From Abracadabra to Zombies
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homeopathy
11 Nov 2003
Subject: Definition in homeopathy article is wrong.
Student, do the research.
The definition of allopathy has nothing to do with balancing the humors.
reply: According to William T. Jarvis
The term "allopathy" was invented by German physician Samuel Hahnemann (1755-1843). He conjoined allos "opposite" and pathos "suffering" as a referent to harsh medical practices of his era which included bleeding, purging, vomiting and the administration of highly toxic drugs. These practices were based on the ancient Greek humoral theory which attributed disease to an imbalance of four humors (i.e., blood, phlegm, and black and yellow bile) and four bodily conditions (i.e, hot, cold, wet and dry) that corresponded to four elements (earth, air, fire, and water). Physicians following the Hippocratic tradition attempted to balance the humors by treating symptoms with "opposites." For instance, fever (hot) was believed due to excess blood because patients were flush; therefore, balance was sought by blood-letting in order to "cool" the patient.
Thanks anyway, Roger. Maybe if you slap my answer against your leather pouch it will release its spirit energy and become more dynamic for you.
07 Nov 2003
As a subscriber to your Skeptic's Dictionary Newsletter, I share many of
your viewpoints. On the subject of homeopathy, however, your skepticism is
shallow.
You argue that since homeopathy does not work, it is not worth investigating how it works. What positive evidence is there that it does not work? What are your criteria?
reply: I explain this in the entry:
Before attempting to explain why so many people believe homeopathy works, let me first defend the claim that homeopathic remedies are ineffective. There have been several reviews of various studies of the effectiveness of homeopathic treatments and not one of these reviews concludes that there is good evidence for any homeopathic remedy (HR) being effective. Homeopaths have had over 200 years to demonstrate their wares and have failed to do so. Sure, there are single studies that have found statistically significant differences between groups treated with an HR and control groups, but none of these have been replicated or they have been marred by methodological faults. Two hundred years and we're still waiting for proof! Having an open mind is one thing; waiting forever for evidence is more akin to wishful thinking.
A review of the reviews of homeopathic studies has been done by Terence Hines (2003: 360-362). He reviewed Taylor et al. (2000), Wagner (1997), Sampson and London (1995), Kleijen, Knipschild, and ter Riet (1991), and Hill and Doyon (1990). More than one hundred studies have failed to come to any definitive positive conclusions about homeopathic potions. Ramey (2000) notes that Homeopathy has been the subject of at least 12 scientific reviews, including meta-analytic studies, published since the mid-1980s....[And] the findings are remarkably consistent:....homeopathic "remedies" are not effective.
I don't know how I could make my point any clearer: hundreds of studies, same conclusion: remedies are not effective.
One of the axioms of homeopathy is that it is tailored to the patient. Thus, if patients A and B are diagnosed with the same bacterial infection, the same homeopath may well prescribe different remedies. This renders problematic the conventional way of testing a drug's efficacy, since strictly speaking, if one were to meet homeopathy on its own ground, then one would have to amass populations of patients like patient A (or B, as the case may be). Conventional science does not generally meet homeopathy on its own ground. This is not helpful.
reply: Let's get one thing straight. There are not two kinds of science, conventional and non-conventional. There is just science. You are either doing it or not.
What you are saying is that control group testing of homeopathic remedies is irrelevant to whether homeopathic remedies are effective. Why should homeopathy be exempt from a fundamental precept of sound science? You're suggesting that homeopathy be allowed to use anecdotes of satisfied customers as evidence homeopathic remedies are effective. But why stop with homeopathy? Why should any other discipline be expected to do controlled studies? There are good reasons science uses controlled studies. The dangers of self-deception should be apparent. The vulnerability to post hoc fallacies like the regressive fallacy should be obvious. How could we ever separate out the placebo effect from remedy effect from practitioner effect if we did not do controlled studies? You're asking that homeopaths be given a free pass to draw conclusions about their treatments based on their subjective impressions.
Equally it is not helpful that homeopaths have difficulty in articulating how homeopathy works in a manner which is easily comprehended. They may not even know how it works. But not knowing how something works does not entail that it does not work, although it may entail other things.
However, if skepticism is not simply to masquerade as the arrogance of the established view, perhaps the sounder approach is to generate and test new hypotheses about how homeopathy might work and then establish whether these may lead to a reappraisal of whether homeopathy does in fact work. This is the approach taken by Paolo Bellavite and Andrea Signorini in The Emerging Science of Homeopathy: complexity, biodynamics and nanopharmacology (ISBN 1-55643-384-0). Whilst the latter author practises homeopathy, the former is a university professor of pathology. I commend this book to you and, in particular, its spirit of inquiry. It is scientific in a far more noble and profound sense than, I regret to say, the brand of skepticism demonstrated in your article about homeopathy.
