of their products.

For whatever reason, about a month ago the FDA announced that it was looking to update its regulation of homeopathic remedies; not surprisingly, that led to quite a bit of consternation among homeopaths, with reactions ranging from dismay to outright fear mongering that the jack-booted thugs from the FDA were coming to take away your homeopathic remedies and this had to be resisted, because, you know, FREEDOM! (Or "health freedom," anyway.) No wonder the vast majority of those testifying were either homeopaths, manufacturers of homeopathic remedies, or supporters of alternative medicine. Left to stem the tide. For instance, representing the side of science and reason was Michael DeDora of the Center for Inquiry, along with a few others. For instance, I was happy to see that Adriane Fugh-Berman, a pharmacology professor at Georgetown University Medical Center, came down solidly on the side of science, as related by this article in the Washington Examiner:
\

A key part of the hearing was whether the products are effective.

"The evidence for homeopathy's effectiveness is between scant and nil," said Adriane Fugh-Berman, a pharmacology professor at Georgetown University Medical Center at the meeting.

Fugh-Berman cited a recent effort by Australian researchers to pore through more than 170 studies on homeopathic medicines. The researchers concluded there is no reliable evidence homeopathy is effective.

A supporter of homeopathy shot back that the Australia study was "poorly done" and doesn't take into account specific treatments or conditions and do analyses of those treatments.

Same as it ever was. I had been concerned that Fugh-Berman might be wishy-washy given her history of being somewhat sympathy towards alternative medicine and her antipathy to big pharma, but she wasn't. Good on her. Neither was Luana Colloca, a placebo researcher from the University of Maryland Baltimore, who discussed placebo effects and characterized homeopathy as placebo.

De Dora was even more blunt:

Proponents of homeopathy will suggest that there are studies which show homeopathy is effective. It is true you can find studies that suggest homeopathy has brought about a positive result. Yet these studies have found only a placebo effect, and significantly do not and cannot explain if and how homeopathy has treated the illness. Further, these studies must be seen within the broader context of hundreds of studies that have found homeopathy ineffective.

Of course, this all makes sense: by its own definition, homeopathy cannot work. Its centuries-old pseudoscientific principles sit at complete odds with our modern understanding of biology, chemistry, and physics — the bodies of accepted scientific knowledge that form the basis of modern medicine.

Again, we need not spend much time on this, as the federal government is well aware of the scientific evidence against homeopathy. As the National Center for Complementary and Integrative Medicine states on its website:

There is little evidence to support homeopathy as an effective treatment for any specific condition.

All of which is true. He then went on to answer the question "What's the harm?" and to present proposals for how the FDA should regulate homeopathy going forward.

Links to the text of all the testimony submitted can be found here. Unfortunately, I couldn't watch the live streaming video coverage because I'm at a cancer research meeting right now and I'd have had to miss the meeting to do it. (Watching it at the convention center—or even parts of it—was not an option because the wifi here sucked so badly that just checking e-mail and Twitter was a teeth-grinding exercise in futility, and the convention center seemed to blunt cellular Internet connectivity to the point where it was little better.) Last night, though, taking advantage of the fast Internet in my hotel, just for yucks I perused some of the testimony of the various homeopathy advocates, including naturopaths (of course!), homeopaths, homeopathic pharmacists (the jokes write themselves on this one!), and homeopathy advocates. One, Bruce Shelton, characterized homeopathy as "critical to his success in helping patients" and that he has never experienced safety or quality issues, the latter of which seems like an extraordinary claim given that Shelton claimed over 20,000 patient visits. Confirmation bias, anyone?

In any case, the homeopathy supporters who testified didn't say anything that any skeptic who pays attention to homeopathy (like me) hasn't heard a million times before. At least the skeptics did discuss exactly what homeopathy was and why its principles are so ridiculous.

Which brings me to an observation about the news coverage that a reader named Andrey Pavlov sent me in response to an NPR report on this review. It starts with an anecdote about a homeopath named Anthony Aurigemma practicing in Bethesda (!), MD. He's an MD who became disillusioned with medicine and switched to homeopathy, a truly depressing conversion to contemplate, one I've never understood because a physician should have enough basic science knowledge to understand why homeopathy can't work other than as placebo. Be that as it may, and despite my good bud Steve Novella being quoted in the article, this reader noted a problem, which he describes as why news stories so seldom seem to describe exactly what homeopathy is. This particular NPR story does, but a lot of others don't. Even in stating what homeopathy is, it doesn't really explain why homeopathy is so utterly ridiculous; rather, the explanation was couched in the annoying "tell both sides" trope so common in reporting of pseudoscience by letting Aurigemma explain:

"We believe that there is a memory left in the solution. You might call it a memory. You might call it energy," Aurigemma says. "Each substance in nature has a certain set of characteristics. And when a patient comes who matches the physical, mental and emotional symptoms that a remedy produces — that medicine may heal the person's problem."

Critics say those ideas are nonsense, and that study after study has failed to find any evidence that homeopathy works.

No, science itself says the ideas behind homeopathy are nonsense. Critics of homeopathy cite that science to show why the ideas behind homeopathy are nonsense. I've explained why more times than I can remember. Other medical skeptics have explained why so many times they can't remember. In fact, I consider knowing why homeopathy is The One Quackery To Rule Them All (with the possible exception of reiki and "energy medicine," which vie with homeopathy for the title) and being able to explain it a test of whether one is actually a skeptic in terms of medical quackery.

