Bad Science piece sneaks undetected into Time Out’s “Alternative Health Special Issue”

November 18th, 2005 by Ben Goldacre in alternative medicine, bad science, homeopathy, statistics | 62 Comments »

Ben Goldacre
Time Out, London
November 16-23 2005

I feel a bit mean, since you’re all having so much fun here, but let me quickly point out a couple of things about homeopathy. First, it doesn’t work. Second, it’s old fashioned and paternalistic. And third, that’s what they say about us: how weird is that?

We’ll do them in order. Stick with me here: at least if you disagree, you’ll disagree with a whole lot more panache by the end. So how do we know homeopathy doesn’t work? By the modern miracle of “counting”. There’s no voodoo here: you take 100 people on homeopathic pills, and 100 people on placebo sugar pills, and you count up how many people get better in each group. The answer is, people on placebo do just as well as people on homeopathic pills. You can’t argue with that fact. You can try and argue around it, but the people in these studies are all individuals: are you denying the reality of their experiences?

Occasionally, yes, you hear about a clinical trial which has found that homeopathy did perform better than placebo. But if you take the figures from all these little trials, and add them all up, and do one big count, you find, again, that homeopathy is no better than placebo. This is called a “meta-analysis”. There have been lots of them. No wriggling. It’s just counting, and if you doubt the methods, or the references, then come to www.badscience.net, and we’ll all happily talk you through it. Nothing is hidden here.

But it’s more complicated than that. What is a placebo? It’s not just a sugar pill: a placebo is about much more than that. Placebo is about expectation, and the cultural meaning of the treatment. Green sugar pills are a more effective treatment for anxiety than red sugar pills. Weird. Why? Your guess is, well, almost as good as mine: and my guess is, it’s because of the cultural meaning of the colours “green” and “red”.

The experiments are endless. Salt-water injections are a more effective placebo treatment than white sugar pills – not because there’s anything especially useful about salt water injections, but because the ceremony of performing an injection is a much more invasive, authoritative and dramatic thing to do to someone.

It gets much better. An experiment in the 1950s found that a placebo operation for angina was just as effective as the real one. I read the academic article again today. In the discussion section, do they say: “Woah, placebo operations work, how weird is that?” No. Because nobody ever notices how completely weird the placebo effect really is.

Branding, of course, is the key with your little white sugar pills. Marketing, after all, is engineered cultural meaning. So a four-way comparison, of sugar pills and aspirin, in either unbranded aspirin tubs or mocked up Disprin brand packaging, showed that brand-name packaging kills pain. The huge wealth of cultural background material – the adverts, the word-of-mouth endorsement, the childhood experiences – everything that the packaging plays on, it’s all part of the pill.

So sneery rationalists, who buy generic, unbranded tablets like aspirin and ibuprofen instead of Disprin or Nurofen: they’re wrong too. It’s perfectly rational to believe that expensive Nurofen is more effective than cheap unbranded ibuprofen, even if they’ve both got the same active ingredient – but only, in a perverse turn, if that’s what you believe.

And this is the key also to alternative medicine: homeopathy is a “complex intervention”, rich in cultural meaning, drawing on attractive contemporary ideas like individualism, patient empowerment, and personalised healthcare, not to mention word of mouth. More importantly, all alternative therapies also offer something missing from modern medicine: the “containment” of symptoms, with understanding and certainty.

A transparent modern medic will say: “I can’t be exactly sure what the cause for your problem is. This treatment might make it better, but, well, it might not.” Nice. “Oh, and it also might have these side effects.” Thanks. Sometimes we even finish off with: “What do you think?”

Enter the alternative therapist: they understand your problems, whatever they are; they’re privately employed, so they have all the time you need; and they have an answer. In fact, they can give you an attractively complicated, wilfully obscure, authoritative explanation for whatever is going on in your body. Energy, chakras, some fictitious and chemical sounding dietary deficiency, whatever you’re buying, they’re selling. They maintain the power imbalance, in their therapeutic relationship with you, because they play up their exclusive access to arcane knowledge, and their authority.

