Lionel Milgrom – Quality Homeopathic Debate

December 16th, 2006 by Ben Goldacre in bad science, hate mail, homeopathy | 131 Comments »

Bit of a ramble, so feel free to bypass this post, but this is quite odd to me. When a chap receives a communique from one of the Directors of the Society of Homeopaths, that august representative body, it only seems fair to give it some thought and some space. This charming email from Lionel Milgrom arrived today: it’s unsolicited, we’ve never met, we have no pre-existing dialogue, it brings a new meaning to “please send your bad science to bad.science@guardian.co.uk“, and is full of scorn, but he clearly hasn’t bothered to actually watch the video of the debate.

I’m happy to give this feedback some space, as it’s so representative both of what happened with the audience on that night, and because it’s representative of the kind of criticism one tends to get from the CAM industry, and the kinds of things I see said on discussion lists and emails forwarded to me from within the industry, and because of his seniority.

“Benjamin, oh lttle Benjamin,” he begins.

Lionel Milgrom standing next to some science

“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”

Now, look, if you want to check whether I was there for the entirety of Peter’s talk you can see me in the very first frame of the video (that’s me on the right).

and then throughout the whole of the rest of it, listening carefully and dealing with an abusive and hostile crowd of homeopaths with courteousy and thoughtfulness, as you can see, it’s all on tape. Bizarre.

Lionel Milgrom, a Director of the Society of Homeopaths.

Looking on a wider scale, personal slights are one thing (and I’m afraid I do personally rather suspect that Lionel’s extensive popular journalism on homeopathy and quantum physics might betray the same low standards of factual accuracy and rhetoric as his email): but a great deal of what I said on that night was about the poor quality of popular discourse throughout the homeopathy industry.

On that very night, for example, I mentioned that published undercover survey data shows that most homeopaths are against the MMR vaccination, and at least half advised a researcher posing as a client against giving the MMR vaccine to her child.

www.bmj.com/cgi/content/full/325/7364/597

The reaction of the homeopaths in the crowd was simply to deny that this had ever happened, to deny that such a thing was even possible, and to become angry and hostile. Even Peter Fisher seemed to find this regrettable.

There’s plenty that could conceivably be valuable to society in homeopathy, as I have said on many occasions. Moreover, homeopathy is a mature discipline, and there’s absolutely no reason why it cannot engage in reasoned self-appraisal, rather than simply holding its head in the sand. There’s no excuse for it, just like there’s no excuse for homeopaths performing endless methodologically inept trials, and selectively quoting those, or misrepresenting the published literature, or failing to police itself.

I don’t think this happens so much in other fields. Interestingly, I don’t think it happens so much in other countries either. I was recently lucky enough to have several long and fascinating conversations with representatives of the homeopathy industry from all over Europe at a conference on CAM in Exeter, and although there were things we disagreed on, for the most part they were intellectually rigorous, they were able to engage – engagingly – on ethical issues, cultural issues, and, where appropriate, on a level of odds ratios, confidence intervals, and methodological flaws in research literature, like you’d find in any other academic field.

I’m sorry to be a bore, but I’m starting to feel quite conflicted about this. I think alternative therapies are incredibly interesting for a whole host of reasons, for what they say about the cultural role of medicine, and for the way they provide such an excellent resource of simple methological flaws for my hobby horse of teaching the world about evidence based medicine. And of course the battiness of popular rhetoric in CAM is part of the appeal too. But the more I see of the British homeopathy industry – well represented in the crowd at the debate with Fisher, and the weekly crop of ill-argued vitriol that appears at badscience mansions – the lower my jaw drops.

Here are the two blog entries Milgrom is so upset about:

www.badscience.net/?p=323

www.badscience.net/?p=339

Here is my entire homeopathy output:

www.badscience.net/?cat=35

Yeah, I make jokes. I am also reasonable, knowledgeable, I have never lied, my articles are full of information, I give references where appropriate, but yes, I point it out when people misrepresent the scientific literature. I am also more than ready to engage on the issues with people who are able to discuss them, I welcome the opportunity to discuss things with Peter Fisher, and I have made it clear on countless occasions that I would welcome the opportunity to discuss the issues with anyone who was able to engage meaningfully. I’m trying not to take this to heart, and stay focused on the issues. But you homeopaths seriously have to grow up.


