Reimagined and Revamped. Fighting the spread of nonsense often feels like a Sisyphean task. However, the joy is in making the information available, not the hope of conversion.

Homeopathy equivocation


This is not going to be a unique post about homeopathy or natural rememdies, or equivocation. In keeping with my mission, I'm writing this post as simply one more place to find on the internet as an article that extracts good and points our nonsense of a body of so-called knowledge that pervades our society. I am not the first to point out that homeopathy is bunk, I certainly won't be the last.

Homeopathy, despite the horrible pervasiveness, is utter nonsense. Let's clear one thing up immediately so that we can see why I say that. Homeopathy cures the exact same things that water and sugar cure. Nothing more and nothing less. It is also fatal in the cases where homeopathy is used where evidence based medicine should have been, for example kidney failure, malaria, pneumonia, and so forth. These are the same things that could kill you if you treat them with water or sugar pills.

The reason for this is that homeopathy is water or sugar pills. How do I know this? Because this is what the practitioners of homeopathy tell you it is. There are no lies out there as to what it is. There are three fundamental flaws in the reasoning behind homeopathy that make it absolutely bizarre that anyone anywhere takes it seriously.

1. Law of similars
This is the idea that "like cures like". An example described at the National Center for Homeopathy discusses ipecac, a substance derived from the root of Ipecacuanha. It causes vomiting, and we use it for this feature. The idea is that since it causes vomiting, then if you are vomiting for another reason, then taking ipecac should cure it.

2. dilution
But why would taking something to make you throw up fix you when you are already throwing up? Ahhhhh that doesnt really make sense, that just sounds like you will throw up even more. Well, to counter the 'toxic effects' of the extract, it is diluted. The more diluted the stronger. So when you buy a homeopathic remedy it has a reference in its ingredients it might say something like 10x or 10c, or 30c. The higher the better.

What does that mean? Let's let the Society of Homeopaths answer this:

How are the remedies made?
...The raw extracts (from plants or animals) or triturations (from minerals and salts) are made into a ‘tincture’ with alcohol which forms the basis of the dilution procedure. Dilutions are made up to either 1 part tincture to 10 parts water (1x) or 1 part tincture to 100 parts water (1c). Repeated dilution results in the familiar 6x, 6c or 30c potencies that can be bought over the counter: the 30c represents an infinitessimal part of the original substance.
What happens at 12c? (My bold)
Are homeopathic remedies safe?
Homeopathic remedies are a unique, potentised energy medicine, drawn from the plant, mineral and animal worlds. They are diluted to such a degree that not one molecule of the original substance can be detected (after the 12c potency).
To be clear, a 30c solution (the strongest by homeopathic standards) is more dilute than putting a drop of the tincture into the Atlantic ocean. So, if there is nothing in there. Why does it work? Its the shaking that embues the substance with its magic healing power
...the critical component of shaking ('succussion') between serial dilutions without which they would, indeed, be merely water rather than potentised substances.
3. No evidence, No Provenance

Evidence

The reason evidence based medicine works so well is that it is checked for its efficacy. The single most powerful tool in the arsenal for doing this is the double blind controlled study. With this tool we can determine if a procedure, method or substance is not only superior to other methods, procedures, and substances in treating an ailment, but we can check if its better than something known to not treat the ailment, like water, saline or sugar, otherwise known as a placebo.

But even with controlled studies, there still has to be verification and improvement of the study. This is because its expensive to do this studies properly. So pilot studies are done with few (as low as 5 or 10) participants. These are good as a screening mechanism to answer the question "should we check further?".

So what happens, homeopaths do a pilot study, usually poorly, and then claim success. Then when the test is repeated under more controlled conditions with more participants, lo and behold, the homeopathic remedy works as well as water does. With good reason, it is water. There is even a challenge out there, for free money that challenges any homeopath to do a proper study on homeopathy and show statistically (as opposed to interpreted) significant results. Their money is safe. Why? Because homeopathy is water.

Provenance
This is a great post on provenance and why it is important. Let me sum up by quoting:
If the claim is based on earlier sound science – backed by quality evidence – it is more likely to be true. Not certain to be true, of course. But it will at least have scientific plausibility. But if the claim is based on something that was just made up, then it seems much less likely it would be true.
Where did homeopathy come from? Well it turns out that homeopathy is based on the personal experience of one man, Samuel Hahnemann. He was born in Germany in 1775 and published his homeopathy work in 1810.

So how did he come to his conclusion?
...he read the claim that the drug, cinchona (Peruvian Bark), was effective in treating the symptoms of malaria because it was a bitter astringent and had a tonic effect on the stomach.

Hahnemann rejected this claim outright as it suggests that other drugs which had these characteristics should have a beneficial effect on malarial states, which they don’t. In order to establish exactly what effects cinchona did have on the human organism he decided to take the drug himself. He began to administer doses of cinchona to himself over a short period of time and discovered that this bark actually created malaria-like symptoms in a healthy individual. Hahnemann reasoned that it was the similarity of symptoms that somehow produced the healing effect. This prompted the postulation of the first principle of homoeopathy: “like cures like.”
There is no provenance for homeopathy. It popped out of the blue from the personal experience of one man. It is not the result of an improvement of prior work, it is subject to all the biases that comes with research in a box. Was it his own opinion that he had malaria like symptoms? Or was he just feeling sick from poisoning himself? He got better when he stopped poisoning himself, and somehow made the jump that poisoning himself less would cure a disease that has nothing to do with the poison. Please note...he never caught malaria nor cured it to check his theory.

