This is the first paragraph from Ben Goldacre’s recent comment piece Benefits and risks of homeopathy in The Lancet‘s November 17 edition.
Five large meta-analyses of homoeopathy trials have been done. All have had the same result: after excluding methodologically inadequate trials and accounting for publication bias, homoeopathy produced no statistically significant benefit over placebo. 1–5
(1) Kleijnen J, Knipschild P, ter Riet G. Clinical trials of homoeopathy. BMJ 1991; 302: 316–23.
(2) Boissel JP, Cucherat M, Haugh M, Gauthier E. Critical literature review on the effectiveness of homoeopathy: overview of data from homoeopathic medicine trials. Brussels, Belgium: Homoeopathic Medicine Research Group. Report to the European Commission. 1996: 195–210.
(3) Linde K, Melchart D. Randomized controlled trials of individualized homeopathy: a state-of-the-art review. J Alter Complement Med 1998; 4: 371–88.
(4) Cucherat M, Haugh MC, Gooch M, Boissel JP. Evidence of clinical efficacy of homeopathy: a meta-analysis of clinical trials. Eur J Clin Pharmacol 2000; 56: 27–33
(5) Shang A, Huwiler-Müntener K, Nartey L, et al. Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. Lancet 2005; 366: 726–32
Note that Goldacre omits the Linde et al meta-analysis published in The Lancet in 1997 (6) from his listed studies.
Below are comments and conclusions from each of these studies. Remember, Goldacre is saying that they each support his assertion that homeopathy has no statistically significant benefit over placebo.
(1)
The 1991 study by Jos Kleijnen, Paul Knipschild and Gerben ter Riet assessed the methodological quality of 107 controlled trials in 96 published reports found after an extensive search. Trials were scored using a list of predefined criteria of good methodology, and the outcome of the trials was interpreted in relation to their quality. In 14 trials some form of classical homoeopathy was tested and in 58 trials the same single homoeopathic treatment was given to patients with comparable conventional diagnoses. Combinations of several homoeopathic treatments were tested in 26 trials; isopathy was tested in nine trials. Most trials seemed to be of very low quality, but there were many exceptions. The results showed a positive trend regardless of the quality of the trial or the variety of homoeopathy used. Overall, of the 105 trials with interpretable results, 81 trials indicated positive results whereas in 24 trials no positive effects of homoeopathy were found.Within the discussion of their findings, the authors state:
“The amount of positive evidence even among the best studies came as a surprise to us. Based on this evidence we would be ready to accept that homoeopathy can be efficacious, if only the mechanism of action were more plausible.”
And go on to say:
“The way in which the belief of people changes after the presentation of empirical evidence depends on their prior beliefs and on the quality of the evidence. Critical people who did not believe in the efficacy of homoeopathy before reading the evidence presented here probably will still not be convinced; people who were more ambivalent in advance will perhaps have a more optimistic view now, whereas people who already believed in the efficacy of homoeopathy might at this moment be almost certain that homoeopathy works.”
They concluded:
“At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias. This indicates that there is a legitimate case for further evaluation of homoeopathy, but only by means of well performed trials.”
(2)
I don’t have a copy of this paper. This comment on it is extracted from a 2002 Italian literature review (Cornelli, Prof Umberto et al):
“These experts identified 377 clinical trials, short-listed 220, and reviewed 184. Detailed research lasting several months was conducted on the best trials, to evaluate their scientific value.The conclusions researched by the Advisory Group are unequivocal: the number of significant results cannot be attributed to chance. The analysis provided a random hypothesis value of p < 0.001.The Advisory Group remained very cautious, but expressly stated: “The null hypothesis that homeopathy has no effect can be rejected with certainty; in other words, in at least one of the studies examined the patients treated with the homeopathic remedy received benefits compared with the control patients who received the placebo”.”
(3)
Klaus Linde and Dieter Melchart’s paper on Randomized Controlled Trials of Individualized Homeopathy was a limited study designed to test a subset of homeopathic trials. Because of its small size, it’s consequently not a particularly appropriate study to cite in support of generalised conclusions about the therapy as a whole, even if it does test trials that attempt to adhere more closely to homeopathy as it’s practiced.
“Randomized or quasirandomized controlled clinical trials comparing an individualized homeopathic treatment strategy with placebo, no treatment, or another treatment were eligible. Information on patients, methods, interventions, outcomes, and results was extracted in a standardized manner and quality was assessed using a checklist and two scoring systems. Trials providing sufficient data were pooled in a quantitative meta-analysis.”
Results:
“A total of 32 trials (28 placebo-controlled, 2 comparing homeopathy and another treatment, 2 comparing both) involving a total of 1778 patients met the inclusion criteria. The methodological quality of the trials was highly variable. In the 19 placebo-controlled trials providing sufficient data for meta-analysis, individualized homeopathy was significantly more effective than placebo (pooled rate ratio 1.62, 95% confidence interval 1.17 to 2.23), but when the analysis was restricted to the methodologically best trials no significant effect was seen.”
Conclusions:
“The results of the available randomized trials suggest that individualized homeopathy has an effect over placebo. The evidence, however, is not convincing because of methodological shortcomings and inconsistencies. Future research should focus on replication of existing promising studies. New randomized studies should be preceded by pilot studies.”
(4)
This paper was financed by the European Commission and undertaken by the Homoeopathic Medicine Research Group as in (2) above.
“The selection criteria were randomised, controlled trials in which the efficacy of homeopathic treatment was assessed relative to placebo in patients using clinical or surrogate endpoints. Prevention trials or those evaluating only biological effects were excluded. One hundred and eighteen randomised trials were identified and evaluated for inclusion. Sixteen trials, representing 17 comparisons and including a total of 2617 evaluated patients, fulfilled the inclusion criteria … The reasons for exclusion of the remaining 102 trials were primary outcome not clearly defined (92, 90%) and methodological defects (10, 10%).”
Comment:
“The signficant combined P value obtained in the main analysis does not imply that the homeopathic treatments were efficacious in all the pooled comparisons. This result provides evidence that in at least one trial the homeopathic treatment was more efficacious than placebo. In other words, more trials had a positive result than would be expected due to chance alone.“
Publication bias:
“Although we cannot exclude the possibly that the results of the meta-analysis are affected by publication bias, the results of the sensitivity analysis suggest that this is unlikely.”
Conclusion:
“From the available evidence, it is likely that among the tested homeopathic treatments tested at least one shows an added effect relative to placebo. The meta-analysis method used does not allow any conclusion on what homeopathic treatment is effective in which diagnosis or against which symptoms. It is of no more practical value than to answer yes to the question “are homeopathic treatments effective?” without specifying which drug?, which dose or regimen? and against which disease?However, the strength of the evidence for this conclusion remains low because of the overall low quality of the trial designs and reporting and the limitations of the meta-analysis approach used.
[…]
It is clear that the strength of available evidence is insufficient to conclude that homeopathy is clinically effective; however, homeopathy can and should be assessed using the same methodology used for allopathy. More well-designed and well-run clinical trials, including many hundreds of patients, are needed before definitive conclusions can be drawn regarding the clinical efficacy of homeopathic treatments.”
(5)
The Shang et al meta-analysis published in The Lancet in August 2005 and trumpeted in a blaze of nationwide publicity as “the end of homeopathy” really deserves an entry all to itself. It attracted widespread condemnation and its methodological weaknesses, coupled with its blatant violations of transparency, have led many reviewers to state emphatically that it should never have passed peer review.
“When orthodox scientists, statisticians, molecular chemists, clinicians, and mathematicians, and rigorous, scientifically trained, academic clinical homeopaths begin corresponding in response to the publication of a paper in a learned journal, to draw attention to a serious scientific error, quite apart from its associated moral and ethical implications, and when letter after letter, quietly reasoned, and objectively critical of the original publication, is rejected by the initiating journal, it is surely time to reflect very deeply on what might be taking place and to ask “why?””
Jobst, K A. Homeopathy, Hahnemann, and The Lancet 250 Years On: A Case of the Emperor’s New Clothes? Journal of Alternative & Complementary Medicine. Volume 11, Number 5, 2005, pp. 751–754
Of the total 220 matched trials (110 for each therapy), the authors identified 21 “high-quality” homeopathic studies, and 9 “high-quality” conventional studies. No comparative analysis of this subset of trials was presented. The authors then proceeded to further select the small subset of purportedly larger and higher methodological quality trials (8 homeopathy trials and 6 conventional medicine trials) from which the paper’s conclusion that homeopathy is no better than placebo is drawn, but failed to describe the weighting of their selection attributes (size and methodological quality). They didn’t explain how they chose the particular cut off point that they used to select the final 14 trials, neither did they identify which trials these were, neither did they provide any information on which to assess whether those trails were still matched. Initial requests by other researchers to identify these trials were refused repeatedly and data finally permitting their identification was not made available until several months after.
Most telling of all perhaps is the following from the Discussion section of the paper:
“We assumed that the effects observed in placebo-controlled trials of homoeopathy could be explained by a combination of methodological deficiencies and biased reporting. Conversely, we postulated that the same biases could not explain the effects observed in comparable placebo-controlled trials of conventional medicine.”
This a priori assumption means that essentially the study can do nothing but produce a null result. Having filtered for methodological deficiency, the assumption is that any positive effect remaining must be bias. By those standards, the only course of action left is to remove all the trials with any positive effect and leave the ones that show no benefit.
The authors do at least admit that it they’d chosen a different set of 8 homeopathy trials, the results would have been quite different:
“For example, for the eight trials of homoeopathic remedies in acute infections of the upper respiratory tract that were included in our sample, the pooled effect indicated a substantial beneficial effect (odds ratio 0·36 [95% CI 0·26–0·50]) and there was neither convincing evidence of funnel-plot asymmetry nor evidence that the effect differed between the trial classified as of higher reported quality and the remaining trials. Such sensitivity analyses might suggest that there is robust evidence that the treatment under investigation works. However, the biases that are prevalent in these publications, as shown by our study, might promote the conclusion that the results cannot be trusted.”
The study’s designer, Matthias Egger, is well known for his anti-homeopathy stance. His assumption that any positive effect from homeopathy, after allowing for methodological deficiency, is due to publication bias merely highlights the extent of his own bias.
(6)
Linde K, Clausius N, Ramirez G, Melchart D, Eitel F, Hedges LV, Jonas WB. Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials. The Lancet. 1997 Sep 20;350(9081):834-43.This is the meta-analysis which Goldacre omitted to mention.
“Double-blind and/or randomised placebo-controlled trials of clinical conditions were considered. Our review of 186 trials identified 119 that met the inclusion criteria. 89 had adequate data for meta-analysis, and two sets of trial were used to assess reproducibility.”
Findings:
“The combined odds ratio for the 89 studies entered into the main meta-analysis was 2·45 (95% CI 2·05, 2·93) in favour of homoeopathy. The odds ratio for the 26 good-quality studies was 1·66 (1·33, 2·08), and that corrected for publication bias was 1·78 (1·03, 3·10).”
Implications:
“We believe that a serious effort to research homoeopathy is clearly warranted despite its implausibility.”
Conclusion:
“The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homoeopathy are completely due to placebo. However, we found insufficient evidence from these studies that homoeopathy is clearly efficacious for any single clinical condition.”
The evidence from these studies is not conclusive either way. The general consensus is that there seems to be an effect greater than placebo, but it’s not very strong in trials of higher quality and that more studies, and more studies of different kinds testing the therapy in different ways, are needed. This is a long long way from supporting Goldacre’s null hypothesis.