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131 Responses



  1. Mojo said,

    December 20, 2006 at 5:00 pm

    Re post 94: Some people have no sense of gratitude… 😉

  2. Dr Aust said,

    December 20, 2006 at 5:38 pm

    re post 97:

    And another (anachronistic) t-shirt:

    Picture of witch being dunked into pool of water:

    Caption (one peasant to another): Ha! I love it when we give one of these homeopaths a dose of his own medicine!

  3. Dr Aust said,

    December 20, 2006 at 6:08 pm

    On a more serious note, Anthony Campbell’s online book about Homeopathy (URL in post 95 above) is actually quite an interesting read.

    – Though having read the last two chapters, I’m not altogether sure Lionel M and Ben’s audience from the debate would recognise Campbell as a homeopath..!

    – from the final chapter:

    ” So are we to conclude that homeopathy is simply a powerful placebo? Probably, yes, but a placebo in the sense that psychotherapy is a powerful placebo. A homeopathic consultation affords the patient an opportunity to talk at length about her or his problems to an attentive and sympathetic listener in a structured environment, and this in itself is therapeutic..

    Psychotherapy is defined as “the talking cure”, and judged on that basis, homeopathy is a form of psychotherapy. This is true whether or not the homeopath recognizes that she is using psychotherapy. Many homeopaths would agree that there is an element of psychotherapy in the consultation, but they would not accept that that is the main part of it. However, homeopaths generally pride themselves, often with justification, on being people with good powers of intuition and empathy; indeed, unless they have these abilities they will not succeed in their profession. This also means that they are good psychotherapists.

    The psychiatrist Anthony Storr is sceptical about much psychoanalytic theory but nevertheless thinks that psychoanalysis can have beneficial effects on patients. I should say the same is true of homeopathy.”

    Campbell’s book gives an interesting account fo the history of homeopathic thought, which might shed some light on why the British homeopaths seem more “woo-ish”, and rabldly anti conventional medicine, than those in some other countries, e.g. in mainland Europe. Campbell stresses the influence in the late 19th century of the American James Tyler Kent (1849-1916), whose ideas

    “[represent] Hahnemann’s later, more extreme, ideas taken to their logical limit…”

    including

    “….- Insistence on the theoretical aspects of Hahnemann’s thought, especially the miasm doctrine and vitalism.
    – A corresponding rejection of modern scientific and pathological knowledge as a guide to prescribing.
    – Great emphasis on the importance of psychological symptoms in prescribing.
    – Insistence on the use of very high potencies. [i.e. dilutions] ………..”

    Campbell also notes that

    ” In the early years of the twentieth century advocates of Kent’s ideas took over homeopathy in Britain almost completely, and as a result the notion of homeopathy that most people [in the U.K.] have today is based on Kentian homeopathy, which is an extreme and “fundamentalist” version”

    Campbell’s book traces the reasons why homeopathy has survived in Britain, including its royal patronage which dates back to the 1820s, and explains how the Homeopathic Hospitals became part of the NHS. Good fun if you’re into history.

  4. fg said,

    December 20, 2006 at 7:28 pm

    On a less serious note: if water has a memory, then surely—at some point in its history—its been urine. So can it remember that? Do two bottles of water reminisce about the time they were urinated by a brontosaurus, and moan how pathetic us primates are, sweating it all away? What about the stuff that’s been used as a coolant in a nuclear reactor? Gives you pause for thought, doesn’t it?

    Re: BSM @ 67
    “It was certainly used while open heart surgery was done, but the patient was drugged up to the eyeballs and also had local anaesthetics injected.”

    No…No…No….I recant my naïve, open-mindedness – these people are insane!

    Re Twm – loved them all. I emailed Ben my rather more pedestrian efforts.

