Homeopathy Debate Video Stream

December 14th, 2006 by Ben Goldacre in bad science, homeopathy | 75 Comments »

The video for the homeopathy “debate” at the Natural History Museum two weeks ago is up, it’s me and Dr Peter Fisher, Clinical Director of the NHS Royal Intergalactic Homeopathic Hospital in Queen’s Square. It feels to me as if some of the discussion might be missing, looking at the timebar, but I haven’t had a chance to watch it all yet.

As I remember it, Peter’s talk involves rather a lot on how Dawkins said something a bit stupid about homeopathy once in an introduction to someone else’s book 7 years ago, and there was a TV program four years ago which he didn’t like very much either. Then I rather recklessly try and jam the entire foundations of evidence based medicine into 15 minutes of hand waving. Unfortunately the headmounted microphone they make you wear for these things made my normally excellent and big hair look a bit rubbish, which I fear may have undermined my case.

Oh, but stick with it to the end, because the homeopaths in the audience discussion are the real stars. Believe me. Enjoy:

www.nhm.ac.uk/nature-online/life/plants-fungi/301106homeopathy/does-homeopathy-work.html

(thanks PM for the easier embeddable vid link).


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75 Responses



  1. coracle said,

    December 14, 2006 at 3:59 pm

    Looking forward to watching that when I get home. How long is it?

    I think Peter’s comment about Dawkins was referring to John Diamond’s ‘Snake Oil and Other Preoccupations‘. Dawkins wrote an introduction to the book proposing a method of DBPC trial for homeopathy.

  2. MJBarnett said,

    December 14, 2006 at 4:50 pm

    The homeopaths in the audience were certainly interesting, but there was barely any comment on what they said, or indeed on what anyone said. Everyone sort of stated their views in an orderly manner with little comment or criticism. Admittedly some of the audience comments about homeopathy working in a realm beyond matter were rather strange, but even so, a worrying proportion of the homeopaths seemed to be of the conviction that they were somehow beyond scientific investigation, a proportion which surely warrants some kind of response. The whole thing just seemed a bit sanitised.

    Anyway, Ben you mentioned you would be willing to put up critiques of some of the studies mentioned – would that be possible at all or to direct me elsewhere if its already on the web?

    Also I was surprised by your ambivalence to the question of whether homeopathy should be funded by the NHS. I agree with you that homeopathy should not be banned in any way, but I feel uncomfortable at the thought of the NHS funding a treatment for which there is no evidence of an effect beyond a placebo. I recognise the placebo effect is real, however in a public organisation such as the NHS, in which there is significant attention placed on allocating funds and resources in an efficient manner (such as the controversy over the funding of herceptin), i think that funding such a treatment is highly objectionable. Why for instance, if it is only the placebo effect we are after, can we not have doctors themselves adminstering sugar pills or the like, instead of funding a whole private industry of questionable characters to provide a placebo? Its a sort of outsourcing essentially to a ‘company’ who don’t really realise their actual role. But then if we feel this outsourcing is necessary is homeopathy the ‘best’ placebo avaliable, if there is such a measure? You mention that placebos often require cultural and social elements to be effective, but again, is funding this whole industry necessary to do this – can the rituals not be done by doctors?

    I suppose my question with homeopathy at heart is, if it is shown to be a placebo, indeed if a number of these alternative remedies are taken to work as placebos, why are they necessary as individual treatments? Why not just have one generalised treatment such as taking sugar pills with suitable songs, dances, costumes, mythology as necessary? I would even volunteer to be the guy determining how to changes the practices regularly so that people don’t get bored…

    Its often said that, ‘at least (insert treatment here) does no harm’. But is not public or a patient’s money being handed to these alternative industries harm, if not to the patient’s pockets themselves then in the wider sense that this blog documents – that is, harm to science?

  3. bawbag said,

    December 14, 2006 at 4:54 pm

    Here is the Dawkins article he mentioned if you want to read it:

    www.simonyi.ox.ac.uk/dawkins/writings/snakeoil.shtml

  4. dolfinack said,

    December 14, 2006 at 5:35 pm

    Man this dude loves the sound of his own voice. And he talks some nonsense. Me thinks the studies to which he lovingly refers are a wee bit dodgy…..

  5. three tigers said,

    December 14, 2006 at 5:49 pm

    Just confirmed all my worst fears. Homeopathy is a religion with an irrational belief system. Hence, as with all God bothering, no chance of changing anyones mind. Reasoned scientific argument is wasted on these idiots. If Dr Fisher is/was a decent rheumatologist, he should be ashamed of himself, peddling and trying to legitimise this quackery.

    Here in Switzerland they are really into this drivel; even with more Nobel prizes per head of population than anywhere else.

    Good try Ben, but the odds unfairly stacked against you I feel.

  6. doctormonkey said,

    December 14, 2006 at 6:05 pm

    On the plus side, my mother-out-of-law thinks she had an adverse reaction to a homeopathic remedy! So I suppose that this means that MJBarnett’s comment #2 is not even right in saying that at least CAMs are safe.

    There is also the question of poorly people getting potentially fleeced in having money taken from them by CAM practitioners for treatments that are not or will ultimately prove not to be effective.

  7. Ben Goldacre said,

    December 14, 2006 at 6:08 pm

    fisher told me afterwards he was slightly embarrassed by the crowd. i sent him a jolly nice email afterwards inviting him to do a podcast discussion but sadly i’ve not heard back from him, which i think is a shame, i think outside the rowdy environment of that crowd we could have an unusually interesting discussion, never mind.

    my recollection at the time was certainly feeling that they did me more favours than him, i don’t think the microphones for the video captured the excellent whooping and catcalling very well either.

    but the reality is, that crowd is the industry peter fisher speaks for and promotes. homeopathy is not the nuanced practise of peter fisher, it is the bizarreness of the opinions in that room, it is their flat refusal to engage in critical self appraisal, it is their head-in-the-sand denial of published findings about their destructive inappropriate and dangerous attitudes towards mmr. that is the homeopathy industry, and that is why they are such fun.

  8. john souray said,

    December 14, 2006 at 6:46 pm

    I think the first question you put to your audience was technically flawed.

    If a doctor knows that a pill “performs no better than a placebo”, then that pill surely is to all intents and purposes a placebo. Consequently your question just boils down to this: is giving a placebo ever justified? After all, whether or not a doctor actually says “this pill will make you better” the act of giving or prescribing a pill by such an authority figure already implies it.

    But that sounds a bit pernickety, so let me add a more general congratulation on dealing with what seemed in the majority like a fairly smugly hostile audience. All those little rounds of applause for anyone making a pro-homoeopathy point, however feeble.

    And why the special applause for the homoeopath from Iran? You don’t suppose, do you, that they got a little confused with a neighbouring country with a similar name? I’m not aware of any special handicaps under which a homoeopath might labour in Iran. The country is a democracy, and I’m not aware of any fatwahs against homoeopathy.

    I thought what he said was very interesting, and there was a little phrase slipped in there which passed almost unnoticed. After mentioning the environment of scarce resources, he spoke approvingly of how cheap homeopathic remedies are. You might already think that’s a pretty poor justification, or at least, in terms of a debate about effectiveness, somewhat begs the question. But then if I heard right, he went on to add “…and easy to dispense”.

    Easy to dispense? Surely part of the homoeopathic case is that they’re harder to dispense, because the “holistic approach” (which you’d already addressed rather well in your talk) requires more time and attention to specific details.

    Cheap, and easy to dispense. I wonder if this man really is the most effective advocate of homoeopathy.

    I’d love a reference if available to be able to read more about the “malaria advice” study you mentioned.

  9. fg said,

    December 14, 2006 at 7:07 pm

    Re #2 MJBarnett.

    I don’t think anyone would accept a one-size-fits-all sugar pill, even with lots of mumbo jumbo. To harness the power of placebo for the public good, there would need to be a spectrum of obscene and baroquely weird therapies, each with their own “scientific” theory, so that someone could find exactly the placebo that’s “right for them”. Moreover, I’m not sure that an average Jo[e] who knew they were handing out a placebo could be sufficiently convincing to make it work – what would be needed would be a bunch of people who really believed the stuff worked and could then convince other people likewise…Wait – you know, that sounds remarkably like the Alternative & Complimentary Medicines (ACM) industry at present…

    However, you’d also need to ensure that: (1) treatments caused no long-lasting physical harm, (2) that people needing real medical or psychological assistance got to see real Doctors and (3) that it was value for money (in the case of the NHS) and that people weren’t being completely ripped off (though presumably if people are being “healed” then they are getting some value).