For more comment, see this annex to The European Committee for Homeopathy’s press release on The Lancet’s November 17 issue.
Laughing my socks off ... 
81 comments
Comments feed for this article
November 27, 2007 at 9:17 am
jdc
You highlighted the following from Klaus Linde and Dieter Melchart’s paper: “individualized homeopathy was significantly more effective than placebo”, yet do not highlight the explanation for this finding: “when the analysis was restricted to the methodologically best trials no significant effect was seen”.
Linde and Melchart have stated that the methodologically best trials showed no significant effect. If the analysis that included trials with a poorer methodology showed an effect, doesn’t that tell you something? Poorly-designed trials show an effect beyond placebo, well-designed trials do not.
You aren’t simply cherry-picking studies, you are singling out the parts of the study that suit you best and highlighting them. This highlighted statement: “the results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homoeopathy are completely due to placebo” is followed by a statement you chose not to highlight – “however, we found insufficient evidence from these studies that homoeopathy is clearly efficacious for any single clinical condition”.
November 27, 2007 at 9:46 am
laughingmysocksoff
The highlighting is there simply to emphasise the fact that Goldacre’s null hypothesis is not supported by the evidence he cites. It’s not there to ‘prove’ anything about homeopathy one way or another. If I was doing it to ‘cherry-pick’ I’d hardly have cited the rest of the comment now would I?
I state quite clearly at the end that the evidence so far, in terms of meta-analyses of RCTs at least, is equivocal. A null hypothesis requires unequivocal evidence to be considered proven.
There are enormous issues around the suitability of these methods of analysis to ‘prove’ the validity of an entire therapy and a lot of ongoing debate on the subject. These issues apply to conventional interventions too.
If you personally believe that homeopathy is no better than placebo, then you’re perfectly entitled to do so, and plainly you’ll be predisposed to latch onto the negative conclusions more than the positive. I might do the opposite. But for either of us to conclude that the evidence itself confirms our personal beliefs is disingenuous and tainted with bias. The jury is still very much out and the debate is ongoing.
Horton, Goldacre and others appear to be attempting to force the negative conclusion on the world at large prematurely. Their own bias sticks out like a sore thumb, no less so than the positive bias they perceive among homeopathy’s supporters. Their methods have been highly suspect and to a significant degree ‘unscientific’, yet Goldacre in particular claims the mantle of ‘science’ to bamboozle the general public into believing that there’s now scientific consensus on this issue. There isn’t.
November 27, 2007 at 2:36 pm
jaycueaitch
Why do homeopaths not perform double-blinded tests themselves? The whole point of such tests is that the neither the person admininistering the medication nor the people receiving it know who is getting placebo and who is getting the real deal. If such tests did produce evidence that homeopathy works better than placebo, then your point would be made.
November 27, 2007 at 5:20 pm
laughingmysocksoff
My point here is that Ben Goldacre has been citing references to meta-analyses that he says support his claim that homeopathy is no more than placebo. They don’t. So I think I’ve made my point. Or would you disagree?
You ask
They do. Try a search on PubMed. A large number of the trials that are being assessed in these meta-analyses have been done by homeopaths and researchers working in the homeopathic hospitals in this country. The trouble is, it’s not as simple as the theory would have you believe — even for conventional drugs, as the SSRI analyses I mentioned above show. The more trials that are done, the more it becomes plain that there’s a lot more going on than just the simple expedient of disease + medicine = cure, and that using RCTs as a tool to determine the efficacy of complex interventions like homeopathy is probably not the best way of going about it.
The crux of the problem here is that a medical system that works on a different set of base assumptions to the biomedical model is being asked to ‘prove’ itself in terms of the biomedical model’s base assumptions. Although the biomedical model might seem to be just “the way it is” if you’ve never stepped outside it, it’s nevertheless just a model we’ve constructed of how we think things work in relation to our bodies in health and disease. It’s not the only one out there (Traditional Chinese Medicine, Ayurveda, Acupuncture, Tibetan medicine, Homeopathy, to name but a few). And while it seems self-evidently plain-as-a-pikestaff “true” to anyone working within it, that’s equally true for all these other models too. Who’s ‘right’ and who’s ‘wrong’? Or is it possible that everyone’s right and that a fundamental characteristic of any belief system is that it’s capable of generating its own proof?
To give you an example of what I mean (there are many others), biomedicine sees diseases as separate entities. It believes that each should have its own separate disease-specific interventions which, once defined as effective in reducing the specific symptoms of that disease, are given to every person suffering from that disease.
It follows from this that a high quality double-blind placebo-controlled RCT should evaluate only people suffering from a single disease ‘entity’ since otherwise you can’t say whether the treatment is effective for the disease. So this has become one of the criteria used to weed out the “high” quality trials from the “low” quality ones.
Fair enough. From that perspective. However, homeopathy doesn’t look on named diseases as separate entities requiring disease-specific treatment. The homeopathic perspective on disease is that it’s something that affects the whole person and you treat the person, not the disease. This might sound like splitting hairs initially, but it’s an entirely different philosophy, because what flows from it is that every person gets treatment that’s unique to them, regardless of how many biomedical disease conditions they might have. The lack of disease-specificity in many homeopathic RCTs results in them being rejected from the final analyses of these meta-analyses because they don’t conform to the strict definitions of “high” quality trials, but does it necessarily follow that the trial is ‘low’ quality just because homeopathy doesn’t treat the disease as an entity?
The assessment of quality also includes other tick boxes that flow from the biomedical assumptions about medicine, so while those working from a biomedical perspective believe they are filtering out the homeopaths’ bias in favour of homeopathy, they’re actually imposing the bias of the biomedical model on their analysis. When you take this process to its inevitable conclusions — which we saw to great effect in Shang et al — you can only ever end up with a handful of trials which have no benefit over placebo. This is exactly what’s been happening in the trend of homeopathic meta-analyses.
The whole area is fraught with difficulty and inevitably subjective in its approach.
November 28, 2007 at 8:36 am
jaycueaitch
You repeat the claim that homeopathy treats the whole person and not the disease. However, since homeopathy operates on the basis of like cures like, ie administering a remedy that produces the same symptoms as the patient is describing, it matches remedies to symptoms and not the underlying disease.
November 28, 2007 at 8:39 am
jaycueaitch
Whoops. Hit “submit” too soon! My point is that homeopathy is purely about treating symptoms and is anything but holistic.
November 28, 2007 at 9:41 am
laughingmysocksoff
You can’t separate the symptoms from the disease! The symptoms are the expression of the underlying disease. The difference here between homeopathy and the biomedical model is in the definition of disease and in what are considered its symptoms.
The biomedical model looks at the range of symptoms a person is experiencing, filters for symptoms that match those in the lists of symptoms for named disease entities, rejects the rest as insignificant or irrelevant, selects the disease entity that fits the selected symptoms best, diagnoses the named condition and gives the treatment established for that condition.
The homeopathic model looks at the range of symptoms the person is experiencing, considers every one of them, and asks for a whole lot more. A homeopath looks at everything to do with that individual person. Not just the principal symptoms they’re complaining of, but all the other seemingly irrelevant and insignificant things that evidence the person’s overall state. Like what time of day the symptoms are better or worse, the person’s mental and emotional state, their sleep patterns, other complaints they might have that have nothing to do with the presenting complaint, the characteristics of their discomfort (eg. are the pains burning, sharp, dull, localised, fleeting, throbbing, etc, etc) — in short, absolutely anything about them that’s characteristic of them as an individual and that’s changed since they got sick. The entire range of symptoms are then analysed for the underlying patterns running through them, and a remedy is selected which matches the person’s entire dis-eased state.
This is how a bunch of people with the same biomedical diagnosis can all receive completely different treatment. It’s not the disease entity that’s being focused on as the target of treatment. It’s the individual who’s suffering, among who’s symptoms happen to be ones that match up with a biomedical disease entity. If you don’t consider that to be holistic treatment, then you’ll have to give me your definition of ‘holistic’ so I can see where you’re coming from.
November 28, 2007 at 4:51 pm
freetochoosehealth
It is clear that there are many double blind studies of homeopathy but jaycueaitch chooses to ignore them. Well, objections after objections.
But laughingstock you are doing a wonderful job of explaining homeopathy and how Goldacre and bad science has created a science of how to ignore the published medical literature.
Trying to explain a humanistic approach to medicine and treating human beings is much more difficult though. I’m not sure someone who views the world within a narrow nihilistic scientific perspective can truly see its value.
November 28, 2007 at 5:50 pm
laughingmysocksoff
Aw my socks have gone off in a huff now. They’re a bit touchy that way, being so continually downtrodden and all …
November 28, 2007 at 9:52 pm
M Simpson
I have a simple question for you (and for all other supporters of homeopathy). It’s this:
I can tell you, in one sentence, what it would take to convince me that homeopathy works; can you tell me what it would take to convince you that it doesn’t?
All I would need is this: a properly conducted, double blind, randomised controlled trial, published in a respected, peer-reviewed journal, with results that showed an inarguable difference between homeopathic treatment and placebo in both the original trial and repeats of the trial by other researchers.
Granted, it’s a long sentence. But that, just that, would cause me to change my mind completely and utterly about homeopathy (or indeed, any other contentious treatment). And I would expect it to change the minds of pretty much the entire scientific community too. Science is open-minded and good scientists are always willing to change their opinion totally if compelling evidence is presented that what they thought was true, isn’t.
There would be no need to prove that all homeopathic remedies work, or that homeopathy works for all conditions. Just one remedy and/or one condition would suffice. There would be no need to explain how it works; the fact that the results were positive, clear and reproducible would be sufficient.
You think homeopathy works. I think it doesn’t. We can’t both be right. This, above, is all that is needed to make me eat humble pie and admit that I was mistaken. If you have an open mind then you must be open to the possibility that you are in the wrong. What level of proof would be required for you to admit that?
November 28, 2007 at 11:51 pm
laughingmysocksoff
Oh yes. Very easily. Nothing would convince me that homeopathy doesn’t work. And that’s not through some sort of woo-like quasi-religious belief in mumbo jumbo. It’s because in the nigh on 2 decades since I was first curious enough to try the therapy for myself, what I’ve witnessed and what I’ve experienced have left me in no doubt at all. I’ve used it for myself, I’ve used it for my family, I’ve used it for my pets, I’ve been impressed enough with these results that it convinced me to train as a homeopath, and I’ve practiced for it for 10 years. During that time I’ve seriously considered the placebo hypothesis, but it just doesn’t fit the evidence. It might look plausible from a theoretical standpoint, but in the nitty gritty of daily homeopathic practice or as a homeopathic patient it just doesn’t stack up.
Too many times we don’t get the right remedy first time. Too many times a remedy is given to babies or animals and can be seen to have an instant effect. Too many times I’ve given or taken remedies during the waxing phase of an acute complaint (which, left to its own devices or with conventional treatment would go on to peak and then decline) and seen the entire complaint resolve in a matter of hours. Too many times I’ve successfully treated people who’ve come to homeopathy as a last resort because nothing else has worked for them. That doesn’t argue for much susceptibility to placebo effects. When you experience and witness these things often enough for yourself there is no doubt.
So to convince me that I’m wrong, you’d also need to convince me that everything I’ve experienced and witnessed in the last 2 decades has been a complete delusion, and you’d also need to convince all my family, my patients, both adults, children, and parents of those children, that their experience was a complete delusion too.
