Diluting a Disease?. . .Or Deluding Yourself?

My clinical counterpart, surgical oncologist Dr David Gorski, has an excellent post up today at Science-Based Medicine on the irresponsible and misleading information being provided at The Huffington Post during the current H5N1/2009 influenza ("swine flu") outbreak. "The Huffington Post's War on Medical Science: A Brief History" provides a cautionary tale for us in embracing web-based news sources as our excellent print newspapers are going by the wayside.

Within the post, Dr Gorski shows that he is even more familiar with my writing than myself by citing a post at the old Terra Sig on the last time the press proposed the use of homeopathy to combat the then-avian flu outbreak.

I am extremely concerned that a similarly misleading stories put forth by HuffPo's "health and wellness" experts who lack any credentials in science-based medicine and are either authors of books on enemas or practitioners of the repeatedly-disproven practice of homeopathy. Among these stories and blog posts propose treating H1N1/2009 influenza with massage therapy, colon cleansing, liver cleansing, and detoxification.

Dr Gorski deals with these cases in a systematic manner but I specifically take issue with any "detoxification" protocol. I have yet to have an alternative practitioner tell me when challenged what exactly are the toxins for which we are being detoxified? Chemical structures? IUPAC names?

In my original field of drug metabolism and toxicology, detoxification referred to the oxidation, reduction, or conjugation of hydrophobic or chemically-reactive metabolites by enzymes in the liver, kidney, and elsewhere. I have never been given a satisfactory explanation of what "detoxification protocols" do for our bodies than what our intrinsic physiology of the liver and kidney already do for us.

Off soap box.

In any case, I thought I would unearth the post of mine to which Dr Gorski describes, when an article in Ode Magazine suggested that homeopathy might be used to treat avian flu. It's fun to read the old stuff but I am also reminded that we keep revisiting the dangerous side of pseudoscience with this irresponsible journalism.

Dear Editors of Print Magazines to which I subscribe,

I really, really appreciate your coverage of liberal issues that speak to the core of my being and the values I am trying to instill in my young daughter: equality and tolerance, the fight against racism and poverty, the mysteries of love and the power of music and the written word.

However, when writing about science and medicine, I implore you to be more responsible. Equip your staff and interns with some training in how to evaluate medical topics, alternative medical approaches, and evidence-based medicine, with emphasis on the word "evidence." I am open to considering anything new that challenges existing dogma, but I won't risk my health without some evidence.

With love and admiration otherwise,
Abel Pharmboy

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Regular readers may recall my objection a few weeks ago to Ode Magazine's article on the potential of homeopathic remedies to combat the human H5N1 form of avian flu, citing cure rates from the homeopathic literature following the horrific 1918 influenza epidemic.

While fighting off a migraine from reviewing research grant applications, I ventured out on this snowy/rainy Saturday to our snail-mailbox and was happy to see my usual issues of Mother Jones and Utne that invariably arrive on the same day. As a white-collar professional removed only one generation from the Northeastern, blue-collar factory culture, I still resonate with the fight against worker exploitation and the real-life Mother Jones' fight for rights among unionized labor, especially coal miners in the East and in Colorado ("Pray for the dead, and fight like hell for the living."). Ah, Utne has a nice article on Billy Bragg and his "songs of passionate anger at injustice." Cool.

But on the cover of this March/April issue of Utne is an article on how homeopathy could stop the avian flu. Okay, okay, I'm willing to forgive Utne for republishing the article from Ode - after all, much of Utne is derived from the culling the best of the alternative media and the Ode homeopathy article was quite widely-publicized and demonized, both in the blogosphere and in their own 'Letters to the Editor" section.

But, no, the Utne article is an original: "Diluting a Disease: Could Homeopathy Stop the Avian Flu?" This brand-new article, covering much of the same ground as the earlier Ode article, is authored by Morgon Mae Schultz, an Utne intern who, best as I can tell from Google, had been a journalism student at the University of Minnesota and editor of their student publication, The Wake.

Given the admirable stature of Minnesota higher education and my personal respect for Prof PZ Myers (although he is at the far western campus of Morris and can't be held responsible for what happens in the Twin Cities), I was sure that Schultz would be rigorous and fact-based in cautioning Utne readers about relying on homeopathy for much of anything. In fact, even herbal medicine trade groups have declared quite wisely and responsibly that no dietary supplement company should even claim remotely that their products would be useful in an avian flu pandemic.

Unfortunately, the aspiring U of M journalist fell prey to the same claims of 1920s homeopathic literature claiming a 99% survival rate among 1918 flu-stricken patients, as opposed to 70% for conventional medical care. Schultz even interviews a homeopath and describes the ritual of dilution and succussion (vigorous shaking) to produce a "remedy." "No one knows exactly why this works, but homeopaths posit that water retains the energy of the substance and delivers a message to the body."

Yes, and that message is to keep both hands on your wallet.

But what struck me was the journalist's assumption that "this works" while also blowing off the mystery of the mechanism. Moreover, the article claims that "homeopaths...already have the ability to study the disease in patients without worrying about which strain of the virus is the culprit...Best of all, homeopathy is about strengthening the body instead of targeting the bug, so patients don't become unwitting vessels for a mutated virus."

Well, call off the CDC - no more worries about tracking and genotyping Asian flu viruses each year to know what strains to use in vaccine generation. As for strengthening the body, one needn't worry about getting proper balanced nutrition, plenty of sleep, and exercising general handwashing hygiene during the flu season. One needs to just rely on a homeopathic remedy.

But nowhere in the article is mention of what specific homeopathic remedies would be used against avian flu. Why wouldn't one make a 30C dilution of the H5N1 bug if that were how homeopathy really worked?

In fact, why not just drink regular tap water as your homeopathic remedy??? Think about it: the molecules of water we drink today could have been the urine of Alexander the Great or the industrial effluent of Monsanto. Today's water has had diluted in it over thousands and millions of years almost every infectious organism, toxic metal or organic substance (natural or synthetic). Hence, it should be a remedy for every illness created by every solute ever dissolved amongst its molecules.

Let's say that I am willing to admit that homeopathy might work, albeit through some unknown physical mechanism that I cannot explain. What would follow is that drinking tap water should have every potential remedy in it that I could ever want, to cure everything from multiple chemical sensitivities and mercury-induced autism all the way to the diseases I might incur from eating anything from gold mine tailings to my own feces.

Oh, I forgot..drinking tap water would not create revenue for homeopathic practitioners.

As so eloquently stated by the late Gilda Radner's character, Roseanne Roseannadanna, "Never mind."