    Homoeopathy’s ridiculous dilution scheme certainly takes care of condition 1. Condition 2 is more problematic with ACM – though people don’t use it for broken bones. As for condition 3, I have no idea.

    However I should also reveal that I am infact a fully licensed and registered practitioner of “colour pill therapy” whereby the colour of sugars pills subtly effect their metabolic properties so that, when correctly matched to the patient’s aurora, they ensure that the patient’s ontological proteins fold in ortho-obvious ways so as to… Oh sod it, I’m off to the pub.

  10. Sid said,

    December 14, 2006 at 7:21 pm

    Hmm.
    I’m not sure if that was Dr. Fisher talking or, Dr. Rupert Sheldrake, with a mask on.
    Both are dazzling in their presentation skills, research knowledge and convincing argument techniques.

    I wait to see if Dr. Fisher, and/or Prince Charles, takes Prof. Dawkins’ offer of serving on an advisory committee for the scientific testing CAM therapies.

    I wouldn’t hold my breath though.

    Well done Ben!
    When is the next installment?

  11. phayes said,

    December 14, 2006 at 7:40 pm

    “Both are dazzling in their presentation skills…”

    I was particularly impressed by Dr. Fisher’s getting such a good slide presentation out of a USB stick he’d earlier liquefied, diluted and shaken..

  12. JohnD said,

    December 14, 2006 at 9:45 pm

    Well done, Ben, for being such a good sport to stand up and speak for science.

    However, I feel I’ve just wasted 90 minutes (odd) watching it. As a shootout it was more a bunfight.

    Neither of you really debated the question, more presented prepared statements, his about the veniality of meta-analysis, you about how mendacious are the homepaths. Both couched in courteous and gentlemanly language, but in fact just name calling.

    So many statements just floated away, without being harpooned. For instance:
    Dr.Fisher mentioned the ‘structures in water’ idea, and you let him get away without comment. If there is anywhere that the ‘science’ of homeoepathy is weak it is there, because that is the theory. What structures? Describe them.
    Can water retain structures that can influence other things, apart from human wellbeing? Action on enzyme systems for instance, or enzymes themselves.
    It was declared that boiling water ‘destroys’ it’s structure. What other actions or agents can do the same? This might explain the ‘structures.

    John

  13. Geoff_S said,

    December 14, 2006 at 9:48 pm

    Dr Fisher certainly seemed a very smooth operator … but what was all that name-dropping nonsense about Brazil for? I think you did very well, but you would have probably done much better if you’d worn a suit and had a Power Point thingy. If nothing else, that shows how mere appearance can trump erudition.

    I’m very sceptical about all so-called alternative therapies. After a serious cycle accident caused a minor high spinal injury I’ve tried a lot with no real success. Although acupuncture gives my wife a better night’s sleep as it stops my sleeping spasms … she says, and it does ease the pain. .

    Geoff

  14. Geoff_S said,

    December 14, 2006 at 9:53 pm

    Dam, I meant to mention the water memory issue, which is crucial to the whole debate. The analogy Dr Fisher used is totally false because we know how data are stored in a memory stick and a CD and we know it’s not conducive to a chemical analysis because it’s a physical effect. Homeopaths must find a better explanation for the alleged phenomenon.

    I’m surprised you let him get away with that.

    Geoff

  15. tideliar said,

    December 14, 2006 at 10:05 pm

    Ben, I think your absolutely massive hair actually adds to the case. When you’re, like, old and stuff and grey, you are going to be even MORE convincing!

    Water memory? WTF? Are these twats on drugs or something? I ha no idea it was all such a load of daft bollocks…can people be this dumb?

  16. ayupmeduck said,

    December 14, 2006 at 10:24 pm

    I expected more from Fisher, he’s quite slick at times, often reasonable, but in the end still comes over as a fraud to me.

    The USB stick analogy seems particularly disingenuous. FLASH memory in a USB stick works by isolating electrons into places where they can be detected, hence “read” when a current flows. I suspect that Fisher was banking on his audience being bamboozled by the complexities of NOR and NAND gate technology in USB FLASH devices. Otherwise why did he not take the analogy of a newspaper – “hey look! it’s only wood pulp, but guess what? You can store information on it!”. When people come out with stuff like that there are only two possibilities: 1) He does not understand the subject 2) He’s lying.

    On the other hand, Ben should have his own TV show.

    Most of the homeopaths have got religion and there is no way you will convert them with any amount of reasoning. It’s melodrama, such as when the guy with the beard gave gravity to the German translation of “Prüfung” as “proving”, when in fact a more correct translation is “test” or “exam”.

    The other sort of homeopaths are those that publicly try and distance themselves from the religious ones, least it draws to much attention to their vested interests.

    When we get bored of these people we should do a darwinistic-microfascist-type Prüfung and send ‘em off to an island to live their holistic-alternative-whatever lives without science. They’ll all get killed while changing plugs.

  17. micromegas said,

    December 14, 2006 at 11:38 pm

    It reminds me of the Jasper Carott joke about being deeply suspicious of any group of people that sound like gay serial killers.

  18. micromegas said,

    December 15, 2006 at 1:13 am

    Ben, with all the talk of using ultra-purified water to prepare their treatments, I thought the least you could have done was suggest that the homeopathic industry engage in some synergetic collaboration with the good people at Penta Water. Imagine getting treated for a medical condition whilst at the same time enjoying all the benefits that Penta Water has to give.

    Seriously though, I thought that the Iranian homeopath accidentally raised a very interesting issue. He mentioned that homeopathy’s increase in popularity in Iran was in part due to the cost of conventional medicine. It is interesting to speculate whether or not homeopathy would be so popular if the medical/pharma establishment did not use such a capitalist economic model. I mean, if the cost of prescription drugs was no higher than that of homeopathic remedies, and if they were both dispensed by one individual, the only difference between them would be the evidence justifying their efficacy. Although Ben points out that there is a place for homeopathy where conventional medicine has failed, it seems that choosing such a treatment is often currently seen as a political statement. Taking the politics out of the equation, you’d really have to ask how popular it would be.

  19. Ben Goldacre said,

    December 15, 2006 at 2:25 am

    i guess i can understand the “i’m surprised you let him get away with that” comments, but at the time, i was literally bowled away by the extent of the ignorance in the crowd, it was washing over me in waves. peter fisher honestly felt like the second sanest person in the room. more than anything else, i’m just really glad of having a document of the state of popular debate among working homeopaths in 2006, i think the intellectual level of their commentary and their resistance to critical self appraisal is absolutely amazing, so good to have it on tape.

  20. jackpt said,

    December 15, 2006 at 4:36 am

    I think you did a very good job of explaining the placebo effect in layman’s terms. There is a terrible tendency of the alternative and complimentary crowd to abuse the placebo position by portraying it as denial of people’s personal experience. I’m somewhat more hostile towards Peter Fisher on the grounds of his statements regarding the sanity of homoeopathy trials. He’s a bit of a paradox it seems, because I could imagine him applying his critical faculties elsewhere.

    You’ve got to stop dealing with idiot questions, if they didn’t get it the first time don’t bother addressing their argument, just repeat whatever you want to get across. “I addressed this earlier, but I would like to note … ” Take a leaf from politicians. The people sitting on the fence are the ones that matter.

    The Cox-2 inhibitors thing is something somewhat close to my heart because I was taking them for a year or two. The idea of acceptable risk seems to have been lost in some quarters. While Cox-2 inhibitors were clearly increasing risk for some people as otherwise fit 20 something having to rely on standard NSAIDs (which themselves carry risks) I don’t feel represented. No doubt I could also increase my chances of stroke or heart attack by gaining weight or a bad marriage.