Against this sort of evidence, I’m afraid analyses of RCTs are meaningless. Personally I find it hard to understand this almost religious faith in them evidenced by people who claim to be scientists. Empiricism is what matters, no? So if RCTs have a 20% failure rate and low external validity (which they do) exactly what justifies such reliance on them? They’re a tool, sure, but not a particularly good one. And anomalous results are not unique to homeopathy, as the analyses of SSRI trials above demonstrates quite clearly. The idea of RCTs is wonderful, but in practice they just don’t seem to work out quite so perfectly as the theory would have you believe they should. So another statistical analysis is devised and applied and debated and accepted a while then rejected, and so it goes on. Just one more analytical technique and it’ll be clear! As mud. Because all the layers and layers of sophistication that get piled on add yet more layers of a priori assumptions (hence subjectivity) until in the end the results you’re looking at are little better than meaningless. As scientists, we should be questioning the map, not the territory.
November 29, 2007 at 10:03 am
Jeff Garrington
I imagine from your replies above, with regard to the individual nature of each homeopathic prescription. That the homeopaths selling an across the counter and internet, product for Malaria are misguided homeopaths or frauds. The same for a leading Homeopath offering musical downloads as a cure for AIDS. You might want to consider Boots the chemist in that list.
November 29, 2007 at 11:30 am
ross
laughingmysocksoff Says: “Nothing would convince me that homeopathy doesn’t work. ”
In my opinion this phrase sums up everything that is wrong with Homeopathy.
November 29, 2007 at 4:30 pm
laughingmysocksoff
I know nothing about the product for malaria you refer to and I’ve never tried a musical download either, so I can’t really comment on these either way. Just like any other field, people have taken the principles of homeopathy in lots of different directions, done their own research and experimentation, and come to their own conclusions, so you’d have to ask the people concerned what their rationale is. I can’t speak for them.
As for OTC remedies, there are groups of remedies that have affinities for certain acute states (eg. Arnica for shock, trauma and bruising). Since the state has less to do with the individuality of the person and more to do with the circumstances in which they find themselves, it’s possible for people to self-prescribe in the same way they can with OTC biomedical treatments. If the remedy happens to be a good match, the effects can still be quite dramatic, which is what brings many people to a homeopath to begin with. They’ve tried it for themselves, it worked, so they’re willing to see if it can do the same for more chronic states.
Equally well OTC remedies may do nothing at all if it’s the wrong remedy for the individual (or the right remedy isn’t contained in a particular combination). OTC remedies for less acute states (eg. hayfever) are sold on the basis that they can give some degree of symptomatic relief by mixing together all the remedies that have hayfever symptoms prominently in their picture, so they’re not being sold according to homeopathic best practice. They do provide some symptomatic relief for a lot of people — probably on a par with other OTC remedies — but they’re highly unlikely to provide any deep or lasting cure.
I do find it fascinating how so many sceptics seem to presume that all alternative medical practitioners are frauds and/or brainless idiots deserving of complete contempt just because science hasn’t found any mechanisms of action for the therapies yet. This really is a case of mistaking the map for the territory, not to mention exhibiting a large measure of arrogance. And why do they feel so driven to ridicule a therapy they’ve never bothered to actually go and try for themselves? That’s not a very scientific approach. This sort of reaction owes more to tribalism than it does to science and gives itself away every time by the language it uses to express itself.
And especially when there’s so much in their own house that badly needs to be put in order. An easy majority of my adult patients come full of anger and resentment at the treatment they’ve experienced at the hands of conventional medicine. Their concerns have been regarded as insignificant, the symptoms they feel most concerned about are treated as irrelevant, they’ve been talked down to and made to feel like lesser forms of life, told what’s ‘wrong’ with them (which, when they explore the diagnosis for themselves, feels wrong and often is), they’ve had pills pushed on them when they’ve said they don’t want to take any drugs, told it’s “all in their heads” when they know it’s not (and are subsequently proved right), and so it goes on … Biomedicine seems to be failing so many people so badly that they’re voting with their feet in large numbers. That’s when they’re not actually dying in their tens of thousands from the side effects of the medication alone. (Starfield, B. (2000, July 26). Is US health really the best in the world? Journal of the American Medical Association, 284(4), 483-485).
Since the whole purpose of medicine is to make sick people well again, you surely need to start asking some very serious questions about the thinking here when the theory is so patently taking precedence over the actuality. If so many ordinary people can see plainly that the theoretical explanation doesn’t fit with their experience of their complaint, try the interventions which either don’t work or make them feel terrible, and finally give up on it in disgust, what purpose is all this clever-clever stuff serving? Several clinical trials of homeopathy in comparison to conventional medicine have shown greater efficacy for homeopathy (eg. Witt, C, Keil, T, Selim, D et al. Outcome and costs of homoeopathic and conventional treatment strategies: a comparative cohort study in patients with chronic disorders. Complement Ther Med. 2005 Jun;13(2):79-86), so why such determined efforts to claim it’s ineffective? And when your best theory for rationalising this situation to yourself ‘scientifically’ is to plump for the notion that all homeopaths are frauds and all their patients idiots, then I feel very very sorry for you.
Biomedicine has a lot to offer, but there are areas where it’s much less effective than others. If other therapies have proved themselves efficacious where it really matters — treating sick people — then sick people deserve to be able to make the choice over what therapy they want to pursue for themselves without biomedicine playing bully-boy or gatekeeper. Homeopathy has proved itself effective in 200 years’ worth of case history, and in all the modern trials that show positive effects.
November 29, 2007 at 4:36 pm
laughingmysocksoff
In my opinion these two phrases sum up everything that is wrong with biomedical thinking.
November 29, 2007 at 5:09 pm
ross
Hi, if I understand you correctly you don’t believe you should change your thinking according to the available evidence?
Please correct me or tell me to put a sock in it if I have misunderstood you.
November 29, 2007 at 7:09 pm
M Simpson
Laughing – could you explain how your description of yourself in your post ‘A Socking State of Affairs’: “But being open minded and curious, I tried it for myself.”
…relates to your reply to my question in this thread: “Nothing would convince me that homeopathy doesn’t work”?
What is your definition of ‘open-minded’? How can a mind be considered ‘open’ if its owner cheerfully refuses to countenance even the possibility that their view of the world is not accurate?
November 29, 2007 at 7:15 pm
laughingmysocksoff
No, it’s not a case of i don’t think I should. It’s a case of I don’t think I would. I keep an open mind on things and if I’d seen anything to cause me to doubt that the therapy has an effect over and above placebo then it would have had serious consideration long before now. So far, the evidence that homeopathy’s detractors offer in support of their claim that homeopathy is no more than placebo is pretty much non-existent and based on subjective filtration of trials of homeopathy in aggregate, none of which are particularly faithful demonstrations of the therapy in practice, and none of which actually prove the null hypothesis. These analyses also demonstrate much the same problems found in using this method to assess the efficacy of drugs with more subtle systemic effects than localised action, which calls into question the whole suitability of this methodology for evaluating interventions of this kind. Against this is a vast weight of solid clinical evidence to support homeopathy’s efficacy, along with my own personal experience.
If you can demonstrate to me how this evidence, whatever it is, is superior as a proof system to 200 years’ worth of clinical evidence plus the evidence of my own experience and that of my patients for the last 20 years then I’ll certainly consider it, but your argument is going to have to be one helluva lot better than what’s been produced so far.
I’m game if you are. Try me. But I expect this to be a 2-way process. If you’re going to expect me to address the holes you’re going to shoot in the arguments in favour of homeopathy’s efficacy, then you’re also going to have to address the holes I’ll shoot in your arguments in return. Which, conspicuously, nobody here in the contra camp has yet done …
November 29, 2007 at 7:37 pm
laughingmysocksoff
I wasn’t talking about my view of the world, M, I was talking about my experience of the world. That’s a big distinction. I’m constantly altering my view of the world according to my experience of it, and continually testing the resultant theory as a consequence. That’s the nature of scientific method. That’s how new world views evolve and how science progresses. The theories should never be considered sacred cows. The map is not the territory. Maps can be reliable for a while, but sooner or later they prove themselves deficient and have to be redrawn.
Can I ask you a similar sort of question? How can someone call themselves a scientist if they put the theory on a pedestal and rely on ridiculing the bearers of new evidence and discounting their evidence as ‘invalid’ in order to continue to keep faith in their theory?
November 29, 2007 at 8:02 pm
M Simpson
Now I’m confused. You said: “Nothing would convince me that homeopathy doesn’t work.” Now you say: “I’m constantly altering my view of the world according to my experience of it, and continually testing the resultant theory as a consequence.” How can these both be true? How can you constantly alter a view which you say can never be changed?
As for your question, I’m not sure I can answer it as I have never put a theory on a pedestal (in fact I already explained that I was willing to change my views completely if suitable evidence is presented), nor have I ever relied on ridiculing people or discounting evidence as invalid. I may have ridiculed people and discounted invalid evidence but I have never [i]relied[/i] on such things and I would not approve of anyone who did. Oh, and I have never called myself a scientist on account of I aren’t one.
November 29, 2007 at 8:18 pm
ross
Hi can I just say it is nice to see a homeopath willing to engage in debate so thanks for that, but I still cant resolve your claim to be open minded with your comment :
“Nothing would convince me that homeopathy doesn’t work.”
In the spirit of open mindedness how about as a thought experiment you try and think of an experiment that could convince you Homeopathy doesn’t work. Like you said “The theories should never be considered sacred cows.”
I am quite happy to discuss what evidence would convinve me Homeopathy works.
—
Also, you said “How can someone call themselves a scientist if they put the theory on a pedestal and rely on ridiculing the bearers of new evidence and discounting their evidence as ‘invalid’ in order to continue to keep faith in their theory?”
I am not really sure what theory you think we are putting on a pedestal, Germ theory, Avagadro’s number…?
November 29, 2007 at 10:16 pm
laughingmysocksoff
OK. To both of you. There is no inconsistency here. There is the territory and there is the map of it. The two are not the same thing even if many people live their lives as if they are.
Experience is experience. It is what it is. How we interpret that experience — devise a rationale for what’s going on, how it all inter-relates and why — is a different matter entirely. My experience of homeopathy is what it is. Nothing can change that. I give or take a remedy and witness/experience it working. How I interpret what goes on in the situations in which I give a remedy, witness the responses, correlate that with what the person I’ve given it to is telling me about their experience of it, all that is constantly under review. But I can tell you one thing for sure. In my experience (and I’m not alone in this) it does not correlate in any way satisfactorily with what is presently defined (rather nebulously) as “placebo effect”. Look, I’ve been working closely with this for the last decade. You haven’t. Give me some credit for having an ounce of sense will you?
“Placebo effect” is presently generally understood to be the psychosomatic impact of the patient’s belief that what they’re taking will help them. So it’s assumed to be a kind of mind game the patient plays on themselves so should be filtered out of any robust test of an intervention’s efficacy to determine whether the intervention has any effect of its own. Fair enough.
But my own observations over 20 years, not to mention the work of others who have come to similar conclusions from similar observations, have led me to the conviction that the term is presently a kind of dumping ground for all the non-specific and non-material aspects of any medical intervention, and there’s a helluva lot, and I mean a helluva lot more going on there than just the impact of the patient’s own belief. That on its own does not pass tests for validity in far too many instances (babies and animals being just one pair of examples).
