The end of homeopathy?

November 16th, 2007 by Ben Goldacre in bad science, homeopathy | 472 Comments »

Time after time, properly conducted scientific studies have proved that homeopathic remedies work no better than simple placebos. So why do so many sensible people swear by them? And why do homeopaths believe they are victims of a smear campaign? Ben Goldacre follows a trail of fudged statistics, bogus surveys and widespread self-deception.

Ben Goldacre
The Guardian
Friday November 16 2007

There are some aspects of quackery that are harmless – childish even – and there are some that are very serious indeed. On Tuesday, to my great delight, the author Jeanette Winterson launched a scientific defence of homeopathy in these pages. She used words such as “nano” meaninglessly, she suggested that there is a role for homeopathy in the treatment of HIV in Africa, and she said that an article in the Lancet today will call on doctors to tell their patients that homeopathic “medicines” offer no benefit.

The article does not say that, and I should know, because I wrote it. It is not an act of fusty authority, and I claim none: I look about 12, and I’m only a few years out of medical school. This is all good fun, but my adamant stance, that I absolutely lack any authority, is key: because this is not about one man’s opinion, and there is nothing even slightly technical or complicated about the evidence on homeopathy, or indeed anything, when it is clearly explained.

And there is the rub. Because Winterson tries to tell us – like every other homeopathy fan – that for some mystical reason, which is never made entirely clear, the healing powers of homeopathic pills are special, and so their benefits cannot be tested like every other pill. This has become so deeply embedded in our culture, by an industry eager to obscure our very understanding of evidence, that even some doctors now believe it.

Enough is enough. Evidence-based medicine is beautiful, elegant, clever and, most of all, important. It is how we know what will kill or cure you. These are biblical themes, and it is ridiculous that what I am going to explain to you now is not taught in schools.

So let’s imagine that we are talking to a fan of homeopathy, one who is both intelligent and reflective. “Look,” they begin, “all I know is that I feel better when I take a homeopathic pill.” OK, you reply. We absolutely accept that. Nobody can take that away from the homeopathy fan.

But perhaps it’s the placebo effect? You both think you know about the placebo effect already, but you are both wrong. The mysteries of the interaction between body and mind are far more complex than can ever be permitted in the crude, mechanistic and reductionist world of the alternative therapist, where pills do all the work.

The placebo response is about far more than the pills – it is about the cultural meaning of a treatment, our expectation, and more. So we know that four sugar pills a day will clear up ulcers quicker than two sugar pills, we know that a saltwater injection is a more effective treatment for pain than a sugar pill, we know that green sugar pills are more effective for anxiety than red, and we know that brand packaging on painkillers increases pain relief.

A baby will respond to its parents’ expectations and behaviour, and the placebo effect is still perfectly valid for children and pets. Placebo pills with no active ingredient can even elicit measurable biochemical responses in humans, and in animals (when they have come to associate the pill with an active ingredient). This is undoubtedly one of the most interesting areas of medical science ever.

“Well, it could be that,” says your honest, reflective homeopathy fan. “I have no way of being certain. But I just don’t think that’s it. All I know is, I get better with homeopathy.”

Ah, now, but could that be because of “regression to the mean“? This is an even more fascinating phenomenon: all things, as the new-agers like to say, have a natural cycle. Your back pain goes up and down over a week, or a month, or a year. Your mood rises and falls. That weird lump in your wrist comes and goes. You get a cold; it gets better.

If you take an ineffective sugar pill, at your sickest, it’s odds on you’re going to get better, in exactly the same way that if you sacrifice a goat, after rolling a double six, your next roll is likely to be lower. That is regression to the mean.

“Well, it could be that,” says the homeopathy fan. “But I just don’t think so. All I know is, I get better with homeopathy.”

How can you both exclude these explanations – since you both need to – and move on from this impasse? Luckily homeopaths have made a very simple, clear claim: they say that the pill they prescribe will make you get better.

You could do a randomised, controlled trial on almost any intervention you wanted to assess: comparing two teaching methods, or two forms of psychotherapy, or two plant-growth boosters – literally anything. The first trial was in the Bible (Daniel 1: 1-16, since you asked) and compared the effect of two different diets on soldiers’ vigour. Doing a trial is not a new or complicated idea, and a pill is the easiest thing to test of all.

Here is a model trial for homeopathy. You take, say, 200 people, and divide them at random into two groups of 100. All of the patients visit their homeopath, they all get a homeopathic prescription at the end (because homeopaths love to prescribe pills even more than doctors) for whatever it is that the homeopath wants to prescribe, and all the patients take their prescription to the homeopathic pharmacy. Every patient can be prescribed something completely different, an “individualised” prescription – it doesn’t matter.

Now here is the twist: one group gets the real homeopathy pills they were prescribed (whatever they were), and the patients in the other group are given fake sugar pills. Crucially, neither the patients, nor the people who meet them in the trial, know who is getting which treatment.

This trial has been done, time and time again, with homeopathy, and when you do a trial like this, you find, overall, that the people getting the placebo sugar pills do just as well as those getting the real, posh, expensive, technical, magical homeopathy pills.

So how come you keep hearing homeopaths saying that there are trials where homeopathy does do better than placebo? This is where it gets properly interesting. This is where we start to see homeopaths, and indeed all alternative therapists more than ever, playing the same sophisticated tricks that big pharma still sometimes uses to pull the wool over the eyes of doctors.

Yes, there are some individual trials where homeopathy does better, first because there are a lot of trials that are simply not “fair tests”. For example – and I’m giving you the most basic examples here – there are many trials in alternative therapy journals where the patients were not “blinded”: that is, the patients knew whether they were getting the real treatment or the placebo. These are much more likely to be positive in favour of your therapy, for obvious reasons. There is no point in doing a trial if it is not a fair test: it ceases to be a trial, and simply becomes a marketing ritual.

There are also trials where it seems patients were not randomly allocated to the “homeopathy” or “sugar pill” groups: these are even sneakier. You should randomise patients by sealed envelopes with random numbers in them, opened only after the patient is fully registered into the trial. Let’s say that you are “randomly allocating” patients by, um, well, the first patient gets homeopathy, then the next patient gets the sugar pills, and so on. If you do that, then you already know, as the person seeing the patient, which treatment they are going to get, before you decide whether or not they are suitable to be recruited into your trial. So a homeopath sitting in a clinic would be able – let’s say unconsciously – to put more sick patients into the sugar pill group, and healthier patients into the homeopathy group, thus massaging the results. This, again, is not a fair test.

Congratulations. You now understand evidence-based medicine to degree level.

So when doctors say that a trial is weak, and poor quality, it’s not because they want to maintain the hegemony, or because they work for “the man”: it’s because a poor trial is simply not a fair test of a treatment. And it’s not cheaper to do a trial badly, it’s just stupid, or, of course, conniving, since unfair tests will give false positives in favour of homeopathy.

Now there are bad trials in medicine, of course, but here’s the difference: in medicine there is a strong culture of critical self-appraisal. Doctors are taught to spot bad research (as I am teaching you now) and bad drugs. The British Medical Journal recently published a list of the top three most highly accessed and referenced studies from the past year, and they were on, in order: the dangers of the anti-inflammatory Vioxx; the problems with the antidepressant paroxetine; and the dangers of SSRI antidepressants in general. This is as it should be.

With alternative therapists, when you point out a problem with the evidence, people don’t engage with you about it, or read and reference your work. They get into a huff. They refuse to answer calls or email queries. They wave their hands and mutter sciencey words such as “quantum” and “nano”. They accuse you of being a paid plant from some big pharma conspiracy. They threaten to sue you. They shout, “What about thalidomide, science boy?”, they cry, they call you names, they hold lectures at their trade fairs about how you are a dangerous doctor, they contact and harass your employer, they try to dig up dirt from your personal life, or they actually threaten you with violence (this has all happened to me, and I’m compiling a great collection of stories for a nice documentary, so do keep it coming).

But back to the important stuff. Why else might there be plenty of positive trials around, spuriously? Because of something called “publication bias“. In all fields of science, positive results are more likely to get published, because they are more newsworthy, there’s more mileage in publishing them for your career, and they’re more fun to write up. This is a problem for all of science. Medicine has addressed this problem, making people register their trial before they start, on a “clinical trials database“, so that you cannot hide disappointing data and pretend it never happened.

How big is the problem of publication bias in alternative medicine? Well now, in 1995, only 1% of all articles published in alternative medicine journals gave a negative result. The most recent figure is 5% negative. This is very, very low.

There is only one conclusion you can draw from this observation. Essentially, when a trial gives a negative result, alternative therapists, homeopaths or the homeopathic companies simply do not publish it. There will be desk drawers, box files, computer folders, garages, and back offices filled with untouched paperwork on homeopathy trials that did not give the result the homeopaths wanted. At least one homeopath reading this piece will have a folder just like that, containing disappointing, unpublished data that they are keeping jolly quiet about. Hello there!

Now, you could just pick out the positive trials, as homeopaths do, and quote only those. This is called “cherry picking” the literature – it is not a new trick, and it is dishonest, because it misrepresents the totality of the literature. There is a special mathematical tool called a “meta-analysis“, where you take all the results from all the studies on one subject, and put the figures into one giant spreadsheet, to get the most representative overall answer. When you do this, time and time again, and you exclude the unfair tests, and you account for publication bias, you find, in all homeopathy trials overall, that homeopathy does no better than placebos.

The preceding paragraphs took only three sentences in my brief Lancet piece, although only because that readership didn’t need to be told what a meta-analysis is. Now, here is the meat. Should we even care, I asked, if homeopathy is no better than placebo? Because the strange answer is, maybe not.

Let me tell you about a genuine medical conspiracy to suppress alternative therapies. During the 19th-century cholera epidemic, death rates at the London Homeopathic Hospital were three times lower than at the Middlesex Hospital. Homeopathic sugar pills won’t do anything against cholera, of course, but the reason for homeopathy’s success in this epidemic is even more interesting than the placebo effect: at the time, nobody could treat cholera. So, while hideous medical treatments such as blood-letting were actively harmful, the homeopaths’ treatments at least did nothing either way.

Today, similarly, there are often situations where people want treatment, but where medicine has little to offer – lots of back pain, stress at work, medically unexplained fatigue, and most common colds, to give just a few examples. Going through a theatre of medical treatment, and trying every medication in the book, will give you only side-effects. A sugar pill in these circumstances seems a very sensible option.