  21. three tigers said,

    December 15, 2006 at 7:24 am

    I just re-read the intro where you describe the Peter fisher as the Clinical Director of the “NHS Royal Intergalactic Homeopathic Hospital”.

    Can we chip in for a set of new signs to be made including the word ‘intergalactic’, and change the current inaccurate and boring ones as a sort of early Xmas prezzy for them? I wonder how long it would be before anyone noticed?

  22. kingcnut said,

    December 15, 2006 at 10:09 am

    “Peter Fisher honestly felt like the second sanest person in the room…”

    Ouch. Well, that’s put me firmly in my place. And it took me about five minutes of deep breathing to pluck up the courage to ask Dr Fisher that question about trial sizes, as well. I (sob) know when I’m (sob) not appreciated…

  23. Mojo said,

    December 15, 2006 at 10:37 am

    doctormonkey said,

    “On the plus side, my mother-out-of-law thinks she had an adverse reaction to a homeopathic remedy!”

    Ah, but one of the beauties of homoeopathy is that there is no such thing as an adverse reaction: if the patient gets worse, it is termed and “aggravation” which shows that the remedy is working. After all, one of their rationalisations is that symptoms are the body’s way of healing itself, and that homoeopathy enables the body to heal itself by helping it express the symptoms better.

    This is how it works:

    1. After the initial consultation, the homoeopath prescribes a remedy.

    2. If the patient subsequently gets better, this means that the remedy worked.

    3. If the patient subsequently gets worse, this means that the remedy worked.

    4. If the patient gets neither better or worse, this means that the remedy would have worked, but it wasn’t the right one. The homeopath prescribes another remedy.

    5. This continues until the patient no longer returns for further consultations, whether because of recovery, death or ennui.

    6. The homoeopath chalks up another successful case.

  24. monstermunch said,

    December 15, 2006 at 10:38 am

    Welldone with your talk Ben, I think you came across very well and explained your points in a friendly and intuitive way. It might have been good to have had some slides with your main points clearly stated (e.g. “Tests with invidividuals tells us nothing”, “All postive homeopathy tests were flawed”), but this probably would have angered the sheep more. I really couldn’t believe the audience wouldn’t answer your placebo poll question. It wasn’t loaded in the slightest.

    I too was bowled over by the sheer ignorance of some of the speakers in the discussion section. I felt it would have been good if you had shot some of them down in flames in a Dawkin-esque style though as allowing them to go unchallenged makes their point seem legitimate in most people’s eyes. For instance, it would have been good to address the absurity of water memory (as in “just think about it, it doesn’t make any sense! For example…”) and how homeopathy somehow cannot be tested with trials. I can understand how it is difficult to address a group such as this though.

    Thanks for fighting the misinformation and keep up the good work. :-) Let us know what we can do to help.

  25. Ben Goldacre said,

    December 15, 2006 at 10:48 am

    mojo: i agree, it’s a great system.

    monstermunch, i don’t know, you know, its an interesting rhetorical question, and its a question of why you are somewhere (for me the answer is often “to have fun”). i think when youre in a room with a rabid crowd answering every point is a bit tilting at windmills, also you’d end up doing a disproportionately large amount of talking and look like a windbag. also, that set up that night was very much a “public engagement with science everyone has an equal voice lets hear from the people and vote on whether dinosaurs existed” scene.

    also, i just kind of felt, once i realised how bonkers the crowd were, that i was playing to the tape, and watching a document of homeopaths’ arguing style unfold. there was no changing the more pseudosciencey people in that room, they can’t really engage on that level of discussion. and even the rational people in the room had a healthy dose of resistance. there were so many funny moments, like when mel o from the society of homeopaths kept banging on like a politician about how she would never say anything bad about mainstream medicine and nobody in homeopathy would, and then, like, almost the next question was someone banging on about vioxx. heh. joy. and their collective flat refusal to even engage with the issue of their industry’s proven and hugely irresponsible antipathy to MMR. heads in the sand. they simply denied it ever happened. priceless.

  26. Dr Aust said,

    December 15, 2006 at 10:58 am

    Yes…. definitely a problem with engagement gigs. As scientists we, erm, privilege one narrative over the others, post-modernistically, the point being that this is the “narrative” with non-personal-opinion-dependent evidence showing it to be true, see many past threads.

    But if the audience have similarly Uber-“privileged” their evidence-FREE belief in Magic Water, or the Power of Prayer, or the World-Made-10000-Years-Ago, talking them out of it is a non-starter.

    BTW, does this make Homeopaths Post-Modernists as well as Religious?

  27. coracle said,

    December 15, 2006 at 11:05 am

    I haven’t watched all of it yet but from Peter’s talk I thought there were some odd bits.

    First ‘groovey young scientists’! Is that us? If so, excellent!

    Second, I hadn’t heard about the ‘presensitisation’ concept. It was very woolly, ‘the system has to be presensitised in some way’ sounds like ‘I don’t really know what I’m talking about’.

    Third, Basophil study (Ennis). There are a number of odd things here, first I don’t think it’s a good system to study, too sensitive to a number of confounding factors. Has any effect been observed in other systems. Next, how does the study of Basophils relate to ‘presensitisation’? Finally, if the study relied on an n of thousands to power it, then how would that translate to a clinical study? Presumably one would get very poor NNTs out of it.

    Anyway, I thought the criticisms of the meta-analysis were interesting, and on the face of it valid. Worth looking into some more.

  28. Ben Goldacre said,

    December 15, 2006 at 11:09 am

    on pomo and homeopathy, there is of course the NHS funded work on homeopathy and its untestability by Christine Barry, discussed most excellently by the unstoppable Professor David Colquhoun FRSM

    www.ucl.ac.uk/Pharmacology/dc-bits/quack.html#barry1

    (i was talking with colquhoun somewhere recently, he thought it was very funny that the person doing his biog had called him FRSM instead of FRS, FRS being the very difficult thing that not many people ever get in their whole lives, and FRSM being the thing that sadly even quacks can get if they just cough up a few hundred quid a year. in fact FRSM is so easy to get that they sent me a form for a 6 week free trial fellowship last week, its a nice club with great rooms and a good organisation, dont get me wrong, lovely overnight facilities, good library, just that FRSM is not a grand title in the way that many cranks woul have you believe).

  29. Dr Aust said,

    December 15, 2006 at 11:21 am

    Yes, Mrs Dr Aust got sent the FRSM trial offer. I did try to persuade her to sign up so that I could drink in their bar.

    I’ve given up hope of an FRS, BTW.

  30. Mojo said,

    December 15, 2006 at 11:54 am

    Ben Goldacre wrote:
    “also, that set up that night was very much a “public engagement with science everyone has an equal voice lets hear from the people and vote on whether dinosaurs existed” scene.”

    Never mind: they’re actually going to vote on homoeopathy for real in Switzerland:

    www.nzz.ch/2006/12/01/eng/article7300660.html

    Apparently last year the Swiss government decided that homoeopathy and four other alternative therapies didn’t meet the criteria for efficacy, suitability and cost-effectiveness set out in their health insurance law. The homoeopaths have collected enough signatures to force a referendum.

    Nice approach: if the science doesn’t back you up, appeal to popularity.

    If only we could have a vote on whether cold fusion or Steorn’s device works, we could solve all the world’s energy problems and stop global warming in its tracks.

  31. superburger said,

    December 15, 2006 at 2:23 pm

    Ben?

    What did the Sureesh bloke threaten you with?

  32. BrickWall said,

    December 15, 2006 at 3:24 pm

    Perhaps one of the isues here is that science isn’t a debate? In the debating format all the opponent has to do (as Dr Fisher does here) is say, “We all know that it works at some level, I’ve got the studies and references here for you to look at if you like, that show all the hundreds of studies done that show it works.”.

    That then just leaves yourself either having to ignore this completely or effectively say well I’ve got my studies (and common sense of course!) to show it doesn’t work, so there. Because of course in the debate format you can’t say, “Oh well give me a few hours to go through those referenced papers and I’ll get back to you on why they don’t answer the question proferred”.

    So in the end it just looks like you are two equally weighted scientists arguing over minutiae, and obviously science can’t answer this question because both of you refer to contradicting scientific papers therefore true answer must be other worldy.