I'm not the only one who's noticed, apparently. For example, Jerry Coyne noted:

Reader Howie Neufeld sent me a note about two CBS television segments I missed (readers can assume I miss every show except for “60 Minutes” and the NBC Evening News):

This morning CBS News had Dr. Holly Phillips (internist) discuss homeopathy. When the anchor asked her if it was pseudoscience, she sidestepped the question, referring mainly to the lack of FDA regulation of such remedies. Having taught about homeopathy (I consider it junk, not pseudoscience) for years, I was extremely disappointed in her lackluster and inadequate responses. She should have debunked it totally, as she had a national audience. Instead, she caved in to the herbal drug industry.

Howie was right; CBS abnegated its responsibility here in refusing to say that homeopathy is not only ineffective, but dangerous in drawing sick people away from science-based treatment.

Here's the segment:

And the screenshot featured at the beginning of this article illustrates my point almost better than I can explain it. Anyone here who knows anything about homeopathy knows what an epic fail CBS medical correspondent Dr. Holly Phillips' description of homeopathy was in this segment. Truly, one wonders if she has clue one what homeopathy really is!

Andrey ends up asking:

Why is it that we are allowing the discussion to be framed from a "health freedom" and "regulatory" perspective instead of just saying what homeopathy is at every single chance available?

An excellent question. Clearly Dr. Phillips either had zero clue what homeopathy really is and how utterly pseudoscientific it is, or she didn't care.

I've related the tale before about how even medical students and residents whom I teach have no idea what homeopathy really is. Whenever the topic comes up (which isn't that frequently, but over the years I've accumulated quite a few discussions) and I ask the trainee what homeopathy is, he will answer that it's some sort of herbal medicine. Heck, its not just trainees. It's attending physicians and senior scientists, too, who don't know what homeopathy is.

So I tell them.

I tell them the two main "laws" of homeopathy, the first being "like cures like." That one will sometimes cause some amusement, because there really is not scientific justification for concluding as a general principle that to treat a symptom you need to use something that causes that symptom in healthy subjects. Next, I'll explain the law of infinitesimals, specifically how homeopaths believe that diluting a substance—with vigorous shaking between dilutions, of course, to "potentize" it—makes the remedy stronger. Of course, it's not just that. It's that diluting a remedy away to non-existence makes it stronger, dilutions of 30C or greater, which is a 10-60 dilution, or more than 1036-fold greater than Avogadro's number, are commonly used by homeopaths. When I tell the students or residents this, not infrequently their jaws drop, and they respond, "Really? You're kidding. That can't be. That's ridiculous!"

Minds blown.

I then explain how homeopaths believe in the "memory of water" as the mechanism by which this effect supposedly occurs.

More minds blown.

This brings me back to Andrey's point, which is a valid one. Part of the reason that homeopaths and their apologists so easily get away with making appeals to anecdotal evidence and framing the pseudodebate in terms of regulation and health freedom is that there is so little understanding among politicians and the public just how utterly nonsensical homeopathy is. It's magical thinking. Actually, as I've argued before, it's sympathetic magic. My favorite example to make this point is compare homeopathy to the principles of sympathetic magic. For instance, homeopathy’s law of similars (“like cures like”) is uncannily similar to Sir James George Frazer’s Law of Similarity as described in The Golden Bough (1922) as one of the implicit principles of magic. In addition, the concept that water can somehow retain the imprint of substances with which it’s been in contact, which really underlies the belief among homeopaths that remedies diluted to nonexistence (basically anything diluted more than around 12 C–14C or 15C, to be safe) can have biological effects, is very much like the Law of Contagion. Given that it's been a while since I've written about this, now seems a good time to invite you again to read the following passage from The Golden Bough and tell me that it doesn’t sound almost exactly like homeopathy:

If we analyse the principles of thought on which magic is based, they will probably be found to resolve themselves into two: first, that like produces like, or that an effect resembles its cause; and, second, that things which have once been in contact with each other continue to act on each other at a distance after the physical contact has been severed. The former principle may be called the Law of Similarity, the latter the Law of Contact or Contagion. From the first of these principles, namely the Law of Similarity, the magician infers that he can produce any effect he desires merely by imitating it: from the second he infers that whatever he does to a material object will affect equally the person with whom the object was once in contact, whether it formed part of his body or not. Charms based on the Law of Similarity may be called Homoeopathic or Imitative Magic. Charms based on the Law of Contact or Contagion may be called Contagious Magic.

See what I mean? These passages would not be out of place in a textbook of homeopathy, with the word "magic" replaced with various vitalistic mumbo-jumbo to "explain" how homeopathy "works." A later passage by Sir Frazer actually provides an excellent criticism of the two pillars of homeopathy:

Homoeopathic magic is founded on the association of ideas by similarity: contagious magic is founded on the association of ideas by contiguity. Homoeopathic magic commits the mistake of assuming that things which resemble each other are the same: contagious magic commits the mistake of assuming that things which have once been in contact with each other are always in contact. But in practice the two branches are often combined; or, to be more exact, while homoeopathic or imitative magic may be practised by itself, contagious magic will generally be found to involve an application of the homoeopathic or imitative principle.

Of course, homeopaths make exactly these mistakes, assuming as a general rule based on no science that to counter or control a symptom requires a substance that can cause the symptom and assuming that, just because the water used to dilute homeopathic remedies was once in contact with the homeopathic remedy (and the water from the later dilutions were in contact with the water that was originally in contact with the original homeopathic remedy and so on to many, many powers of 10), that the homeopathic remedy is somehow still in mystical contact with the original substance.

Finally, if I want to blow minds to the point of skepticism, I'll talk about homeopathic provings, homeopathic plutonium, and, of course, homeopathic antimatter. Oh, and homeopathic Saturn light, which was made by exposing powdered milk sugar to a powerful telescope while it was focused on Saturn. The homeopath then made a 3C dilution, which means there was actually some milk powder left. The results were described thusly:

The trituration process began with lots of giggling and silliness; and throughout there was talk of getting high, stories about getting high. Senses were distorted. One prover kept seeing smoke rise from the milk sugar as she ground and scraped.