But just as homeopathy has unexpected benefits, so it can have unexpected side-effects. Prescribing a pill carries its own risks: it medicalises problems, it can reinforce destructive beliefs about illness, and it can promote the idea that a pill is an appropriate response to a social problem, or a modest viral illness.

But there are also ethical problems. In the old days, just 50 years ago, “communication skills” at medical school consisted of how not to tell your patient they had terminal cancer. Now doctors are very open and honest with their patients. When a healthcare practitioner of any description prescribes a pill that they know full well is no more effective than a placebo – without disc losing that fact to their patient – then they trample all over some very important modern ideas, such as getting informed consent from your patient, and respecting their autonomy.

Sure, you could argue that it might be in a patient’s interest to lie to them, and I think there is an interesting discussion to be had here, but at least be aware that this is the worst kind of old-fashioned, Victorian doctor paternalism: and ultimately, when you get into the habit of misleading people, that undermines the relationship between all doctors and patients, which is built on trust, and ultimately honesty. If, on the other hand, you prescribe homeopathy pills, but you don’t know that they perform any better than placebo in trials, then you are not familiar with the trial literature, and you are therefore incompetent to prescribe them. These are fascinating ethical problems, and yet I have never once found a single homeopath discussing them.

There are also more concrete harms. It’s routine marketing practice for homeopaths to denigrate mainstream medicine. There’s a simple commercial reason for this: survey data show that a disappointing experience with mainstream medicine is almost the only factor that regularly correlates with choosing alternative therapies. That’s an explanation, but not an excuse. And this is not just talking medicine down. One study found that more than half of all the homeopaths approached advised patients against the MMR vaccine for their children, acting irresponsibly on what will quite probably come to be known as the media’s MMR hoax.

How did the alternative therapy world deal with this concerning finding, that so many among them were quietly undermining the vaccination schedule? Prince Charles’s office tried to have the lead researcher sacked.

A BBC Newsnight investigation found that almost all the homeopaths approached recommended ineffective homeopathic pills to protect against malaria, and advised against medical malaria prophylactics, while not even giving basic advice on bite prevention. Very holistic. Very “complementary”. Any action against the homeopaths concerned? None.

And in the extreme, when they’re not undermining public-health campaigns and leaving their patients exposed to fatal diseases, homeopaths who are not medically qualified can miss fatal diagnoses, or actively disregard them, telling their patients grandly to stop their inhalers, and throw away their heart pills. The Society of Homeopaths is holding a symposium on the treatment of Aids, featuring the work of Peter Chappell, a man who claims to have found a homeopathic solution to the epidemic. We reinforce all of this by collectively humouring homeopaths’ healer fantasies, and by allowing them to tell porkies about evidence.

And what porkies. Somehow, inexplicably, a customer satisfaction survey from a homeopathy clinic is promoted in the media as if it trumps a string of randomised trials. No wonder the public find it hard to understand medical research. Almost every time you read about a “trial” in the media, it is some bogus fish oil “trial” that isn’t really a “trial”, or a homeopath waving their hands about, because the media finds a colourful quack claim more interesting than genuine, cautious, bland, plodding medical research.

By pushing their product relentlessly with this scientific flim-flam, homeopaths undermine the public understanding of what it means to have an evidence base for a treatment. Worst of all, they do this at the very time when academics are working harder than ever to engage the public in a genuine collective ownership and understanding of clinical research, and when most good doctors are trying to educate and involve their patients in the selection of difficult treatment options. This is not a nerdy point. This is vital.

Here is the strangest thing. Every single criticism I have made could easily be managed with clear and open discussion of the problems. But homoeopaths have walled themselves off from the routine cut-and-thrust of academic medicine, and reasoned critique is all too often met with anger, shrieks of persecution and avoidance rather than argument. The Society of Homeopaths (the largest professional body in Europe, the ones running that frightening conference on HIV) have even threatened to sue bloggers who criticise them. The university courses on homeopathy that I and others have approached have flatly refused to provide basic information, such as what they teach and how. It’s honestly hard to think of anything more unhealthy in an academic setting.

This is exactly what I said, albeit in nerdier academic language, in today’s edition of the Lancet, Britain’s biggest medical journal. These views are what homeopaths are describing as an “attack”. But I am very clear. There is no single right way to package up all of this undeniable and true information into a “view” on homeopathy.

When I’m feeling generous, I think: homeopathy could have value as placebo, on the NHS even, although there are ethical considerations, and these serious cultural side-effects to be addressed.

But when they’re suing people instead of arguing with them, telling people not to take their medical treatments, killing patients, running conferences on HIV fantasies, undermining the public’s understanding of evidence and, crucially, showing absolutely no sign of ever being able to engage in a sensible conversation about the perfectly simple ethical and cultural problems that their practice faces, I think: these people are just morons. I can’t help that: I’m human. The facts are sacred, but my view on them changes from day to day.

And the only people who could fix me in one camp or the other, now, are the homeopaths themselves.

It doesn’t all add up …
The ‘science’ behind homeopathy

Homeopathic remedies are made by taking an ingredient, such as arsenic, and diluting it down so far that there is not a single molecule left in the dose that you get. The ingredients are selected on the basis of like cures like, so that a substance that causes sweating at normal doses, for example, would be used to treat sweating.

Many people confuse homeopathy with herbalism and do not realise just how far homeopathic remedies are diluted. The typical dilution is called “30C”: this means that the original substance has been diluted by 1 drop in 100, 30 times. On the Society of Homeopaths site, in their “What is homeopathy?” section, they say that “30C contains less than 1 part per million of the original substance.”

This is an understatement: a 30C homeopathic preparation is a dilution of 1 in 100^30, or rather 1 in 10^60, which means a 1 followed by 60 zeroes, or – let’s be absolutely clear – a dilution of 1 in 1,000,000,000,000,000,000, 000,000,000,000,000,000,000,000,000, 000,000,000,000,000.

To phrase that in the Society of Homeopaths’ terms, we should say: “30C contains less than one part per million million million million million million million million million million of the original substance.”

At a homeopathic dilution of 100C, which they sell routinely, and which homeopaths claim is even more powerful than 30C, the treating substance is diluted by more than the total number of atoms in the universe. Homeopathy was invented before we knew what atoms were, or how many there are, or how big they are. It has not changed its belief system in light of this information.

How can an almost infinitely dilute solution cure anything? Most homeopaths claim that water has “a memory”. They are unclear what this would look like, and homeopaths’ experiments claiming to demonstrate it are frequently bizarre. As a brief illustration, American magician and debunker James Randi has for many years had a $1m prize on offer for anyone who can demonstrate paranormal abilities. He has made it clear that this cheque would go to someone who can reliably distinguish a homeopathic dilution from water. His money remains unclaimed.

Many homeopaths also claim they can transmit homeopathic remedies over the internet, in CDs, down the telephone, through a computer, or in a piece of music. Peter Chappell, whose work will feature at a conference organised by the Society of Homeopaths next month, makes dramatic claims about his ability to solve the Aids epidemic using his own homeopathic pills called “PC Aids”, and his specially encoded music. “Right now,” he says, “Aids in Africa could be significantly ameliorated by a simple tune played on the radio.

· Ben Goldacre is a doctor and writes the Bad Science column in the Guardian. His book Bad Science will be published by 4th Estate in 2008. Full references for all the research described in this article, and the text of the Lancet article, can be found at badscience.net.

References:

This all cuts so deeply to the heart of medicine and stats that it’s hard to know where to begin with references. A great deal is referenced in the text with weblinks. The Lancet piece is the best place to go if you want all the hardcore academic references, as it is extremely clear what refs what in there.

The classic beginners text on evidence based medicine is “How to read a paper” by Trisha Greenhalgh in BMA books. I cannot recommend this book highly enough.

Greenhalgh is not at all difficult to read, but an even more accessible (and gently political) book is the magnificent “Testing Treatments”, co-authored by the chap who founded the Cochrane Collaboration. In it you can read to your heart’s content about blinding, randomisation, and the scoundrels who abuse them, as well as the reasons why the public should be more engaged in research, the scandal of bad research, and more.

For a review of the placebo effect, you can’t beat the excellent “Meaning, Medicine, and the Placebo Effect” by Daniel Moerman.

For meta-analyses of homeopathy, I would quote the five below. There are even more, but I have specifically quoted these five as part of an in-joke with myself, which I will one day reveal.

1 Kleijnen J, Knipschild P, ter Riet G. Clinical trials of homoeopathy. BMJ 1991;
302: 316–23.

2 Boissel JP, Cucherat M, Haugh M, Gauthier E. Critical literature review on the
effectiveness of homoeopathy: overview of data from homoeopathic
medicine trials. Brussels, Belgium: Homoeopathic Medicine Research Group.
Report to the European Commission. 1996: 195–210.

3 Linde K, Melchart D. Randomized controlled trials of individualized
homeopathy: a state-of-the-art review. J Alter Complement Med 1998;
4: 371–88.

4 Cucherat M, Haugh MC, Gooch M, Boissel JP. Evidence of clinical efficacy of
homeopathy: a meta-analysis of clinical trials. Eur J Clin Pharmacol 2000;
56: 27–33.

5 Shang A, Huwiler-Müntener K, Nartey L, et al. Are the clinical effects of
homoeopathy placebo effects? Comparative study of placebo-controlled
trials of homoeopathy and allopathy. Lancet 2005; 366: 726–32.


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472 Responses



  1. Bolly said,

    November 16, 2007 at 12:57 am

    Thanks Ben, an excellent article. Any chance the Grauniad could print it in full;)

    I’m saving a copy in case it ever goes missing

  2. jackpt said,

    November 16, 2007 at 1:11 am

    Wow. The above article, for the target audience, is about as good as it could be and covers a lot of issues. If this doesn’t induce a rabid response among the alt-med crowd I’d be very surprised. It could as well be titled “an introduction to why you shouldn’t trust the claims of homeopathy”, and this could actually hurt the business of homeopathy. It’s eduvangelical :).

  3. Ed Yong said,

    November 16, 2007 at 1:17 am

    Absolutely pitch-perfect piece of science writing you’ve got there.

    I wonder if anyone’s ever gone on a homeopathy training course with the intention of ‘knowing the enemy’?

    Also, lol @ jackpt’s use of the word ‘eduvangelical’.