    You can’t win in this debate, that’s why you have the peer reviewed real science. It doesn’t matter to Dr Fisher’s supporters if someone comes back on him later to say those papers/studies/whatever are not the answer because they think they’ve already addressed this now.

    (Haven’t actually watched past Dr Fisher yet so maybe you do get round to ripping him to pieces, if so ignore everything I’ve said and sign me up to your own cult!)

  33. Ben Goldacre said,

    December 15, 2006 at 3:24 pm

    oh god, that, he is a bit peculiar, 3 years ago, he sent me an awful lot of emails, he wanted to do an experiment on me, where he would make me very ill with homeopathy, and only when i begged him to help me and admit that homeopathy was effective would he end my torment. those were pretty much his words, not mine. it was worded in a way that made me feel quite threatened, i certainly didnt want to meet him in person, and i did think it was a bit odd that the homeopaths all thought that was really really funny but i guess maybe i didn’t explain myself very well at the time. mind you, hard to think of many venues where a crowd of so-called healthcare professionals could be so wound up with selfrighteousness that they feel entitled to bay and laugh when someone says they felt threatened by someone.

  34. BSM said,

    December 15, 2006 at 4:10 pm

    Your two questions pretty thoroughly skewered them. Wasn’t it interesting that the majority found themselves unable to answer honestly?

  35. Mojo said,

    December 15, 2006 at 5:47 pm

    “…he wanted to do an experiment on me, where he would make me very ill with homeopathy, and only when i begged him to help me and admit that homeopathy was effective would he end my torment.”

    This seems to be a fairly common “threat” from homoeopaths. Amazing that they are absolutely confident that they can quickly and easily produce all sorts of spectacular effects, but as soon as there is a control and blinding involved…

  36. BSM said,

    December 15, 2006 at 6:52 pm

    “but as soon as there is a control and blinding involved…”

    Well, not even then. Several people of our internet acquaintances have tried this and have signally failed to fall ill as predicted.

    Let me take the liberty of rephrasing your post;

    Amazing that they are absolutely confident that they can quickly and easily produce all sorts of spectacular effects, but as soon as there is an absence of emotional or financial vested interest…

    There, that’s better.

  37. BSM said,

    December 15, 2006 at 6:56 pm

    “So in the end it just looks like you are two equally weighted scientists arguing over minutiae, and obviously science can’t answer this question because both of you refer to contradicting scientific papers therefore true answer must be other worldy.”

    Referred to, by Oliver Wendell Holmes, as the Hydrostatic Paradox;

    “You know, that, if you had a bent tube, one arm of which was of the size of a pipe-stem, and the other big enough to hold the ocean, water would stand at the same height in one as in the other. Controversy equalizes fools and wise men in the same way,–and the fools know it.”

  38. BSM said,

    December 15, 2006 at 6:57 pm

    By the way, Ben, I thought you gave a very good presentation that could only have been enhanced by punching the lights out of some audience members.

  39. j said,

    December 15, 2006 at 7:59 pm

    ““…he wanted to do an experiment on me, where he would make me very ill with homeopathy, and only when i begged him to help me and admit that homeopathy was effective would he end my torment.”

    This seems to be a fairly common “threat” from homoeopaths. Amazing that they are absolutely confident that they can quickly and easily produce all sorts of spectacular effects, but as soon as there is a control and blinding involved… ”

    iirc (in the video) the homeopath in question was talking about making two batchs of homeopathic water; one would be boiled and one wouldn’t; only the unboiled one would make someone ill. Did I get that right, or have I misremembered?

    Anyway, I’d think that’s easy enough to arrange if you boil one batch – just make sure you contaminate the water with something that boiling will kill at the same time as making up the remedy.

    otoh, I wouldn’t be so confident in the homeopathic ‘cure’ for this illness :)

  40. bawbag said,

    December 15, 2006 at 8:04 pm

    I don’t want to give Ben a big head to match his hair, but i’ve never seen politeness deployed as a debating weapon to such amusing effect.

    The homeopaths were an odd bunch, really funny when they collectively took offense at the perfectly reasonable questions about placebos and MMR.

  41. RS said,

    December 15, 2006 at 9:27 pm

    I got the impression their response was “we’re not answering that, you know we don’t like MMR but if we say so that’ll give you a stick to beat us with”.

  42. le canard noir said,

    December 15, 2006 at 9:58 pm

    The questions did rather cut straight into the rotten heart of alt med! Ben, how long did you spend thinking them up?

    For me, coming from the physical sciences, the debate was rather light on my biggest problem with homeopathy – its denial of basic physics, chemistry and biology.

    One can debate meta-analyses and methodological problems with placebo controlled trials with the true believers til the cows come home, but when the basic tennets of like-cures-like, dilutions and succussions remain unchallenged, the ‘clinical evidence’ debate is lending the subject credibility that it has not yet earned.

    If homeopathy had been invented today and research money was being requested to look into efficacy based on what is little more than voodoo science, no one would even think twice in sending the homeopathist packing.

  43. Twm said,

    December 16, 2006 at 12:57 am

    Ben, I can also understand the “can’t believe you let him get away with it comments”, but it a hard position to fight off all the sillyness in that particular format without looking like you were a jumped up and impolite.

    What I found interesting was the fact that Gillian Mckeith can be debunked in a way which is easy for the public can understand. “She’s not a doctor of medicine”. But I feel if Peter presented to a group alone, his argument backed with his credentials are very convincing.

    I don’t believe the dilution mumbo jumbo, but I can imagine why homoeopathy could outperform a straight placebo. If the patient had a more attention and was made to feel that the treatment was individual and bespoke, then the net effect is likely to be that the patient feels better.
    Two placebos are not equal. The context in which they are delivered is important.
    I think this aspect is very hard to test, but from experience I can tell you that my typical consultation on the NHS with a doctor is 5-10 minutes and 3-4 months in between.
    Where as the initial consultation with the homoeopath can be an hour or so and 4 weekly follow ups at around 30-40 minutes.
    This extra time may be spent talking about further stresses in the patient’s life and further refinement of the treatment puts the patient under the spot light rather than the disease.

    This all reminds me of an episode of Curb Your Enthusiasm where Larry David goes to see a acupuncturist and challenges him $5000 to make him better.
    A few weeks later, Larry speaks to the acupuncturist’s receptionist and she ask how he feels today, he replies “I feel better today”. And promptly loses the bet, despite his argument about the linguistic twists of the word better.

    It is a widely held public perception that a patient visiting a medical doctor is part of a production line, and once the initial diagnosis is made, the interest in the patient, especially the stresses and psychological impact are reduced.
    I’ve had a lot of exposure to NHS consultants and private (sometimes the same!). The private experience of seeing the actual consultant who’s name is on the appointment card and developing a long term rapport is good, where as seeing a different registrar each visit is not.

    The ‘Holistic’, ‘complimentary’ and even ‘homoeopathic’ seem to have different meanings depending on the expectation of the person and if those expectations are matched by a treatment then I’m sure the individual feels better. If the expectations are not met with public health services and advice, then the vacuum crated is sure to attract quacks who are responding to the demand with their supply.

    A few years back, I was in a bit of a state after a flare up of ulcerative colitis and after a battle of surgical vs medical consultants I had little choice by to have my colon removed which left me with an ileostomy.
    The stoma nurse (who takes an active role in the rehabilitation, diet and psychology of a patient coping with a stoma) was brilliant and for me helped to realise my expectation of holistic care.
    The latest issue of the IA (ileostomy journal) highlights a concern that specialist nurses may be the targets of cost reductions by NHS trusts. I understand the need for ‘compliment’ services but would personally be horrified if the number of homoeopaths on the NHS grows to the detriment of valuable specialist nurses.

    (this is worth reading www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1279936)

    I have faith that evidence based treatments which can be proven ‘in the usual’ way will by definition be part of the tools available to medicine. Both my surgeon and GI specialist have suggested VSl#3 (a probiotic not available on the NHS) but they showed me where to look on the internet to read about the clinical trials, and how to buy it, which was very refreshing.

    I do worry that the top level question should be “why does the current health system not meet the expectations of it’s patients”, rather than “how can homoeopathy be incorporated”.