“Drugs come into the mainstream… truckers used speed to stay awake. Ecstasy was first used for marriage counseling.”

“I’m feeling really high… spacey.”

Provers were laughing until the tears came. “You guys are ripped.” “I feel like I smoked.” “Sound is distorted as if I’m high…” “Do you remember the first time you smoked?”

There were a number of other symptoms reported, including itching, headache, watery eyes, and others.

The homeopath's conclusion? She concluded that the sorts of behavior and symptoms observed were consistent with what, from an astrological standpoint, Saturn stood for, the structure of the body, the bones, especially the spine, knees and teeth. Apparently Saturn is also connected to old age and maturity as well as the cycles of time and aging, while the goat aspect of Saturn is connected to "robust sexual expression." This led the homeopath to conclude:

From a homeopathic point of view, both the physical symptoms that appeared and the content of the discussion during the proving suggest that this remedy might be effective for accident-related trauma, bone and nerve damage. The Titan-like quality of strength, survival and endurance seems connected; perhaps an ability to survive disasters is part of this remedy. This remedy may also be effective for allergies, in light of all the itching that occurred.

If you're not satisfied with the ridiculousness of homeopathic provings, take a look at this sampling, which includes Jupiter rays, helium (that must have been fun), Yellow Box Fish, placenta, and the common loon, for which the jokes write themselves.

A huge part of the problem with science and medicine reporting in this country (and the world) can be demonstrated with a simple reference to homeopathy. Homeopathy is, as Steve Novella characterized it, an "excellent example of the purest form of pseudoscience," and as I, more blunt that Steve, like to call it, "The One Quackery To Rule Them All." Failing to make that clear in media coverage of homeopathy lets advocates of homeopathic quackery to label skeptics as "homeopathic naysayers" and claim that the current FDA regulatory framework for homeopathic products is working just fine.

Of course they would say that. As currently formulated, FDA regulation (or, more properly the lack thereof), lets homeopathic "pharmacies" sell whatever they want with minimal oversight, and few know or care enough about it to force change. This FDA reevaluation of its regulatory framework for homeopathic remedies is the first glint of light in ages that could lead to actual reform. However, with news coverage like that of CBS and even NPR, it's going to be difficult to build a consensus to regulate homeopathic remedies the same way other drugs are regulated or at least to stop homeopaths from making scientifically unsupported claims about what their treatments do.

It is, after all, just water (or ethanol, or whatever an individual remedy is diluted with). You'd never know that from the news coverage though, or at the very least all you'd get is a hint of that. Therein lies the problem.

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The moderator said yesterday that recordings of the hearings will be posted somewhere, --did anyone find it?
I live in a Western state and only caught the last few speakers each day.
I gathered that the last speaker was a retired bureaucrat who'd worked on the regulations in 1988. He basically said to the FDA panel, "you guys have a tough job, we couldn't figure out then what to do about homeopathics, so good luck with that."
I read the Examiner story last night but was too tired to comment over there.Thanks for dissecting the coverage,

She concluded that the sorts of behavior and symptoms observed were consistent with what, from an astrological standpoint, Saturn stood for, the structure of the body, the bones, especially the spine, knees and teeth. Apparently Saturn is also connected to old age and maturity as well as the cycles of time and aging, while the goat aspect of Saturn is connected to “robust sexual expression.”

I'll leave the goats for later.

ObMiller.

From the picture

designed to trigger immune response

Groan. The old "vaccines are like homeopathy" canard.
Had a few years ago a heated discussion about this with my dad, when he was going into a woo phase. Thankfully, he got better.
Funny they didn't put the "homeopathy is like nanoparticles" one.
Both analogies are utterly wrong. Homeopathy is about (very, very) high dilution, vaccines are about using killed or weakened germs (or bits thereof), nanoparticles about using (plenty of) thingies of very small size.

the goat aspect of Saturn is connected to “robust sexual expression.”

*heroically resisting the urge to make bad lewd jokes*

In Roman/Greek mythology, Saturn/Cronos castrated his father to take his place and devoured whole his many children to avoid them dethroning him.
There is a goat involved in raising the child who escaped.

Not sure I would cast Saturn as a role model for healthy sex.

By Helianthus (not verified) on 21 Apr 2015 #permalink

mho #1

The live stream was plagued with audio issues, the sound sometimes disappearing for 15 minutes. The close captioners were obviously listening to the same feed and they were also missing a lot of it. I hope the 'official' recording will have been separate from this, but it may not be. So, if the recording is made available, it may have been as bad as the live stream.

They also said that a transcript will be available within 45 days - but I'm not holding out much hope that it'll be complete.

I did record the speech by Dr Peter Fisher (the penultimate speaker) in case he said anything interesting (he didn't - it was a long way to go to say nothing). He's homeopath to Elizabeth Windsor (aka the Queen) and wanted to make sure he told all you yanks that because he thought you'd be impressed by that...

By Alan Henness (not verified) on 21 Apr 2015 #permalink

An example of somewhat better reporting than that from CGBS on the FDA homeopathy hearing:

http://news.sciencemag.org/health/2015/04/fda-takes-new-look-homeopathy

From the article:

"Elaine Lippmann, regulatory counsel in CDER’s Office of Regulatory Policy, asked several speakers the same question: “What is it about the scientific method of demonstrating safety and efficacy though our approval process that is inconsistent with homeopathy?”