  4. surpriserman said,

    November 16, 2007 at 1:59 am

    thanks so much Ben, i’ve been looking for the single article that will convince my homeopathy devoted friend to cop on. This will save me future arguments. It will also quite possibly dull her placebo effects, I don’t know how I feel about that, but definitely feel on the right side of logic and science.

  5. Twm said,

    November 16, 2007 at 2:23 am

    >> dull her placebo effects

    That’s probably an interesting subject in its own right.

    How does the placebo’s effectiveness change in relation to media coverage?
    It’s really weird to think of a treatement becoming ineffective overnight due to mass placebo awareness.

    I always liked the scene in the Simpsons when an epedemic of Osaka flu engulfs the town of springfield.

    “An angry crowd has gathered outside the Hibbert Medical Clinic…

    Crowd: We need a cure! We need a cure!
    Hibbert: Ho ho ho. Why, the only cure is bedrest.
    Anything I give you would be a placebo.
    Woman: [frantic] Where can we get these placebos?

    The crowd overturn a truck in search of placebos, but alas the only
    thing inside is a crate of killer bees.

  6. surpriserman said,

    November 16, 2007 at 3:13 am

    ……and then one of the crowd eats a bee, knowing its a placebo, and it does him harm.

  7. Mart said,

    November 16, 2007 at 3:48 am

    You’re right about people confusing homeopathy with herbalism. Once, when I was dissing homeopathy to a bloke in the pub (which I admit is a bit of a bad habit of mine) he launched into a triumphant defence of it by citing the example of quinine being an effective treatment for malaria. When I explained to him what homeopathy actually was, he refused to believe me!

    Also, a colleague of mine who was a True Believer in homeopathy would not even accept a few completely uncontroversial (though they do sound a bit far-fetched when you say them out loud) facts about the sacred art that even a homeopath would agree with. I don’t expect anyone to take my word for anything, but when people are so mistrustful of science and ‘mainstream medicine’, whose word will they take?

    A True Believer in homeopathy has to be anti-science, because homeopathy is scientifically impossible. Thus, if the precious delusion is to be maintained, science must be wrong. How can you argue with that?

  8. Dr T. fortunei said,

    November 16, 2007 at 7:47 am

    How nicely were many of your points illustrated on the ‘today’ program this morning?
    A Lancet editor and a former FoH [Faculty of Homeopathy] president debated (I wasn’t quite awake enough to catch the names…).
    FoH member claimed that medics were stifling debate (!?), called BadScience forum discussion about Tunbridge Wells, the “…crowing of playgound bullies” and commented of the Lancet editor ..” I don’t know what sort of doctor you are…”
    Not very mature, and a bit AdHom.
    The Lancet editor, took the view that NHS money is being spent on a therapy for which there is no clinical evidence of efficacy. As journalists they have a right to have a view on that.
    Good start to the day, I reckon.

  9. drunkenoaf said,

    November 16, 2007 at 8:42 am

    Superb article, Ben!

    And totally worth the effort to try and educate people (especially a certain demographic of Guardian readers [like my Mum]).

    I just wonder how many homeopathic medicine fans will read it and change their minds. It seems they have a religious zeal for their mystic ways, and will protect their opinions from fact, just like the creationists in the US deep south. *sigh*.

  10. Freudus said,

    November 16, 2007 at 9:06 am

    Excellent article. I’ll be forwarding it to my true believer friends. If it sows the smallest seed of doubt in their magical ways, that’s no bad thing.

  11. brodski said,

    November 16, 2007 at 9:15 am

    @ Ed Young
    The “bad homeopath”( badhomoeopath.com/ ) did just that.
    He is now a “fully qualified” homeopath, who can say (with the kind of authority than only Alt-Medders can bring to bear these days) that it’s all rot.

  12. misterjohn said,

    November 16, 2007 at 9:22 am

    Let me add my congratulations on this article. Clear, focussed and to the point. Quite unlike what the homeopaths say. I hope you’ll forgive me if I use it with my statistics students.

  13. 8839 said,

    November 16, 2007 at 9:26 am

    Thanks for that. It is a beautifully argued piece. How can anyone not follow its logic? This is getting printed out and posted.

  14. Diotima said,

    November 16, 2007 at 9:27 am

    Thanks Ben, this made my day, my week , my life.(Indeed such is the power of rational prose [even in G2] that reading your article cured a mild hangover. When I saw Winterson’s piece I had hoped for a response from you.
    John Maddox has been repeatedly pressed to write a full account of his investigation of Jacques Beneviste’s Paris lab; as his wife, the journalist Brenda Madddox has said. ‘You even have the perfect title’, “The Memory of Water”‘. Maybe he’ll do it. However homeopathy has now extended its empire to the animal world; I recently endured a cold call from some poor young man in a call centre, asking about vetinerary treatment; as he was not trying to sell me anything I answered his questions until we got to the climax; would I try either homeopathy or acupuncture on my cat? The late Alan Coren missed a trick as ‘Homeopathy for Cats’ would have been a best seller.

  15. igb said,

    November 16, 2007 at 9:30 am

    Buying the `How to read a paper’ book this morning, having meant to last time Ben mentioned it, caused me to sign up for Amazon Prime. So one side effect of homeopathy will prove to be getting shouted at by my wife.

  16. Jessica said,

    November 16, 2007 at 9:32 am

    A very nice and thorough article, and read side by side with Ms Winterson’s, much better stylistically, which might be disappointing for her. But as its timing makes it read like a response, I think it was a failing that you don’t address her clear, even labored point that she sees homeopathy as a way to help with the side effects of vital proper medicine in HIV and AIDS treatments.

    I find it impossible to see homeopathy as anything but a placebo; nonetheless seeing two or three friends going through proper medical cancer treatment and benefiting from the effect of some dilution of some plant with the word ‘paw’ in it to deal with their attendant nausea and exhaustion makes me think it’s a great placebo.

    I’m not sure you’d disagree, and if Winterson could get more comfortable with the ‘placebo’ word she’d probably agree, so it’s naughty that you glossed over the fact that she was very explicit about not seeing homeopathy as a primary treatment for HIV and AIDS. Especially as that could have helped you highlight the fact that some of the homeopaths she’s a fan of perhaps don’t.

  17. simongates said,

    November 16, 2007 at 9:47 am

    Ben, absolutely magnificent article – congratulations.

  18. kim said,

    November 16, 2007 at 9:52 am

    Beautifully written piece, Ben.

  19. nekomatic said,

    November 16, 2007 at 10:09 am

    Magnificent, masterful, magisterial, and probably some other things beginning with M (other letters are available). Please God (other belief systems are available) a few people actually take the time to read, engage with and even understand it. You know, this might even switch a few mildly impressionable people on to why science is good.

  20. radar said,

    November 16, 2007 at 10:21 am

    Absolutely cracking article, and so very important. I wonder what goes through your average homeopath’s head when he/she reads something like this? You’d hope they couldn’t read such a well-balanced and informed article without feeling at least a little ashamed.

    Keep up the good work

  21. Bogusman said,

    November 16, 2007 at 10:22 am

    I would just like to add to the general congratulations. Brilliant piece. However I doubt how much influence it will have on the believers.

    At a conference (IT industry, not science of any kind) a couple of weeks ago I found myself in a post dinner conversation with a fellow delegate who I had believed to be a rational intelligent person up to that point. A passing reference on my part to quantum physics (yes I am that sad) led to a cry of recognition “Oh yes, I know all about that because I am a homeopath”.

    The next half hour was spent in a fruitless attempt to get her to tell me
    1. How exactly homeopathy demonstrated any quantum effects whatsoever and
    2. How she could persist in her advocacy of homeopathy in the absence of any evidence of its effectiveness.

    The point I twigged after a while was that she cared not in the slightest about evidence. In fact she treated the whole issue of evidence as some sort of underhanded sophistry on the part of “the establishment”. I think this is at the heart of the whole issue. We have managed to arrive at a point in our development as a species where large numbers of people actively prefer the irrational to the rational. Those of us educated in science or any evidence based discipline simply do not have the ability to understand that position, at least I know that I don’t.

    And that’s why I think that Ben’s article, excellent as it is, will not convince anyone. Because the adherents of homeopathy, creationism, electrosmog and the like simply have no common ground on which to conduct a discussion.

  22. Dr Aust said,

    November 16, 2007 at 10:38 am

    Masterful exposition, Chief.

    Warning: Shameless self-plug:

    I have just put up a (NB – rather long and rambling) blog post about the utter lack of scientific scepticism that characterizes AltMed journals and papers… … if anyone fancies an excuse to avoid working.

    Talking of Diotima’s point about John Maddox and the Nature Benveniste article, the published version of the “investigators’ report” is a good read. You can currently find it here, among other places.

  23. raygirvan said,

    November 16, 2007 at 10:43 am

    Good work.

  24. used to be jdc said,

    November 16, 2007 at 11:19 am

    @ Jackpt – “If this doesn’t induce a rabid response…” I’m looking forward to that. Could be some pretty funny stuff coming out.

    BTW Ben – did you draw the cartoons as well?

  25. Max Sang said,

    November 16, 2007 at 11:32 am

    The best thing you’ve written, IMHO. And fantastic that it’s got such a prominent place in the paper.

  26. Jessica said,

    November 16, 2007 at 11:34 am

    I’m sure you could understand that position, Bogusman. Because, logically, when the rational doesn’t work out for people they’ll try the irrational. Ben mentions “situations where people want treatment, but where medicine has little to offer – lots of back pain, stress at work, medically unexplained fatigue, and most common colds, to give just a few examples”, which homeopathy’s placebo effect often helps with, in a way which, if not rational, is perfectly logical.

    More importantly, when someone is at the tail end of their life because of a disorder like, say, ovarian cancer, which should be detectable early on with a simple blood test made part of yearly physicals for higher risk groups, the rational bottom lines in proper medicine start looking very alienating to people suffering from under-researched disorders, to women, to those without access to experimental or expensive treatments due to holes in proper funding, and to those who love them.

    I bet a good fraction of the irrational love that the English have for kooky alt-med treatments is a perfectly logical, if unconscious consequence of gazing across the Channel at the French smoking, drinking, stressing out, bearing a comparable tax burden and still enjoying some of the best cancer treatment and recovery rates in the world while what people like your kooky table mate call the Establishment – in fact, the neglected and definitely irrationally funded NHS – crumbles around them.