All of these subtle effects have a bearing on any intervention, biomedical or otherwise, and the more subtle and systemic the intervention, the more it’s targeted at the psychoneuroendocrine axis (the ‘control centre’ of the individual if you will), the more prominent these other aspects of treatment become. This may well explain the anomalous results in trials and meta-analyses with psychoactive drugs as well as with homeopathy.
A lot of exploratory work is now being done on this whole area, teasing out what might be going on, testing for it, formulating theories about it, though the bulk of the work seems to be under the ‘alternative medicine’ research unbrella, so often doesn’t make it into more mainstream journals (so many doctors won’t have been exposed to it). You’d be unlikely to come across it in the Guardian either.
Some of the work that’s being done seriously calls into question the whole rationale behind placebo-controlled trials. There’s a lot of evidence to suggest that the intervention itself (biomedical or homeopathic) has a non-material as well as material dimension to it, and that the non-material dimension creates a kind of field effect around experiments involving it. (eg. Milgrom, L. R. Are Randomized Controlled Trials (RCTs) Redundant for Testing the Efficacy of Homeopathy? A Critique of RCT Methodology Based on Entanglement Theory. Journal of Alternative & Complementary Medicine, Volume 11, Number 5, 2005, pp. 831–838). So even if you give someone placebo, they may still pick up on the substance field and react to it, albeit to a generally much more subtle degree, and one that’s not at all obvious next to the effect of large material doses. But in more subtle therapeutic interventions, it becomes far more obvious. So it’s perfectly plausible that what’s currently assumed to be the level of response invoked by the patient’s belief they’re getting something to help their condition is tainted by verum response, which means that your rigid distinction between placebo response and verum response no longer holds up. I’ve witnessed and experienced this “field effect” many times. It’s a fascinating area for study and one I’ve been working with a lot over the last 3-4 years.
So before you jump the gun and say that homeopathy is nothing more than placebo effect and therefore doesn’t work, you’ve got to make sure you’re making the right correlations and imputations. First, you’ve got to define placebo effect adequately. Second, you’ve got to identify all the other non-specific effects of intervention, both in trial situations and in clinical situations, and design trials and tests to make some sort of quantitative assessment of them. Third, you’ve got to sort out what belongs to the specific intervention and what’s inherent in any healing situation, and then maybe you can make some sort of robust judgement about the efficacy of the intervention.
The present rationale governing RCTs, in the light of what’s been learned testing homeopathy, is unsatisfactory and open to both false positives and false negatives, a fact which seems borne out in practice when the trialled interventions are employed in a clinical situation.
November 29, 2007 at 10:40 pm
M Simpson
You’re doing a grand job of addressing (at length) questions that we haven’t asked. But I still don’t know which is true – do you have a fixed belief in homeopathy which nothing could ever change or are you constantly altering your view of the world based on your experience? If the latter, then there must be some conceivable experience, however hypothetical it may be, which could make you believe that homeopathy doesn’t work after all.
I don’t think the evidence you need is out there, I don’t think we’ll ever change your mind, But as along as you are telling us completely contradictory things about yourself – and posting at great length about RTCs – we’re getting nowhere.
November 30, 2007 at 12:26 am
laughingmysocksoff
What is there about this that’s so hard to understand? There’s nothing contradictory here at all. Looks to me like you’re conflating the map and the territory.
Let’s take a different example to see if it helps. You buy a car, you turn the key in the ignition, the engine starts, and the car goes. That’s your experience, day in, day out. Sometimes you pick up the wrong set of keys before you head out in the morning and because of that the car won’t start until you find the right ones. But you don’t assume from that experience that the car doesn’t work. If one day the engine seizes and the car stops working, then yes, car no longer goes, but it doesn’t invalidate all your previous experiences of the car working. You don’t have to have a fixed belief that your car works for this to happen. You don’t even need to know how it works. You just get in the car and turn the keys in the ignition.
And if someone comes along and looks at your car and says “Oof that make of car is dreadful. They don’t make sense the way they’re put together. They can’t possibly go. They’re sold by a bunch of con artists who are just out to take you for a ride. Ditch it. My car is far superior. That’s the sort of car you should have.” does that mean you suddenly turn your back on your own extensive experience of driving your car with it working absolutely fine for you and suddenly come to the conclusion that your car never worked after all?
Such a suggestion is plainly idiotic. Yet that’s what you seem to be asking me to contemplate the possibility of. And the only evidence you seem to have to support your assumption that my car doesn’t go are a bunch of equivocal meta-analyses of RCTs and the fact that you don’t know what my car runs on, so that’s why I go on about RCTs. It’s my blog, M. 🙂 There’s plenty of other people reading this who might find it helps them think about the whole nature of RCTs in more depth and realise that things are not quite as simple as the theory would have you believe.
The core of this present wave of hysteria about homeopathy seems to have precious little to do with the underlying science, yet it’s ‘science’ that’s constantly being invoked to defend opinion. My aim here is to actually get some of that science out into the public domain so people can start to look at it for themselves and see the extent of debate that’s going on round the subject. And from that they can make their own minds up about things, rather than have some opinionated ‘expert’ who’s never even bothered to try the therapy for himself because “it can’t possibly work” attempt to make their minds up for them.
November 30, 2007 at 4:14 am
goodscience
OMG laughingmysocksoff, you are amazing!! You are the voice of sanity amongst the insane. You are bold, intelligent and refreshing.
November 30, 2007 at 8:59 am
gimpy
You might be interested in this fairly damning critique of Lionel Milgrom’s understanding of quantum theory from someone who knows what they are talking about.
November 30, 2007 at 9:04 am
gimpy
laughingmysocksoff, I am not happy acting as a spokesperson for people who might not necessarily share my views, it would also imply a degree of co-ordination that I assure you we lack. However, if you are interested in discussing this in depth and don’t want to be overwhelmed by a huge number of blog comments (completely understandable IMHO) you may like to come to the badscience forums. People there are always willing to engage with homeopaths in a perfectly polite and reasonable manner and I believe Ben Goldacre would like to encourage more homeopaths to address our concerns.
November 30, 2007 at 10:31 am
ross
socks tbh that rather long winded explanation has left me none the wiser but thanks for trying anyway.
November 30, 2007 at 11:00 am
laughingmysocksoff
Fair enough Gimpy. I appreciate your point. Interesting though, eh? There’s so much mirroring going on here. Many in the homeopathic camp are perceiving the sceptics camp as having some degree of organisation and coordination, while an equal number of the sceptics seems to perceive some kind or organisation and coordination within the homeopathic camp. I can assure you there is none. Or at least none that I’m aware of.
Oooops … there go the socks again. Perfectly polite and reasonable manner? Hahahahahahahaha … oh crap … now I’ve got hiccups. You have got to be joking. I’m sorry, but when the rules of engagement include being rude and the whole forum is set up as some kind of homeopath-baiting sport based on the unshakable conviction that homeopathy doesn’t work and that all its practitioners are either frauds or idiots, there is no possibility for open debate. Most of the participants seem to spend their time in mutual self-congratulatory back-slapping for the latest “point” they’ve managed to score somewhere. No wonder everyone there is continually complaining no homeopaths will engage with them. What on earth is the point?
I’m happy to try and answer genuine concerns from my personal perspective in a spirit of open dialogue, and to explore all the possible interpretations of the scientific data, but I’m not into playing games and I’m not into wasting my energy on discussing evidence with people behaving more like a pack of dogs with their tails up than anyone with any genuine interest in the subject.
Sorry Gimpy, you’ll have to do better than that.
November 30, 2007 at 1:29 pm
ross
“the whole forum is set up as some kind of homeopath-baiting sport based on the unshakable conviction that homeopathy doesn’t work”
I think it is moron baiting rather than Homeopath baiting. You don’t seem like a moron, I think you would be made very welcolme over at badscience.
“Most of the participants seem to spend their time in mutual self-congratulatory back-slapping for the latest “point” they’ve managed to score somewhere.”
there is perhaps a bit of truth in this which is why I wish a few Homeopaths would dip their feet in the water over there to stop it getting too backslappy. It’s only a bit of lively debate.
November 30, 2007 at 2:23 pm
gimpy
laughingmysocksoff, stever, one of the moderators of the badscience forums has stated that,
with specific reference to your blog. I assure you that if you do come to the forums you will be given the freedom to state your views without censorship. Of course your views will be challenged but you would also be able to challenge the views of others.
November 30, 2007 at 3:17 pm
laughingmysocksoff
“Moron” is an entirely subjective derogatory judgement which is usually just shorthand for “people-I-think-are-idiots-because-they-can’t-see-how-clever-I-am”. I’ve caught myself thinking the same about many a sceptic. It’s a dreadful tendency in human nature because it denigrates other people’s points of view just because those points of view are different from your own and expressed in different ways. In Jungian psychoanalytical terms calling someone a moron is just a projection of your own inner moron. Haven’t you ever noticed how stupid people look immediately they start calling someone else a moron? Does it never occur to you that we might get a lot nearer to the underlying “truth” of things if we listened to everyone’s points of view and experiences on the subject and then looked for the common ground amongst them all?
I may not qualify as a moron, but I’m very definitely a loser and probably a twat as well because I do like to go on a bit when I’m trying to make it clear where I’m coming from.
If you all like to get backslappy with each other that is really not my problem, and your idea of “a bit of lively debate” isn’t mine I’m afraid. From here it looks more like a bunch of alpha males in the rutting season cruising about looking for someone to lock horns with so they can show off to each other and the audience and establish who’s the monarch of the glen (which is really what that old Oxbridge adversarial debating tradition is all about). If you’re really serious about wanting homeopaths to join you in some sort of meaningful discussion, then you’ll all have to stop ODing on the testosterone. Most homeopaths are women, most of whom aren’t particularly keen on the smell of men’s locker rooms.
So thanks, but no thanks. You know where to find me if you have a genuine question to ask. I can’t guarantee you’ll understand my answer or that I’ll understand your question, but at least we can give it a try.
November 30, 2007 at 4:04 pm
laughingmysocksoff
Gimpy your comment sounds more than a tad disingenuous in view of this one:
If this is your idea of polite and courteous engagement, then we must be working from different dictionaries. Are you prepared to accept the possibility that biomedicine doesn’t work? I very much doubt it. Because if you’ve lived the daily reality of seeing it working for yourself for x number of years, then nothing’s going to persuade you it doesn’t. This is the situation homeopaths are in. It’s got nothing to do with being closed-minded or unreasonable, it has do to with the lessons of experience. Day in, day out, year after year. It’s exactly like the example I gave with the car above.
You people who are all so convinced it doesn’t work (because it “can’t”) why don’t you pay a visit to a homeopathic hospital (before you’ve destroyed them all) and see for yourself? Better still, go see one in action in India where homeopathy, along with ayurveda, other traditional practices, and “English medicine” are all available for people to choose between as they judge fit.
Belief systems can come and go and are neither here nor there but if something doesn’t actually do what it claims to do on the tin, there is no way on earth that it could possibly survive for 200 years. It would be lucky to get past 2.
November 30, 2007 at 4:24 pm
ross
“but if something doesn’t actually do what it claims to do on the tin, there is no way on earth that it could possibly survive for 200 years. It would be lucky to get past 2.”
I’m not really sure longativity is a good substitute for evidence. All sorts of quakery abound in the 21st century, would you suggest they are all worthy because of their longativity? I imagine not, so that isn’t really a helpful argument is it?