“It’s like comparing apples and eggs,” explained homeopathic physician Karl Robinson of Houston, Texas. “Homeopathy is very much of an observational science,” he said. Five patients with the same official diagnosis could receive five different treatments based on their complex mental, emotional, and physical qualities. “It’s a different paradigm, that’s all.”

No it's not. All you need to do is to take those five "treatments" and double-blind them before administration.

To pile on:

Five patients with the same official diagnosis could receive five different treatments based on their complex mental, emotional, and physical qualities.

Yeah, nothing at all like regular medicine. It's not like some people take aspirin, other take acetaminophen and other go for ibuprofen.

To add to Elliott, if the goal of the study is to show the overall efficiency of homeopaths, it doesn't matter how many different prescriptions there are. Send the prescription to a third party who will check a randomized list and either send back a vial of sugar pills or, well, another vial of sugar pills.
If all prescriptions are supposed to work, it won't change anything.

By Helianthus (not verified) on 22 Apr 2015 #permalink

This sounds like a typical day at the National Organic Standards Board meeting, which is held twice a year. People repeatedly quacking about the evils of chemicals and Monsanto with no proof or understanding.

I often try to contribute to the general ridicule of homeopathy on facebook. Yesterday afternoon, IFLS posted an anti-homeopathy article and the place went nuts. I had notifications 'on' and my phone went bonkers trying to keep up with the thousands of entries seemingly every second.

When things quieted down and i could drop more than a morsel (Vactruth isn't, etc.), I ran into a woman claiming we were all vibrational beings. Absolutely nuts. The flavor of the posts were so insane that I finally turned off notifications.

In my personal opinion, homeopathic medicine can cause people to stop pumping their bodies with the chemicals in normal medicine. So, maybe homeopathic medicine isn't a completely bad thing?

By Mikaela Nicolau (not verified) on 22 Apr 2015 #permalink

designed to trigger immune response

@Helianthus: I noticed that one, too. Of the three bullet points, the first is technically true but severely understated, and the last is unfortunately straight truth, but that middle statement? "Designed"? That's a rather generous definition of "designed", to include schemes that can't possibly work--like waving my arms in the air as a tiger repellant, and claiming that it works because there are no tigers within a 20 km radius. (I'm in North America, and there are no zoos within 20 km of my location.)

The homeopath’s conclusion? She concluded that the sorts of behavior and symptoms observed were consistent with what, from an astrological standpoint, Saturn stood for

Lovely. We have one pseudoscience (homeopathy) based on another pseudoscience (astrology). The bits relating Saturn to old age, etc., are straight out of Greek mythology: Gustav Holst, who named the movements of The Planets after mythological characteristics, called the fifth movement "Saturn, the Bringer of Old Age". Likewise the references to "strength" related to Titan, Saturn's largest moon (also named after a mythological character). It's one thing to do that for the sake of Art, as Holst did; it's another thing to do that in an alleged pharmacology study. Oh, and I suspect the people doing that proving may have been smoking some non-homeopathic herbal preparation.

from the second he infers that whatever he does to a material object will affect equally the person with whom the object was once in contact

There are ways to do this in a physics lab, but it takes very careful preparation on the part of the experimenters. Typically, you create a pair of particles that must be in opposite states (e.g., electron spins: there are two allowed states, up and down, and you can force a pair of them to have one in each state), and after separating them, perform some action which forces one of the particles to be in one state (measure the spin of the electron). The other particle will turn out to be in the opposite state. But as I said, this requires a laboratory setting with a fair amount of fancy equipment. Homeopaths don't have that equipment (it's only been in the last decade or so that such lab experiments have been possible, and even today it only works on microscopic systems), and even if they did, I doubt they are careful enough to pull it off.

By Eric Lund (not verified) on 22 Apr 2015 #permalink

MikeMa@8 -- If string theory is right, then maybe we actually are vibrational beings, in some sense, but not in the sense she intended.

There's a Guardian article on this, a bit old now, which has accumulated a fair number of comments.

By palindrom (not verified) on 22 Apr 2015 #permalink

I am still surprised by the level of gullibility of people who fall for and pay for these scams. Or the greed and avarice of those promoting it.

palindrom@11: I remember some of the string theory discussions about this. Over my head and definitely NOT what the woman was preaching.

The NCCAM (no I cannot change it) states:
"The Status of Homeopathy Research
Most rigorous clinical trials and systematic analyses of the research on homeopathy have concluded that there is little evidence to support homeopathy as an effective treatment for any specific condition."
As I tell my students "do you really want your water to remember where it's been?"

By nutritionprof (not verified) on 22 Apr 2015 #permalink

Homeopathy doesn't REALLY involve the memory of water but its tenets are based upon how the faculty of human memory operates.

As Frazer illustrated, primitive folk associated two unrelated events or items because they *resembled* each other in some manner- visually, functionally or symbolically ( law of similarity) or because they were once in contact ( law of contagion) and thus, remain so for all time.

So, a particular plant may resemble a physiological state to which one aspires (you may use your imagination) or a particular object may have once been in contact with the object of one's desire ( or scorn) - OBVIOUSLY these items' relationships hold a powerful significance PURELY in the mind's eye- which then is transferred to an imagined relationship in the world at large. Which doesn't exist outside of one's head.

Rather than viewing memory as a passive reflectance of perceived reality, it often results from an active working upon supposed links: attending to them, re-iterating them and strengthening them, until they seem quite solid- at least in memory rather than in the world. But the focus here is on the internal world.

Again, modern homeopathy relies upon a belief in a connection between unrelated items or states that exist only in the imagination but is, in believers, actively reinforced frequently through reading, thought and discussion, thus giving it power. In memory and thought, nowhere else.

