I think it was Martin Gardner who commented that taking homeopathic “medicine” was like throwing your car keys in a river, going downstream thirty miles, scooping up a cup of water from the river, and trying to start your car with it.
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That said, not all OTC stuff labeled “Homeopathic” follows the “water memory” and dilution methods of classic Homeopathy.
I can think of two.
1. Zinc lozenges that people take to make colds feel better unquestionably contain significant amounts of zinc, the active ingredient. They are labeled “homeopathic” anyway.
2. There are little teething tablets that we give our toddler sometimes to numb her mouth a bit. The ingredients include all manner of stuff, and it unquestionably has measured amounts of active ingredients, yet also says “homeopathic” on the label.
Among the more non-scientific believers there’s a differentiation between “allopathic” medicine (MDs) and “homeopathic” medicine. Along with the myriad “naturopathic”, “nutripathic”, and all the other “-pathic” pseudo-sciences.
I suspect “homeopathic” is often used simply as an advertising catch-word, to attract the “alternative medicine” idiots, who also have money.
I think it was Martin Gardner who commented that taking homeopathic â€œmedicineâ€ was like throwing your car keys in a river, going downstream thirty miles, scooping up a cup of water from the river, and trying to start your car with it.
Good analogy at first glance, but what if the water shorted the right contacts on the switch? Improbable, but not improbable enough to make the required point cleanly, IMHO.
How about throwing your CPU in the river, going downstream 30 miles, scooping up a cup of water, pouring it into your computer and trying to boot it up? or your TV remote and changing channel? Little chance of short circuits recreating the required effects there Something non-electrical would be even better, given the requirement of water…
I suspect â€œhomeopathicâ€ is often used simply as an advertising catch-word
Actually, I’d hypothesize that most people simply think of ‘homeopathic’ as meaning ‘herbal’ or ‘natural’, and that advertisers use it accordingly. Marketers like to use ‘consumer language’, so if consumers think ‘homeopathic’ means ‘herbal’ then that’s how they’ll use it.
They do a similar thing with ‘chemical’: people don’t like ‘chemical’ additives, for instance. In this context, people know what they mean by ‘chemical’, and they wouldn’t be interested in hearing that water (say) is a chemical. If a food is labelled ‘no chemical additives’ then they know what to expect (even if a chemist would wisecrack about how ‘it must just be an empty pot then, ha ha’).
“Randy’s cynicism is a pleasant way of avoiding the truth.” Randi’s argument is very weak because it relies on a straw-man argument: no scientifically literate homeopath will argue that the preparations have a chemical effect. For believers in homeopathy there must be some non-chemical mechanism involved, that doesn’t depend on the dilution/succussion per se but on some phenomenon that happens during the process.
The reason that Randi can swallow a whole package-full of pills is that the pill acts as a stimulus which has to be distributed over time – taking 80 pills at once is like taking 1 pill once, and totally different from taking 1 pill 80 times over time. Moreover, the pills have no effect on him because they are not matched to the symptoms (this is a big problem with OTC preparations which are not professionally prescribed; these are shunned by most homeopaths and are marketed largely in wilfull ignorance of homeopathic prescribing principles – so Randi’s concern with homeopathic OTC is justified, unlike his wholesale rejection of homeopathy.
Incidentally, Randi betrays his no-deeper-than-textbook knowledge of homeopathy by twice mispronouncing “succussion” as “succession”, suggesting that he has never actually heard the word uttered from a homeopath’s mouth. While on the same topic, his description of the shaking process (up-down, sideways, forward-back) is fictive and is used for purposes of mockery only.
The homeopathic preparations are based on lactose, not lactic acid, which is milk sugar which tastes sweet and not disagreeable the way he described it (again, he must have done it to gain rhetorical points).
I have personally correponded with Randi and his knowledge of philosophy of science is basic – or, at least, he avoided all discussion about the criteria he uses for determining whether something is scientific or not.
Homeopathy stretches the bounds of what constitutes science, and cannot fit within the existing paradigm, a simplified version of which Randi is defending. The question is whether we should automatically reject homeopathy on these grounds, or consider the possibility that homeopathy (not popularized, commercial aspects of it, but high-level, professional practice) constitutes a welcome challenge to the paradigm. Randi has no reasons to do so; but many people sick with supposedly incurable diseases think otherwise. In any case, Randi has built his reputation based on solid theater rather than solid science.
The “existing paradigm” of science is rationality, reason, and skepticism. Randi is reflecting those qualities, not science, so his lack of scientific pedigree is a straw-man of your own.
Homeopathy, the real thing, completely ignores science, that is, it flies in the face of reason, rationality, and skepticism. Randi was only pointing that out.