If that’s not old-fashioned medical paternalism, I don’t know what is. Sure, it feels like it works, they’re bigging up the placebo with all the authority and technical flammery they can muster. It’s positively Victorian. Doctors don’t do that any more, but it seems it was popular: there’s a demand, a need, a gap in the market. You know how people sometimes say “doctors should give homeopathy to their patients”? Well we can’t, because to do that, we’d have to lie to our patients. No thanks.

So spend your money. If you want interventions that might work (damn right they have side effects, this is potent stuff) then come to us. But if you prefer your treatment served with extra lies, expense, reassurance, and paternalism: then you’ll be needing a time machine, or an alternative therapist.


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62 Responses



  1. Doug said,

    November 18, 2005 at 1:47 pm

    Beautifully subversive, this will rape the hippy preconceptions.

  2. Mathew said,

    November 18, 2005 at 1:55 pm

    Ben, I’m shocked to the core of my ethereal essence at your lack of faith!

    To my mind, the strongest argument against homeopathy is the ridiculous level of dilution that it involves. As has been pointed out time and time again, the ‘active ingredient’ is so heavily diluted in water that there is not a cat in hell’s chance of there being a single molecule of said ingredient left in the treatment by the time it is offered to the victim, I mean patient.

    You could, of course, reject the atomic theory and so dismiss the argument above. Or perhaps you could argue that water has some sort of ‘memory’ of the active ingredient, long after all trace of that ingredient has vanished.

    You could also strip naked and whistle in the wind and you would be making as good an argument for homeopathy.

    Now, how about pyramid power? There’s a real treatment for you!

  3. Squander Two said,

    November 18, 2005 at 2:06 pm

    Since this is the home of pedantry, I feel I have to mention that a couple contains two things, not three.

    On that note, I shall sod off.

  4. Dr* T said,

    November 18, 2005 at 2:07 pm

    I like the argument about water ‘memory’ of any active ingredients. I also like the idea that water only remembers the active (ahem) ingredient, and not whatever the water was surrounding prior to being added to the ‘active’, especially if it was London water they were adding….

  5. Dave M said,

    November 18, 2005 at 2:22 pm

    Squander Two – Sorry to out pedant you but a couple can mean ‘a few’ as well as just two.

  6. Neil said,

    November 18, 2005 at 2:34 pm

    How about an equivalent for medics – maybe an opportunity for a royal voodoo hospital in the NHS!

    vetpath.co.uk/voodoo/

  7. flaky humanities grad said,

    November 18, 2005 at 2:38 pm

    Didn’t they attempt to replicate the Beneviste (sp?) memory experiments in Nature? If so, what were the results?

    Does this mean I can snigger when my friends compare what remedies they’re using?

  8. Gavin said,

    November 18, 2005 at 2:38 pm

    Re: green and red. I bet that experiment would give the opposite result in China, where red is considered lucky.

  9. Mathew said,

    November 18, 2005 at 2:45 pm

    This is somewhat off topic, but I can’t resist a bit of pendantry. Just checked an online dictionary and…

    ‘Couple’ comes from Middle English, itself from Old French, itself from the Latin ‘copula’, meaning a bond or pair.

    So, a couple really should be two. Although the dictionary does note that it can mean ‘a few’ when used informally.

    The question is, was Ben being formal or informal in his opening paragraph?

  10. flaky humanities grad said,

    November 18, 2005 at 2:52 pm

    since it was written in the first person and directly adressed its audience I’d say it was informal…

  11. Ben Goldacre said,

    November 18, 2005 at 2:54 pm

    Great to have some flaky humanities graduates of our own about to clear these issues up. Vive la difference. This is multidisciplinary action in action.

  12. Dave M said,

    November 18, 2005 at 3:17 pm

    Something that worries me ethically. Placebos can help people recover from illness. By exposing homeopathy as no more than a placebo does that mean that people who may have got better using homeopathy will now not? Is their proverbial blood on our hands?