  5. ayupmeduck said,

    December 20, 2006 at 7:43 pm

    Dunno if this will fit (or if the HTML) will work, but you can have it for a T-shirt if it will somehow fit:

    i145.photobucket.com/albums/r227/ayupmeduck/water-cartoon.jpg?t=1166643533

  6. ayupmeduck said,

    December 20, 2006 at 7:45 pm

    Hmm, guess the HTML didn’t work, here’s a link:

    i145.photobucket.com/albums/r227/ayupmeduck/water-cartoon.jpg?t=1166643533

  7. Delster said,

    December 21, 2006 at 10:40 am

    re post 91…. hate to point it out but it’s fairly easy to get a virgin pregnant… mind you back then then may not have known this :-)

    ayupmeduck, you been reading the hitch hikers guide again? “it’s unplesently like being drunk” “whats wrong with being drunk” “ask a glass of water!”

  8. used to be jdc said,

    December 21, 2006 at 12:43 pm

    I’m sure I read somewhere recently that there were (in different places, different eras…) different definitions of the word virgin, which could mean pre-pubertal or post-menopausal. So the miracle of the virgin birth could be a little like those modern miracles in the red-top (“gran gives birth to triplets” etc…). Err… maybe.

  9. Dr Aust said,

    December 21, 2006 at 1:28 pm

    re. 105…talking religious doctrine

    If we’re talking New Testament textual analysis, my memory of this was that the Greek word in the original version of the relevant gospel didn’t necessarily mean” virgin” but rather “young woman”. When it was translated it became virgin, the irreligious neo-marxist historians’ view being that it suited the compilers of the early church in late Roman times to have Jesus born of a virgin, rather than being simply a child born to a married couple.

    This sort of argument is a source of endless fun annoying serious and/or dogmatic Christians, if that’s your kind of thing.

  10. Gordon said,

    December 21, 2006 at 2:04 pm

    Steve Bell’s cartoon in today’s Guardian has a homeopathic interpretation – Bush diluted into Blair diluted into Cameron:
    www.guardian.co.uk/cartoons/stevebell/0,,1976707,00.html

  11. j said,

    December 21, 2006 at 6:25 pm

    “If we’re talking New Testament textual analysis, my memory of this was that the Greek word in the original version of the relevant gospel didn’t necessarily mean” virgin” but rather “young woman”. When it was translated it became virgin, the irreligious neo-marxist historians’ view being that it suited the compilers of the early church in late Roman times to have Jesus born of a virgin, rather than being simply a child born to a married couple.

    This sort of argument is a source of endless fun annoying serious and/or dogmatic Christians, if that’s your kind of thing. ”

    The christians are at it too nowadays. Christian ‘true love waits’ approaches to contraception often suggest that members can become ‘born again virgins’ when they take their pledge to abstain until marriage – even if they’ve already had sex.

  12. fg said,

    December 21, 2006 at 7:52 pm

    Sorry TWM, but I was so impressed by your USB water bottle I had to do my own –

    farm1.static.flickr.com/144/329341712_6fdf1a60cd_o.jpg

    Hope you’re not too narked. There are some more designs here,

    www.flickr.com/photos/82545477@N00/329341715/

    starting with a post-feminist reinterpreation of “MMR is safe”. (I thought this needed to appeal to women – so I went pink and fluffy.)

  13. bootboy said,

    December 21, 2006 at 8:58 pm

    “Steve Bell’s cartoon in today’s Guardian has a homeopathic interpretation – Bush diluted into Blair diluted into Cameron:”

    At sufficent levels of dilution, that particular solution will bring eternal peace to the universe, infinite respect for people of all creeds and colours and a never-ending reign of social justice.

    If only this homeopathy stuff wasn’t a load of cobblers. sigh.

  14. oneiros said,

    December 22, 2006 at 8:07 am

    @107: Some nice ideas, but you might want to double-check your spelling on that first (water memory) one… 😉

  15. TimW said,

    December 22, 2006 at 11:10 pm

    I’m usually pretty good at spelling errors but I can’t spot it this time. Has it been fixed? Or is it Homoeopathic that you don’t approve of? Or something I’ve missed – gah!