Even if you dilute an idea with other stuff, it can remain.

By Denice Walter (not verified) on 22 Apr 2015 #permalink

I caught part of a piece on NPR about this. The reporter characterized homeopathy as an "ancient healing art." While being ancient is hardly a good thing in medicine, it is also not true of homeopathy. It told me the reporter had not done even the barest investigating of what homeopathy is.

I should note before I run...
the law of contagion - temporal contiguity- is the foundation upon which anti-vaccine hysteria was erected.

By Denice Walter (not verified) on 22 Apr 2015 #permalink

#10
This school project is still going on huh? Mikaela Nicolau you forgot to sign your number. How are you going to get credit for your inanity without your number?

By capnkrunch (not verified) on 22 Apr 2015 #permalink

Didja hear about the homeopath who forgot to take his medicine?

He died of an overdose!

(Plagiarized from Singh & Ernst's "Trick or Treatment")

By Old One Eye (not verified) on 22 Apr 2015 #permalink

The first regulation of Homeopathy should application of the same "Quack Miranda Warning" as with supplements:

"These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease."

But, of course, that would have absolutely no effect on the "true believers"!

See also David Kroll at Forbes for a report on the FDA hearing:
http://www.forbes.com/sites/davidkroll/2015/04/22/pharma-critic-skewers…

He mentions that the "Science Babe" managed to get Petco to remove a homeopathic pet "calming" remedy from their stores--it used ethanol as a diluent.
Drunk doggies, anyone?

Also, my apologies to CBS for that typo in their name in my earlier message. I think that my morning coffee was too dilute. Need to get me some of that homeopathic java.

@ BKsea

The reporter characterized homeopathy as an “ancient healing art.”

Eh, it depends how you define "ancient". If you are blasé about it, yesterday is ancient...

Although I wouldn't be surprised if the reporter was confusing homeopathy with herbalism. A lot of people do, and homeopathy proponents aren't above maintaining the confusion.
I mean, see bullet point #1 in the picture of Orac's post.

By Helianthus (not verified) on 22 Apr 2015 #permalink

I listened (not intently, and with an average health care consumer's ear) to the hearings for a few hours over two days. I did a fair amount of head-shaking and laughing.

I heard "patients want", "patients appreciate", "patients enjoy", patients like", patients are happy" in reference to ease of access, affordability, and lack of side effects/drug interactions, etc.. I interpret that as you can get it at Rite•Aid or Whole Foods, it's cheap, and it has zero physical effect.

I believe more than one practitioner stated the appropriateness of homeopathy for "self-diagnosed, self-limiting, and self-treatable conditions". I'd say "way to testify yourself out of a job", but I'm sure those not-covered-by-insurance homeopathic consults help to boost the placebo effect immensely.

Another presenter put up a slide from a sham-controlled vertebroplasty study, pointing out equal pain relief in both groups. Supporting placebo effect. . . of something unrelated to homeopathy. . . to support the placebo effect of homeopathy? Did I hear that right?

I heard a presenter say that efficacy studies by "provings" were indeed double-blind. (?) Although with that apples to eggs thing. . . that snowflakes. . er, patients, with the same dx may not receive even remotely similar formulations - wouldn't each individual homeopathic remedy have to undergo a double-blind study for each indication it's to be "proven" for? Not to mention combinations of remedies? And how, in light of the fact that the remedies are nothing,could that be done? I think they believe this has already been accomplished, somehow.

The closed captioning was hilarious at times. While a speaker was discussing "hormetic effect", the caption read "comedic effect".

I look forward to science-based rebuttals on blogs and in the press. Although I don't think homeopathy isn't going away, ever, maybe perceptions of it's value be shifted in the minds of some consumers (closer to voodoo).

I love this (hope the hyperlink works):

[The Periodic Table of Irrational Nonsense]

As for the credibility of Holly Phillips, consider her tweet from two days ago:

"My first year at Columbia Medical School, Dr. Oz (before fame) talked to our class - Gave the most inspiring lecture of my entire education."

A Dr. Oz wannabe.

I wonder why

for the most part, the FDA turns a blind eye to homeopathic products because back in the 1930s, an update to the law authorizing the FDA to regulate food, drugs, and cosmetics defined anything that is listed in the Homeopathic Pharmacopoeia of the United States (HPUS) as a drug.

homeopathic pharmacists (the jokes write themselves on this one!)

Really? What's the punchline other than the obvious extreme dilution when used according to the labeling? People and policy are allowed to do silly things all the time; From breading their cats to locking away millions to protect them from Satan's Weed and Cheetos.

As currently formulated, FDA regulation (or, more properly the lack thereof), lets homeopathic “pharmacies” sell whatever they want with minimal oversight

I'm getting the idea that 'pharmacy' here is the rows of little vials at the vitamin store which contain all manner of exotic herbs and compounds -- Many of which are a precursor the stuff now locked behind authority-authorized-only prescription pricey paywalls.

Orac, you have been duely long-running and long-penned on the 'sillyness' of homeopathy but, should I ever find out a need for one of those compounds, I won't be giggling.

In my personal opinion, homeopathic medicine can cause people to stop pumping their bodies with the chemicals in normal medicine. So, maybe homeopathic medicine isn’t a completely bad thing?

I don't see how that follows. My wife is a Type I diabetic. for example--it would be anything but a good thing if she stopped 'pumping her body' with insulin regularly. My three year old has a seizure disorder--it would be anything but a good thing if we stopped 'pumping her body' with levetiracetam twice a day.

A relative of mine spends so much time keeping up with her vibrations, auras, homepeopathic profile, etc. that it has paralyzed her emotionally and socially. It's evident to others, but not to her. Just another danger of homeopathy.