    So I think Ben’s article could convince a lot of people who have been hating the player (proper medicine) instead of hating the game: that old bastard Mortality, combined with imperfect market and political forces at work in proper medicine that could, quite rationally, be seen as inhuman.

    It’d certainly be a lot more helpful than insulting each other’s intelligence.

  27. DrJ said,

    November 16, 2007 at 11:48 am

    Great article, I’d love to see the homeopathic counter to this

  28. bextera said,

    November 16, 2007 at 11:49 am

    Wonderful response to the novelist’s article.

    I think they should have also let you publish a literary critique of Oranges Are Not The Only Fruit.

  29. Diotima said,

    November 16, 2007 at 12:02 pm

    Jessica: I’d be a bit sceptical about French cancer survival rates versus those in the UK as record keeping is not identical in both health systems. The French born French resident mother of a friend of mine had her death (from cancer) described as ‘sudden death’ on her death certificate. (Perfectly legal in France.) Her French GP, whom she had known for years, refused to accept that she was in a moribund condition and also refused to authorise an ambulance for her ten days before her agonising death.

  30. Everytimereferee said,

    November 16, 2007 at 12:09 pm

    Incidentaly I just followed the “Aids in africa…..” link and surfed from there to www.healingdownloads.com/free.php
    and cured my entire office of the common cold, AIDS and Tape worms. The healing power of Jazz. I kid you not, I’ve bookmarked the page in case of a worldwide bird flu pandemic

  31. profnick said,

    November 16, 2007 at 12:14 pm

    Ben, a really magnificent piece of scientific writing; congratulations.

  32. fnorman said,

    November 16, 2007 at 12:32 pm

    I loved it and learned a lot from it too. I look forward to the film version …

    If there were a Nobel prize for science writing I’m sure this article would put Ben at the top of the running.

    Kohn award maybe?
    www.royalsoc.ac.uk/page.asp?id=1839

  33. DoctorDavid said,

    November 16, 2007 at 12:49 pm

    That is one of the best articles to appear in the Grauniad in many a long year. It’s a perfect response to Ms Winterson’s inane babbling.

    Give that man an OBE. And make Prince Charles present it to him :-)

  34. kim said,

    November 16, 2007 at 1:01 pm

    The only thing that worries me is what will Ben do when he finds himself with incurable back pain? Prescribe himself a placebo?

  35. zlsiida said,

    November 16, 2007 at 1:03 pm

    One point about the dilution thing…
    Unless the molecules of the “active” ingredient degrade into something else, a tiny fraction of the doses handed out will, surely, have 1 (or more) molecules of it in them?
    No way to tell which doses, of course.

  36. Jessica said,

    November 16, 2007 at 1:05 pm

    Diotima, I’m skeptical of everything that comes out of France. But I still have a naive faith in articles that proper oncologist research teams make publicly available:

    ki.se/ki/jsp/polopoly.jsp?d=933&a=3315&cid=940&l=en

    The PDF is at the bottom.

    And what in heaven’s name was your friend’s mother’s GP doing determining her treatment programme whilst she was suffering from terminal cancer?

  37. censored said,

    November 16, 2007 at 1:20 pm

    > Unless the molecules of the “active” ingredient degrade into something else, a tiny fraction of the doses handed out will, surely, have 1 (or more) molecules of it in them?

    Well, yes. But I very much doubt a single molecule of anything could do anything. We’re bombarded by single molecules of thousands of things as we walk along the street.

  38. Arthur Dent said,

    November 16, 2007 at 1:23 pm

    As an analytical scientist I have always been puzzled by the supposed power of the 30C and 100C homeopathic remedies. What do they use for the dilution medium? Even HPLC grade water will contain residues of most elements at concentrations in the pg-ng/l range, so adding a small amount of Arsenic to water and diluting by 1:100 100x with the same water containging say 10pg/l of original Arsenic is sort of mystifying.

  39. seenoevil said,

    November 16, 2007 at 1:31 pm

    Loved the article.
    “…or they actually threaten you with violence ”
    Do they indeed?
    Blimey, I bet they’d beat you with feathers, the homeopathic equivalent of being hit by a 25lb sledgehammer…

  40. Bogusman said,

    November 16, 2007 at 1:32 pm

    Jessica,

    I don’t think its is about insulting intelligence per se. Maybe it is about different types of intelligence. My dinner companion was certainly not stupid in her contributions to the conference or in lots of other ways. She just had a very specific approach to this subject – which included a refusal to permit her daughter to be vaccinated (against anything, not just MMR) now that I recall the conversation more fully. And yet if I had not made the remark about quantum physics I would never have had any reason to question her intelligence.

    I do understand the thought that if conventional medicine offers no hope then the desperate will turn elsewhere, but I believe that there are many people who are pre-disposed towards the irrational even without the stimulus of desperation. I myself believe that Oldham Athletic will someday regain their rightful position in the premier league but there is precious little evidence to support this view. It’s when this approach crosses over from the trivial to the vital that we have problems.

  41. mikew said,

    November 16, 2007 at 1:33 pm

    No doubt the person who “knew about quantum physics” was a fan of the film “What The Bleep Do We Know?”

    film.guardian.co.uk/features/featurepages/0,,1484925,00.html

  42. misterjohn said,

    November 16, 2007 at 1:34 pm

    @everytimereferee

    I notice that the track title for the common cold is Whoooeee!

    So apt.

  43. zlsiida said,

    November 16, 2007 at 1:49 pm


    > Unless the molecules of the “active” ingredient degrade into something else, a tiny fraction of the doses handed out will, surely, have 1 (or more) molecules of it in them?

    Well, yes. But I very much doubt a single molecule of anything could do anything. We’re bombarded by single molecules of thousands of things as we walk along the street.

    Oh, of course. And also there’s Arthur’s comment just below.

    The beliefs in alternative therapies in many ways mirror beliefs in the supernatural. A good look at how otherwise rational people come to believe this stuff is in Luhrmann’s “Persuasions of the Witches’ Craft”.

  44. Bogusman said,

    November 16, 2007 at 1:55 pm

    You know, I think she just might have been. Mercifully we didn’t discuss it ;-)

  45. Seany said,

    November 16, 2007 at 1:55 pm

    Just as I was wodering if the article should be on CiF:

    blogs.guardian.co.uk/science/2007/11/homeopathy_have_your_say.html

  46. Pennant said,

    November 16, 2007 at 1:59 pm

    Bogusman – intelligent people do, say and think stupid stuff all the time.

  47. Bogusman said,

    November 16, 2007 at 2:07 pm

    Yes, this is the point that I have been stumbling around trying to express. I don’t think it is a simple matter of intelligence but something much more subtle. Maybe to do with culture, maybe to do with selective learning from experience, maybe something really mechanistic in the brain. Maybe all of the above and more. And that’s why I don’t think that reading a piece of journalism, however well argued and researched will convince many – if any – supporters of homeopathy.

  48. pv said,

    November 16, 2007 at 2:11 pm

    I think Bogusman is at least to some extent right. The extent to which anyone’s view might be changed by this article (an it is an excellent piece) depends largely on how committed they are (1) to homeopathy, (2) to conspiracy theories and (3) a world view that automatically dismisses anything that can be seen as part of an Establishment.
    I’m sure homeopathy flourishes primarily because of ignorance of the scientific process, which can be seen as a disastrous failure of education. One doesn’t need to be a scientist in order to understand the process, nor indeed in order to understand how such ignorance creates victims.
    Something Ben doesn’t really touch on in his article is the self-selecting nature of the homeopath’s patients.; i.e. there’s nothing much medically wrong with most of them when they present themselves and they would get better anyway without any medical intervention. This accounts for homeopathy’s apparent claims of success.
    I have some questions.
    Why, when they claim to be able to treat malaria or AIDS, or anything the might actually kill you if left untreated, are homeopaths unable to provide a single incontrovertible example.
    As people much more intelligent than I have elsewhere asked:
    Why is there no homeopathic A & E department in hospitals? If homeopathy is so powerful as to be able to treat malaria and aids, why isn’t it even used in A & E? Surely if claims of efficacy are true homeopathy should be the medicine of choice in all our hospitals!
    Heaven forbid that anyone in a position of authority is cretinous enough to even consider the option.

    Btw, nice article Ben. :-)

  49. Jessica said,

    November 16, 2007 at 2:13 pm

    Fair enough, Bogusman, but if she was endangering her own children’s health and the health of the people around them, then insult away as far as I’m concerned. And I’d say Jeanette Winterson popping sugar pills to fix her spotty throat so she can make deadline is pretty trivial too, considering the execrable quality of her output since The Passion.

    But the real problem with the sort of irrationality that makes people turn to homeopathy is that in England you have an especially predatory professional association waiting to exploit perfectly logical emotions and frustrations (whilst apparently in the process of exploiting third world AIDS zones) and successfully constrasting themselves with a cold and seemingly inefficient medical establishment.

    The problem isn’t the irrationality, emotions, or frustrations themselves, which I do think could be addressed when a doctor like Ben takes the time to explain, in his nice accessible language, the sing-song behind the neat-o figures about old-time cholera hospitals and the like.

    It could certainly addressed if people had a friendlier, more communicative relationship with their proper doctors in general, which probably means a much more expensive NHS with much less stress among its employees, but there you are. Throwing some public money at homeopathy is cheaper, I suppose.

  50. Teek said,

    November 16, 2007 at 2:15 pm

    by far the best article on the subject i’ve ever read – many congrats Ben, batten down the hatches and prepare for a deluge of abuse from homeo-woo fanatics…!

    really pleased the Grauniad carried this as a G2 feature as well, just to put Jeanetter Winterwoo in her place…!

  51. Diotima said,

    November 16, 2007 at 2:17 pm

    Jessica: she had been treated with great success for an early stage primary cancer in the Netherlands, however when any GP in any country might have thought–hey, wait a minute, might this not be a secondary? Her French GP simply said to her francophone daugher ‘she is simply feeling the heat; she needs to take more liquid in hot weather in the Luberon’. Let us say, in terms of international health recording garbage in, garbage out.

  52. pv said,

    November 16, 2007 at 2:37 pm

    #
    Arthur Dent said,

    November 16, 2007 at 1:23 pm

    As an analytical scientist I have always been puzzled by the supposed power of the 30C and 100C homeopathic remedies. What do they use for the dilution medium? Even HPLC grade water will contain residues of most elements at concentrations in the pg-ng/l range, so adding a small amount of Arsenic to water and diluting by 1:100 100x with the same water containging say 10pg/l of original Arsenic is sort of mystifying.