Until homeopathy can survive *real* scientific scrutiny, that is, survive double-blind trials that are completely reproducible and replicated on a wide scale, it’s not only “outside the paradigm of science”, it’s also bullshit.
You are speaking as though you have researched the literature and found no evidence for homeopathy. As a matter of fact, in peer-reviewed journals alone there are well over 100 studies of homeopathy with more than half of them showing positive results.
Your call for these studies to be “completely reproducible and replicated on a wide scale” is a fair demand in an ideal world but it ignores the reality that:
(a) studies are rarely
“exactly replicated” – it is much more difficult to obtain funding for exact replications than for variations on previous studies that may reveal something new; given the almost total lack of institutional funding for homeopathy this is a relevant constraint.
(b) “Widely reproduced” studies cost many millions and I don’t need to elaborate on the fact that such funding is unavailable.
(c) Small, very well-designed studies such as have been done in homeopathy, including several published in The Lancet and British Medical Journal, can offer scientifically very powerful evidence; larger-scale studies are often performed in order to increase the clinical relevance of the study to a wider population and to present evidence to non-scientists (such as politicians and regulatory bodies) who are easily impressed by the “size” of the evidence, and not necessarily to strengthen the statistical certainty of the result.
(c) The experience of homeopathic researchers thus far has been that even the best studies get dismissed on rationalist grounds, i.e. by the argument that “extraordinary claims requires extraordinary proof”; needless to say it is the skeptic who gets to determine what “extraordinary” means in each case, and the target remains ever-elusive not because of lack of positive evidence but because it is moved farther after every new positive study is published. The limited resources available to the homeopathic community are thus better allocated to education and other means of improving the profession.
(d) Randomized controlled studies arose from the need for proof-on-paper that interventions carrying a risk of side effects worked: there are legal and social reasons for the demand for these trials that have little to do with science. It is not clear whether non-dangerous treatments need to undergo this sort of scrutiny rather than other approaches to establishing clinical efficacy.
(e) The whole Evidence Based Medicine enterprise has never ever subjected itself to testing: it remains a claim and assumption that randomized controlled studies lead to improved clinical results. I have written a large academic research paper on this topic – you may contact me through my site and I will gladly send a copy of it.
Rhetorical appeals to “reason, rationality, and skepticism” are primitive: one has to specify what each of these terms means – and that is where the whole debate resides. This fact is wholly unsatisying to the one who wishes to feel certain about his knowledge. But science demands this sort of tentativeness from all parties in the debate.
Dave/Homeopathy Zone says:
Homeopathy stretches the bounds of what constitutes science, and cannot fit within the existing paradigm, a simplified version of which Randi is defending.
There must be a duck in the comments with all this quacking.
Yours is truly a substantive contribution to the discussion!
To the genuinely interested:
What I am saying is that rejecting homeopathy on the basis of the current paradigm (and doing so in a simplistic way, in Randi’s case, i.e. by caricaturing homeopathy and attacking the caricature instead of the real thing), avoids the critique of the current paradigm, which is wideranging and arises from multiple disciplines in conventional scientific circles. This is why I called it “very weak”.
OK, David: four questions.
Firstly, what is the ‘real thing’? Where exactly does Randi’s description of homeopathy fail to dovetail with the facts? Of course his analysis is peppered with dismisdsive mockery, but as far as I can see it is deserved if his statement as to the facts of what homeopathy is are true. If you can show that he is simply wrong – that, say, homeopathy is not based on proving, that homeopathic remedies are not diluted to the extent he describes etc etc – then please do so.
Secondly, what exactly is ‘the critique of the current paradigm’? (I assume that by ‘current paradigm’ you mean things like current understanding of biology, molecular chemistry, and so on since that is the foundation for easy dismissal of homeopathy.) (PS – If you’re going to use the word ‘quantum’ here then make damn sure your thesis really explains time-tested, much-proven chemical effects as well as the hoped-for things such as water memory – also why every drom of water is not already a vehicle for a thousand homeopathic goods&ills!)
Thirdly, you claim that ‘It is not clear whether non-dangerous treatments need to undergo this sort of scrutiny rather than other approaches to establishing clinical efficacy.’ I would point out that even if it is not ‘necessary’ (whatever that means), any treatment which actually works should show results using such methods (that is, randomized double-blind placebo-controlled clinical trials). Why has this not been the case with homeopathy?
Finally, what grounds do you have for claiming homeopathy is so short on funds as to be unable to afford decent research? Homeopathic concoctions are ridiculously cheap to produce and often sell for as much as or more than their EBM counterparts, and surely the potential returns on a proven homeopathic remedy would be at least comparable to those on, say, a generic painkiller (and thus pretty fricking big). OK, it might not be patentable since these treatments are already known – but the flipside of that is no R&D costs. And the alt med industry is not exactly small: your talk of the ‘homeopathic community’ suggests a few earnest herbalists pottering around in garden sheds, but in truth expenditures on CAM are estimated at roughly GBP 200,000,000 per year in Britain alone (don’t know how much of that is hom rem specifically, but a significant amount I’d bet).