My suggestion to the FDA was to require an insert in every homeopathy package that explains in detail every aspect of homeopathy, similar to a vaccine or other insert. A few words on the bottle is not enough.

I think I must be homeophobic

By TRIALNERROR (not verified) on 22 Apr 2015 #permalink

As a med-sci lay-guy, I wonder...

• Are homeopathic remedies too diluted to be testable? That is, if I send a potion to a chemist unlabeled, will an analysis of its contents verify that it contains what the homeopath claims is the 'active' ingredient?

• Am I correct in taking homeopathy to differ from some other Alt-Med 'modalities' in that it doesn't ever aver 'well, it won't work if it don't believe in it'? That is, it sounds like the model of 'like curses like' in this case is just supposed to work at some fundamental level of physiology; and according to homeopathic theory a remedy should do it's thing sans any placebo effect. Thus, like fluoridated water, if a person ingested a homeopathic solution with no knowledge they were doing ANYTHING, it should 'work', yes? Can I assume this has been tested and found false? Not 'homepathy vs. placebo', but 'secret homeopathy'?

• Following from the above... re:: "Do you really want your water to remember where it’s been?” Joking aside (yes, all but impossible I'm sure). It's not supposed to be a question of 'want', yes?, but rather tan assertion that water just DOES, am I right? So, on what basis would a homeopath assert that the water 'remembers' the vibration of the now-diluted homeopathic stuff, but NOT the vibrations of anything else it has been in contact with, which may also have trace elements remaining in any non-distilled water? Why aren't the mineral elements in spring water producing a variety of homepathic effects?

• How long does water remember? Does contamination/contact with other substances post-dilution cause it to 'forget'? If I put a homepathic dilution in orange juice, should it still work? If not, wouldn't I have to take it while fasting for it to get to the site of med problem unaltered?

• If a homeopathic potion sits on the shelf past it's expiration date; if the water 'forgets' the vibrations after the passing of time, shouldn't it then have 'a vibration of forgetting' that would make it effective in treating Alzheimer's? :-)

sadmar #26, that is some brilliant and concise deduction. Considering you just destroyed the 'placebo effect' for millions, may one transcribe your analysis into untraceable assasin-water?

@sadmar

1. Depends on the dilution. "homeopathic" cold-eze is barely diluted so has 13.3 mg of zinc in the lozenge according to the label. But for a lot of the "most powerful" that is the very most dilute dilutions you are talking that statistically there is no chance there is even one molecule of the active ingredient left in the dose by many orders of magnitude. Homeopathy was developed before we knew how many molecules of a something there would be in the undiluted mixture. So they didn't really know when they invented it where you would go from 1 molecule to no molecules.

About all we get out of homeopaths when asked how you tell them apart is you look at the label or you use a dowsing rod.

2. Well the claim it works on animals, so I don't know if that answers the question (although placebos work on animals, based on the owners subjective assessment, that don't know what you gave them so have no beliefs other than pills always should be spit out if you can). I'm not sure if we have done like they do with some lactose intolerance experiments where they put it in the meal but don't tell you that it is there.

3. I think the shaking violently is supposed to reset the memory or something like that.

4. Um, as long as the label stays on the bottle??

OK, looked up from one of the popular homoepathic kid stuff remedy sites

"Homeopathic medicines are good indefinitely as they are very stable when stored under normal conditions (away from moisture and excessive heat or cold). For this reason, in the US the FDA has exempted homeopathic manufacturers from putting expiration dates on the label."

5. Apparently once you write homeopathic on the label it never forgets.

By Kay Marie (not verified) on 22 Apr 2015 #permalink

I suppose the serial dilutions could be so it only remembers the last, strongest thing; forgetting all past joys and woes in the washing thereof.

Mikaela Nicola: "In my personal opinion, homeopathic medicine can cause people to stop pumping their bodies with the chemicals in normal medicine."

Yesterday I had surgery on my wrist due to a Colles fracture, I fell on a tiled bathroom floor. Do tell me how much better homeopathy would work better than the nerve blocker and anesthesia to keep me still while titanium plates were installed to get the arm bones correctly aligned with the wrist joints.

(note: from noon yesterday until I woke up this morning my left forearm was a numb paralyzed pendulum hanging from my elbow... more than once I got smacked in the face with it)

Would it stand to reason (well, homeopathic "reason") that if one were to mix a batch of Kool-Aid with a single drink crystal and a single sugar crystal, you'd have the most sickly sweet glass of Kool-Aid ever?

Belle Gibson, y'all.

@#10

In my personal experience, quackery and pseudoscience (to include homeopathy) can cause people to delay seeking real treatment.

A little story. I was 40 when my first and only child was born. Before that, we'd lost 3 babies, and spent untold $$$ on ART. There is nothing wrong with him, there is nothing wrong with me -- oh wait -- I was old. Old eggs.

Alternative practitioner said to me, age 39, don't do ART! Instead, do my treatment, and here's why....and she was very compelling.

Imagine if I'd listened, instead of pursuing real evidence-based methods. Pretty sure that my child wouldn't otherwise exist, and both timing and the passage of time are sometimes every single thing.

@10 Hmmm....decisions, decisions. Nope, I think I'll stay with my chemical laden inhalers for COPD and Asthma, rather than the bottle of water CVS sells as "homeopathic asthma relief." I'm trying to put off going to the hospital; have no desire to hurry it up.

BTW, you are aware, aren't you, that water is made of chemicals?

My favorite remedy- works every time
"Eye of newt, and toe of frog,
Wool of bat, and tongue of dog,
Adder's fork, and blind-worm's sting,
Lizard's leg, and howlet's wing,--
For a charm of powerful trouble,
Like a hell-broth boil and bubble."