November 30, 2007 at 7:49 pm
M Simpson
“Belief systems can come and go and are neither here nor there but if something doesn’t actually do what it claims to do on the tin, there is no way on earth that it could possibly survive for 200 years. It would be lucky to get past 2.”
People have been knocking on wood for luck for more than 200 years. Are you saying that this action genuinely increases good fortune?
November 30, 2007 at 8:20 pm
M Simpson
“Let’s take a different example to see if it helps. You buy a car”
I like analogies, especially car analogies, so let’s try this. Put yourself in our shoes and tell us what you would think in this situation.
You meet someone who says they have a terrific car. It’s environmentally friendly, it’s cheap to run, it’s goes like a dream and what’s more, it’s powered by water. Not any old water but water which has been given a special feature that makes it a fuel, although there is no way to detect any difference from ordinary water.
Well, that sounds wonderful but… could it be true? Doesn’t an internal combustion engine need some sort of actual fuel, like petrol, diesel or biofuel, to run? No, says the car-owner, internal combustion engines don’t run the way that most people think they do. And if you’re still doubtful, well there are lots and lots of people who have been for a ride in a water-powered car. They’ll tell you it’s true.
Now I don’t know about you, but I wouldn’t just take this person’s word for it. I would ask them for a demonstration, and if they were serious I would expect a very carefully controlled experiment so that we could be absolutely certain that it was the water that was making the car move, not a strong wind or a powerful magnet or a slope or some hidden energy source or maybe the person dreamed the whole thing. There are lots of possible explanations which, though they sound unlikely, are not as unlikely as a completely unknown scientific phenomenon that changes everything we know about internal combustion engines.
Would you accept this person’s word for this globally important scientific discovery? Would you accept the stories of lots of other people who say they have been in a water-powered car? Would you consider an experiment which showed the car moving a tiny, tiny bit to be proof that the water-fuel works?
What would you do? What would you say? I’m genuinely curious.
November 30, 2007 at 8:33 pm
gimpy
actually laughingmysocksoff if you check the forums thoroughly you will find that I have been rather kinder to you than your compatriots who claim to be able to cure aids, autism and cancer. It is these individuals who attract my ire and I will not apologise or take back my words against them.
Just out of interest do you condemn those homeopaths who claim to cure such serious diseases?
Oh and I would accept that biomedicine didn’t work if it were shown not to work in an appropriate trial. Indeed many thousands of compounds fail such trials every year.
November 30, 2007 at 8:41 pm
laughingmysocksoff
I assume you mean longevity. Nobody’s suggesting it’s a substitute for evidence. There’s evidence in plenty but it seems nobody who’s convinced themselves there’s no possible way this therapy can work wants to look at it or acknowledge that it’s evidence. And haven’t we been here plenty of times before throughout history?
Well you can ignore it for as long as you like. That’s your choice. And if you feel alternative treatments are no more than quackery that’s also your choice. You don’t have to use these therapies. Nobody’s trying to make you.
But it’s everybody else’s choice too. And there are millions of people out there who have used alternative treatments and been very happy with them. Who are you to tell people what choices they should make with their own bodies and their own lives just because you don’t believe the evidence for their efficacy? People are quite capable of making their own minds up and making their own choices about what therapy they want to use in what circumstances.
Why sceptics seem to feel “there can be only one” and that they have some sort of public duty to resort to any means necessary, including distortion of scientific and historical evidence, to force these therapies beyond the reach of many people who’d like to use them, for the life of me I do not know. There’s been a great tradition of maintaining freedom of choice in this country, but it seems that along with our fast-disappearing civil liberties, the likes of Colquhoun, Horton, Baum, Goldacre et al feel that we should no longer have freedom of choice in healthcare either.
November 30, 2007 at 9:15 pm
laughingmysocksoff
M I know exactly where you’re coming from. I’ve been there. So have an awful lot of people who now work as homeopaths. We didn’t spring out of potentised amniotic fluid with fluffy pink angel wings gurgling a-woo instead of a-goo. We got born the usual way and were schooled and universitied in the biomedical model. The difference is, we went and tried homeopathy for ourselves rather than relying on other people’s reports and analyses and our own prrejudice to make our minds up for us.
I’d be highly sceptical at first, but open-minded to the outside chance there could be something in it. (I’m under no delusions of grandeur about what humankind knows about the laws of the universe. I don’t think we’ve grasped a fraction of it yet for all our technological achievements. History is full of the seemingly implausible turning out to be highly plausible in the end.) Then if I heard lots of stories from other people who’d been in water-powered cars, I’d start to think hmmmmm … interesting.
At this stage, what would I do? I’d find someone with a water-powered car and ask if I could take it for a test-drive. If it worked, then I’d want to have a good look under the bonnet and at the fuel and ignition system and listen to the story of its discovery and testing. You learn a helluva lot about these things by talking and really listening to the people involved. It doesn’t take much to sort out who has honesty and integrity and who’s spinning a yarn. And I’d listen to the daftest of ideas from a straightforward person before the most supremely plausible of spindoctors any time. It’s often the crackpot ideas that later turn out ot be the ideas of pure genius. So if in all of that preliminary investigation I didn’t smell a rat, then I’d probably be very interested in learning about water-powered cars in a lot more depth.
One thing I wouldn’t be doing. I wouldn’t be berating every single driver of a water-powered car, calling them fools and morons, and doing my level best to stop government funding of their development because “they can’t possibly work” without ever getting in one and giving it a thorough going over for myself.
November 30, 2007 at 11:25 pm
laughingmysocksoff
That’s very gracious of you Gimpy. Should I feel somehow flattered that you consider me marginally less of a moron than every other homeopathic practitioner?
But yet again — and this is something I completely fail to understand with all of you — If someone is making claims you find hard to believe, why don’t you go check it out for yourself? Sit in with them in practice, review their case notes, check out the lab work and scans, sit down and listen to what they have to say and what their patients have to say about the treatment and THEN make up your minds? What are you all so frightened of? That you might actually be wrong? That you might actually have to rewrite your world view as a result?
And no I don’t “condemn” people who “claim to be able to cure AIDS, autism and cancer” because unless I’ve gone and thoroughly checked them and their claims out for myself, how can I possibly make any kind of meaningful judgement? All I would be doing is expressing supposition and opinion. Doubt and healthy scepticism is one thing. Condemnation is another matter entirely.
Let me ask you this. How would you feel about your behaviour towards these people if it later turns out that their claims are verifiable? Stranger things have happened. The world is full of surprises.
Thousands of compounds failing trials is a different thing entirely from suggesting that biomedicine as a whole doesn’t work — that the assumptions on which interventions are based are invalid.
November 30, 2007 at 11:51 pm
M Simpson
“But yet again — and this is something I completely fail to understand with all of you — If someone is making claims you find hard to believe, why don’t you go check it out for yourself? Sit in with them in practice, review their case notes, check out the lab work and scans, sit down and listen to what they have to say and what their patients have to say about the treatment and THEN make up your minds? What are you all so frightened of? That you might actually be wrong? That you might actually have to rewrite your world view as a result?”
I think this is absolutely the most vital aspect of all this which homeopaths don’t get. We – sceptics, rationalists, whatever – don’t base our understanding of the world solely on our own personal experiences and observations. Because an anecdote is still an anecdote, even if it’s about oneself. Individual personal experience is not reliable. It’s good for prompting ideas and investigations but if those investigations show the original anecdote was wrong then we accept that we didn’t see what we thought we saw.
Homeopaths are forever urging sceptics to try homeopathy for ourselves. But that will never convince us because it would be an experiment where n=1 and there’s no control group. If I have a sore throat, and you give me a homeopathic medicine and my sore throat gets better – that won’t convince me that homeopathy works because there is no evidence there of cause and effect. My throat would have got better anyway and so the question is simply: did it get better quicker? And because this is one instance of one infection in one throat, we can’t ever know that unless we have access to a parallel universe.
People are individuals, people are different, people with the same condition experience it in different ways and to different extents. Yet, despite homeopaths constantly talking about this they fail to understand that the only way to examine if something works is to use large, random groups to average things out and eliminate individuality from the equation.
If 500 randomly selected people with sore throats use homeopathy – individualised for them and all that stuff – and another 500 random people with sore throats don’t, and the average recovery time of the first group is significantly quicker than the average recovery time of the second group… well, there’s some good solid evidence. But no one member of the group that used homeopathy is going to be able to say that homeopathy cured their throat unless they take the other 999 throats into consideration too.
That’s why we don’t sit in with you, review your case notes, check out your lab work and scans, sit down and listen to what you have to say and what your patients have to say – because none of that can ever trump a simple comparison of two large groups of randomly selected people. This is not being closed-minded – I think we’ve already established whose mind is open and whose is closed – it’s simply understanding what makes effective evidence, evidence that is robust enough for our open minds to change our opinions of the world.
“Let me ask you this. How would you feel about your behaviour towards these people if it later turns out that their claims are verifiable? Stranger things have happened. The world is full of surprises.”
Since most of this behaviour is in your perception of us, rather than anything we’re actually doing, I wouldn’t see anything to be ashamed of. I think the open-minded scientists of the world have been remarkably tolerant of, and patient towards, the closed-minded homeopaths. Mind you, if the claims are verified I would be puzzled why they weren’t verified earlier to save us all so much grief.
December 1, 2007 at 1:28 am
laughingmysocksoff
Neither do homeopaths M. They just don’t write off all of personal experience as insignificant and invalid just because it’s not 100% reliable. Nothing is. You seem to put an awful lot of faith in trials. Far more than appears to me to be justified by their 20% failure rate and low external validity. And the quality of some of these studies (Shang et al for example) is mindbogglingly poor.
Answer me this: if authors of a meta-analysis state that they assume all positive effects of homeopathy to be due to either methodological deficiency or bias and then set out to remove both those components from the equation, exactly what are you left with? And what are they demonstrating in the result? And on that basis do you feel they are justified in trumpeting “the end of homeopathy” based on that one meta-analysis?
It’s a way. It’s certainly not “the only” way. So far from homeopaths failing to understand this point, I think you’ll find they take a much more comprehensive and pragmatic approach rather than relying on a single perspective to give them the whole picture. I’ve already gone into my reservations about DBPCRCTs at great length so I’m not about to rehash it all again. (And I notice nobody has disputed any of these.) They’re a great idea in theory, but the theory doesn’t work out so well in practice.
But let’s look at it your way. Let’s look at the trials that have been done on homeopathy. There’s a good number of them now and taken in aggregate, they overwhelmingly show efficacy for homeopathy. All the meta-analyses (see main post for citations) concur on that point. But of course that’s not good enough. First you’ve got to filter for methodological quality. Do that and the balance still comes out positive, though less so because some of the tick boxes that need to be ticked to rate a trial “high” quality, like sample size for instance, are hard for researchers in a minority therapy with minimal funding to satisfy. Then you’ve got to filter for bias. Well this is where it all gets far more subjective. I’ve gone into this in responses above.
But leaving the comparisons with placebo aside for a minute, let’s look at how homeopathy fares in comparison to conventional reference drugs in specific conditions. Of the 21 trials between 1991 and 2001, 100% demonstrated that homeopathic treatment was not therapeutically inferior (ie. it was either equal or superior) to the corresponding conventional reference drug (Cornelli, Prof Umberto et al. Homeopathy, the scientific proofs of efficacy. 2002 Italian Advisory Board literature review). 100% is a pretty good performance by most people’s standards. So exactly where in all this is evidence for homeopathy not working?
