Thursday, November 15, 2007

At the nexus of credulity and stupidity...II

Oh what the hell. Let's talk about homoeopathy for a minute. In the Guardian this week, there's a defence (or defense, if you're so inclined) of homoeopathy. Let's take a look at what Jeanette Winterson has to say about this. And I wonder if there's a logical fallacy of two to find...

In defence of homeopathy | Health and wellbeing | Life and Health
Picture this. I am staying in a remote cottage in Cornwall without a car. I have a temperature of 102, spots on my throat, delirium, and a book to finish writing. My desperate publisher suggests I call Hilary Fairclough, a homeopath who has practices in London and Penzance. She sends round a remedy called Lachesis, made from snake venom. Four hours later I have no symptoms whatsoever.

Hmmm. First of all, that's a single data point. I also do like the fact that the Hilary Fairclough treats the whole person (a common claim among the woo-set) without seeing the patient.
So what is Lechesis?
Lachesis by Weleda, Homeopathic Medicines, UK
Lachesis A homoeopathic medicine for bites and stings - Purple discoloration around the bite. Also for menopause - Hot flushes with headache and dizziness. Flooding periods. Also for pre menstrual tension - Breasts painful. Symptoms worse in the morning.

The above is a useful reference and highlights the common ailments or symptoms that homeopathic remedies are frequently used for, but is not fully comprehensive. In most cases the 6c potency should be used for self help. It is most appropriate for conditions that are mainly physical, for example first aid situations or coughs and colds. 6c remedies are ideal for the family medicine chest. The 30c potency can be used for conditions which affect our health more generally or illnesses which may be partly emotional in nature such as occasional sleeplessness. 30c remedies should be taken as a short 7 day course, unless prescribed by a practitioner. If a condition is at all persistent or could be serious, please consult your doctor or a qualified homeopathic practitioner.

Weleda endorses a very individual approach to healthcare, aiming to treat the whole person rather than just the symptoms of the illness, by stimulating the natural healing process. It's an approach that echoes the thinking of Samuel Hahnemann over 200 years ago when he established the principles of homeopathy.

On a trivial note, Hahnemann made up his principles out of whole cloth before the Germ Theory of disease; he had the brain fart that the body wouldn't allow 2 similar conditions to affect it simultaneously, so like should cure like. And if it's true, that kills about a third of the plot lines on House. Apologies to Hugh Laurie.
Wait, did she have the symptoms associated with Lachesis as a cure?
Dramatic stuff, and enough to convince me that while it might use snake venom, homeopathy is no snake oil designed for gullible hypochrondriacs. Right now, though, a fierce debate is raging between those, like me, who trust homeopathy because it works for them, and those who call it shamanistic claptrap, without clinical proof or any scientific base.

My grandfather got shot a half dozen times in the 1940's (doing what I wonder; it was either in the war or exiting bedroom windows. 50-50 split on that one) and lived to be 90. Not recommending that as a prescription for achieving octogenarian status. Like bullets and my grandfather's age, there's no reason to suspect that homoeopathy is related in any way good or bad to someone's health.
There have been a number of articles in the press recently criticising homeopathic remedies as worthless at best, and potentially lethal at worst, if they are being taken instead of tried-and-tested conventional medicines for conditions such as malaria or HIV.
I have found myself cited, and drawn into this, because I am on record as supporting homeopathic practice in general, and in particular the Maun homeopathy project, a clinic in Botswana set up by Fairclough.

Wait, you're involved in supporting a clinic set up by the "doctor" you were recommended by your desperate publisher? So why did your publisher have to recommend her to you? What order did this happen in?

The organisation Sense About Science and journalists such as Ben
Goldacre and Nick Cohen are targeting a symposium in London in December
that will discuss HIV and Aids and the homeopathic response to such
diseases. Of particular concern is a claim by the British homeopath
Peter Chapel and his Dutch colleague, Harry Van Der Zee, that Chapel
has developed a remedy, PC1, that can be used to treat the HIV virus.
a patron of Fotac (Friends of the Treatment Action Campaign) that has
been fighting President Mbeke's lunatic insistence that HIV sufferers
just need Vitamin C and a good diet, I am dismayed by any claim that
may deter HIV sufferers from taking anti-retroviral drugs (ARVs). And
so is Peter Fisher, an NHS doctor, director of the Faculty of
Homeopaths, and, incidentally, homeopath to the Queen. Good homeopaths
know the value of conventional medicine and do not seek to undermine
that value. Fairclough's clinic, and her talk at the symposium,
concentrate on using homeopathy to support the ARV programme by
alleviating the side-effects of ARVs, and boosting the patient's immune
system so they are better able to fight off the opportunistic viruses
that follow behind HIV, and the drugs necessary to suppress it. There
is no suggestion that homeopathy can replace ARVs.

Key point for woos: never promote CAM for anything that's not self-limiting. Stuff we understand, like cancer or AIDS -- Never. Stuff that gets better on its own, like nausea, jetlag, etc -- knock yourself out. If the shit worked it would be part of conventional medicine.

Edwin Cameron, a justice of South Africa's supreme court of appeal who
is HIV positive, has done much to counter the disastrous Aids
denialists there. He visited Maun and agreed in writing that "there are
patent health benefits". He also admitted that, although initially
sceptical of homeopathy, he had had a persistent mouth and gum disease,
untreatable by antibiotics, but which was cleared by homeopathic

W00t! We have a second data point. No. Sorry. My bad. We have two anecdotes, completely subjective and unconnected or controlled. So what's that prove? Nothing.
I use the word "intervention" because I admit it is hard to talk about
what it is that homeopathy actually does, or why it works. For my part,
I want to know more, not less, but I can't dismiss the thing in the way
that Sense About Science, many doctors, and some journalists are asking
me to.