  44. Ben Goldacre said,

    December 16, 2006 at 1:15 am

    “What I found interesting was the fact that Gillian Mckeith can be debunked in a way which is easy for the public can understand. “She’s not a doctor of medicine”. But I feel if Peter presented to a group alone, his argument backed with his credentials are very convincing.”

    yeah, for a lot of reasons i try and keep away from the cheap ad hominem cards, even though they are a winner, and keep my comments – jokes even – to the facts of the evidence, simply because one of my major bugbears with CAM is the dumbed down quality of their rhetoric. oh and also i am a vaguely serious bloke and a lot of this stuff is fairly important and interesting.

  45. AndrewT said,

    December 16, 2006 at 3:29 am

    Finally got round to watching the video. Lovely.Fantastic the way they refused to vote on your questions. brilliant. If i didn’t know you were a ‘kick-ass academic ninja’ i would have said you learnt your presentation skillz from my old man at Uni of Herts.

    Any way the point of this post is that i shall be taking the wellcome trust shilling (non-pharamaceutical techincally, but i’m sure someone will find a conflict ofi interest…) in a couple of months in Brazil. So if you want that free house in brazil (i recommend carnival season,or a trip to Fernando de Noronha) then its open house chez AndrewT….

  46. Twm said,

    December 16, 2006 at 4:31 am

    >> i try and keep away from the cheap ad hominem cards
    Yes, this comes through from the video. I think this approach works best in the long run, though you should aim for at least one ‘Wittgenstein’s Poker’ type encounter in your career.

    I know someone who died of malaria, being protected only by homeopathic remedy.
    So yes this stuff is important, and I much appreciate the column.

    Yes the dumbed down rhetoric is frustrating, but given the lack of evidence, CAM has certainly had pretty successful PR over the years, and that’s pretty interesting in itself.
    Do you think that in the future, doctors will have to gain sales and marketing experience in order to better sell their ‘product’ to health trusts and consumers?

  47. BSM said,

    December 16, 2006 at 11:24 am

    “For me, coming from the physical sciences, the debate was rather light on my biggest problem with homeopathy – its denial of basic physics, chemistry and biology.”

    The problem with tackling nonsense like homeopathy by appealing to the conflict it creates with known scientific principles is that it leaves the woos with the ability to say things like, “Science doesn’t know everything” and then to start waffling on about speculative mechanisms such as the memory of water then walk away smugly thinking they more know than the rest of us.

    Using what science knows is effectively an example of the logical fallacy of the Appeal to Ignorance, essentially meaning that if we don’t know about something then it can’t be true. Using the fallacious argument is weak, though it is always necessary to define the boundaries of their lunacy by showing where it does diverge from known science.

    I think the really killer arguments are when you pick on the contradictions that are intrinsic to their systems. Take their principles seriously and follow them to their logical conclusion and see what a mess results. Their happy little world is riven by huge philosophical divisions that they keep very quiet about when debating outsiders, but read their own exchanges on their internet forums and elsewhere and you will find it impossible to define one consistent version of what homeopathy really is. Strictly speaking this does not logically disprove homeopathy as a whole, but where you have two mutually incompatible versions of it, at least one of them is wrong. One example of their philosophical divisions is in the area of “constitutional remedies”, which are a brilliant little scam that requires people who say to the homeopath that they are healthy to permanently take a remedy that matches their ‘constitution’. Use of these causes real knock’em down drag’em out fights among them.

    The other best tactic in my mind is to use scientific knowledge but turn it into an argument capable of being decided on logical rather than evidential grounds such as futile disputes over the presence or absence of evidence for water crystals, energy auras or similar bollocks. One logical argument was alluded to in the NHM debate. How does the water know which component to magically potentise? Ben’s Iranian pen-pal countered this by saying that the water was distilled and even Peter Fisher found himself unable to support that idea. The problem for the homs is that even after a couple of dilution steps their raw materials are already at levels indistinguishable from background contaminants even in the best water that they might use. The cunning homeopath could use a counter-argument to say that this problem of contaminants doesn’t really matter because it is the effect of the final remedy that is the proof of the pudding, though I’ve not yet met one smart enough to think of this. The killer return is to point out that the contaminants will vary between hom pharmacies and the only way that they can all claim the same effects is because the the remedies are truly indistinguishable by virtue of having no effect at all.

    But, I’m not sure that NHM audience would have been able to keep up with Ben if he had used these arguments given that they were in such difficulty with even the simplest concepts.

  48. BSM said,

    December 16, 2006 at 11:37 am

    Just to elaborate a little further, one reason why we can always find inconsistencies to pick on is that, because their therapy is based on fiction, it is never refined by its contact with reality, whereas scientific medicine, maybe incomplete, but because it uses the real world as a reference it is not logically internally inconsistent.

  49. Jut said,

    December 16, 2006 at 12:27 pm

    Thankyou for posting that Ben,
    I’d like to say i couldn’t believe how childish the audience behaved but it really didn’t supprise me.
    I loved your questions though, the words that came out of my mouth when they were asked were along the lines of “you beautiful, beautiful bastard” :)

  50. Dr Aust said,

    December 16, 2006 at 12:58 pm

    “For me, coming from the physical sciences, the debate was rather light on my biggest problem with homeopathy – its denial of basic physics, chemistry and biology.”

    “The problem with tackling nonsense like homeopathy by appealing to the conflict it creates with known scientific principles is that it leaves the woos with the ability to say things like, “Science doesn’t know everything” and then to start waffling on about speculative mechanisms such as the memory of water then walk away smugly thinking they more know than the rest of us”

    Both true.

    I think what I take from these two arguments together is that the place to debunk homeopathy with basic science is when people are LEARNING about the fundamental principles of science in schools (and also in Universities).

    As I have written before, if people have not yet bought into the homeopathic religion, and have the basic scientific knowledge to do molarities, it is relatively easy to “inoculate” them against homeo-balls by getting them to calculate that there is nothing in the potion.

    badscience.net/forum/viewtopic.php?t=822&postdays=0&postorder=asc&start=0

    But of course, if they have bypassed or rejected science as a way of understanding the physical world and have “bought” the religion, complete with all it’s trappings, cultural baggage and Pseudo Quantum Bollocks, it is too late, as the second quote aptly points out.

    FYI, the scientific societies are trying to encourage their members to get more involved in talking about the principles of science in order to help combat delusionary pseudo-science nonsense, including homeopathy. At least, we are:

    www.physoc.org/publications/pn/issuepdf/65/3.pdf

    – and hopefully so are others…

  51. Ben Goldacre said,

    December 16, 2006 at 2:03 pm

    quality commentary from the homeopathy community continues to roll in. just received this charming email from lionel milgrom, who clearly hasn’t bothered to even watch the video.

    “Benjamin, oh lttle Benjamin,

    “I’ve just read your purile blog about the debate at the Natural History Museum. How did you know what Peter Fisher said? You missed most of it because you couldn’t be bothered to turn up on time. That makes you somewhat mendacious, wouldn’t you agree? Reporting about things for which you weren’t in attendance? A typical reorter’s scam. I thought better of you. What a major disappojntment you are.

    “Lionel Milgrom”

    if you want to check whether i was there for peter’s talk you can see me in the very first frame of the video above, and then throughout the entire subsequent video. absolutely bizarre. i personally suspect lionel’s extensive popular journalism on homeopathy and quantum physics might betray the same high standards of accuracy and rhetoric as this comment.

    somebody at a party two years ago tried very persuasively to drag me away from the friends i was talking to and introduce me to milgrom, and the more i tried to politely suggest that i hadn’t seen my friends for a while and wanted to chat to them, the more persuasive and then angry the person who was trying to get me over became. she was indignant and expressed the notion that i was somehow remiss in an important political, medical and moral responsibility to go and talk to the great lionel milgrom. at the time i was thinking, i’m having a nice time talking to friends, and i dont want to talk to an angry homeopath in my leisure time. looks like it was a good call.

    this homeopathy lot really are extraordinary.

  52. mad dog said,

    December 16, 2006 at 3:08 pm

    Hello, I’m new around these parts, though I have been a grateful reader of the BS column (hmmm, not sure I should call it that) for some time (gotta love a bit of righteous anger on a Saturday morning – almost as good as going to church).