    Don’t you think “mystifying” is the operative word here? In the parallel world of homeopathy and medical woo in general, all too often the matter of their ignorance is generally perceived and presented as a mystery rather than what it is – ignorance (or deception). At the same time knowledge of evidence based medicine and the scientific process are presented as ignorance when it comes to the fantastic assertions of the workings of homeopathy. If the leading lights of homeopathy aren’t all barking mad or wilfully ignorant then clearly a fair amount of fraudulent behaviour/practice goes on in that world in order to take advantage of (profit from) ignorance. Just like organised religion.

  53. NeilHoskins said,

    November 16, 2007 at 2:43 pm

    www.jesusandmo.net/2007/11/16/snap/

  54. Bogusman said,

    November 16, 2007 at 2:45 pm

    Yes pv, it would be fascinating to see how participation in organised religion and belief in homeopathy correlate. I suppose both depend on accepting the existence of miracles.

  55. Citizen Deux said,

    November 16, 2007 at 3:52 pm

    So, Ben, how do we get this article into the Washington Post or New York Times? The plague of homeopathy and “alt-med” business is orders of magnitude greater here in the United States than here in the UK. I am in strong favor of continued, disciplined research in the fringe regions of medicine and science. But it should be our first rule to accept the prospect of error. Disproving the null hypothesis, as it were. I applaud your respectful tone and historical perspective. I think all of modern society could benefit from a rigorous education in science and logic.

  56. whitelodge1 said,

    November 16, 2007 at 5:02 pm

    “…we know that brand packaging on painkillers increases pain relief.”

    I was hoping for a reference on this. Where can I read more?

  57. cleeray said,

    November 16, 2007 at 5:59 pm

    “…if you sacrifice a goat, after rolling a double six, your next roll is likely to be lower.” Did you sleep in Probability Theory 101?

  58. Ben Goldacre said,

    November 16, 2007 at 6:02 pm

    hahahah go on then cleeray, seriously, i’ll play you at dice, any day, for hard cash. up front. name the place and bring at least £10k.

  59. TimD said,

    November 16, 2007 at 6:04 pm

    Following the Guardian blog article above () I noticed a responder (‘Goodscience’) directed attention towards the recording of a recent homoeopathy meeting at the University of Connecticut Health Center () which claims to provide, amongst other things, a ‘demolition of the main “weapon” used against [homoeopathy’s] plausibility’ with, and I kid you not, their ‘preliminary data’. (The main weapon being the implausibility of water memory)

    I thought anyone who can bear to sit through either the 2 hour filmed version or the 163 slide powerpoint presentation might be interested in the latest ‘advances’ in this area. In particular, I guess people who commented on *that* recent journal issue on water memory might want to see if this makes any more sense (I think that the answer might be ‘no’).

    Anyway, it’s a great laugh of a presentation. Many of the classic issues seem to be there rewrapped.

  60. Hawcutt said,

    November 16, 2007 at 6:04 pm

    Excellent. I got a letter back from my MP (who shall remain nameless) supporting homeopathy, after I wrote to him to express my disappointment at his signing an early day motion supporting homeopathic hospitals. Now when I reply I can reference this and save myeslf a lot of writing. Thanks

  61. TimD said,

    November 16, 2007 at 6:06 pm

    doh, the links didn’t work:

    Following the Guardian blog article above blogs.guardian.co.uk/science/2007/11/homeopathy_have_your_say.html I noticed a responder (’Goodscience’) directed attention towards the recording of a recent homoeopathy meeting at the University of Connecticut Health Center www.sonicfoundry.com/uconn which claims to provide, amongst other things, a ‘demolition of the main “weapon” used against [homoeopathy’s] plausibility’ with, and I kid you not, their ‘preliminary data’. (The main weapon being the implausibility of water memory)

    I thought anyone who can bear to sit through either the 2 hour filmed version or the 163 slide powerpoint presentation might be interested in the latest ‘advances’ in this area. In particular, I guess people who commented on *that* recent journal issue on water memory might want to see if this makes any more sense (I think that the answer might be ‘no’).

    Anyway, it’s a great laugh of a presentation. Many of the classic issues seem to be there rewrapped.

  62. jimyojimbo said,

    November 16, 2007 at 6:27 pm

    @ Citizen Deux

    The observer have that condensed NY Times section, don’t they? I don’t know if that means there’s some kind of relationship between the NYT and the observer, or if they just licence the NYT “weekly” or something.

    Anyway, when the Observer NYT section contains science writing, it is *streets* ahead of any science reporting in the Grau or any other UK newspaper (besides bad science). So yeah, Ben’s article definitely should be pushed to them.

  63. cleeray said,

    November 16, 2007 at 6:47 pm

    @Ben: Do you seriously not realize that fair dice throws are probabilistically independent? Or are you talking about a probability of an outcome in the whole series of experiments, NOT in the next experiment? I suggest you read your text again before making wagers.

  64. Ben Goldacre said,

    November 16, 2007 at 6:49 pm

    yup, i said: “if you sacrifice a goat, after rolling a double six, your next roll is likely to be lower.”

    are you able to withdraw large amounts in cash at short notice? i really do think we should meet up for a dice gambling night sooner rather than later, i’m keen that your certainty doesn’t get the chance to wear off.

  65. misterjohn said,

    November 16, 2007 at 6:50 pm

    I looked at some of the Homeopathy meeting video. Good sense from the Yale man and the first medic. I was forced to speed through the pro-homeopathy people, including Doctor Rustum Roy, a University Physicist who supports the theory of water memory, drawing analogies with different states of carbon, such as graphite and diamond, and saying you could microwave away crystalline structures in a matter of seconds.
    I’m thinking of putting a pencil in the microwave when I cook my supper, to see if it’ll turn to diamond.
    He syas you can turn water into Hydrogen and Oxygen by shining bright lights on it.
    Can a real physicist look at it and tell me that it’s not nonsense? Can liquids really have the sort of structure he talks about? I have severe doubts; no, no doubts, it’s all rubbish!

  66. woodbine said,

    November 16, 2007 at 6:53 pm

    You’re a bit good at this aren’t you Ben?

    Your column gives me great pleasure every week, but this is the coup de grace…

    Wonderful… I hope you’re enjoying your well earned praise.

    p.s. did they find any dirt on your private life? You can share it with us, we won’t tell a soul.

  67. misterjohn said,

    November 16, 2007 at 6:54 pm

    @cleeray
    I think you’ve missed the point. The likelihood, as Ben suggests, is that the next throw won’t be a double six. I think Ben realises that sacrificing the goat probably will have no effect on the result.
    If you want to bet against Ben’s theory, I think you’ll be on a loser 35 times out of 36 in the long run.

    Can you afford to take the risk?

  68. Ben Goldacre said,

    November 16, 2007 at 6:59 pm

    misterjohn you are banned from this website for all time.

    pay no attention to misterjohn, cleeray. if you have two forms of ID your bank will let you withdraw a much larger amount over the counter. i’d be okay with bankers drafts.

  69. cleeray said,

    November 16, 2007 at 7:00 pm

    @misterjohn: I agree with Ben’s intended claim in the article (homeopathy, like sacrificing a goat, has no effect). But he’s trying to use “regression to the mean” to support his claims. In the dice example no “regression to the mean” occurs; he is supporting valid claims with invalid arguments.

  70. Ben Goldacre said,

    November 16, 2007 at 7:01 pm

    thank you cleeray, i will also accept cash bets on whether “regression to the mean” applies to dice rolls. we can escrow paypal payments online very easily, would that be easier for you?

  71. cleeray said,

    November 16, 2007 at 7:02 pm

    @Ben: Are you joking or drunk?

  72. RedTim said,

    November 16, 2007 at 7:06 pm

    I’ll put a monkey on regression to the mean, but only if you’re rolling more than one die. Actually, the RSPCA might object – can I put money on it instead?

  73. cleeray said,

    November 16, 2007 at 7:07 pm

    @Ben: Ok, how about the following setup:

    We’ll perform a large number of individual rolls of a fair die, where I will bet on getting another six after a double six, and you will bet on any other (single) outcome of your choice according to your “regression to the mean” rules. One point awarded to you or me for each correct guess. If our total score does vary significantly after the whole series of experiments, I will pay you 10K GBP. If there is no significant difference in the total score, then YOU will pay me. Still interested?

  74. Ben Goldacre said,

    November 16, 2007 at 7:14 pm

    i will bet you £2k GBP on five occasions that the next roll after a double six will be lower than double six, because of regression to the mean. that’s the claim i made, that’s the claim you doubt, that’s the claim i will take your £10k on. how quickly can you get the cash? i think we should do this soon.

  75. cleeray said,

    November 16, 2007 at 7:17 pm

    The claim I doubt is that the probability of another double-six roll after a double-six roll is lower than the probability of the first double-six roll.

    I guess this is the point where I say “oops”.

  76. Ben Goldacre said,

    November 16, 2007 at 7:19 pm

    show me the money.

  77. cleeray said,

    November 16, 2007 at 7:24 pm

    The “oops” above means that I didn’t notice that you are just talking about the probability of a “lower than double-six” roll (meaning: any result other than double-six), which is lower than the probability of a “double-six” roll, regardless of what outcome preceded it.

  78. cleeray said,

    November 16, 2007 at 7:26 pm

    I meant “higher than the probability of a double-six roll” in the last post, of course.

  79. Ben Goldacre said,

    November 16, 2007 at 7:32 pm

    I guess this is how they built Vegas.

  80. cleeray said,

    November 16, 2007 at 7:55 pm

    I take that your “regression to the mean” suggests the following reasoning: Information about an extreme outcome X=double-six should raise the probability assigned to a less extreme outcome Y in the next trial. However, this doesn’t seem to be the case in the dice example where P(Y|X) = P(Y)

  81. DTM said,

    November 16, 2007 at 8:21 pm

    @Cleeray

    Right: the probability of rolling a double six is 1/36. If rolling a double six represents some kind of curse then perhaps you might sacrifice a goat to ensure it doesn’t happen again. BUT… there is a 35/36 probability that it won’t happen anyway! The designer shaman sacrificing the goat will almost always win. The relevance of regression to the mean is that tests with extreme scores at one point in time will probably have less extreme scores the next time they are tested. That’s what regression to the mean IS!