If water has memory, shouldn't it remember the first multi-cellular organism? Mass extinctions? The bladder of the first true human? So much information, right at our fingertips. Dare I suggest waterboarding??

Might all water be inherently traumatized by the memory of it's ride on the asteroids that brought it crashing to Earth?

Denice Walter #15 wrote:

Homeopathy doesn’t REALLY involve the memory of water but its tenets are based upon how the faculty of human memory operates.

I think you've nailed it (at least in part) on why homeopathy seems plausible to the people who do know what it means. They're making analogies to the way the mind works and blurring distinctions between the subjective and objective 'worlds.'

It's the same perspective taken with spirituality and religions. There's something about homeopathy which feels familiar and intuitive and so it doesn't matter if the science isn't there. As above, so below. Everything is connected by similarities which are discovered mentally. I like your examples.

"Oh, the science is totally there. I've seen the studies. But if it's not, it doesn't matter." Two opposing ideas, held at the same time. And like all mystical knowledge, personal and private confirmations -- aha! -- are the gold standard.

This very afternoon I was once again gently reminded that homeopathy "works if you believe it will." That's apparently supposed to squash all my skepticism. Proponents who use this explanation by Magic Placebo though have little understanding of what they're really giving up. They think they're not only endorsing homeopathy and alternative medicine, but New Thought and the power of Mind over Matter. But they're throwing out both an honest search for truth and the capacity to recognize lies.

What is the status of fraud in a world where "things become true when you believe they're true?" Adopt this philosophy and you become a sitting duck for any con artist or good-intentioned nitwit with something to sell. You also become incapable -- or rather OUGHT to become incapable -- of ever accusing the Big Evil Pharmaceutical Companies of any crime at all. The only problem with a lie is a failure to believe it.

@ Sastra:

Sometimes I think that myths and the rules of magic exist in the particular forms we recognise because of how memory and perception work. Items are grouped by category; certain combinations are easier to learn; some unfinished stimuli edge us towards their closure; superficial diversity may hint at and then reveal an underlying identity - a prototype.

Oh there's so much more.
Woo-merchants rely upon the rules of how cognition works - despite often being rather impoverished examples of human cognition themselves- to set up their marks.

By Denice Walter (not verified) on 22 Apr 2015 #permalink

In my email news feed:
"The Whole Pantry author Belle Gibson admits she lied about having terminal cancer" http://tinyurl.com/mlbfohx

To stay with the current thread, I'll wonder if NSA homeopaths can dilute Ms. Gibson's sweat to produce fail-safe truth serum for use on suspects in the 'War on Terror'.

If water has memory, shouldn’t it remember the first multi-cellular organism? Mass extinctions? The bladder of the first true human?

"Don't put that in your mouth, you don't know where it's been. Although I suppose you could ask it."

3. I think the shaking violently is supposed to reset the memory or something like that.

That would undo the previous succussions. As Dullman would be more than happy to advise you, the carrier is reset by Double Secret Distillation.

You might wish to review this analysis by Claudia De Rosa.

"By using the same container the final remedy contains the energy pattern of all the potencies up to and including the final potency, allowing the patient’s body to use the most effective potency for the condition."

The Korsakovian approach here is less "scientific," but it's MOAR Quantum.

Hmmm... Going to try the Korsakovian method with my favorite wine.

As above, so below. Everything is connected by similarities which are discovered mentally.

I could tell a story about "as above, so below," which involves this and this. It would make me sound crazy, though. It also involved the ingestion of some pomegranate seeds, which, looking back on things, was probably a bad idea.

My favorite remedy- works every time

Saying something stupid because you're desperate for attention?

My second link above seems not to work. I suppose we could try this.

It also involved the ingestion of some pomegranate seeds, which, looking back on things, was probably a bad idea.

If you don't have more than six it seems to be OK.

By herr doktor bimler (not verified) on 22 Apr 2015 #permalink

Do you really want

do you really want your water to remember where it’s been?”

per Tim Minchin's Storm

'It's a miracle! Take physics and bin it!
Water has memory! And while it's memory of a long lost drop of onion juice seems Infinite
It somehow forgets all the poo it's had in it! '

I didn't listen to the podcast, but I did scroll through the 52 pages (at the time; it's possible there's more now) of people writing in to the FDA about homeopathy.

A huge chunk of the entries were of tthe "Get your government hands off my homeopathy!" ilk. There were large numbers of anecdotes from people that seem to think that constitutes evidence. I would just like to say in an aside that the average post was deeply scientifically illiterate, and the people claiming to have credentials were barely coherent and may well have been completely baldfacing it.

My favorites were the conspiracy nuts, and one person who just called the FDA Satanists. That was fun "You're just Pharma Shills!" was the most common trope.

I think that perhaps 1 in 10 or 20 posts as described abover were sensible, straight-forward, science-based arguments in favor of regulation. Those people tended to be very methodical in laying out facts (which the rest definitely lacked) and a compelling argument.

I guess I can only hope that the regulators at the FDA recognize that popularity does not make a thing right, and that those in favor of regulation have actual facts and not anecdotes on their side.

Or, yannow, I can hope for Moon Colony Gingrich to open in a year or two.

Re. Denise @ 43, and re. 'Saturn light':

The 'Saturn light' episode is a textbook case of 'shared trance,' also known as 'contact high.' The participants talked themselves into an altered state together. People talk each other into altered states all the time, from 'falling' in love to having angry arguments to engaging in role-playing games, religious rituals, etc. Children with decent imaginations can play 'let's pretend' all day, and to them it's real.