    Anyhow, Ben, I thought your performance was smashing, though ultimately futile, given the massed ranks of wilful ignorance against which you were arrayed. It would have been nice if the museum had made it clear where they had recruited (or rather, dredged) their audience from, as I spent most of the first half wondering who you were talking to.

    I have to say I think you’ve been too kind on Fisher, though. I don’t keep up to date with who’s who in the wacky world of homoeopathy, having many more interesting ways to spend my time, so I’d never before heard of the ‘eminent’ gentleman, but his talk had me spitting with rage from the very first, when he started by saying, “of course it works – it’s 210 years old and it’s all over the place.” What kind of a *scientific* argument is that, for goodness’ sake? And how is the concept of “treating like with like” not controversial? It’s at the very least highly counterintuitive.

    I actually thought that it was rather sweet and earnest, the way that he’d clearly thought long and hard about the question of how to apply the scientific method in support of his beloved (and no doubt extremely lucrative) homooooooeopathy. Unfortunately, the question a real scientist would ask would be, how can we use the scientific method to try to *disprove* my pet theory?

    One wonders what testable predictions derive from the nonsensical theory of water memory? Why is this effect so mysteriously invisible with modern measuring equipment? Would one homoeopathic tablet dropped in a reservoir cure the ailments of an entire city? Does a cup of tea stirred with a clockwise motion have different properties from one stirred anti-clockwise? If so, I want to know what they are …

  53. BSM said,

    December 16, 2006 at 3:11 pm

    “when people are LEARNING about the fundamental principles of science in schools (and also in Universities).”

    I have been interested to see in primary school science work that their experimental investigations all pay consideration to what makes that investigation a ‘fair test’.

    I think it just doesn’t stick with some people. Let’s face it, some manage to go the whole way through a university medical education and still ‘go bad’.

  54. BSM said,

    December 16, 2006 at 3:18 pm

    “I actually thought that it was rather sweet and earnest, the way that he’d clearly thought long and hard about the question of how to apply the scientific method in support of his beloved (and no doubt extremely lucrative) homooooooeopathy. ”

    Perhaps the time spent on Copacabana beach paid for by the homeopathic industry had slowed his thought processes.

    The question is, at what point does one’s enjoyment of a jet-setting internationl academic career based on water retailing become a major obstacle to critical thought? What does the phrase ‘vested interest’ mean? Clearly, these questions are entirely hypothetical.

  55. Ben Goldacre said,

    December 16, 2006 at 4:45 pm

    “I have to say I think you’ve been too kind on Fisher, though.”

    seriously, all of you who keep saying this, he’s a nice guy, informed and intelligent, the best of the lot, and a pleasure to discuss things with. can you imagine even trying to have that kind of constructive disagreement with someone like lionel milgrom, or any of the people in the audience?

  56. scentless_apprentice said,

    December 16, 2006 at 4:52 pm

    Ben, I admire your viewpoint on Fisher.

    However, the less erudite members of the homeopathy crowd come across to me like the school bully’s snivelling little mate, Fisher being the strong character supported by the weak, unintelligent rats trying to get some of his kudos and status to rub off onto them.

    Unfortunately, it’s exactly because of people like Fisher that there’s this heaving mob of pseudoscientists pedalling this crap.

  57. mad dog said,

    December 16, 2006 at 7:05 pm

    I’m afraid I disagree (with Ben, think I am agreeing with scentless_apprentice) – he might be a nice guy, but it’s intelligent , articulate, and erudite people like Fisher who cause the most damage, by giving the whole charade the veneer of scientific respectability and that it so patently doesn’t deserve. Fisher’s problem, it seems to me, is that comes from a position of faith in the thing that he is supposed to be studying. He then builds a convincing, tightly-welded cathedral of highly coherent logic around this, which is an impressive feat, but ultimately a hollow one, and in my opinion no different (except perhaps in degree of erudition) to the ways in which paranoics and religionists can justify their own idiosyncratic world views. The fact that he doesn’t question this fundamental premise ought to automatically exclude him from debating it. It’s like asking someone who’s devoted their life to Biblical exegisis whether God exists. Of course they’re going to say yes – their entire livelihood is postulated on His divine existence.

    What is needed is some real impartial studies. Unfortunately, most real scientists won’t touch the subject because who the hell wants to waste their precious time on a hypothesis with no discernable mechanism and scant, anecdotal observational data?

  58. monkeychicken said,

    December 16, 2006 at 8:13 pm

    Are you hungover, you keep drinking lots of water.

  59. dwbee said,

    December 16, 2006 at 10:50 pm

    Very interesting Saturday evening viewing! Certainly better than X-factor and come dancing.

    Well done Ben. You performed admirably against the mob. Three points remain with me:

    – “It is spiritual”, said one of the pro-homeo audience. Of course it is!! Millions of people believe in a god. No evidence for that either. (Excuse the football analogy but….) I believe that Brentford football club is the best team in West London. No evidence to support that belief in fact plenty to dispute it yet I wouldn’t dare question the efficacy of Chelsea and I will not change my believe.
    – (Ref – Ben’s post no.33) When Ben described how a member of the audience suggested making him ill, the homeopathy lobby in the audience (i.e. most people in the room) were sniggering. A very infantile uncaring approach to another person’s health. Would someone from mainstream medical profession laugh in the face of someone who doubts the value of a life saving drug?
    – Lastly, Ben has a striking resemblance to a younger version of the detective Colombo. Should Hollywood be considering a re-make I suggest they should avail themselves of Ben’s email address. Work on an Italian-American accent in anticipation Ben! (EXcuse this comment, as a baldy I am just diplaying some jealousy towards your big-hair)

  60. inicholson said,

    December 17, 2006 at 9:48 am

    I was completely baffled by the woman at the start who complained that neither of you had properly explained the diffefence between a homeopathic substance and a potentised one – it was obviously very important to her! However the woman in the green dress with bits of ostrich round her neck explained it very clearly – water with nothing in it (but a “memory”) has been potentised, if it cures your ilness it’s also homepoathic but if it doesn’t it isn’t. Thus demonstrating that homeopathy is effective 100% of the time (and therefore much more effective than a placebo).

  61. john souray said,

    December 17, 2006 at 3:42 pm

    (inicholson:) I don’t think that’s what she was saying, though she certainly wasn’t clear. I understood her to be saying that a progressively diluted substance was only potentised. A potentised substance only becomes a homoeopathic remedy when it is “prescribed” (do they use that word?) by a homoeopathic practitioner following their specific (holistic) analysis of the symptoms.

    If my understanding was right (and I’m not at all confident) then the interesting thing is it renders fraudulent all those bottles of potentised substance on sale in Boots and Holland & Barrett and so on which you buy just like you buy an ordinary medicine (they even have handy booklets listing the diseases – not, note, symptoms – to which they’re appropriate).

    We might legitimately think it’s those manufacturers and retailers they ought to be getting angry with, not just Ben Goldacre.

  62. Ken Zetie said,

    December 17, 2006 at 9:38 pm

    Just caught up with this thread after a lovely weekend in the Lake District. Having just finished reading Dawkins’s “The God Delusion” I can’t help see an awful lot of overlaps between the homeopathy debate and what Dawkins portrays as the struggle for atheism to be accepted as a valid philosophical position.

    Not least amongst the similarities is the presence of appeasing moderates. In the religious debate Dawkins talks about the problem with moderates is that they accept de facto that faith stands above evidence and place faith above other philosophies. Therefore another faith – even one they must avowedly dismiss – is given prominence over no fatih (rationalism). Hence the problem of trying to appease everyone’s views. The similarity with Ben’s debate with the faith-based medicine lobby is only partly the fundamentalist, extremist leaders – it it mainly with the moderate audience. Moderate in that they accept some science (they get in a jet plane to go on holiday, microwave their dinners and can probably use a word processor to spell-check the word ‘hypocrite’ accpeting along all the scientific advances to produce these things) but are all too ready to dismiss the whole of science when it doesn’t accord with one shot of personal experience – usually Aunt Edna smoking 60 a day and living to be 93. If they don’t have an Aunt Edna who kippered herself then they have to resort to the old standard of bumble bees (about which I could write at excessive length…and have done). It is the masses who refuse to accept that science is a system, whole and complete and you cannot just take the bits you like, who are the problem.