    Game of dice?

  82. DTM said,

    November 16, 2007 at 8:21 pm

    But why is he a designer shaman? Hmmmm….

  83. misterjohn said,

    November 16, 2007 at 8:37 pm

    If you take a double six as an extreme case, then other throws are likely to be less extreme. (Arguing that a total of 12 is the highest score and therefore most extreme; one could just as well say that a score of 2 is extreme, and is just as likely as 12)
    I don’t think Ben is arguing that P(Y|X) = P(Y) is untrue, or that the prior information about the first result of double six will affect the next result. Even some doctors are aware of that fallacious line of argument. It is simply that after an extreme result in any situation you will probably get a less extreme result the next time.
    In the medical context it’s like taking a sample of patients with high blood pressure and then measuring their BP again some time later. It is often (usually?)the case that the average BP is lower on the second occasion, even if there’s been no medical intervention, or the use of placebos (Or even homeopathic remedies, so that such results might be used as a “proof” of the efficacy of homeopathy).
    So even in properly conducted trials the phenomenon may occur, simply because we are looking at extreme cases, not average cases.
    People with “normal” BP are not treated, only people with high BP. (Or so it seems in this country, in other countries people get treatment for low BP)
    For a variety of reasons, their average is likely to be reduced.

    I note that you’re trying to wriggle out of the bet, Cleeray.

  84. Moganero said,

    November 16, 2007 at 8:44 pm

    IF there is anything in homeopathy, a worrying thought occurs to me . . .
    . . piped music carrying a homeopathic dose/signal could be surreptitiously broadcast, piped to lifts and supermarkets, used for hold music on switchboards etc.
    Unless there is actually a mechanism involved that prevents it from actively doing harm, what is to stop this having a negative effect on people, children, pets etc?
    The only way to feel safe from it would be to have an irrational disbelief in the power of homeopathy!
    Are there evil “black homeopaths” (as in black witches) out there? Are they poised to send out a wave of imaginary illnesses sweeping the world carried by negatve homeopathic music?
    (OK, it’s late and I’ve been working too hard today – or has Radio 2’s been output been hijacked?)

  85. raygirvan said,

    November 16, 2007 at 9:15 pm

    At the risk of complicating things… Cleeray, you’re reading Ben’s statement as an exposition of the Gambler’s Fallacy, that falsely claims past history affects probability of some chosen outcome (e.g roll a run of double sixes, and the chance of a double six becomes less than if you hadn’t had that run).

    Having read the thread, I don’t see any such implication. Ben’s just stating the situation at face value: if you just rolled a double six, the next throw is highly probable to be lower, simply because p=1/36 for a double six and p=35/36 for anything lower.

    And “regression to the mean” is the generalisation of this. If you have a probability distribution and an event X happens, the result for the next one is more likely to be closer to the mean than X than further.

    A simpler example is that TV game where they draw a playing card at random and the contestant has to guess whether the next will be higher or lower. The obvious strategy, since regression to the mean applies, is to guess closer to the mean than the current card.

  86. misterjohn said,

    November 16, 2007 at 9:54 pm

    @raygirvan

    Assuming going from ace to king as 1 to 13,(I.e. ace low, king high) you have a problem if your card is a 7. But don’t worry, you’ll be all right if you play the game with Cleeray

  87. julie oakley said,

    November 16, 2007 at 10:01 pm

    I love your column and this article makes the science completely understandable to me (I went to a convent school that didn’t teach science because they reckoned girls didn’t need it). However what am I now going to do about my hayfever? The only thing that stopped my sneezing and streaming eyes was treatment from the lovely doctors at the London Homeopathic Hospital and undoubtedly now it won’t work!

  88. cleeray said,

    November 16, 2007 at 10:03 pm

    @misterjohn: I don’t need to wriggle out of Ben’s bet because I didn’t accept it. Ben didn’t accept my bet either (no wonder). For the record: I mistakenly attacked a claim which he didn’t make.

    I’m not convinced by the previously posted attempts of explaining the “regression to the mean” issue, so here is another one:

    We begin with P(X)=0.5, X is a statement ‘score in trial B is less than the score in trial A’, in a context where more extreme scores are less likely than average scores. The actual ordering of the trials doesn’t matter. The “regression to the mean” rule says that P(X|Y) is greater than P(X)=0.5 if Y is a true statement about the score in trial A being extreme (thus improbable).

    I view it as a convoluted way of restating the premise that extreme scores are less likely than average scores.

  89. emmer said,

    November 16, 2007 at 10:15 pm

    Really lovely article – thank you. I’m another one who’s just ordered the ‘how to read a paper’ book – hope you’re on commission!

  90. Ben Goldacre said,

    November 16, 2007 at 10:19 pm

    heh i hate to blow my own trumpet but i just got a congrats email from trisha greenhalgh, author of how to read a paper. my main worry is that one day she will bust me for stealing all her best lines and reworking them into a sarcastic evidence based medicine column with bum jokes.

  91. cleeray said,

    November 16, 2007 at 10:28 pm

    @raygirvan: Is the single-draw probability of drawing a high card smaller than the probability of drawing a medium card in your TV example?

  92. kingshiner said,

    November 16, 2007 at 10:51 pm

    A throw of a pair of fair dice after throwing a double six is likely to be lower than a double six, because a throw of a pair of dice is *always* likely to be lower than a double six, after, before or during anything, including trying to have sex with with your bicycle

    news.bbc.co.uk/1/hi/scotland/glasgow_and_west/7095134.stm

  93. pv said,

    November 16, 2007 at 11:52 pm

    #
    Bogusman said,

    November 16, 2007 at 2:45 pm

    Yes pv, it would be fascinating to see how participation in organised religion and belief in homeopathy correlate. I suppose both depend on accepting the existence of miracles.

    We’ve covered this a bit in the main forum. Homeopathy has many similarities to religion, not the least being the complete contempt for evidence. They have a god or leader in Samuel Hahnenmann. There is a bible in the form of The Organon of the Healing Art. They have their different factions who are always bickering, like the SoH, ARH… (take a look at this lot www.corh.org.uk/members.html). There are the committed followers who wouldn’t change their views no matter what the evidence confronting them. They believe in miracles and the physically impossible, and they tend to embrace all sorts of other conflicting superstitions as and when the need arises (alt med in general). I’m sure there’s more.

  94. Ben Goldacre said,

    November 16, 2007 at 11:52 pm

    sigh

    ELIZABETH BIAGI to ben

    Hi Ben

    I’m a homeopath and proud to be one. Like many homeopaths, I have an honours degree outwith my homeopathic training. I found my homeopathic training to be superior to the average university degree course. Where is your evidence that homeopaths are not well educated in homeopathy? Have you surveyed any homeopaths about their training?

    Unlike yourself and the other righteous bad scientists who contributors to website, I have a very open mind on what constitutes scientific evidence. I have not been indoctrinated in conventional medicine and therefore have tried other treatments.

    I understand that you write on sociology then you will be aware of your own use of hegemony to substantiate your claims of homeopathy’s failings. However, you do this in the midst of a paradigm shift in public opinion on the claims of conventional medical to have an answer for every human condition. People no longer believe that conventional medicine has all the answers, is the best option for them or that it even works for the condition they have.

    It would seem that you have decided to focus on homeopaths as they symbolise a popular therapy that logic driven scientists have no answers on. A nice easy target to kick, for the bully boys with a science degree.

    Your energies would be better employed investigating your own profession- one that sadly has attracted rapists, murderers and sadists to its ranks. Just read the newspapers, court reports and historical documents for evidence. The rest of the public do, and the funny old thing is, that they are looking for other treatments that they find beneficial rather than relying on what your profession have on offer.

    Is the problem that you believe that those who use homeopathy have no right to personal choice? Or can you see into the future where the NHS embraces therapies other than what is now known as conventional? Is this the real reason that you have started a fight with homeopaths?

    I have read and commented on your website and find the comments slanderous and encouraging hatered towards homeopaths. We are called hoes- (whores) by your following. I believe your ambition is to head an angry mob of witch hunters. Remember your code of ethics, please…do no harm!

    If you truely want to be a good scientist then why not work with homeopaths to carry out research on homeopathic treatment rather than shadow boxing.

    Elizabeth

    etc

  95. guthrie said,

    November 17, 2007 at 12:10 am

    Is there a technical name for the fallacy of “These new scientific discoveries suggest a way this woooo might work, but none of us can be bothered actually doing the work to find out but of course it works anyway.”?

    As for conventional medicine not having all the answers, that happened a decade or two ago. The problem is that homeopaths keep on peddling the same junk they did then.

    I assume Elizabeth is unaware of the multitude of posts you have done pointing out how homeopaths have signally failed to carry out proper tests to show how their stuff works?

    A good question for her, if she is still reading this, is to explain why a BBC investigation (as explained in the above article) found that

    “almost all the homeopaths approached recommended ineffective homeopathic pills to protect against malaria, and advised against medical malaria prophylactics, while not even giving basic advice on bite prevention.”

    This clashes with her views.

  96. pv said,

    November 17, 2007 at 12:41 am

    For anyone who hasn’t seen it, here is James Randi on homeopathy.

    video.google.co.uk/videoplay?docid=4780514592678474423&q=james+randi%23&total=451&start=0&num=10&so=0&type=search&plindex=2

    Mr Randi calls them liars and cheats and invites them to sue him. If he is wrong then I say that at the least they are most certainly deluded.
    Homeopathy is not a difficult thing to figure out in spite of the polite protests of Elizabeth Biagi and the crude stupidity of the SoH, even for a non-scientist like me. The science is actually very well understood. It’s not difficult, even for me. Homeopathy, just like astrology and phrenology, is unsupportable, unmitigated nonsense.
    The problem for homeopaths is one of profit – it is how they “earn” their living. For the manufacturers of homeopathic water and magic sugar pills it is all profit. And for Politicians it is a source of profit in the form of votes from the gullible. For Universities it is a source of profit – bogus degrees for bogus science. Homeopathy is a multimillion pound deception.

  97. pv said,

    November 17, 2007 at 12:43 am

    Sorry, wrong link. Homeopathy by James Randi is here (I hope):
    www.youtube.com/watch?v=BWE1tH93G9U&feature=related

  98. jackpt said,

    November 17, 2007 at 12:47 am

    . Couldn’t find any on the forums either. Maybe she mistook Badscience.net for woefullymisogynisticpimps.com or something. Maybe she dreamt it.