Please, give substantive answers if you answer at all – your post above is sophisticated whiffle, frankly.
David: Billerica’s contribution was perfectly valid, it was highlighting the lack of meat to your point in post 5. I’d have gone for post 7 myself, but maybe Billerica doesn’t like shooting fish in a barrel?
Long story short: Enough lame excuses, there needs to be evidence (not even proof, yet, just something other than anecdotes and waffle will be sufficient). Either that or you should wear the charlatan label with good grace while you’re laughing your way to the bank.
1) Randi is stating the simplistic facts about homeopathy – the ones found in introductory descriptions. The “real thing” is a sophisticated clinical approach that relies on reams of reference data, many fine details concerning interpretation of symptoms and progress of illness or cure, and on and on – not something that can be understood on cursory inspection.
- Homeopathy relies on provings combined with verification and expansion from clinical data, not just on raw provings. In order to understand what a proving is one has to at least read a single proving and learn the details of the process (if not participate in one), but of course one who rejects the possibility of homeopathic remedies having an effect will reject the possibility of a proving having an effect – but don’t try to make what is one strike against homeopathy into two strikes.
- Homeopathic remedies are indeed highly “diluted” but, again, no one is claiming that the effect is chemical or that this fact is not an anomaly vis-a-vis current accepted theories, so Randi is saying no more that than current theory does not support homeopathic dilutions (science does not say that this is impossible, and this distinction is important; a recent paper claiming that water/alcohol solutions show stable non-random molecular arrangement is:
Dixit et al., “Molecular segregation observed in a concentrated alcohol-water solution” Nature 416 (25), April 2002, pp. 829-832.
2) The critique of the current paradigm is anything starting from critiques of logical positivism, to Thomas Kuhn to David Hull to the of Rupert Sheldrake (which deserve attention rather than villification they have received) in philosophy, epigenetics and developmental systems theory in biology (with their associated critique of strictly genetic heredity and its philosophical basis) in biology, and more, to the critique of Evidence Based Medicine and the supremacy of Randomized Controlled Trials, and more. (I’ll mention again that I’ve written on this last topic and could supply the paper to those interested if contacted.) Many of the topics touched in these critiques have a bearing on the likelihood of homeopathy being anything real; under the current paradigm I totally agree that homeopathy cannot but be considered quackery, but there are multiple reasons to consider the current paradigm incorrect on many counts.
3) There are over 100 placebo controlled studies of homeopathy in the peer-reviewed literature (the majority appearing in conventional scientific journals including The Lancet and British Medical Journal which are top authorities, at least when it comes to non-homeopathic medical research), most
of them showing a statistically significant positive effect using standard research methods. One of the most rigorous of those is:
Reilly et al., “Is evidence for homoeopathy reproducible?” The Lancet 344 (1994) pp. 1601-06 and accompanying editorial on p. 1585.
- A note: one must remember when inspecting such evidence not to expect both statistical and clinical significance – ofte studies are optimized for the former (to show convincingly that there is some effect) rather than to prove usefulness clinically (which is a research question to be addressed separately once basic efficacy is agreed upon).
- Here’s a detailed, albeit biased, review of research articles with numerous references, among them likely ones relevant to your query:
- The current state of the evidence is such that it is sufficient to say that there is an anomaly in need of further research (though of course not enough to claim that homeopathy rests on a conventional scientific basis). Those who reject this claim will not, I believe, be swayed by any amount of further evidence.
4) I am a classical homeopath and the specific prescribing required by the system means that I have to spend considerable time with each patient. I certainly do not laugh my way to the bank in comparison to alternative practitioners who dispense loads of supplements at each visit (and you shouldn’t presume that my defense of homeopathy implies a defense-at-large of alternative medicine). Single homeopathic preparations such as used by classical homeopaths are bought for under $5 and each last for several weeks or months (until the remedy or potency are changes). The stuff you see on the shelves for treatment of various illnesses contains mixtures of remedies aimed, using a “shot-gun” approach, to treat symptoms. While these have some effect it is very sporadic as to be expected from the lack of individualization (yet some of them show at least statistically significant clinical effects, such as studies on a substance called “Oscillococcinum” (these studies can be looked up via Medline)). Unfortunately such preparations are marketed as homeopathy (as are completely non-homeopathic preparations, because this word sells) because homeopathic remedies are used in the preparation. It is only these companies that make money in the homeopathic field broadly speaking. As far as I am concerned these preparations are overpriced, mostly ineffective, and should be regulated somehow. But this issue doesn’t impinge on the question of whether homeopathy is effective in principle (i.e. when dispensed in an individualized fashion by a proficient homeopath), just as issues of poor medical care, doctors caring only about profit and not patient welfare, systemic corruption in the pharmaceutical industry and its influence on medical research, etc. shouldn’t impinge on the question of the effectiveness of good medical care. And this really is the final point about Randi’s “critique”: that he deliberatly departs from the principle of charity, according to which one picks the best representation of the object of criticism not the worst of it.