  13. Miss Prism said,

    November 18, 2005 at 3:22 pm

    The nocebo effect is even weirder, if you ask me – and it means that placebos can have nasty side-effects too.

  14. Rob Sang said,

    November 18, 2005 at 3:25 pm

    But after everything you say about the power of placebo perhaps it’s irresponsible to try to tear down people’s beliefs about homeopathy. If they stop believing, it’ll stop working.

  15. Rob Sang said,

    November 18, 2005 at 3:27 pm

    Sorry Dave M, should’ve refreshed the page again before writing exactly what you just wrote ;)

  16. Dave M said,

    November 18, 2005 at 3:32 pm

    Actually, thinking about it, if i go to my doctor suffering from anxiety and I am given some green tablets, Having read Ben’s article I will now probably assume they are placebos and thus negate their effect (whether they are placebos or not.)

    Maybe I am worrying about this too much!

  17. RS said,

    November 18, 2005 at 3:32 pm

    But maybe we can plough back the money they’d spend on snake oil into real medical research – research that might benefit the rationalists who lose out on placebo treatment because they don’t believe – see, we’re just selfish really.

  18. RS said,

    November 18, 2005 at 3:34 pm

    Dave, it’s worse than that for depression, if you’re given some pills, even if they contain an active antidepressant, they’re still probably mostly placebo. But we don’t like to highlight that fact for obvious reasons.

  19. Dave M said,

    November 18, 2005 at 3:40 pm

    Ahh! Don’t tell me any more. It turns out ignorance is not only bliss but probably healthier for you!

  20. Jay said,

    November 18, 2005 at 3:54 pm

    > Didn’t they attempt to replicate the Beneviste (sp?) memory experiments in Nature? If so, what were the results?

    I seem to remember when Nature tried to replicate these results in Bienveniste’s lab, as soon as the researchers were unaware which sample they were studying, the difference between homeopathic treatment and control disappeared.

    Not to say they were doing it deliberately though, it was an unintentional bias.

  21. Tristan said,

    November 18, 2005 at 4:07 pm

    Here’s my £0.02 worth.

    I can see the point Dave M and Rob Sang are trying to make and think it should be taken on board, whilst accepting that outright lying, as occurs with homeopathy, is unacceptable.

    We have established that placebo works. What we now need to research is why it works, and how it works – how can the mind physically affect the body? If we can understand that, can that not lead to more effective use of those processes?

    Could it not lead to techniques that could be used by doctors to help make people better, without having to lie to them. Using processes that they actually understand and can demonstrate in action and are ethically sound. Replace the pseudoscience with science to keep the same outcome basically.

    Any thoughts Ben?

  22. Jay said,

    November 18, 2005 at 4:23 pm

    Dave M – Is their proverbial blood on our hands?

    Possibly, but I would imagine not as much as on the hands of the shamans who persuade people to stop their scientifically tested treatment in favour of homeopathic water, rare plant extracts, aura magnets etc.

  23. Dave M said,

    November 18, 2005 at 4:34 pm

    Fair point.

  24. Fred said,

    November 18, 2005 at 5:42 pm

    I have a question for Ben. Have there ever been any experiments to see if the placebo effect works when people know that they are taking a placebo?

    That is, one group is given sugar pills (say) and another nothing. Half the group with the pills are given a short talk explaining the placebo effect, and that they are taking sugar pills, before the experiment begins. Is an overt placebo better than taking nothing, and is the effect as great as when the patients don’t know that they are taking a placebo? It would be interesting to know.

  25. Frank said,

    November 18, 2005 at 6:09 pm

    You’re all missing the real point here: placebos work! I for one am going to establish a business first thing Monday morning seling Plazebo(TM), the world’s first over-the-counter, branded placebo.

    It’s a safe, reliable medicine that can used to treat anything from angina to out-of-alignment skull plates. It’s safe for the whole family!

    This is not an alternative medicine: it’s been used in top medical labs for decades, and it’s scientifically proven to work. …

    I’m gonna make me a mint.

  26. Rod said,

    November 18, 2005 at 6:29 pm

    Ben,

    Have you heard about the homeopathy patient who recently died of an overdose?