  16. fg said,

    December 23, 2006 at 8:39 pm

    oneiros – please tell me what I’ve spelt wrong – as I’ve just put this slightly revised version (bottle has electrode, bubbles and label) through the spell checker, and beyond swearing at www.badscience.net, there were no complaints.

  17. pseudomonas said,

    December 24, 2006 at 8:46 am

    fg: 850ml at 4Gb/ml doesn’t make the 4Tb on the label.

  18. abahachi said,

    December 25, 2006 at 10:14 pm

    Re 105: Why discredit this by attributing it to neo-Marxists? Lots of entirely non-Marxist conservative historians would happily agree that the whole ‘virgin birth’ issue is (a) pretty late in origin and (b) quite possibly due to mis-translation due to lack of cultural context.

    Re everyone else: basic problem is, given that homeopathy is so manifestly obviously barking – the memory of water??? – why is it that people, even apparently sane and sensible people, believe it? It’s all very well producing yet more witty expositions of why it’s ridiculous; the crucial question, to quote Shermer, is ‘why do people believe weird things?’.

    It lurks underneath almost every post here. Yes, sometimes there’s a clear enough divide between what the maths actually tells you and what seems normal, but too often we end up as a little clique of true science believers against the dark mass of astonishing unscientific ignorance. Since it’s Christmas, even I can get illogical at times; I want to believe in the possibility of enlightenment. So, what is it about ‘science’ that people seem to have lost faith? How much is that actually the problem?

  19. billgibson said,

    December 29, 2006 at 12:19 pm

    fg – it’s homeopathic not homOeopathic.

    It’s such a pain conversing with so many eaqgle-eyed pedants!

    Bill

  20. billgibson said,

    December 29, 2006 at 12:19 pm

    And I’e just spotted the q in eagle. Bugger.

  21. Twm said,

    December 29, 2006 at 4:41 pm

    Homeopathy (also spelled homœopathy or homoeopathy) from the Greek words όμοιος, hómoios (similar) and πάθος, páthos (suffering)[1],

  22. Mojo said,

    December 30, 2006 at 1:42 pm

    “it’s homeopathic not homOeopathic.”

    Someone had better tell the MHRA!

    www.mhra.gov.uk/home/idcplg?IdcService=SS_GET_PAGE&nodeId=98

  23. Robert Carnegie said,

    December 30, 2006 at 3:37 pm

    They seem to be in two minds whether their “National Rules Scheme” applies to homoeopathic medicine, homeopathic medicine, or both.

    The “homeo-” form seems much more common on the Internet, and I’ll guess that it’s more emphatically the orthodox spelling in America, where they tend to leave off frills from words imported into English.

  24. jre said,

    January 10, 2007 at 7:46 pm

    In a gesture of Trans-Atlantic comity, I have decided to alternate between the two spellings.

  25. jimrog said,

    January 19, 2007 at 11:44 am

    This is all very intersting. You all seem to follow Ben in assuming that anyone who is interested in Homeopathy is a deluded fantasist who is in a flight from science.
    In fact many serious scientists engage with Homeopathy because they recognise that there is a puzzling phenomena that has some real evidence for it and therefore warrants further investigation.
    The truth is that not all of the scientific research shows Homeopathy to be no more than placebo. It is simply untrue and an evasion to suggest that any research which demonstrates some evidence for Homeopathy is of poor quality and can therefore be dismissed. There is clinical and pre clinical evidence which does demonstrate some action of ultra molecular dilutions.
    A scientific mind would say ” that’s interesting. lets investigate further”.
    Closed minds have already decided that Homeopathy cannot be true and will therefore dismiss it without properly examining the evidence.

    Just one recent example……………………………………………………………………..