So, Denise, you're spot-on about this: it's psychologically lawful. That is to say, it 'makes sense' to us in a similar manner to the way that fictional story plots 'make sense.' And, a moment of critical thinking can 'break the spell' and bring the reader back to where s/he is, sitting in an ordinary chair in an ordinary house, reading printed words on a page.

For purposes of entertainment, creative expression, self-exploration, and spirituality, it's for the most part harmless, plus or minus obvious counter-examples such as mind-control cults. Some of it is useful in psychotherapy. Some of it is even useful for working scientists, to let their minds engage in a bit of free play that may lead to a testable hypothesis.

The harm comes when it's concretised, that is, taken as The Literal Truth that should therefore have direct physical effects. This is what homeopathy is about: the belief that a magic ritual is more than a mental exercise, but something that has physical effects and can be counted on to work. To paraphrase Sir Arthur Clarke, the word for magic that always works is 'technology.' And if homeopathy had anything to it, the word for that would be 'medicine.'

---

Lsm @ 28: "...require an insert in every homeopathy package that explains in detail every aspect of homeopathy..." That's just super! Yes, do it!

Per what Orac said, 'So I tell them (what homeopathy actually is)...' and when they hear it, '...not infrequently their jaws drop, and they respond, “Really? You’re kidding. That can’t be. That’s ridiculous!”'

If people get package inserts explaining 'what it is,' and bother to read them (some will), their jaws will drop too. Some of them will go to the chemist's and say 'I wasted my money!, why are you carrying this crap at all?' Slowly but surely, the harmlessly harmful little bottles of worthless water and pointless pills will begin to disappear from the shelves. Like magic!

do you really want your water to remember where it’s been?

True, if homeopathy worked, water purification would be impossible.
Anyway, how about homeopathic remedies for germs and parasites? They get sick too and need their ailments treated somehow.

In my personal opinion, homeopathic medicine can cause people to stop pumping their bodies with the chemicals in normal medicine. So, maybe homeopathic medicine isn’t a completely bad thing?

Sure, sometimes people would quit taking medications they don't really need, and substitute something homeopathic instead.
The problem is the deception involved - because someone who does that might also quit taking a medication they do really need, and substitute it with a homeopathic remedy.
If there were full disclosure that the homeopathic med can't have a physiological effect beyond the water or sugar in it, and other than that, any effect is from one's mind - then perhaps it would be ethical to sell.
I've heard placebos can work even if one knows it's a placebo.
But, there are also people who think their minds (or a supernatural power) can heal any disease. Such people essentially think the placebo effect can do anything.
So is it ethical to sell a placebo to someone who does believe it has magical powers? If the seller knows the placebo doesn't have magical powers - not ethical.
If both the seller and buyer think it's a magical cure - similar to buying & selling holy water - then it would be ethical. They would just be practicing their shared religion.

Slowly but surely, the harmlessly harmful little bottles of worthless water and pointless pills will begin to disappear from the shelves. Like magic!

But as there's less and less of it on the shelves the pull towards it will just grow stronger.

By capnkrunch (not verified) on 25 Apr 2015 #permalink

Is this supposed to mean she knows anything about homeopathy? What a joke - ask an expert on the subject, not a pharmacology professor. Ties to the pharmaceutical lobby, anyone?

“The evidence for homeopathy’s effectiveness is between scant and nil,” said Adriane Fugh-Berman, a pharmacology professor at Georgetown University Medical Center at the meeting.

By Nancy Herman (not verified) on 25 Apr 2015 #permalink

I wouldn't expect too much from CBS. The president of its news division is David Rhodes who was trained by Roger Ailes at Fox News. He rose from production assistant to VP of News at Fox before CBS hired him to spread Murdoch-style pseudo journalism to the once venerable CBS.

By Theodora30 (not verified) on 25 Apr 2015 #permalink

Nancy Herman #60 said:

"Is this supposed to mean she knows anything about homeopathy? What a joke – ask an expert on the subject, not a pharmacology professor. Ties to the pharmaceutical lobby, anyone?"

No arguments other than ad homs and unevidenced conspiracy theories, Nancy?

By Alan Henness (not verified) on 27 Apr 2015 #permalink

#61 Theodora30:

"I wouldn’t expect too much from CBS. The president of its news division is David Rhodes who was trained by Roger Ailes at Fox News. He rose from production assistant to VP of News at Fox before CBS hired him to spread Murdoch-style pseudo journalism to the once venerable CBS."

So: The Law of Contact or Contagion.

271994121

By NoPanShabuShabu (not verified) on 28 Apr 2015 #permalink

Congrats to NoPanShabuShabu for being our first university assignment visitor to actually make an amusing comment.

By justthestats (not verified) on 28 Apr 2015 #permalink

Here's what I don't get. Homeopathy has never been found to have harmed anyone. Not true of Big Pharma's products. To those of you who believe homeopathy is bunk: stay away from it; don't waste your $$ on it; keep taking the stuff with lists of untoward side effects; leave the rest of us alone. I have used homeopathic remedies for myself with much success. Arnica Montana for trauma; Nux Vomica for constipation; Hyper Perf for nerve pain and on and on. Placebo effect you say? I also have used homeopathic remedies on my pets--Nux Vomica for a constipated cat or dog works within a hour or so; remedies to treat cat wounds and issues such as acne and abscesses--where's the placebo effect there? I repeat: You think homeopathic remedies are bunk? Don't use them. If you want to address toxic stuff that actually does little good but much harm, talk to Monsanto about Roundup and Big Pharma about, well, just about everything they produce.

By Anne Kass (not verified) on 28 Apr 2015 #permalink