    It appears that he stopped taking his homeopathic medicines.

  27. Kristin said,

    November 18, 2005 at 6:37 pm

    Sucrosa: It’s Going To Work

  28. John A said,

    November 18, 2005 at 6:40 pm

    Nature published the Benveniste paper with a disclaimer and the condition that a replication be attempted. Benveniste’s own team could not replicate their results when overseen by a team investigators (which included James Randi). Benveniste never retracted his original paper and claimed that he was being persecuted. Two subsequent attempts at replication failed. A variation of Benveniste’s original experiment succeeded but this failed to replicated when tested by a team at UCL as part of a Horizon program shown last year.
    Full details here.

    I disagree with Matthew. The question is not whether homeopathy can work in theory, it’s whether or not it does. However that said, it is undeniable that the prior probability of homeopathy actually working is very low because it is inherently nonsensical. Thus when we see a few positive results with perhaps borderline significance and inadequate blinding the question is what is more likely? That this particular treatment works (for some reason – not necessarily due to homeopathic theory being correct) or that we are seeing a combination of placebo, publication bias or methodological error, etc?

    Think of it this way – imagine that homeopathy did not work. What would the state of the research look like?

  29. John Jackson said,

    November 18, 2005 at 7:07 pm

    My understanding is that the placebo effect does NOT cure disease and illness; it is a psychological response to treatment that that makes the patient feel better because they re-interpret their symptoms due to their expectations and beliefs.

    This is why homeopathy, and other bogus remedies, can appear to be effective for self-limiting and psychosomatic conditions, but are useless at actually curing anything.

    Homeopathy does not work, but it can appear to work.

    I think that placebo effects are often mistakenly thought of as some mystical or magical healing effect; but they’re not.

  30. Tessa K said,

    November 18, 2005 at 8:05 pm

    From what I’ve read, placebos work best in certain areas – depression, pain and allergies/skin complaints are the three I can remember.

    One of the (many) things that makes me laugh about homeopathy is the number of things that ‘prevent’ it from working. You can’t have anything minty because that de-activates the treatment, for example. I was once talking to a homeopath at a party who had bad hayfever. I asked why she hadn’t taken anything for it. She said she had been painting her flat that day and the paint fumes would prevent the pills from working. OK, some substances interact, but how can something that claims such serious effects be so fragile? And of course, the presence of a skeptic is likely to de-potentize a remedy.

    I must confess that in my ignorant youth I tried homeopathy. Back then, I thought it would work. It didn’t. I was really disappointed. Not even a placebo effect.

    What’s the verdict on osteopathy? As far as I can see, it’s pretty much the same as physiotherapy.

  31. tom p said,

    November 18, 2005 at 8:26 pm

    Pain is usually a symptom of some other ailment or injury, so placebo working on pain would simply be it treating a symptom.

    Depression and skin conditions are often made worse by feeling stressed and out of control. Taking something that people have told you will make you better often does. As John Jackson pointed out above, you reinterpret the symptoms looking for positive data. We all want to do this, which is why trials are blinded, to see what actually works as oposed to what we think is working.

    If memory serves, I think that the placebo effect works in about 20% of cases, which suggests that 1 in 5 of us are weak-willed and easily suggestible. Given that 10 million people read The Scum every day, which is about 1 in 6 of the british population, that seems about right.

  32. Rosie said,

    November 18, 2005 at 11:02 pm

    Another thing to consider is that things like pain and depression are inherently variable. By that, I mean people don’t tend to feel the same every day – they have better days and worse days, and good periods and bad periods. When you start taking something/having a treatment/whatever it can be pretty hard to determine if it’s actually doing anything (unless the effect is hugely dramatic), because you don’t know if you feel better because of the treatment or you’d feel better anyway. They’re also things that are much harder (impossible?) to measure objectively, compared to, say, something you can do a blood test for.

  33. Tristan said,

    November 19, 2005 at 1:35 pm

    Jack Johnson: I didn’t mean that we could develop techniques based on the placebo processes to cure illness, but I probaby didn’t make that clear enough.