One more item on homeopathy. Its not ancient and it is not Chinese. Its less than 200 years old and its from Germany. But even if it were, just becuase something is old and from an unfamiliar area doesn't make it good. The average lifespan of chinese people in 1900 was around 25 (it was 47 for us), as late as 1956 is was only 35. To claim that there is anything good about ancient medicine that has not been verified with evidence is beyond ridiculous.

Enough of homeopathy.

Equivocation with natural remedies
The biggest problem right now with homeopathy is that is is often confused with natural remedies. In fact, the pushers of homeopathy enjoy this confusion as it allows them to slip the sales of pure water under the auspices of natural remedies, of which many are real.

Lets define a natural remedy: A medicine prepared from plants or a chemical that occurs naturally. So extracts from various plants are included, but so are vitamins, even hormones. Clearly there are natural remedies that can help us, and they are not watered down to nothing.

So if we have a diet that is low in vitamin C for example, we would choose a natural remedy of eating vitamin C or a diet with more fruits, particularly citrus, in it. So clearly there is a natural remedy for scurvy (which is sadly still not unheard of today). There are a number of natural remedies that have gone through double blind testing and shown to have efficacy:

  • Aloe has some evidence that it is good for constipation and skin irritations.
  • Devil's Claw has some evidence that it can reduce pain
  • Ginko Biloba has some evidence that it can help with pain due to clogged arteries and dementia
  • Psyllium can help with high cholesterol
  • Saw Palmetto can help with urination issues
  • St Johns Wort can be used to reduce depression
(That's a pretty cool site in those links, however I have not looked into the standards applied to that chart, but you can look more into it here. However, they are clear that these things do not work for everything and many of the herbs, like echinacaea, are shown to have no evidence of doing anything, so I am inclined to go along with this, but the only grade I would accept to indicate a useful herb is an A. If the grade is B it indicates that pilot studies show a positive result, while a better controlled study found no such result)

The point is that there is no controversy that there are, in fact, remedies that grow naturally. Evidence based medicine recognizes it. Each claim must be assessed individually. Then, if efficacy is found, the active ingredient, ingredients or mechanism can be weaned out, understood and used. This doesn't mean that all things that grow in nature are good for you (poison ivy, arsenic) or can be used for something (I encourage you to peruse the list for your favorite herb).

But when you equivocate homeopathy and natural remedies you are not only endowing the homeopathy with undeserved respect, you are lowering the importance of the natural remedies that have been researched with positive evidence made available for its efficacy. In order to keep the eye on the ball, we must be tsting the claims of people who say that one herb or another is good for us.

This goes for equivocating the ancient Chinese secret fallacy with evidentially supported natural remedies. You weaken the standing of the good, verified remedies by relying on an appeal to ancient ways.


10 comments:

On 1/23/09, 3:38 AM , Maria said...

Well said.

The more articles that are out there countering all the nonsense being promoted by homeopushers all over the web, the better.

 
On 1/23/09, 10:18 AM , carnifex said...

Sometimes I consider getting lobotomized, just to ease the tension. Other times I think "hey, I bet that train couldn't stop in time if I jumped onto the track".

I always back off because a real trauma team might save my mangled frame.

 
On 1/23/09, 8:31 PM , Net Admin said...
This comment has been removed by the author.
 
On 1/23/09, 8:32 PM , Snajib Sarkar said...

Trials with homeopathy are a mixed bag. Some show results and others do not. The only homeopathic medicine that is pretty well tested is Oscillicoccinum. It seems to shorten the flu by about 6 hours but does nothing for prevention. More trials are necessary to confirm this. I found about 4 trials showing it does shorten the flu. One of the trial is from the cochrane database so you know it is well done trail. Researchers do note that trials can be inconsistent. Sometimes the trial may work just because of pure luck.

 
On 1/24/09, 4:39 AM , Techskeptic said...
This comment has been removed by the author.
 
On 1/24/09, 4:53 AM , Techskeptic said...

Please link to any evidence supporting your contentions here so we can discuss the reality of them. For example, in your review of chochrane, what did homeopathy improve? Was it flu? It really isnt a mixed bag at all.

Positive homeopathic results come from poorly done studies. Even in your example, considering that the strong flu symptoms last 4-7 days and minor symptoms (cough and tiredness) can last for weeks, its a little hard to bleeive that a 6 hour difference was actually recorded to be a significant difference.

There are most certainly positive homeopathic results, but virtually in every case, those studies are superceded by better studies with better controls and more participants. The result is that the magic powers of homeopathy dissapear.

Here is a quote from the Cochrane summary regarding flu:

However, taking homoeopathic Oscillococcinum once you have influenza might shorten the illness, but more research is needed.

 
On 1/24/09, 5:04 AM , Techskeptic said...

cccccceven more interesting:

Oscillococcinum also increased the chances that a patient considered treatment to be effective

Which can explain the 6 hour difference, the length of the flu was determined by the patient ("I feel better now").

Since only 2 of the 7 studies provided enough data for a quantitative data extraction its hard to say from that summary, how any of these results leads to a positive conclusion.

Even the authors conclude the same thing:
"the data were not strong enough to make a general recommendation to use Oscillococcinum for first-line treatment of influenza and influenza-like syndromes."

The summary can be found here.

 
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