  99. jackpt said,

    November 17, 2007 at 12:48 am

    No hoes around here. Maybe she mistook badscience.net for woefullymisogynisticpimps.com. Or dreamt it.

  100. marcdraco said,

    November 17, 2007 at 12:52 am

    Didn’t someone wise once caution teachers and parents, “Be careful what you put into that brain because it will be very difficult to get it out again.”

    Or words to that effect. Homeopathy is a feel-good dogma rather like creationism. People who believe it (my current in-laws being a case in point) stubbornly resist any counter arguments because they don’t want to see their bubble burst.

    Elizabeth Biagi may be polite, but I’ll bet her the contents of my piggy bank that she can’t show me a double-bind experiment proving the efficacy of any homeopathic treatment. You want science darlin’? Come get some.

  101. don_pedro said,

    November 17, 2007 at 4:25 am

    Here I am, still awake after nursing the flu all day, with only a dilution of water for my thirst, and then I read:

    “I guess this is how they built Vegas,”

    and I spew it all over the screen.

  102. jobrag said,

    November 17, 2007 at 6:41 am

    Could Elizabeth Biagi tell what her honours degree is in please?

  103. oneiros said,

    November 17, 2007 at 8:15 am

    It’s all been said before Ben, but never so well. Excellent stuff…

  104. phayes said,

    November 17, 2007 at 8:43 am

    “I’m a homeopath and proud to be one… Unlike yourself and the other righteous bad scientists who contributors to website…”

    Heh!

    Verbrennt die Hexe! Auf den Scheiterhaufen mit ihr!

  105. Gimpy said,

    November 17, 2007 at 9:15 am

    What is it with the woo-sters and their willingness to play top trumps with qualifications? They seem to think that because they have a degree on some silly doctor or nurse supports homeopathy that this proves it works.
    Who needs evidence when you have authority?

  106. Dr Aust said,

    November 17, 2007 at 10:11 am

    It is a depressing fact that quite a number of homeopaths I have come across have biology degrees – for instance, the staff at my local homeopathic college include several with Biology BScs, some former A level biology teachers (!!? – even more worrying) and an ex-Critical Care Nurse.

    Just what these people “learnt” in their degrees I have no clue, but I strongly suspect that a course in (the philosophy of) the scientific method was not included.

    Think I am going to set Ben’s article, together with Richard Feynman on “cargo cult science”, as
    compulsory reading for all my 1st yr BSc students.

  107. BSM said,

    November 17, 2007 at 10:18 am

    “Is there a technical name for the fallacy of “These new scientific discoveries suggest a way this woooo might work, but none of us can be bothered actually doing the work to find out but of course it works anyway.”?”

    BZZZZZTT!!

    We already know that one. It’s HOMEOPATHY.

    Please try to keep up.

    p.s. Having posted that feeble joke, I am honour-bound to add to the wave of congratulations to Ben. It’s nice to have all the best arguments in one place and to have the sense that he has got ‘behind’ the homs world-view to spike their counter-arguments before they an even make them.

    It’s noticeable that the SoH’s press release is more of their usual pathetic bleating.

    www.homeopathy-soh.org/whats-new/press-releases.aspx

    It includes this section;

    “Society registered homeopaths have satisfied The Society’s educational and professional requirements and agreed to practise in accordance with The Society of Homeopaths’ Code of Ethics & Practice, the Core Criteria for Homeopathic Practice and the National Occupational Standards for Homeopathy.”

    So what happened to the homs who gave dangerous advice concerning malaria? What is being done about the anti-retroviral lobbyists in their ranks?

  108. TimW said,

    November 17, 2007 at 10:20 am

    @jobrag, & Dr Aust, at www.homeopathicgarden.co.uk/content/about.htm Elizabeth Biagi states: “I joined the Society of Homeopaths as a student and am now a registered member hence RSHom. Wishing to deepen my knowledge outside of homeopathy, I have recently completed studying psychology and social science for BSc Hons degree.”

    Amusingly @96 she said “I have a very open mind on what constitutes scientific evidence.” Oh great.

  109. BSM said,

    November 17, 2007 at 10:24 am

    “Just what these people “learnt” in their degrees I have no clue, but I strongly suspect that a course in (the philosophy of) the scientific method was not included.”

    It’s very easy to learn biology as a set of facts with no notion of how to judge their validity.

    I think also, that it is even possible to learn about experimental methods without a visceral understanding of the insidious way in which bias can creep in.

    And also, “What do you call the person who graduated bottom of his medical school?”. “Doctor”. This obviously applies across all the scientific educational disciplines.

    However, the determined promotion of customer satisfaction surveys as alternatives to RCT’s does smack of a conscious desire to misdirect at the very least.

  110. DrJon said,

    November 17, 2007 at 10:28 am

    A bit off topic, but the BBC Editors blog has a bit in it about climate change which includes the following:

    “We are still living with criticism over our coverage of MMR when we gave the impression that each side was underpinned by science of approximately equal weight. We must get it right on climate.”

    I hope they’ve truly taken this on board. Did they ever publish a retraction of any scare stories? Let’s also hope this applies to homeopathy et al. and to scientific “breakthroughs” like ecowatts.

    Keep up the good work Ben – a brilliant article! Maybe a top trumps deck with regular bad science targets and supporters could be added to your shop :)

  111. Budicius said,

    November 17, 2007 at 10:33 am

    I get bored to tears with the same old rigmarole from sceptics. To say that Homoeopathy is nothing but placebo is an uneducated and ludicrous comment. Some Veterinarians prescribe Homoeopathics to farm animals and family pets with great success, I didn’t know animals could respond to placebo and don’t tell me it’s relative to the observer. Look at www.liebertonline.com at the article – Efficacy of the potentized Drug, Carcinosin 200 fed Alone and in combination with another drug – Chelidonium 200, in Amelioration of p-Dimethylaminoazobenzene- induced Hepatocarcinogenisis in Mice. These Homoeopathic drugs have been diluted two hundred fold and are successful in the treatment of and inhibition of Hepatic carcinogens. This should put the matter to rest as to the efficacy of Homoeopathy. Just flick through the pages of a ten volume Homoeopathic Materia Medica and tell me that each and every one of the thousands of symptoms listed were all caused and cured by way of placebo.
    The success of Homoeopathy is obviously in its clinical results and by way of individualized treatment and not in poorly organised double blind clinical trials. The public are turning away from modern medicine not because of its success in clinical trials and trials on animals, (In the beginning the effectiveness of
    Homoeopathic drugs was discovered on humans, not animals.) they are turning away because of its ineffectiveness and dangers in the clinic.
    Big Pharma is so scared of Homoeopathys rise it will pump millions into suppressing it, but it’s runnin’ scared in the prospect of stem cell therapy aswell with losses in the billions.
    Homoeopathy will not work for everybody, but neither does modern medicine. God bless Samuel Hahnemann for he did not live in vain.

  112. Victoria said,

    November 17, 2007 at 10:46 am

    “Winterson tries to tell us – like every other homeopathy fan – that for some mystical reason, which is never made entirely clear, the healing powers of homeopathic pills are special, and so their benefits cannot be tested like every other pill.”

    I read her article and can’t find where she says this.

    That’s the only point I’m making; this isn’t a defence or attack of this article or hers. In fact reading both, it sounds like you have a lot of common ground despite the different conclusions.

  113. ricard said,

    November 17, 2007 at 10:46 am

    Thanks, Ben, for a clear, concentrated, undiluted and powerful refutation of this pernicious delusion. I will refer to this article again and again to end all speculation about whether homeopathy or so-called “alternative therapies” are valid, valuable or meaningful alternatives to evidence-based medical treatment. Brilliant and inspiring article. Please continue to make such a valuable contribution.

  114. kingshiner said,

    November 17, 2007 at 10:49 am

    Budicius, is the article on hepatocarcinogenesis available free anywhere? It sounds fascinating, I’d like a look at it but I don’t feel like forking out $32 if I don’t have to

    Thanks

  115. PO8 said,

    November 17, 2007 at 11:12 am

    @zlsiida: You don’t understand how unthinkably huge these numbers are. There is much, much less than a one in a trillion chance that any of the billions of 100C dilutions that ever might have been administered had a single atom of solute in it. That’s close enough to “100C homeopathic remedies contain no solute” for me.

  116. Budicius said,

    November 17, 2007 at 11:32 am

    Kingshiner- Dunno if it is available free but I found another one with favourable results. Amelioration of Carcinogenisis Induced Toxicity in Mice by Administration of a potentized Homoeopathic drug, Natrum Sulphuricum 200. This ones at ecam.oxfordjournals.org

  117. Mojo said,

    November 17, 2007 at 12:03 pm

    Victoria said, “I read her article and can’t find where she says this.”

    You must have missed this bit (at the start of the eleventh paragraph):

    “This seems to be partly why tests used for conventional medicines fail when used to test homeopathy.”

  118. Mojo said,

    November 17, 2007 at 12:43 pm

    Sorry, I should probably have quoted from the immediately preceding paragraphs as well, in which she talks about homoeopathy thinking differently about the relationship between cure and disease, says that it’s “holistic” (it isn’t, of course – it considers nothing but the symptoms exhibited) and waffles about a “web of relatedness”.

  119. Dr Aust said,

    November 17, 2007 at 1:03 pm

    Re comments from Budicius:

    Frankly, studies published in “Alternative Medicine” journals usually turn out to be so flawed as to be valueless. IMHO this is because the standards of “expert peer reviewing” at AltMed journals like OUP’s eCAM and Liebert’s Journal of Alternative and Complementary Medicine are, to put it very mildly, debatable. The Modus Operandi in these journals is typically:

    (i) Carry out badly-controlled experiment into “alternative modality”;

    (ii) Resolutely ignore all possible confounding factors – instead:

    (iii) Attribute results to mystic effect of homeopathic remedy / pyramid / Reiki energy field;

    (iv) Publish same in AltMed journal where “expert peer reviewers” ignore lack of controls in (i), repeat one-eyed (ii) and unquestioningly accept daft interpretation in (iii), because they share the same belief in mystic nonsense.