    However, I do think it techniques could be used to alleviate symptoms (pain etc) whilst also using exisitng medical methods to cure the underlying physical problem.

  34. RS said,

    November 19, 2005 at 1:42 pm

    Rosie, there’s also regression to the mean.

  35. The Engineer said,

    November 20, 2005 at 2:35 pm

    The ethical question is a very difficult one, i’ve met someone who was utterly convinced that alternative methods had put her into remission from cancer – but he first action was to not take her prescribed treatment. So should we argue with her that it was luck and if her cancer returns she should take treatment? Even though she is convinced the medcine will kill her? What if she goes on to convince someone else to not follow their treatment?

    Perhaps an alternative, alternative therapy approach would be to take everything known about the placebo effect and all the research done on alternative therapy and then pitch it in the language of self help, i’m not saying distort it. I’m saying take this powerful effect and allow people to apply it to themselves without collectively spending billions on false cures. We might need some of those humanities grads, or maybe even some volunteer marketeer’s to help. Now we just need a name…..

  36. alun » Weekend Reading said,

    November 20, 2005 at 2:54 pm

    […] Bad Science continues to rock. What happens if a doctor gets to write an article in an alternative health issue of Time Out? There’s also an update on his MRSA adventure, reporting on his appearance in You and Yours on Radio 4. Except I’ve made a mistake there as I’m pretty certain you can’t appear on radio. […]

  37. Tessa K said,

    November 20, 2005 at 3:59 pm

    Tom P: We’re all more suggestible than we like to think we are. That 20% you quoted could mean that 20% of people are susceptible to placebos or that all of us are susceptible 20% of the time.

    One good thing about homeopathy from the practitioner’s point of view is that, if a ‘patient’ complains a remedy didn’t work, you can blame them for doing something that interfered with it. Even a ‘negative attitude’ could be blamed.

    Engineer – a simpler way would be to teach doctors to be more touchy-feely. Same medicines, just more hand-holding and sympathetic noises.

    Alun: you can appear on radio but that would involve sitting on it.

  38. IT Bloke said,

    November 21, 2005 at 9:50 am

    Where to begin???

    Homoepoathy has sound logical reasoning at its core. The basic belief is that if the body is suffering from a certain malaise (arthritis, for the sake of argument) and the patient’s (victim / mark / rube / punter, whatever…) own immune system is unable to provide relief then the patient is given something the body can fight, in a low dosage, that causes arthritic like symptoms which the immune system can react to and in so doing provide relief to the arthritic symptoms at the same time. Think fight fire with fire.

    Now all sorts of arguments can be lined up against the passage above but that will not change the fact that there is an underlying logic to it all.

    The problem occurs when all the other tripe is placed on top of the logic in order to try and make practitioners of homoeopathy sound more like the very establishment they decry with such venom.

    The problem with the detractors of homoeopathy is that they attack the tripe which in a way lends a legitimacy to the entire charade. If you can find clear logical fault with paragraph 1, and you can do it in such a way that you dont come across as snide or cynical then the house of cards built on top of it will come crashing down.

    Dont bother with attacking or denouncing me as i honestly could not give an es h 1 tee one way or the other. In my experience the entire industry is a self serving bunch of snake oil peddelars.

  39. IT Bloke said,

    November 21, 2005 at 9:55 am

    PS. By “entire industry” im lumping the whole lot, MD’s, pharmaceuticals, homoeopaths, etc. into one large bracket next to which i write “Warning – May contain high doses of BS. Handle with care and keep out of reach of wallet”

  40. Teek said,

    November 21, 2005 at 11:15 am

    homeopathy is something that irritates me to my core…!! here’s a story, recounted by Edzard Ernst. more on who he is later (i’m not quoting verbatim, altho i do remember his words pretty well…).