And if homeopathy doesn’t work, but can still outperform conventional medication, what does that say about conventional medication?
My question was a response to Gimpy’s comment that “It is these individuals who attract my ire and I will not apologise or take back my words against them” (plus the comments he’s actually made about them), so this is not a reaction to “my perception” of you but a direct reference to what Gimpy is actually doing.
December 1, 2007 at 11:53 am
gimpy
My question was a response to Gimpy’s comment that “It is these individuals who attract my ire and I will not apologise or take back my words against them” (plus the comments he’s actually made about them), so this is not a reaction to “my perception” of you but a direct reference to what Gimpy is actually doing.
I think my anger at people who claim that AIDS, cancer and autism can be cured by homeopathy is utterly justified and I think it does you a disservice to focus on the perceived offence my statement may have caused rather than criticise ludicrous and dangerous claims. For the record do you think that Aids, cancer or autism can be cured by homeopathy?
December 1, 2007 at 1:35 pm
laughingmysocksoff
There is a lot of case history to suggest that people suffering from these conditions can be helped by homeopathy. No doubt until large scale trials can be performed to test this you’ll find the evidence unconvincing, but the work of Dr A U Ramakrishnan in India on cancer is promising.
No doubt you’re aware of Amy Lansky’s book Impossible Cure?
There’s also work being done in India investigating homeopathic treatment in AIDS. A study on 100 people in terminal stages of the condition showed 49% either improved or got no worse. Treatment was effective in preventing opportunistic infections, though did not affect CD-4 counts.
December 1, 2007 at 3:06 pm
Homeopath bloggers « gimpy’s blog
[…] have taken laughingmysocksoff off the list for refusing to condemn the notion that AIDS, cancer and autism can be cured by homeopathy. This is a shame because he seems to be […]
December 1, 2007 at 4:27 pm
gimpy
I’m a bit disappointed in you laughingmysocksoff. I thought you wouldn’t accept unbelievable claims that make homeopathy look a bit foolish. Also I thought you would know better than to quote news reports at the expense of peer reviewed publications.
On the subject of AIDS there was a woman from the Society of Homeopaths on the radio this morning stating that there were only two published papers on homeopathy and AIDS, one of these refers to cell culture experiments and i’m unsure about the other. Surely it is unethical to treat patients with largely unproven remedies?
December 1, 2007 at 7:20 pm
laughingmysocksoff
I couldn’t find an online source of the study, Gimpy. It’s provided as an illustration that there are explorations into homeopathy’s efficacy in these conditions underway, not as any kind of “proof”. You asked me if I condemned these claims, not to prove them false. I don’t condemn them. As I said in an earlier post, I think condemnation is something that should be reserved for claims that have been thoroughly investigated and found without doubt to be false. That is not the case here.
So be as disappointed as you like, but don’t forget these claims are not unbelievable to everyone. It only makes “homeopathy look a bit foolish” from your perspective: the perspective of someone who believes it doesn’t work. Thousands, millions even, don’t hold that belief.
The situation in this country at the moment, where a small group of determined sceptics are doing their level best to deny people access to the therapy just because they think it’s impossible, is extraordinary. Many people are quite mystified as to why this is happening here (except in Switzerland because of the scandal over the degree of political interference in the PEK study). In India, homeopathy is well accepted and integrated into the healthcare system. People choose to have homeopathic treatment for these serious problems. Ditto in South America. Surely it’s unethical to deny patients the right to choose their model of healthcare? There are no guarantees with any form of treatment, and there is no breach of ethics if patients are provided with full information about the state of the evidence base for any treatment before they make their decision.
You seem to feel that the average patient is as much an idiot as the average homeopath and incapable of making up their own minds about their healthcare. There are a huge number of people who, despite knowing that the therapy is “unproven” by biomedical standards, would rather try homeopathy than undergo the biomedical treatment for that condition. That HAS to be their choice Gimpy. They, and they alone, have the right to make it. And you have no right to try and stop them.
Personally speaking, my condemnation is more inclined to be directed towards the likes of Colquhoun, Horton, Goldacre et al who are distorting evidence to support unproven claims that homeopathy “doesn’t work” and influencing PCTs to withdraw funding from NHS homeopathy services. This means that the huge number of GPs making referrals to homeopathic services can no longer do so and people are being denied access to a therapy that has been shown, in several large clinical studies now, to provide a positive benefit in around 70% of cases. (eg. Spence, David S and Thompson, Elizabeth A. Homeopathic Treatment for Chronic Disease: A 6-Year, University-Hospital Outpatient Observational Study. Journal of Alternative and Complementary Medicine Volume 11, Number 5, 2005, pp. 793-798 and Witt, Claudia M, Lüdtke, Rainer, Baur, Roland, and Willich, Stefan N. Homeopathic medical practice: Long-term results of a cohort study with 3981 patients. BMC Public Health 2005, 5:115.)
December 1, 2007 at 10:55 pm
m3dorrh1num
http://acronyms.thefreedictionary.com/Laughing+My+Socks+Off
December 2, 2007 at 12:08 am
M Simpson
Can we, for a moment, leave aside all thoughts of placebos, RCTs, paradigms etc? Can we leave aside all debate about explanations or evidence? For the purpose of this question, it doesn’t matter a jot how homeopathy might work or whether it can be proved to work.
The absolute core of homeopathy, as I understand it, is this: that a chemical property can be transmitted from a solute to a solvent. That’s what homeopathy lives or dies on: if this can happen, then homeopathy is plausible; if it can’t, then we can all pack up and go home.
If this phenomenon can occur then it has enormous possibilities, not just in medicine but also in agriculture, manufacturing, power, transport, pretty much every aspect of industry. The fundamental principle of homeopathy could be applied to almost anything, affecting every aspect of our daily lives.
Why then do we think this hasn’t happened?
December 2, 2007 at 1:33 am
laughingmysocksoff
The absolute core of homeopathic pharmacy was the discovery, from empirical observation, that the characteristic properties of a solute are somehow maintained through repeated cycles of dilution and succussion in an alcohol/water mix and transmissible to individuals when ingested, and that this phenomenon is consistently replicable. There is no assumption that this is a chemical effect, that it’s necessarily a property of other solvents, or even that it’s predicated on physical properties of either solute or solvent. Hahnemann just kept diluting and succussing in an effort to remove toxic chemical effects and discovered that the remedies just kept on working and producing their distinctive characteristic symptoms no matter how much he carried on diluting and succussing. (Diluting on its own doesn’t work. It has to be dilution + succussion.)
Personally, I think the assumption that it’s a chemical effect is a complete red herring, and I can understand how natural it is to be convinced that homeopathy can’t possibly work if that’s what you assume. Of course it’s a nonsense that any chemical effect could possibly remain at such extreme dilutions! Ergo we need to look elsewhere for a mechanism of action.
December 2, 2007 at 2:12 pm
ross
On 1st impression I thought this was going to be the blog of a more rational homeopath. More Peter Fisher than Peter Chappell if you like. 2 quotes from you in particular have made me doubt that:
‘I don’t “condemn” people who “claim to be able to cure AIDS, autism and cancer”’
‘Nothing would convince me that homeopathy doesn’t work.’
I think these quotes get to the crux of what is wrong with homeopathy in 2007. A blind refusal to disassociate themselves from the crank fringe within their profession. And a complete inabilty to grasp the possibility of being wrong.
But it’s good to get these things on the record and I appreciate your willingness to at least engage in a conversation about this unlike many of your contemporaries.
December 2, 2007 at 3:09 pm
M Simpson
“The absolute core of homeopathic pharmacy was the discovery, from empirical observation, that the characteristic properties of a solute are somehow maintained through repeated cycles of dilution and succussion in an alcohol/water mix and transmissible to individuals when ingested, and that this phenomenon is consistently replicable.”
…Which is a longer version of what I said.
“There is no assumption that this is a chemical effect”
I didn’t say it was. I said that what was transmitted was a chemical property, in this instance the ability to cause/cure certain symptoms.
“that it’s necessarily a property of other solvents”
But wouldn’t that be something worth investigating? And even if it wasn’t, the vast majority of manufacturing processes use water – it’s the universal solvent.
“Diluting on its own doesn’t work. It has to be dilution + succussion.”
How do you know this? What tests have been done on diluted but unsuccussed remedies which show them to be ineffectual?
If the homeopathic process works for medicines, it’s not unreasonable to wonder whether it works for other things. After all, the molecules don’t know what they’re going to ultimately be used for. Think what a boon this would be if it could be applied to pesticides or fertilisers or fuel – cheap, virtually inexhaustible and environmentally friendly.
If we accept that this works and that it has been proven to work (and if we can, as I suggested before, forget any concerns about how it works) then I just can’t understand why no-one outside of the health field has investigated applying this process to non-therapeutic stuff.
December 2, 2007 at 8:35 pm
laughingmysocksoff
There’s no reason to presume it’s a chemical property M, or that the primary response mechanism is a biochemical one. That’s why I rephrased your sentence to specifically exclude the term “chemical”.
It was established by Hahnemann right from the get go, and tests have been performed at various times over the years. You’ll have to give me some time if you want study references as I think some of them are pretty old. There’s a brand new study just out though comparing the effect of homeopathic potencies on growth of Lemna gibba (duckweed) and differentiating between unsuccussed water, succussed water and water containing homeopathic potencies — Claudia Scherr, Meinhard Simon, Jorg Spranger, Stephan Baumgartner. Duckweed (Lemna gibba L.) as a Test Organism for Homeopathic Potencies. The Journal of Alternative and Complementary Medicine. 2007, 13(9): 931-938.
They have. If you can access the paper cited above, then check out the references. There are all sorts of studies in the use of homeopathic potencies in plant growth.
December 2, 2007 at 9:41 pm
laughingmysocksoff
Many of today’s accepted “facts” were regarded as the “crank fringe” when they first appeared on the scene. Until these ideas have received a thorough exploration and testing, it would be premature to condemn them. There’s good case history to suggest homeopathy can be of use in people suffering from serious conditions like these. As for things like musical downloads — well I know next to nothing about them. How can I condemn something I know nothing about? That’s irrational. It would be making a judgement based on opinion and presupposition, not evidence.
And as for “a complete inabilty to grasp the possibility of being wrong”, can I suggest you go read this old Buddhist parable, and then go take a look in the mirror? I know what I experience Ross. And it’s been replicated by thousands of other homeopaths today and for the last 200 years. This has got nothing to do with being ‘right’ or ‘wrong’. You’re asking me to deny my experience. If you can’t discern the difference between belief (which is a model of experience and amenable to change) and experience itself (which simply is what it is and can’t be changed), then there really is no point in discussing this further with you.
December 2, 2007 at 11:09 pm
M Simpson
“Many of today’s accepted “facts” were regarded as the “crank fringe” when they first appeared on the scene.”
But homeopathy first appeared on the scene more than 200 years ago. Shouldn’t it have progressed beyond the ‘crank fringe’ by now?
“As for things like musical downloads — well I know next to nothing about them. How can I condemn something I know nothing about? That’s irrational. It would be making a judgement based on opinion and presupposition, not evidence.”
Assuming that you’re not actually a space geologist or one of the Apollo astronauts, would it be true to say that you know nothing about the composition of the Lunar surface? If so, the above suggests that you would consider it irrational to make a judgement about a claim that the Moon is made of green cheese.