Name withheld by request
reply: Name calling will get you nowhere. It only makes sense to hypothesize how homeopathic remedies might work if you believe they do work. The evidence says no. The need is for some hypotheses to explain why homeopathy has so many satisfied customers despite the overwhelming scientific evidence that its remedies are ineffective.
A reply to my reply:
Dear Mr. Carroll,
I read your response with interest, as I did your original entry. May I add the following comments:
1. The stance taken by the book I have commended to you is that very few (if any) of the studies undertaken bear the weight of the conclusion that homeopathy works or does not work. This is principally because, as I articulated it using the vernacular, conventional science does not meet homeopathy on its own ground. Homeopathy claims to treat the person, not the 'disease' or 'illness' from which he or she appears to be suffering. I did not (or at least did not intend to) suggest that control group testing should not be applied to homeopathic remedies - merely that the bespoke nature of homeopathy may render this difficult, if not problematic in practice, and not just because of the more significant role of the practitioner. Nor was I suggesting that there are two kinds of science, conventional and non-conventional, although homeopathy would not currently be considered as conventional science, would it? Here you are mobilizing ignoratio elenchi. (Some - not I - might say that you are also being a bit patronizing.)
2. This leads to the interesting question: if control group testing cannot be applied in a manner that meets homeopathy on its own ground, does this lead us to reject the validity of homeopaths' claims, or alternatively does it suggest that a different, possibly more sophisticated approach testing be taken? The latter, I hope you will agree.
3. I must apologize if you took it that I was name-calling. However, I shall repeat the charge that, in the case of homeopathy, your point of view is shallow. You claim that the evidence says 'no'. I disagree. The evidence does not say 'yes' either. Much more research is required. May I suggest that insisting that the evidence says 'no' does not make it so. In your Dictionary, you are covering an extremely (perhaps impossibly) broad shore-line, and I believe that you need to study the subject far more deeply than you have done so far before you come to so categorical a view. You should remain skeptical both ways, instead of forming a judgment on the basis of insufficient knowledge.
4. The weakness of your position is to some extent indicated in the final sentence of your reply to me. I suggest to you that, if there are so many satisfied customers as well as (which you omit to consider) many very highly qualified and intelligent homeopathic practitioners, perhaps this is because something is escaping the filter of 'overwhelming scientific evidence'? What counts as scientific evidence is always evolving. I am advocating a position of humility based upon the premiss that 'the jury is still out'. I am suggesting you do the same. Otherwise your brand of skepticism may appear to some to be arrogance so far as concerns what are ultimately matters of empirical fact, not just instances of fallacious thinking, easily defeated by the toys of deductive logic.
Name withheld by request
reply: Conventional doctors treat persons who suffer from diseases. Homeopaths are not unique in this respect.
As I see it, we are at a standoff. You think the jury is still out. I disagree. (See "Overview of Homeopathic Research" by Stephen Barrett, M.D. ) In part this is due to your notion of "meeting homeopathy on its own ground," a notion I admit I am not sure I understand.
As you note, it is worth studying why homeopathy has so many satisfied customers even though the scientific evidence that its remedies are effective is negligible. This is a matter for the psychologists. It has been studied and I report on what some, including a practicing homeopath, think is going on. I'm not going to repeat myself here but this is where I think we meet homeopathy on its own ground. We analyze what is going on when a doctor treats a patient with an inert substance with results that satisfy both the doctor and the patient.
I don't claim that there should be no further investigation of homeopathic remedies but I do think it is very unlikely any remedy of interest will ever be discovered by classical homeopathy. I don't know why you think that the results of over one hundred studies isn't sufficient or why you think more studies are needed. I assume you understand the nature of such studies and that finding statistically significant results in single studies should not be taken as proof of homeopathy any more than finding nothing significant in a single study proves a remedy is useless.
In my view, you are not advocating a position of humility but of stubbornness. The jury is not still out. The verdict is in. But of course the case isn't closed because the advocates of homeopathy believe on faith. No matter how many studies indicate their remedies are worthless, they will still hold out hope that the proof is just around the corner. Or they will continue to claim that their stuff is special and not amenable to "conventional" science. Of course, if you bring in the notion that slapping a jar against a leather pouch releases spirit energy and dynamizes a diluted potion, then you truly have gone beyond science into the realm of magic and metaphysics.
Another reply to my reply:
I think that if we disagree, it is essentially about how one should interpret the results of relatively low-quality research. My feeling is that one should invest in higher-quality research.