    “A famous German homeopath had been working at his clinic for over thirty years, and had built up a reputation as someone who could fix/cure/treat any/everything. His office was on the fifth floor of a building, and he sent all his patients down to the first floor, where a pharmacist would dish out the prescribed homeopathic treatment. Nothing wrong there. However, the pharmacist was a clever man. He, for THRTY YEARS, doled out nothing but the diluent – which just happened to be brandy – to EVERY PATIENT THAT CAME HIS WAY. and yet the homeopath was able to build on his reputation as a healer, and hardly anybody complained that his “treatment” didn’t work. here’s a surprise – a 5ml shot of brandy, three times a day, makes one feel a bit sprightly and forget the back pain/depression/headaches of yesteryear…!”

    now, that’s a cracking story, and a true one by all accounts too.

    as for Edzard Ernst. We invited him to speak to the UCL Post-Graduat Biomedical Society about 18 months ago, in his capacity as Professor of Complementary Medicine. but wait, before we all snigger at this (how can you be a prof in placebo i hear you ask), read this…

    www.pms.ac.uk/compmed/ernst.htm

    note, he is a qualified physician, and is trained in (and indeed practised) “acupuncture, autogenic training, herbalism, homoeopathy, massage therapy and spinal manipulation.” from this position, having conducted meta-analysis after meta-analysis, he has come to be the most ardent critic of CAM (Complementary and Alternative Medicine) in the UK. he is a cracking speaker, and really is the sort of guy Ben is speaking about when he says that if you “take the figures from all these little trials, and add them all up, and do one big count, you find, again, that homeopathy is no better than placebo.” hurray for Prof. Ernst…!!

    Ben, kudos for the homeopathy expose, keep up the cracking work – and Kristin – can i have a case of Sucrosa in blister packs please, i have a storming headache…!!

  41. Delster said,

    November 21, 2005 at 12:18 pm

    everybody konws that homeopathy works by shrinking the water molecules and causing them to form microclusters that increase health and vitality…… or some such BS

  42. Mathew said,

    November 21, 2005 at 12:45 pm

    And right on cue, another study showing the efficacy of homeopathy:
    news.bbc.co.uk/1/hi/england/bristol/4454856.stm
    Or not, as it appears as if they simply asked the patients whether they felt better or not. How very scientific.

  43. Mathew said,

    November 21, 2005 at 12:47 pm

    Ben has just added an entry on this very article.

  44. Ben Goldacre said,

    November 21, 2005 at 12:47 pm

    I just put a kind of experimental “not really an article” post up about this… stop me if I’m boring you…

    www.badscience.net/?p=188

  45. Adam said,

    November 21, 2005 at 1:03 pm

    It would be interesting to see how some alternative medicines on the NHS would work:

    Acupuncture – I am going to stick all these pins into you. I’ve no idea whether this will work or not. Side effects include pain and bleeding. What do you think?

    Crystals – Sit next to this crystal and meditate for a bit. I’ll be outside having a coffee. Side effects may include drowsiness. What do you think?

    etc etc

    Would alternative medicine work at all if grumpy old doctors like Ben had to dish it out?

  46. Tessa K said,

    November 21, 2005 at 1:38 pm

    Rescue remedy is another classic, along the lines of the German homeopath’s treatments. It works really well to calm down small children. Could this be because the base of the liquid is pure brandy?

  47. MostlySunny said,

    November 21, 2005 at 2:26 pm

    I think the history of homeopathy is interesting. When it was invented mainstream medicine was an imprecise and indeed brutal thing. No anesthetic, very little knowledge about hygiene and bacteria with leeches, bleeding etc being the order of the day. It seems that modern medicine has evolved so the criticisms levelled at then cannot hold true now whereas homeopathy is virtually unchanged.

    Says it all for me really.

  48. Morag said,

    November 21, 2005 at 10:08 pm

    I suppose IT Bloke isn’t coming back to hear the news that there isn’t even one single molecule of the “something the body can fight” in the actual pills they dole out? That when you buy a bottle of any of the remedies in Boots and look at the contents (small print) as opposed to the headline label, they all say just “sucrose/lactose”. Which is correct, because that is exactly all that’s in them.