David, thanks for your thoughtful response. I cannot say I am overly swayed by your more fundamental points – that is, that homeopathy shows significant and demonstable effects beyond placebo and that the effects of homeopathy are physical but not chemical. Perhaps my judgement here will be proven wrong, but I’ll not hold my breath on that one.
However, I will concede your point about who is actually making the CAM money (I’ve a good friend who is a homeopath, and his experience bears your claims out) and I also grant that Randi loses some points in his rejection of the principle of charity (a criticism that has occurred to me, though often his targets are undeserving of much in the way of charity!)…
I will look into your research citations further, though commentary on the subject is so partisan that doing so is a bit of a grind. One source I’ve read commenting (briefly) on the Reilly et al allopathy research you cite refers to a subsequent similar study (Lewith GT et al, ‘Use
of ultramolecular potencies of allergen to treat asthmatic people allergic to house
dust mite: double blind randomised controlled clinical trial. BMJ 2002;324:520-3) which failed to find a similar effect… That’s one problem here: every study showing effectiveness can be countered by another showing none…
I don’t think that you and I will reap much in the way of rewards by following this discussion much further, to be honest: it’ll take really incontrovertible findings – knockout research, if you like – to lead me to accept that what you call the ‘current paradigm’ is so very wrong (and in the very way that makes a 200-year-old crank right!). While such a shakeup could yet arrive, it has not landed yet.
I will, however, point you in the direction of a thoughtful discussion of homeopathy that I’ve just been reading; while it is broadly sceptical of homeopathy it is not unsympathetic (certainly not Randiite) and could provide food for thought: http://www.acampbell.ukfsn.org/homeopathy/homeopathy-pdf/homeobook.pdf
I’ve skimmed the book your linked to. The particular stream of homeopaths the author belongs to is a group of MD homeopaths that have enjoyed instututional support in the UK due to the Royal Family’s use of homeopathy. They represent the scientific rationalist pole of the profession, which tries to harmonize homeopathy with the existing scientific understanding. Despite and perhaps because of their foundation in medical training, homeopathically they are often poor prescribers who often use homeopathy as an adjunct to conventional treatment rather than independently (Correct prescribing discounts pathological symptoms in favor of functional and mental-emotional symptoms, and because their work in a hospital setting predisposes them to try to address symptoms, when homeopathy correctly used can only address the general state of the organism and not the symptoms directly.)
I agree with the author that the verdict is undecided vis-a-vis the current scientific paradigm, but I believe part of homeopath’s critique should be of the current paradigm. But the author’s background is in medicine and not philosophy of science (which is my background) so he may not be familiar with or interested in issues concerning the current paradigm.
The current paradigm cannot be challenged with one “knockout experiment”, it is rather an edifice with many legs holding it up, and to understand its overall weakness one has to study each of the different legs in sufficient depth. If you’d like to read a 14,000-word critique I wrote of one of those legs, Evidence Based Medicine (which so many people claim is the wave of the future), please e-mail me and I will supply you with that.
In addition to known issues with the current paradigm, clinically I would argue that my results and those of colleagues are too consistent to be explained as placebo: Why is my placebo so much better than that of the dozen specialists and several alternative practitioners before me? – I am not a particularly charismatic person, am mild-mannered and tentative in my pronouncements, I tell my patients that I cannot promise them anything but will do my best, etc. Why does my placebo fail to work when I give remedy A and B for several months, but then suddenly kicks in when I switch to remedy C? Why do I often see a return of old symptoms during treatment without having told patients about this known homeopathic phenomenon, yet this is not something reported in literature on placebo? Why are there sometimes remarkable congruencies between a remedy description and a case, as though a snippet of the person’s clincial history or biography has been anticipated in print? and so on – there are many aspects of informal clinical evidence that together make it difficult to dismiss the effect as placebo alone, even though of course there is a placebo component to treatment, just like anywhere else. If, however, I were to wear a scientific skeptic’s hat then I would have to temper this conviction, but I doubt I would go as far as this author.
Why does my placebo fail to work when I give remedy A and B for several months, but then suddenly kicks in when I switch to remedy C?
I fail to see why this in particular is not testable.
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