“If you can’t discern the difference between belief (which is a model of experience and amenable to change) and experience itself (which simply is what it is and can’t be changed), then there really is no point in discussing this further with you.”
I for one am unable to distinguish between belief (which is what I think happened) and experience itself (which, unless I am blessed with some sort of objective omnipotence, can only ever be… what I think happened).
December 3, 2007 at 1:56 am
laughingmysocksoff
I wasn’t talking about homeopathy. I was talking about what Ross described as the “crank fringe” of homeopathy.
Well I’m neither a space geologist nor an Apollo astronaut but I’ve read a few papers and articles about the lunar surface and I’ve looked at a few pieces of it at a museum exhibition on lunar exploration, so I’d be more than a bit dubious about the green cheese theory and would probably venture an opinion to that effect. I’m a bit dubious about the music downloads too on the face of it, but I can’t condemn them because I have nothing to base that condemnation on. All I could say is that I’m a bit dubious about them. You guys seems to throw condemnation around like it’s a two-a-penny judgement you make every morning three times before you’ve even cleaned your teeth. In my dictionary it’s a pretty damning indictment that I reserve for the most execrable and heinous kinds of human behaviour that really have very little to say in defence of themselves.
Although there’s a degree to which the two are entangled, it’s possible to make some kind of a distinction. The more abstract and theoretical and rationalised, the more you’re in the realms of belief. The more immediate, direct, observable, unrationalised, the more you’re in the realms of experience. There’s no need whatsoever for any kind of abstract theorising if you miss the nail and hit your thumb with the hammer. You’re aware of the lapse in coordination, you’re aware of the hammer hitting your thumb, you’re aware of the pain that results. If you speculate that the lapse in coordination had something to do with one too many beers the previous evening, now you’re more in the realms of belief. More variables are in play here. It could have been the beers or it could have been the sudden realisation you’d forgotten to pay the electricity bill or the fact your left ear chose that moment to itch or your neighbour walked past or …
All of these rationalisations are amenable to change, depending on which makes most sense to you. The fact that you hit your thumb with the hammer isn’t. You could happily admit to the possibility of being wrong about any of your beliefs about why you missed the nail and hit your thumb. But you wouldn’t be prepared to say you were wrong that you hit your thumb. That would be ludicrous. You know you hit your thumb. Nothing changes that.
This is the distinction I’m trying to draw here. The experience of using remedies is comparable to the experience of hitting your thumb with the hammer. You take the remedy, you feel its effects, you experience the changes it precipitates. It’s not something you can be wrong about. It happens. Nothing changes the fact.
This conversation is starting to get extraordinarily tedious (and I’m referring to all 3 of you here). You ask closed questions, then assume from a negative answer that the opposite of your question is implied, which is a complete nonsense. I’ve explained where I stand here and why. If you’ve got nothing better to do than to play endless games in order to try and twist what I say into something it’s not (and then no doubt run back to the badscience forums to claim another backslap) then go take a long hard look in the mirror. What incredibly sad lives you must lead.
I’ve answered your questions in good faith, but I’ve got much better things to be doing with my time than playing these games. So unless you have something genuine to discuss, openly, then don’t bother.
December 3, 2007 at 10:37 am
ross
“I’m a bit dubious about the music downloads too on the face of it, but I can’t condemn them because I have nothing to base that condemnation on. All I could say is that I’m a bit dubious about them. ”
OK you are dubious about the downloads. How about the people giving out homeopathic malaria treatments that “make it so you don’t have a malaria shaped hole in your energy”?
Out of curiousity are you a practising homeopath? Because these people are doing huge damage to your profession.
December 3, 2007 at 12:51 pm
ross
btw I was referring to this story if you weren’t aware of it.
http://news.bbc.co.uk/1/hi/programmes/newsnight/5178122.stm
December 3, 2007 at 1:13 pm
Mary P
Other issues aside, the people commenting here from Bad Science with their longing for ritual removal from blog rolls, denunciations and condemnations are beginning to seem like so many real-life versions of the Izzard sketch where he goes round pronouncing “a jihad on you”.
If this is what passes for informed and courteous discussion in some circles, no wonder we have an intellectual and rational endarkenment.
December 3, 2007 at 9:45 pm
laughingmysocksoff
As I said
What is there in the above you don’t understand? Go away and get a life Ross.
December 4, 2007 at 2:10 am
EZ
M Simpson writes:
“(in response to “There is no assumption that this is a chemical effect”)
“I didn’t say it was. I said that what was transmitted was a chemical property, in this instance the ability to cause/cure certain symptoms.”
So do you really beleive that only a chemical property – chemical effects – are able to cause symptoms? (Also it’s interesting why do you say that you seem to know what was transmitted even though you suggest all the time that nothing can be possibly transmitted at all? SO which of these – is anything transmitted, or nothing can be transmitted – are you assertions then?)
By they way, the princpile of “like cures like” can also be very well applied with crude substances, so if you are not afraid of side-effects of taking the crude substances, you might still want to test this principle (and try to see that it is not chemical in nature), because this is the basis of the homeopathy, and not the fact the potentised (diluted and succussed) remedies work. This latter aspect is just an additional bonus that Hahnemann has left us, but the basic principle of “like cures like” does work without this as well, and can only bring about the real cure and not the suppression that some other techniques in use now can only achieve. (YOu might need to think well what the “cure” really means to you.)
(Another aside, Hahnemann had started his experiments with peruvian bark, he took the powder himself, had some symptoms, like fever etc., which he noted, and which stopped as he stopped taking the powder, but he DID NOT FEEL SATISFIED BY THIS, HE GAVE THE POWDER TO A LOT OF OTHER PEOPLE, AND WHEN HE SAW THAT THEY GET THE SAME SET OF SYMPTOMS BASICALLY, ONLY THEN HE STARTED DRAWING THE CONCLUSIONS – that’s re point about trusting one’s own’s senses etc. Another aspect is that he, of course, DID NOT WARN OTHER PEOPLE WHAT HE WAS GIVING THEM AND WHAT HE EXPECTED THEM TO SEE, because he did not really expect anything, he was set out to find out! – SO IT’S a BLIND TRIAL, actually, and we have arrived at the protocol of HOMEOPATHIC PROVINGS, that is the way how all those symptoms in Homeopathic materia Medica books have been collected. In modern provings, I recall, even the person who supervises the proving does not know the nature of the substance that is being examined, so I personally would say that this is pretty reliable as a BLIND TRIAL, isn’t it? And it’s much more ethical, because it’s conducted on healthy volounteers rather than sick people, who are ready to try anything, as in some conventional clinical trials?)
But going back to the effects being chemical or otherwise:
Many people have suffered when an atomic bomb was dropped in Japan, they had a great number of symptoms, but none of them were caused by any chemical effects – it was energetic in nature – irradiation, – the energetic sort of influence, that is a “nano” sort of influence in modern terminology, the molecules themselves were broken apart… And chemical effects, actually, do finally depend on this electromagnetic sort of thing, don’t they? Just on a rather gross level.
ALso if someone simply hits you on the head (this may sound a stupid example to give, but just to get you “unstuck” from this chemical-only idea of interactions in life that you seem to have!) – I hope you do not doubt that you are going to get a lot of symptoms as a result? That’s a mechanical influence. Another example of mechanical influence is when someone is scared by a loud sound – the mechanical waves affect the membrane in the ear etc. and people end up having psychological symptoms, or maybe even physical – like diarrhoea from fright – afterwards.
Or another example of enrgetic influence – imagine, that you have been crossing the road, turned your head and saw a car rushing along the road in your direction at great speed – I cannot beleive that you are not going to have any symptoms as a consequence, although not even direct mechanical interaction can be said to have caused them… the best you might come up with is enrgetic influence again, as light is perceived by receptors in our eyes, and the make-up of the surrpoundings is constructed on the base of this in our brain and then the rest of the reaction ensues…if you prefer “materialistic” course of events to boost your understanding.
I am not saying that any of these instances may suggest a cure to any condition, but actually irradiation as a cancer therapy does seem to rely on the fact (implicitly, though, without anyone realising the connection) that radiation can cause proliferation – and therefore kill – cancer cells, so it might accidentally cause a real true cure in someone.
Concerning condemning someone for having said something, has it not occurred to you that having to care about yourself is actually your own responsibility – who do you expect to care better for yourself than your own self? Everybody else has other interests, don’t they? They maybe caring, they can help you to some extent, but they cannot completely devote themselves to you, so you always have to do your homework yourself! Why not reading up on homeopathy, the original source – the Hahnemann’s Organon, Chronic diseases – and try to make sense of what he’s saying, and you will come across all the notions about the use of homoepathic remedies – no remedy can reasonably used “in advance”, this might work, or might not, – you can only treat someone when they start having symptoms, and of course no one can predict what type of symptoms they are going to have, – thus you will not need anyone telling you who’s a good homeopath, and who is not quite trustworthy, and that of course, trying to “prevent malaria” (in any way) is a risky thing to do, in case the remedy you personally would need is not included in the kit you will be given – there are several dozens of remedies that might be indicated – but it is only possible to choose after seeing the symptoms, and also you need to know how to choose the symtpoms for prescription – well, you might wish to learn that too! or… Oh, I forgot, you seem to refuse to trust your own perception/experience, in that case, I’m very sorry to say that maybe there’s no solution out there for you in the face of all the challenges of life. (well, the final “anecdote” is going to happen to you personally, and then it will not matter what has happened to others, would it? It would be just “Why me?!” while something worked for someone else… Or do you indentify yourself with a “statistical individual” of a sort?)
Homeopathy is about increasing the person’s ability to deal with challenges of life on various levels, but if they try to relegate this “function” to someone else, well, they should just keep trying until they realise that “God helps those who help themselves”, as the old saying goes.
December 4, 2007 at 10:26 am
ross
I’m sorry you think I am playing games. I am genuinely fascinated by homeopaths and have enjoyed this conversation.
If you continue you to blog I hope you will still engage with commenters, I think this is important.
Thanks for your time.
December 4, 2007 at 11:24 am
EZ
Dear Laughingsocks,
I wanted to apologise for such a long message I wrote earlier today, I realise that it’s you blog and I enjoy enormously your clear and level-headed statements, I just could not stop when I started to write, and I wanted to ask you to please feel free to delete the whole stuff, it might actually sound offensive to M SImpson, I just wanted to try to make an impact that could make him think a little bit in a different direction, and your blog is actually the only place where the atmosphere feels just right for such attempts! Please, have a good time and a lot of success with your work and homeopathy!
WIth very best wishes,
Elena
December 4, 2007 at 3:23 pm
M Simpson
“it might actually sound offensive to M SImpson, I just wanted to try to make an impact that could make him think a little bit in a different direction”
On the contrary, I’m afraid, you have confirmed everything I already believed about homeopathy and its proponents!
December 4, 2007 at 3:40 pm
ross
EZ, brevity is a wonderful thing.
Socks, one last point (I promise) as you seem to be getting fed up of me.
I find the fact that many homeopaths veer into more extreme areas (anti-vaccination for example) a bit worrying.
With regards to the Malaria/Newsnight story I posted earlier Peter Fisher from the London Homeopathy hospital didn’t mince his words.
He said “I’m very angry about it because people are going to get malaria – there is absolutely no reason to think that homeopathy works to prevent malaria and you won’t find that in any textbook or journal of homeopathy so people will get malaria, people may even die of malaria if they follow this advice.”