    But since he says he couldn’t give a sh!te about the facts, so don’t bother to correct him, I suppose it’s a waste of time posting this.

    Fair enough, IT Bloke, stay misinformed. We should coco.

  49. John A said,

    November 22, 2005 at 1:27 pm

    I think what IT Bloke said nicely illustrates the point that people like to feel that they understand why something works with as little effort as possible. Like witchcraft, “like cures like” is metaphorical reasoning and patients can use their day to day knowledge to feel that they understand the treatment (or even self medicate). Much easier than having to learn some science/maths. He makes a good point that in order to explain to people that their reasoning is wrong we have to tactfully tell them that all the science they thought they didn’t have to know is important, that their reasoning is poor and ours is superior and this may involve an implicit attack on their meta-physical beliefs. I doubt people are receptive to this and it is easy to dismiss CAM sceptics as “snide and cynical” because (sadly) ad hominem is usually the best way to “win” a public argument…

  50. John B said,

    November 23, 2005 at 11:54 am

    A lot of the above comments about homeopathy are based on ignorance. Homeopathy is a treatment that employs something that has the power to create the patients symptoms. Whether or not diluted remedies have an effect does not, therefore, have any influence over homeopathy.

    Unfortunately, nowadays, even some homeopaths can not tell the difference between a homeopathic remedy (one that can produce similar symptoms) and a potentised remedy (one that is diluted) and so your ignorance is excused.

  51. Michael P said,

    November 23, 2005 at 2:00 pm

    “Whether or not diluted remedies have an effect does not, therefore, have any influence over homeopathy.”

    Translated….

    “Whether or not the little bottle of water cures your cancer, we still make bundles of cash”

  52. BSM said,

    November 23, 2005 at 3:22 pm

    An important point tha has only been alluded to thus far is that the real size of the placebo effect needs to be considered for various medial settings. In some psychosomatic illnesses it may be all you need, but for a broken leg its real effects are probably negligible.

    There is an awkward middle ground with nasty chronic diseases like cancer, for which the the may be no genuine “mind over body” effect on actual survival rates, but the ability to live with the disease in a better frame of mind is valuable.

    It is dangerously easy for conventional medics to give unnecessary ground to the woos by saying that they at least evoke a useful placebo response, but we should keep our critical guard up and employ some objectivity in assessing the power of that response.

    Conversely, if the SCAMmers were not just in it for the money and the public credibility and really wanted to help medicine, they would properly embrace attempts to tease out the relative merits of the placebo power of their favourite therapy.

  53. John A said,

    November 23, 2005 at 7:44 pm

    John B I am aware of the “like cures like” philosphy underlying homeopathy whereby drugs which may cause a particular symptom in high concentrations are used to treat that symptom at lower doses. However, as I understand it the problem exists that some compounds may be toxic at high concentrations or may (obviously) make the symptoms you are trying to make better worse. For that reason they are often diluted down. I don’t think it is uncommon that homeopathic treatments are heavily diluted to the point that no molecule of the original substance exists. Hence the criticism is well founded. If the homeopathists will admit to this being a silly aspect to their theory and abandon it, we will stop criticising that aspect.

    However the notion that a vague statement that “like cures like” should be a framework for developing medical treatment is a weak theory with no explanatory power. At the time it was as bad as any other theory around but nowdays it is showing its age. Just to prempt the inevitable, yes occasionally “like cures like”, and sometimes “opposite cures opposite”. But both statements are facile, prone to being twisted post-hoc to fit an argument and neither is a sound basis for treating an illness. Convential medicine is not developed from the idea that “opposite cures opposite” (allopathy) despite what the homeopaths might have us believe. They are not even competing. Homeopathy is one weak theory based on metaphorical reasoning whereas convential medicine is a whole hoarde of theories all building on each other and based on centuries of experimental knowledge (and more importantly the more recent one).

    Either a treatment works or it doesn’t. If some (non-potentised) homeopathic treatment works it is probably because the ingredient has an active compound. In this instance “like cures like” is supported but also several more specific theories within the body of knowledge that underlies convential medicine to do with the pharmacological effect of the compound. But if our current scientific knowledge cannot explain how it works homeopathy cannot offer an explanation either. It has no explanatory or predictive power. So in what way is homeopathy a theory with any useful purpose?