    Research article
    .
    Rat models of acute inflammation: a randomized controlled study on the effects of homeopathic remedies
    Anita Conforti , Paolo Bellavite , Simone Bertani , Flavia Chiarotti , Francesca Menniti-Ippolito and Roberto Raschetti

    BMC Complementary and Alternative Medicine 2007, 7:1 doi:10.1186/1472-6882-7-1

    Published 17 January 2007

    Abstract (provisional)

    The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

    Background

    One of the cardinal principles of homeopathy is the “law of similarities”, according to which patients can be treated by administering substances which, when tested in healthy subjects, cause symptoms that are similar to those presented by the patients themselves. Over the last few years, there has been an increase in the number of pre-clinical (in vitro and animal) studies aimed at evaluating the pharmacological activity or efficacy of some homeopathic remedies under potentially reproducible conditions. However, in addition to some contradictory results, these studies have also highlighted a series of methodological difficulties. The present study was designed to explore the possibility to test in a controlled way the effects of homeopathic remedies on two known experimental models of acute inflammation in the rat. To this aim, the study considered six different remedies indicated by homeopathic practice for this type of symptom in two experimental edema models (carrageenan- and autologous blood-induced edema), using two treatment administration routes (sub-plantar injection and oral administration).

    Methods

    In a first phase, the different remedies were tested in the four experimental conditions, following a single-blind (measurement) procedure. In a second phase, some of the remedies (in the same and in different dilutions) were tested by oral administration in the carrageenan-induced edema, under double-blind (treatment administration and measurement) and fully randomized conditions. Seven-hundred-twenty male Sprague Dawley rats weighing 170-180 g were used. Six homeopathic remedies (Arnica montana D4, Apis mellifica D4, D30, Atropa belladonna D4, Hamamelis virginiana D4, Lachesis D6, D30, Phosphorus D6, D30), saline and indomethacin were tested. Edema was measured using a water-based plethysmometer, before and at different times after edema induction. Data were analyzed by ANOVA and Student t test.

    Results

    In the first phase of experiments, some statistically significant effects of homeopathic remedies (Apis, Lachesis and Phosporus) were observed (the reduction in paw volume increase ranging from 10% to 28% at different times since edema induction). In the second phase of experiments, the effects of homeopathic remedies were not confirmed. On the contrary, the unblinded standard allopathic drug indomethacin exhibited its anti-inflammatory effect in both experimental phases (the reduction in paw volume increase ranging from 14% to 40% in the first phase, and from 18% to 38% in the second phase of experiments).

    The interesting thing here, in terms of Homeopathy is that only the more highly diluted and potentised remedies showed any action

    I would like to see more research and less polemic and ill informed deabte on both sides. Homeopathy is not a religion: it started as an effective evidence based medicine and should continue that way.

  26. Ben Goldacre said,

    January 19, 2007 at 11:57 am

    “You all seem to follow Ben in assuming that anyone who is interested in Homeopathy is a deluded fantasist who is in a flight from science.”

    where on earth have i said this? what i say is, the evidence goes very strongly against it, and homeopaths tend to rely on weak rhetorical tropes and abuse in preference to discussing the evidence. your opening sentence rather proves the point jim.

  27. jimrog said,

    January 22, 2007 at 8:52 am

    I have read all of the posts on your site in relation to Homeopathy. If you look at the vast majority of the responses to this deabte on Homeopathy most of your readers are convinced that there is NO scientific evidence at all for Homeopathy.
    Many view it as equivalent to religious belief. I am simply pointing out that there is SOME good scientific evidence that the ultra molecular dilutions have an effect. The evidence might be small but once it is there, the scientific response is to investigate further. You and your readers accuse Homeopaths of being selective but many of your readers are equally selective in ignoring this evidence, and refusing to recognise that there is something there that warrants further investigation. The real history of scientific trials of Homeopathy is actually quite fascinating – see for example Mike Emmans Deans book about this.

  28. darcysarto said,

    July 3, 2007 at 2:18 pm

    Milgrom is in my office. He’s carrying a copy of this:

    www.amazon.co.uk/Need-Know-UFOs-Military-Intelligence/dp/028307034X

    I don’t know if it comes with a free tin hat.

  29. Michael Gray said,

    July 25, 2009 at 1:56 am

    jimrog:
    I note that you failed to offer references for this ‘good scientific evidence’.

    I truly wonder why.

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  31. simoncuming48 said,

    July 16, 2013 at 5:35 pm

    I remember Milgrom from my days at Kingston University, 20 years ago. Always playing around with Porphyrins, hence the nickname Miligram! Very arrogant as a younger man, obviously worse now!