    Can it really be down to schools to help sort it out? If so, we need teachers in school who understand science. And there are fewer and fewer of those. How many primary teachers have any science background at all?

    Ken

  63. Dr Aust said,

    December 17, 2006 at 9:43 pm

    That’s right, John – over-the-counter homeopathic remedies don’t count as “Genuine” homeopathy as they are not individualized, or prescribed with the ritual incantations of a “qualified” homeopath. Therefore a “proper” homeopath should regard them as ineffective and essentially fraudulent.

    In this connection, when the alt health companies were pushing the MHRA to allow them to sell things labelled “homeopathic cold cure” over the counter, the homeopaths were startlingly silent about this perversion of their cherished therapeutic system. Funny, that.

    Also why I was repeating on the Lionel Milgrom thread that I would always like to see “serious” homeopaths like Peter Fisher asked the question “Can Over-The-Counter homeopathic remedies work?” in a debate. I think this is the medically-qualified-homeopath equivalent of asking an old calculator the square root of minus one. Essentially the only way they can claim the pills do anything is via the BELIEF of the person taking it that it will work, ergo placebo.

    Then, once they have admitted that the pills themselves have a placebo effect, they can be asked “So given that you have admitted the pills have a placebo effect, and that we KNOW from many studies that there is a “therapeutic consultation” effect, what exactly IS homeopathy beyond the sum of these two perfectly explicable things?”

    I know what my answer is.

    BTW, Ben referred above to the differences between UK homeopaths (largely barking reject-nasty-drugs alternative crystals-and-Mayan re-birthing fringe loony types) and the ones from places like Switzerland and Germany. One difference is that in those countries many homeopaths are people who started as conventionally-trained doctors but who use homeopathy. I have always suspected that the tacit belief there is that, for people with vague “don’t quite feel right” non-specific and largely non-treatable ailments, they are happy to “mobilize” the power of patients’ beliefs to try and make them feel better.

    The other difference is that if the patient clearly has a serious conventionally-treatable problem then they get told to seek conventional treatment, rather than being told that “18c homoepathic rattlesnake venom” will lower their blood pressure.

  64. Ben Goldacre said,

    December 17, 2006 at 10:20 pm

    its obviously true that the over the counter homeopathy pills presents a major logical problem for the sane homeopathswho try to be consistent, but to me it’s just another example of the total failure to engage in everyday critical self-appraisal in the homeopathy industry which is, as i keep saying, 200 years old, so we are perfectly entitled to expect it to behave as a mature discipline.

    as far as i am aware there have not been discussion papers on the problems posed by the huge over and prominent trade in counter homeopathy pills in the homeopathy and CAM literature, even the grey literature, but i may be wrong. i’d love to see one example.

    as for the stark difference between the rabid and hateful UK homeopathy community and their reasoned and moderate continental counterparts, i don’t really know what’s going on there.

    i think perhaps in germany, for example, they are less fearful and paranoid about their professional identity and standing, so they don’t flip out so viciously when someone pops up and says “hang on that’s just a survey with inadequate follow-up, that doesn’t trump a meta-analysis at all…”

    it might also just be a national temperament thing. we have more street violence and teenage pregnancies than anyone else, too, you know. i think rabid hateful homeopaths might just be an intellectual expression of the same unmediated impulsiveness, and lack of self-regulation in the most individualistic sense.

  65. Mojo said,

    December 18, 2006 at 2:05 pm

    john souray said, “I don’t think that’s what she was saying, though she certainly wasn’t clear. I understood her to be saying that a progressively diluted substance was only potentised. A potentised substance only becomes a homoeopathic remedy when it is “prescribed” (do they use that word?) by a homoeopathic practitioner following their specific (holistic) analysis of the symptoms.”

    This is certainly something I’ve seen at least one homoeopath say in print. See the comments to this story:

    www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=387452

    “Although Prof Ernst claims to have studied homeopathy, his comments regarding the use of serially diluted remedies which he writes for his journal, FACT, do not demonstrate an understanding of homeopathic prescribing principles.

    1) To become a homeopthic remedy, a serially diluted remedy needs to be prescribed to homeopathic standards.

    2) A serially diluted remedy not prescribed to homeopathic standards is not a homeopathic prescription.

    3) Research on the effectiveness of serially dilluted remedies which are not prescribed to homeopathic standards is not a test of homeopathy.

    – Jerome Whitney, London UK”

    Unfortunately for Mr. Whitney, one of the trials mentioned in the article was a randomised placebo-controlled trial of individualised homoeopathy; in other words a test of homoeopathic remedies that have been “prescribed to homeopathic standards”:

    thorax.bmj.com/cgi/content/abstract/58/4/317

    Milgrom’s stuff about “Patient-practitioner-remedy entanglement” is another attempt to invoke the same excuse. For a recent paper see Journeys in The Country of The Blind: Entanglement Theory and The Effects of Blinding on Trials of Homeopathy and Homeopathic Provings:

    ecam.oxfordjournals.org/cgi/reprint/nel062v1.pdf

    You couldn’t make this stuff up!

  66. Mojo said,

    December 18, 2006 at 2:09 pm

    Sorry, the comments seem to not be linked from the version of the Mail story I linked to above. I’ll try this one:

    www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=387452&in_page_id=1774&in_page_id=1774&expand=true#StartComments

  67. ayupmeduck said,

    December 18, 2006 at 9:09 pm

    I probably cannot speak for Germany as a whole, but in Bavaria, Austria and North Italy, homeopathy is rampant. We live in the “artists quarter” of Munich and it is scary. Many of the mothers carry around their €500 a shot homeopathic kits ready to check the accompanying guide and hand out sugar and water for any ailment. Quite a few chemists sell homeopathic “remedies” without telling you anything about what you are getting, never mind a second of consultation. Can you guess how effective a homeopathic remedy is for head-lice? There are at least 10 homeopathic “doctors” in walking distance from my office.

    So maybe, as you say, the German homeopaths aren’t so fearful, but that is possibly because they have the market tied-up. And I could just about live with this, if it wasn’t for the fact that the same people paying out €500 for their water kits are the exact same ones whining on about the poor state of the German health system.

    Most of these homeopaths share offices, or also engage, with other sidelines such as herbal remedies, feng shui, pyramids against e-smog, magnets on water pipes, etc.

    I’ll sit in the Glasto healing fields and talk esoteric bollocks just like anybody else, but this is not just hippy nonsense, this is dangerous mixture and greed and stupidity.

  68. David Colquhoun said,

    December 19, 2006 at 12:25 am

    Yes I think I too have been influenced by Dawkins’ talk of appeasement by agnostics.

    I doubt very much whether I could have kept as cool as Ben did. I’ve come, rightly or (quite possibly) wrongly, that it might be better to just say straight out that these guys are frauds, even Fisher (never mind the unspeakable Melanie Oxley). ‘Fraud’ is short, simple and to the point. Everyone understand it. Since most people don’t seem to understand what makes good evidence and what doesn’t, even masterly expostions like Ben’s don’t seem to cut much ice. I couldn’t resist posting something about magic water being like a memory stick (i managed, with some difficulty, to capture a frame of him brandishing his gigabyte proof that all is OK at
    www.ucl.ac.uk/Pharmacology/dc-bits/quack.html#goldfish )

    By the way, You and Yours (Tuesday 19 Dec 12.04 Radio 4) is doing something on the snoring scam.

  69. Ben Goldacre said,

    December 19, 2006 at 1:51 am

    “I doubt very much whether I could have kept as cool as Ben did. I’ve come, rightly or (quite possibly) wrongly, that it might be better to just say straight out that these guys are frauds”

    ha! this is a difference in approach which i very much look forward to exploring in the colquhoun badscience interview podcast, sorry we didn’t get to do it at the CAM conference, i didn’t have the equipment.

    the odd thing about the memory of water business is that for all their chatter about it, homeopaths actually hand out little sugar pills. you never hear them taking about the memory of sugar, remembering things it picked up from the water, or do you?