What I mean by "meeting homeopathy on its own ground" is incorporating into the design of clinical trials the fact that the remedy prescribed by a homeopath is as much a function of the nature of the patient as a function of the condition from which he is suffering. Homeopathy claims to address the condition indirectly, by enabling the patient to combat it, rather than address the condition directly, as for example by killing off bacteria with antibiotics. This complicates the design of clinical trials considerably, but if you exclude the patient-centric element of the homeopath's modus operandi, then you are not truly testing the claims of homeopathy.
On your final note, you may well call into question whether slapping a jar against a leather pouch has any effect at all, but oddly enough, the following studies indicate that dynamization or potentization does bring about physicochemical changes in high dilutions of homeopathic drugs, as revealed by nuclear magnetic resonance analysis and by infrared spectrophotometic analysis respectively:
Sukul et al. (2000), Altered solution structure of alocholic medium of potentized Nux vomica underles its antalcoholic effect, Br. Hom. J. 89: 73
Barros and Pasteur (1984), Omeopatia, Medecina del Terreno.
Whilst this does not prove any claim that potentization gives the remedy therapeutic effect, it bears out my point that a sceptical attitude requires greater humility.
Name withheld by request
reply: I think you want to test homeopathy, not homeopathic remedies. The verdict is in: homeopathy works but homeopathic remedies are not effective.
As for physicochemical changes in homeopathic drugs I am reminded of transubstantiation. The bread and wine still taste like bread and wine and have no more powers than do bread and wine, even if their accidents bear no relation to their substance. A diluted substance may change structure at certain temperatures, it may change according to nuclear magnetic resonance analysis and infrared spectrophotometic analysis, but whether it is an effective remedy for any ailment is a completely different issue.
Another reply to my reply:
Given the choice, I should indeed prefer to test homeopathy, not homeopathic remedies, but are you not posing a false dichotomy? You are looking at the subject in terms of whether remedy A cures condition B. Homeopaths see their task as treating patient X with remedy A - and, potentially, patient Y with remedy C - to cure condition B.
Homeopathy, therefore, posits a different system of treating disease. If, in their design, clinical trials do not meet it "on its own ground" - as I loosely call it - then such trials do not serve a scientific purpose in so far as they are not directed to testing the precise terms of the hypothesis being made.
reply: You're right. I'm looking at the subject in terms of whether remedy A cures condition B. I don't see how physicians are any different from homeopaths; they also treat different patients with different remedies for the same ailment.
7 May 2000
Hi!, I'm an Englishman, married to an Indian and currently staying most of
my time in India. As you would expect I am in the midst of all kinds of
weird beliefs but none as great as Homeopathy although Astrology runs it
close as does Ayurveda' Truly the Land of the Gullible. I want to take a
little mild exception to the article on Homeopathy. I quote
If people want to buy and drink lemonade which some aquatic entrepreneur has called a tonic that can cure warts, boils and cancer, let them. As long as their products aren't dangerous in themselves, and the government isn't using tax dollars to subsidize the fiasco, then let the buyer beware and let the lawyers be quiet.
I have seen a couple of instances during the time I have been here where Homeopathy has killed. Of course I cannot name names. However I point out that where people are gullible enough to believe that Homeopathy can cure them there must be thousands of undocumented cases where people have died because they were not referred to scientific doctors in time.
The products are dangerous in themselves in that they frequently
postpone qualified scientific intervention until the condition becomes
chronic or terminal.
Roy Eagleton
Chandigarh (U.T.) INDIA.
20 Sep 2000
Although it is amply clear that homeopathy is bogus, please be aware
that, biologically speaking, one molecule per million can be a very
effective quantity of a substance. Many biological molecules are present
and very active in nanomolar (1/billion) or even picomolar quantity.
Drinking an ounce of 1 micromolar nerve gas or plutonium nitrate would
make for a very bad day.
What is more important to note is that many homeopathic remedies have zero molecules per dose. It seems essential is that the concentration of the remedy's main ingredient may be much much higher in the ambient air or water.
I use Ca ion concentration as an admittedly slightly off-topic example. Intracellular fluids contain very few free calcium ions; specifically, about one one-thousandth the concentration of Ca in the highest purity water reasonably attainable in a laboratory. Pure water (a practical impossibility) would be made unusable for many studies simply being left unsealed for, say, an hour in a completely still, completely sterile room.
The point being that your one to one bazillion dilution of Goldenrod pollen extract (or whatever) used for hay fever would be fatally adulterated (undiluted?, strengthened?) in the moment you cracked the seal on the bottle. (Especially in fall, when you would be using it, in the South.)
Given the opportunity to discuss homeopathy, I usually use terms such as "one molecule in an Olympic swimming pool." Although folksy, it is technically more accurate.
Thank you for a wonderful resource.
Greg Griffeth
LSU SVM Class of 2004
reply: Thank you for the comments and information.
homeopathy
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