Look, you can study and look into anything you want. But the literature, not a study but the overall pattern of the literature is clear. There is no mechanism for this stuff, no measurable effect. What is science to do with it?
Stop wasting time.

A recent furore over those homeopaths who offered an undercover
journalist alternative remedies for the prevention of malaria has also
prompted long-term critics of homeopathy to demand its head on a plate.
There will soon be an article in the Lancet calling on doctors to tell
their patients that homeopathic medicines offer no benefit. Until now
the caveat has been no "proven" benefit. But where is the scientific
sense is saying that because we don't understand something, even though
we can discern its effects, we have to ignore it, scorn it, or suppress

Spot the false assumption. We can discern its effects. The better designed the study, the smaller the effect. The best studies show no effect.
It's not a suppression of witchcraft to say it has no benefit.

This homeophobia is, I think, a genuine terror of what homeopathy is
suggesting; which is that we think differently about the relationship
between the cure and the disease. It is not enough to say Disease A is
caused by B and can be cured by C. Homeopathy, in common with other
holistic approaches, asks that we look at the whole picture - the
person, and not just his illness. Specifically, in the case of
homeopathy, the remedy picture, which is carefully drawn up after full
consultation with the patient, follows the "like by like" premise -
that tiny dilutions of the "problem" can prompt the body to effect its
own cure. This is why the homeopathic code of practice does not talk
about the medicines themselves having a simple causal effect - C cures
A. Homeopathy seeks to understand everything we are, everything we do,
as a web of relatedness. The reason why I have a recurring sore throat
will not be the reason why you have one, and what helps me may not help

Umm. The lady who sent you the Lachesis, which is for other symptoms that what you had without meeting you, how was that taking into account the whole person? Are you joking? By the way, how are you going with 'like cures like' and we can't say that A is caused by B and cured by C. If like cures like that C cures A regardless of B. Seriously. Pick one.

This seems to be partly why tests used for conventional medicines
fail when used to test homeopathy. Sceptics will say it is the
medicines that fail, and not the trials, but if the medicines really
are ineffective, why is it that so many people who have tried
homeopathy have found that it makes a difference to their wellbeing?

What does wellbeing mean? How are you defining or measuring it? Why is it that woos always want a total pass when it comes to showing that it works.

I understand it, homeopathy is not a linear medicine - a drug aiming
for a target - nor does it seek to remove the human factor. The patient
and the practitioner are both important and relevant when it comes to
understanding how humans respond to treatment.

Not linear, but like cures like. That's a straight line, isn't it?

That a good doctor
is part of the therapeutic process is commonsense to anyone who has
ever visited their GP or been for surgery. We know too that patients
heal differently, develop complications or not, secondary infections or
not, and so on. The placebo effect that is often cited by detractors as
homeopathy's only resource (ie that people like being talked to and
then given a pill to take), is common to all therapeutic processes, and
it is valuable. We can feel better in the right hands - everyone knows
that - and people can shrivel and die in the wrong hands - whatever the

I am sure that there is a placebo effect in
homeopathy, but it is a fact that many of the people who end up
visiting a homeopath do so as a last resort, when nothing else is
working. That such people often see an improvement suggests that the
remedies themselves are contributing to the wellness of the individual.
Again, no one does actual statistical looks at if people who can't be cured by conventional therapy actually do have improvements or if they do, how it's different to the rate of people who go into spontaneous remissions. Again, we have actually do some research.

to homeopathy begin with what are viewed as the impossible dilutions of
the remedies, so that only nano amounts of the original active
substance remain, and in some cases are only an imprint, or memory. Yet
our recent discoveries in the world of the very small point to a whole
new set of rules for the behaviour of nano-quantities. Thundering
around in our Gulliver world, we were first shocked to find that
splitting the atom allowed inconceivable amounts of energy to be
released. Now, we are discovering that the properties of materials
change as their size reaches the nano-scale. Bulk material should have
constant physical properties, regardless of its size, but at the
nano-scale this is not the case. In a solvent, such as water, nano
particles can remain suspended, neither floating nor sinking, but
permeating the solution. Such particles are also able to pass through
cell walls, and they can cause biochemical change.
We do not know whether this has a bearing on homeopathic dilutions, but it may well be that nanoparticles offer a clue.

Ahh, the appeal to (misundertood/incorrect) quantum physics coupled with a little god of the gaps. First of all, the odds that even a single 'nano-particle' (a meaningless phrase. Is it a molecule? Atom? Electron?) remains in the dilution is about 50-50. A second particle is about is well nigh impossible. And water memory? Are you jucking foking? It's burnt hydrogen, get over it.

says that water as a solvent has properties that are not yet
understood, and there was great excitement recently when a team of
Korean scientists seemed to show that water has "memory". I take New
Scientist every week and I am continually amazed at how the seemingly
well-known physical world of ours is beginning to show itself as
stranger than anyone imagined.

At the risk of repeating myself, burnt hydrogen.

I would like to see homeopathy
better regulated. I would like to see the Society of Homeopaths
engaging with its critics, as well as initiating more research. There
will always be rogue homeopaths and bad homeopaths, but that is true of
any profession. Above all we should be careful of dismissing the
testimony of millions who say the remedies have worked for them.

It's an interesting contradiction, better regulated but less scrutinized and not held accountable. If a doctor told me that praying to a certain angel would help with my weight loss or cure my cancer I would be willing, nay able, nay enthusiastic to dismiss the testimony of millions who believe in angels. Ditto, homoeopathy.

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