  54. Bob O'H said,

    November 25, 2005 at 9:31 pm

    I hope this means you’ll be releasing a new line of placebos, in different colours, in time for Christmas.

    Bob

  55. Ben Goldacre said,

    November 25, 2005 at 10:48 pm

    Actually, can anyone be bothered to make a nice looking “placebo” logo in a capsule, or something? There’s a t-shirt in it. Which in itself will double sales.

  56. BSM said,

    November 26, 2005 at 5:38 pm

    “Actually, can anyone be bothered to make a nice looking “placebo” logo in a capsule, or something?”

    Placebin- does exactly what it says on the tin.

    Support your Local Homeopath-
    a joint message from Thames Water and British Sugar

    Homeopathy-
    for when doing nothing is good enough

    Colonic Irrigation-
    just going through the motions

    Craniosacral Therapy-
    scratching heads and tickling bums

    Alternative Medicine-
    more quacks than your local pond

    Chiropractic-
    Back. Crack. Quack.

  57. Morag said,

    November 26, 2005 at 9:54 pm

    “Actually, can anyone be bothered to make a nice looking “placebo” logo in a capsule, or something?”

    www.panexa.com/

  58. Deetee said,

    November 27, 2005 at 2:45 pm

    Placebo?
    www.tripzine.com/images/placebo_ad.jpg

  59. Ben Goldacre said,

    November 29, 2005 at 1:15 pm

    It’s such a great joke that everybody else has made it first.

  60. Ben Goldacre said,

    January 29, 2006 at 4:21 pm

    Another fantastic letter from the Society of Homeopaths. I’m not quite sure how I came to be known by them as “the allegedly infamous quack-buster Ben Goldacre”. Who alleged my infamy, why did they allege it, and when? I may have to sue over these allegations of infamy.

    17.11.05 – Letter to Time Out
    Re: The Bitterest Pill

    Dear Sir,
    We object very strongly to the highly opinionated article by the allegedly infamous quack-buster Ben Goldacre (The Bitterest Pill, p.24) in Time Out (November 16 – 23). Goldacre used this opportunity to talk about placebo and cited homeopathy as a prime candidate. He must be ignorant of the fact that over 20 rigorous and scientific trials have demonstrated that homeopathy has an effect over and above placebo and this includes large-scale trials on farm animals, which presumably are not susceptible to the idea of placebo.

    In his dismissive conclusion, he asserts our therapy is served with, “extra lies, expense, reassurance and paternalism”. What complete rubbish! The Society of Homeopaths has over 1200 Registered Members, none of whom would recognise themselves in this stupid remark and nor would their patients.

    The Society was pleased to see, however, that despite Goldacre’s views, that homeopathy was placed firmly in the ‘acceptable’ therapies in the same issue (Alternative Health Special, p.146).

    Yours sincerely

    Melanie Oxley
    Communications Manager

  61. Mick James said,

    February 27, 2006 at 11:29 am

    Surely homeopathy is the best explanation of the placebo effect? We all drink water all the time, which by now will be imprinted with the “memory ” of virtually every substance known to man. So our taps are constantly dispensing an endless supply of free medicine?

    So why do we not just get better automatically when we get ill? Well, a lot of the time people do just get better, and that is clearly due to this unseen homeopathy . Unfortunately, the the near-infinite medical potency of tapwater is such that it creates a lot of “therapeutic noise”. The body simply doesn’t know which of the healing voices to listen to. So it’s probably the therapeutic intervention of giving someone a sugar pill, and saying, “this will cure your arthritis” attunes the body to listen out for the healing memory of the homeopathic molecules–in the water they drink to swallow it!

    So far from disproving homeopathy, the placebo effect confirms it. If we could only train our bodies to listen better to the homeopathic cures flooding our veins, then we could shut down the NHS. Thames Water might want to jack up the water rates a bit though.

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