What are your thoughts?
December 4, 2007 at 7:12 pm
laughingmysocksoff
Well you’re persistent Ross, I’ll give you that.
It’s for every parent to make up their own minds about what they want to do for their children, Ross, and for every individual to make their own decisions about their healthcare. Where is patient choice in all this? People are more than capable of doing their own research and making up their own minds, and given the parlous state of conventional medicine and the NHS, that’s what more and more are doing. Side effects of vaccination are poorly researched and many parents are understandably concerned, particularly if they’ve reported adverse reactions and their GP has tried to pass it off as something else. Many are looking for alternatives. Don’t you also find it worrying that many GPs don’t vaccinate their own children? (And no, I don’t have a reference to quote on that. It’s hearsay, but from a GP.)
For the record, I neither use, recommend nor prescribe homeopathic remedies prophylactically. The rationale doesn’t make a lot of sense to me. OK?
December 4, 2007 at 9:44 pm
ross
Thanks, can I have one more go since I think you have misunderstood me, I was really asking what you thought of Peter Fisher’s comments?
December 4, 2007 at 11:03 pm
laughingmysocksoff
Hahahahahaha … there go the socks again. You’re very predictable Ross.
They’re his comments, and he’s entitled to make them. However, I do have a number of reservations about the “data” on which they’re based. Given the rather notable discrepancy between the full text of what homeopaths actually said/wrote and what they’re reported as having said/wrote in this and other similar “sting” operations, I suspect the picture has been very heavily filtered to present a sensationalised view of the responses as very much more polarised than was the case in actuality.
Now don’t you think it’s about time you started answering some of my questions in return?
December 4, 2007 at 11:12 pm
M Simpson
Oh and can I just point out to EZ that everything he/she describes in that lengthy post IS chemical in nature. That’s all we are: big bags of chemicals walking around. Everything that goes on inside you – the muscle contraction when you bend your finger, the way the optic nerve transmits an image to the brain, the absorption of nutrients from your food, the way your skin peels off if you get blasted with intense radioactivity – it’s all chemical reactions. It’s molecules reacting with other molecules in some way, even if all they’re doing is passing an electron from one to the other. It’s called biochemistry. The metabolic pathways of the human body are one of the most beautiful things in science (but then I did biochemistry at school – I may be biased).
We know pretty much all the chemicals in the human body, what most of them do and how most of them interact. We know how diseases, whether infectious or genetic, affect these chemical reactions – on a molecular level – and create the symptoms that we experience. And we can now develop treatments from the starting point of knowing precisely what sort of molecule – where it is, what shape it is – we need to interact with in order to to cure someone.
The problem for homeopathy is that all this was discovered in the past 200 years. In Hahnemann’s day, no-one had a clue about any of this and so people basically had to make wild guesses about what might be going on inside healthy and ill people. Hahnemann came up with the idea of miasms which was probably a good idea at the time. But then, so was phlogiston.
Homeopathy relies on the rejection of biochemistry wholesale in favour of a theory of disease without a single piece of evidence except say-so. It’s not science, it’s a rejection of science. Your own misunderstanding of the nature of biochemistry is a sad and telling indicator of this, I’m afraid
December 5, 2007 at 1:46 am
EZ
M Simpson,
I hope laughing socks will permit me just one little answer – yes, brevity is good, when a certain degree of understanding has been achieved first.
I worked in a microbilogy institute writing software for prediction of antigenic determinants, I know about this stuff a bit as well, by father is a professor of biochemistry at a University. But let’s leave understanding/misunderstanding of biochemistry aside, and just one quick question – so you suggest that a phenomenon for phlogiston can also be explained away by chemistry on a molecular level? An interesting comment, I was thinking about phlogiston as well!
December 5, 2007 at 1:48 am
EZ
I meant phonomenon for which phlogiston was suggested as explanation. (Sorry for typing problems)
December 5, 2007 at 2:52 am
EZ
And while we are at it, I guess you beleive that homeopaths try to deny and reject all the chemical processes that you think are predominant to maintaining our bodies. ALthough I have always disliked the idea of those “chemical robots” – the image that seems to arise from studying too much of minute details of the processes that occur in the living organisms, I personally would never think of denying these occur and the point I was trying to make is not that they do not matter, but that they do not occur spontaneously, but there are some factors that TRIGGER them, and they are not necessarily chemical/molecular in nature.
By the way, my father, who as I sais is a biochemist and a devoted one, specifically interested in enzyme activity, had not only declined to try a homeopathic remedy when he did not feel well, but was glad at the opportunity and said that he’d be very interested to try to monitor what kind of biochemical changes and processes were triggered after a person has taken a remedy, because he “felt” the remedy working, and did not dream of denying his experience. Now, that’s what I’d call a scientific approach and an open mind! (I should say that I did not expect him to agree to try homeopathy at all.) I myself would be very interested if someone has thought of funding this sort of research – measuring activity of brain centers, homeosthatic/hormonal status and the like – after taking a true (carefully prescribed) remedy and a placebo as control.
December 5, 2007 at 2:58 am
EZ
And while we are at it, I guess you beleive that homeopaths try to deny and reject all the chemical processes that you think are predominant to maintaining our bodies. ALthough I have always disliked the idea of those “chemical robots” – the image that seems to arise from studying too much of minute details of the processes that occur in the living organisms, I personally would never think of denying these occur and the point I was trying to make is not that they do not matter, but that they do not occur spontaneously, there are some factors that TRIGGER them, and these factors are not necessarily chemical/molecular in nature.
December 5, 2007 at 8:57 am
M Simpson
“because he “felt” the remedy working, and did not dream of denying his experience. Now, that’s what I’d call a scientific approach”
We clearly own very different dictionaries.
December 5, 2007 at 10:44 am
ross
“Now don’t you think it’s about time you started answering some of my questions in return?”
I would be delighted to mr socks but would you mind asking them again to save me trawling through 74 comments.
Thanks.
Can I take it from your answer you disagree with Peter Fisher? I am interested because he seems like the sensible face of homeopathy and is the only one I have seen to come out against people claiming to offer homeopathic cures to fatal diseases like Malaria and AIDS. You would go up in my estimations if you did the same.
December 5, 2007 at 12:38 pm
EZ
M Simpson – so that’s all from what I’ve written that has catched your eye – you are indeed predictable! On this I’ll stop hi-jacking of the laughing-socks’ blog and wish you luck with defending your “science” whatever it be.
December 5, 2007 at 2:35 pm
laughingmysocksoff
Damn … it’s too cold to be barefoot today … where’ve they gone now?!
Well there we have it folks! The whole miraculous wonder of life — its laughter and its tears, its growing up and its growing old, its infinite diversity, its inspiration, its music, its creativity, its curiosity, its sciences, its languages, its philosophies, its relationships, its loves and its hates — reduced to a bag of chemicals! This really is an entire sock drawer’s worth M … is that really truly honestly all you believe life to be? Goodness, no wonder you people are all so angry …
Don’t you know that if you deny an essential part of your being it’s relegated to a “shadow” side of yourself which you can never escape and never “defeat” simply because it’s a part of you? You’ll see it continually reflected back to you in all the things that you’re driven to try and deny, ridicule, and drive out of your life. Projection, this is called. Go read some Jung if you don’t know what I’m talking about.
And this is, I think, the real crux of what’s going on here in relation to homeopathy right now. All this emotion and emotional language — condemnation, denial, ridicule — has no place in a discussion about scientific proof. So what’s it doing here? Face it people: homeopathy is nothing but a stalking horse for you guys to sort out your own relationships to the immaterial dimensions of life. So why don’t you just go away and do that and leave homeopathy alone? Because you’re not only denying yourselves, you’re denying everyone else the freedom to choose their own healthcare modalities, which you have absolutely NO right to do. This isn’t about the science of the matter. I’d be surprised if it ever has been.
Rubbish. Homeopathy doesn’t reject biochemistry. Homeopathy is just predicated on the understanding that there’s more to life, to health, and to disease than biochemistry, and that it’s the immaterial dimensions of our being that make the difference between a bag of chemicals and a human being. It’s not a rejection of science because it’s utterly empirical. Always has been. Always will be.
And your constant trumpeting about lack of evidence really doesn’t stand up in the face of the volume of clinical trials that show a positive effect. You can try all you like to make this go away M, but it isn’t going to.
December 5, 2007 at 3:20 pm
ross
C’mon socks most of that that last post was irrelevant waffle.
“you’re denying everyone else the freedom to choose their own healthcare modalities, which you have absolutely NO right to do. ”
No. I have no problem with people using homeopathy if the they are informed and doing it with their own money.
My personal gripes with Homeopathy are :
the NHS wasting money on it.
homeopaths claiming to be able to offer treatment to fatal diseases, which is when they start being dangerous.
I’m sorry you object to “emotive language” but when homeopaths advise people against treatment for fatal diseases or advise against vaccination they cease being a harmless indulgence. And yes this makes me angry.
I would have no problem with Homeopaths if they stuck to offering a nice chat and a sugar pill for self-limiting illnesses.
Clearly you disagree, so we’ve probably taken this about as far as we can go.
December 5, 2007 at 4:01 pm
monica raina
What is all this argument, anger, & sorry feelings about?
If you don’t like homeopathic treatment, it’s OK. A true homeopath will never ask you to not try other modalities. Neither will a true homeopath tell you that he is the best. We just are, there’s nothing good or bad about us, & there’s nothing good or bad about you. It would be nice if allopathy & homeopathy could work together in a complementary way, but if not, that’s fine. You do your work, we are doing ours.
We are all free to choose what we want to do.
December 5, 2007 at 4:20 pm
laughingmysocksoff
… denial, ridicule … exactly my point 🙂
Why should people who can’t afford to pay for private healthcare be denied the opportunity of consulting with a homeopath if that’s what they want to do? The very rise in CAM therapies in recent years has been because people have been voting with their feet. If these therapies are popular and in demand, and have proven benefit, why should they not be available on the NHS? You don’t have to use them. But why should you try to prevent others?
And if people would rather take a chance with homeopathy, in full knowledge that the evidence base is what it is, than undergo the conventional treatment for their condition, that’s their choice. Particularly when much of the evidence for the conventional treatment shows that it makes only a minor contribution to survival. Like cytotoxic chemotherapy for instance.
I don’t object to emotive language in the least. It just has no place in a discussion based purely on the science of the matter. Rational is rational. Emotional is emotional. If emotion is present, ergo the discussion involves more than just what is rational.
And as for homeopaths “advising people against treatment” for fatal diseases or vaccination, I think it’s been very clear in the foregoing discussion exactly how you go about trying to extract your “evidence” to make such claims. Selective quoting out of context, assuming by one answer that the opposite is implied, etc, etc. These techniques have been used extensively in all these so-called “evidence-gathering” exercises that you’re quoting.
June 8, 2008 at 2:45 pm
James Pannozzi
God bless laughingmysocks off, at LAST a person with the time available and patience to counter the hysterical innuendo, misrepresentations and omissions appearing in the ongoing hysteria against Homeopathy.
I assume you’ve seen Dr. Bell’s
YouTube Homeopathy debate presentation
overview of current Homeopathy research
at:
A full list of cites some of which were mentioned in the presentation
can be found at:
http://nationalcenterforhomeopathy.org/articles/view,173
KNOCK THEIR SOCKS OFF!!