  70. three tigers said,

    December 19, 2006 at 7:26 am

    Homeopathy is part of the normal curriculum for medics and pharmacists in Germany rather than a looney fringe activity, practiced by deluded ex-medics and never-medics to make money selling water, as in the UK. It must be something to do with the fact it was a german who first came up with the daft idea and they feel it’s a patriotic duty.
    Dr Aust is absolutely right in #63. If you are a ‘worried well, time-waster’ or they are confident the condition is self-limiting, Swiss doctors do give all manner of suger-pills to patients.
    As a parent, I had to decide if my son could be given a homeopathic treatment if he fell over and bumped himself in his gymnastics class. I said no. Plasters yes, quack drivel no thanks.

  71. john souray said,

    December 19, 2006 at 8:36 am

    I think some of you are being a bit unfair about Dr Fisher’s brandishing of a memory stick. I don’t think he was saying “water may well have a memory in the same way that this stick does”. I think he was pointing out that twenty or thirty years ago, nobody would have believed that a thing like his memory stick could have stored the quantity of information that stick held, and that a scientific analysis of it would have failed to reveal it.

    (We all have fun laughing at the science fiction films of old, with their master computers: even the ones with solid scientific advice, like 2001. A particularly interesting example is Nigel Kneale’s The Stone Tape, a BBC Christmas ghost story in which a team of computer scientists retreat to a country house to “brainstorm” a technical solution to a memory storage problem. This is interesting not just because it’s a fine ghost story, but because it deals directly with exactly this problem and because we can all have a good laugh at the awful clunky computers they actually have to work with, just one step up from a punch-card machine. )

    I don’t think this is any more convincing as an argument though. It’s just a sophisticated dressing up of the “more things in heaven and earth” ploy. It doesn’t so much assert that a thing is possible as say “well, it isn’t impossible”.

  72. autism diva said,

    December 19, 2006 at 9:54 am

    My favorite comment from the audience was from a young man asking if a homeopathic dilution of polonium 210 would have saved the Russian spy from a nasty death by polonium 210.

    Regarding the problem of homeopaths threatening skeptics with harm through homeopathic remedies….
    video.google.com/googleplayer.swf?docId=5744729938179836028&hl=en
    Link to a video of Peter Bowditch commiting “homeopathic suicide.”

    Peter Bowditch attempted “homeopathic suicide” by taking 200C belladonna pills, which were sent to him with a wish for Mr. Bowditch’s death or something.

    Later, Bowditch posted to the healthfraud listserv which is public but really hard to search through,

    “I was accused by a homeopath of not understanding homeopathy and being
    frightened to try it. I asked him to send me some pills, which he did.
    Since then he emailed me twice accusing me of gutlessness, so I told him
    that I would be taking a mass of the tablets.

    You can se me committing suicide at the first link on
    www.ratbags.com/rsoles/video/

    He has now told me that by taking a lot of tablets at once I am again
    illustrating my ignorance, as I was specifically instructed to take one
    per hour for 12 hours to get the effect (such effect being unspecified but
    apparently obvious).

    I am now up to hour 5 and I am still alive and showing no effects of
    belladonna. My problem is that the symptoms of belladonna poisoning
    according to my herbal manual are: “Strange indescribable feelings with
    giddiness, yawning, staggering or falling on attempting to walk; dryness
    of mouth and throat, sense as of suffocation, swallowing difficult, voice
    husky; face at first pale later suffused with a scarlatiniform rash which
    extends to the body; pupils widely dilated; pulse, at first bounding and
    rapid, later becomes irregular and faint”. As this sounds like the normal
    me it may be hard to detect the real effect.

    (The pills would be recognisable to any child in the civilised world,
    although some would call them “nonpariels” while others would say
    “hundreds and thousands”. Tiny balls of sugar.)”

    Since he still had pills he continued to take them one per hour, but still surivived.

    But one of the people in the audience said that homeopathic remedies do nothing if there isn’t the proper imbalance already present in the person’s body.

    Still, the homeopath who sent the 200C Belladonna pills must have known what they were supposed to do,, that is kill or maim Bowditch.

    Interesting stuff about occilococcinium which was sort of alluded to by the woman talking about a cure made with a duck egg (?). It’s duck liver and heart.
    www.homeowatch.org/history/oscillo.html

    “Oscillococcinum, a 200C product “for the relief of colds and flu-like symptoms,” involves “dilutions” that are even more far-fetched. Its “active ingredient” is prepared by incubating small amounts of a freshly killed duck’s liver and heart for 40 days. The resultant solution is then filtered, freeze-dried, rehydrated, repeatedly diluted, and impregnated into sugar granules. If a single molecule of the duck’s heart or liver were to survive the dilution, its concentration would be 1 in 100200. This huge number, which has 400 zeroes, is vastly greater than the estimated number of molecules in the universe (about one googol, which is a 1 followed by 100 zeroes). In its February 17, 1997, issue, U.S. News & World Report noted that only one duck per year is needed to manufacture the product, which had total sales of $20 million in 1996. The magazine dubbed that unlucky bird “the $20-million duck.”:
    www.quackwatch.org/01QuackeryRelatedTopics/homeo.html

    I just wanted to add to the “nice hair” comments and say that I enjoyed the explanation of placebo effects.

  73. Penta said,

    January 3, 2007 at 11:06 pm

    I am not a scientist, but as athiest.

    I saw how the whole Quackery of Homeopathy was being bandied about like a religion. “Scietific methodology cant measure the effects….. so change the methodology”……. What nonsence!

    Shame you are wasting much needed NHS funding on such stuff in the UK.

    The NHS is already one of the weakest showcases for proper science and medicine in Europe, if not hte worst exmple. By wasting more money on Homeopathy, some little old lady isnt going to get her hip replacement operation this year!

    Finally I loved the reference to a data key being simply cilacone etc, and a CD being…. so somehow water could hold equivelent properties……. well I can just imagine Cilecone Valley suddenly being turned into a lake….. as it would be so much cheaper and Intel et al, wouldnt need to employ all those highly trained staff in clean rooms preparing chips! All they wold need to do is buy the rights to Penta Water and bob´s your Uncle!

  74. drcarley said,

    January 7, 2007 at 6:45 pm

    Dr. Goldacre,

    One of my clients in the UK sent me the link to the debate you had with Dr. Fischer at www.badscience.net/?p=339#more-339, in which you discussed homeopathy’s “scientific” basis, along with the comments you made afterwords. You also brought up that the majority of homeopaths recommend that the MMR jab not be administered to their children. I hereby challenge you to a debate on homeopathy, vaccines, and science itself.

    I just sent the following e-mail to the National History Museum in London:

    “I am writing to request you sponsor another debate on homeopathy as well as the MMR vaccine, which was brought up as well in the debate. I am a medical doctor, the only court qualified expert in vaccine induced diseases in the world (to my knowledge), and I have developed a protocol to reverse all autoimmune diseases (including autism) and cancer, in people and in pets, using homeopathic remedies and other natural supplements.
    I would like to debate Dr. Goldacre in these areas; in particular, the documents on my website at www.drcarley.com. You will see that I have offered a $10,000 reward to any vaccine promoter to refute these documents; to date, no takers. Perhaps Dr. Goldacre would like to do so; and your museum could get the worldwide attention that such a debate would draw..
    I commend you for your willingness to bring these issues to the light of day, for the good of humanity.

    In Service to the TRUTH, I AM,
    Rebecca Carley, MD”

    I am attaching 2 of the documents on my website (“Inoculations; the True Weapons of Mass Destruction” and my “Response to the CDC’s Public Health Protection Guide”) for your critical evaluation. I would be very grateful for a chance to have a debate with you, as no one in the states is willing to debate me on these issues. I invite you to prove my documents wrong. If the NHM in London is not willing to do so, perhaps we can debate on my worldwide internet broadcast on www.againstthegrain.info. I will post this letter on my website, as well as your response. Let us debate what “bad science” really is….

    Respectfully,
    Rebecca Carley, MD

    2 attachments — Download all attachments
    VIDS Mechanism Paper 0706.doc
    84K View as HTML Download
    Response of Rebecca Carley, MD to CDC’s Protection Guide.doc
    62K View as HTML Download

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