    As I have already said on this thread, and written about at length here, this is precisely what Feynman nailed 30 years ago as “Cargo Cult Science”. It has the appearance of science, but utterly lacks the critical ingredient of appropriate scepticism. What you get instead is a collective act of suspension of critical thinking and implicit belief in magic.

    Clearly I am generalising, but every time I read a paper in one of the AltMed journals that claims to provide “scientific evidence for homeopathy” (or similar), this is what I see.

    BTW, the editor in chief of the Journal of Alternative and Complementary Medicine is Dr Kim Jobst. Jobst is a medical homeopath but is best known in the Badscience world for his endorsement of the ridiculous qLink “anti-EMF” pendant, a medical marvel (not) thoroughly debunked by Ben here.

    To re-iterate the point, if the Chief Editor of a journal apparently believes in undetectable magic energy fields, how is one to believe the journal uses any acceptable scientific standards?

  120. Dr Aust said,

    November 17, 2007 at 1:09 pm

    Oops. All links in the last post scrambled !**!! effing XML editors.

    Here it is again, hopefully with working links.

    ——————-

    Re comments from Budicius:

    Frankly, studies published in “Alternative Medicine” journals usually turn out to be so flawed as to be valueless. IMHO this is because the standards of “expert peer reviewing” at AltMed journals like OUP’s eCAM and Liebert’s Journal of Alternative and Complementary Medicine are, to put it very mildly, debatable. The Modus Operandi in these journals is typically:

    (i) Carry out badly-controlled experiment into “alternative modality”;

    (ii) Resolutely ignore all possible confounding factors – instead:

    (iii) Attribute results to mystic effect of homeopathic remedy / pyramid / Reiki energy field;

    (iv) Publish same in AltMed journal where “expert peer reviewers” ignore lack of controls in (i), repeat one-eyed (ii) and unquestioningly accept daft interpretation in (iii), because they share the same belief in mystic nonsense.

    As I have already said on this thread, and written about at length here, this is precisely what Feynman nailed 30 years ago as “Cargo Cult Science”. It has the appearance of science, but utterly lacks the critical ingredient of appropriate scepticism. What you get instead is a collective act of suspension of critical thinking and implicit belief in magic.

    Clearly I am generalising, but every time I read a paper in one of the AltMed journals that claims to provide “scientific evidence for homeopathy” (or similar), this is what I see.

    BTW, the editor in chief of the Journal of Alternative and Complementary Medicine is Dr Kim Jobst. Jobst is a medical homeopath but is best known in the Badscience world for his endorsement of the ridiculous qLink “anti-EMF” pendant, a medical marvel (not) thoroughly debunked by Ben here.

    To re-iterate the point, if the Chief Editor of a journal apparently believes in undetectable magic energy fields, how is one to believe the journal uses any acceptable scientific standards?

  121. Kid Banana said,

    November 17, 2007 at 1:37 pm

    [quote=Elizabeth Biagi]Your energies would be better employed investigating your own profession- one that sadly has attracted rapists, murderers and sadists to its ranks. Just read the newspapers, court reports and historical documents for evidence. [/quote]
    I there any evidence that Homeopaths have a lower percentage of “rapists, murderers and sadists” in their ranks? Doctors who are criminals are newsworthy and attract oodles of publicity but I’d guess a that a homoepathic murderer (or rapist/sadist) may pass unnoticed by the media.

    Of course, Doctors who are murders do have access to harmful drugs that can kill people, whereas homeopaths are will have great difficulty administering a fatal dose to patients…

  122. Dudley said,

    November 17, 2007 at 2:26 pm

    I’m very confused – how is Big Pharma pumping millions into attacking homeopathy? Judging by his tailoring, Ben Goldacre isn’t getting much payment.

  123. Daibhid C said,

    November 17, 2007 at 2:40 pm

    Jackpt: by searching the website for examples of anyone calling homeopaths “ho’s”, failing to find any, and thereby concluding we don’t, you are displaying a hidebound obsession with traditional forms of evidence…

  124. pv said,

    November 17, 2007 at 3:01 pm

    Kid Banana said,

    November 17, 2007 at 1:37 pm

    Of course, Doctors who are murders do have access to harmful drugs that can kill people, whereas homeopaths are will have great difficulty administering a fatal dose to patients…

    Hehe. They’d also have no small difficulty in administering a dose that does anything at all.
    There are however many more Doctors, GPs etcetera than homeopaths. Do many homeopaths call themselves Doctor? Methinks most of them aren’t allowed to so the news media isn’t going to pick up on them if they happen to have behaved inappropriately. Don’t you love how cherry picking statistics is compulsive behaviour for homeopaths. Really they are forced into this deceptive behaviour because they have nothing else. Homeopathy consists of unsupportable preconceptions and layer upon layer of deception, self deception, deception of others, reciprocal deception (where practitioner and patient deceive each other). It’s not necessarily done on purpose although some of the more idiotic claims of homeopathists most probably are – all in the cause of marketing their scam (oops, I mean “profession”), of course. It’s a complete disaster.

  125. pv said,

    November 17, 2007 at 3:25 pm

    Budicius said,

    November 17, 2007 at 10:33 am

    I get bored to tears with the same old rigmarole from sceptics. To say that Homoeopathy is nothing but placebo is an uneducated and ludicrous comment.

    Be prepared to be bored rigid.
    It’s perfectly educated and sensible to say homeopathy is pointless idiotic drivel. Principally because it is and has been proven to be so every time it is tested in an objective way. It has no basis in fact. Homeopaths cannot agree on how it is supposed to work or why. They can’t even agree on the philosophy of treating symptoms or the disease. It denies the existence of pathogens. It says fantastically that water remembers the homeopathic ingredient but, magically, no other contaminant. Homeopaths drivel on about quantum this and nano that without remotely comprehending either, and they rely on quantity of anecdote rather than quality of evidence to make their case – when they can decide and agree on a case to make.
    It’s really quite uneducated and ill informed (ignorant even) to suggest homeopathy is anything other than a steaming pile rubbish foisted onto a scientifically and medically illiterate public for profit.
    My own view is that the promotion of homeopathy, especially where it discourages the use of evidence based medicine, should be a criminal offence. It is fraudulent.
    And do you know there is a reason why, in some more enlightened countries, it is illegal to treat animals with homeopathy.

  126. Diotima said,

    November 17, 2007 at 3:38 pm

    Budicius: the Guardian (evidently in the pay of BigPharma) published a grim little tale of homeopathy some time ago. A French enthusiast for homeopathy moved with his wife to the UK, because of this country’s positive attitude to sugar pills and nonsense. After weaning, his baby daughter failed to thrive, so he took the child to a homeopathic nurse who insisted that he should take the baby to A & E immediately; he raged at her lack of belief and only took the child to hospital when it was clear that she was dying. The child had a very simple congential problem which only emerged when she came off the breast. But which is the more important, a small child or your own beliefs? This father had no doubts.

  127. misterjohn said,

    November 17, 2007 at 3:38 pm

    But is it legal to treat animals with Hippotherapy? (as opposed to rhinoplasty)

    Hippotherapy and the Significance of Complementary and Alternative Medicine: A Q&A with William Benda, M.D., FACEP, FAAEM

    In the October 2007 edition of Alternative & Complementary Therapies, at www.liebertonline.com/

    @ Budicius Thanks for the link

  128. Hirudo said,

    November 17, 2007 at 3:52 pm

    One suggested amendment:

    “By pushing their product relentlessly with this scientific flim-flam, homeopaths undermine the public understanding…”

    should read

    “By pushing their product relentlessly with this pseudo-scientific flim-flam, homeopaths undermine the public understanding…”

  129. Dr Aust said,

    November 17, 2007 at 6:16 pm

    In case anyone’s interested bored, I have re-posted my rambling riposte to Budicius further up the thread – with working links this time – over at my blog.

    Oops – that comes over as pompously self-promoting. Sorry.

  130. Nickynockynoonoo said,

    November 17, 2007 at 6:43 pm

    Excellent article Ben. Saved and printed too.
    “How to read a paper” is on Santa’s list.

  131. Blondin said,

    November 17, 2007 at 6:53 pm

    That has to be the most clear, concise anti-homeopathy blog I’ve ever seen. I think it should be printed in pamphlet form and left in pharamcies, clinics & waiting rooms everywhere.

  132. frankO said,

    November 17, 2007 at 7:21 pm

    November 16th, 2007. In the morning we have Richard Horton, editor of The Lancet, calling homoeopathy ‘quackery’ on the Today programme, then Ben Goldacre with this truly superb exposition of why homoeopathy sucks, calling homoeopaths ‘morons’. Bravo to both gentlemen! Maybe there IS hope left that the UK public can still become an enlightended, comprehending, anti-superstitious group of people with a realistic attitude to the world that surrounds them.

  133. pv said,

    November 17, 2007 at 8:25 pm

    It’s fascinating reading the posts here, especially those purporting to defending homeopathy having seen it so comprehensively dismantled in one fell swoop by BG.

    I’m looking forward to the next chapter in the BadScience demolition manual, where BG deftly dismantles Harry Potterism. And I anticipate eagerly the ripostes of those same individuals who have bravely stepped up to the plate in this blog to plead the case for homeopathy. I think you’ll stand a much better chance, because the evidence is greater, in your defence of young Master Potter. :-)

  134. Neil Desperandum said,

    November 17, 2007 at 8:29 pm

    Belter, Ben, and well done to you and the Guardian for giving it such prominence.

    Quote “These are biblical themes, and it is ridiculous that what I am going to explain to you now is not taught in schools.”

    But they are, as I think you know.

    Even primary school kids know about fair tests, and secondary school science is full of “How Science Works”, which includes control variables, controls, placebo, replicates, random and systematic errors, bias and more.

    Each year I do an investigation into the effects of caffeine on memory with my GCSE class, which is essentially a randomised placebo-controlled blind trial.

    Indeed many science teachers today think there is too much How Science Works at the expense of actual scientific knowledge.

  135. misterjohn said,

    November 17, 2007 at 8:31 pm

    Too right.
    I’ve seen platform 9&3/4 at Kings Cross. It’s more convincing evidence of the existence of the Blessed Harry (pbuh)than I’ve seen for the efficacy of Homeopathy.

  136. BSM said,

    November 17, 2007 at 8:46 pm

    Budicius said,

    “To say that Homoeopathy is nothing but placebo is an uneducated and ludicrous comment. Some Veterinarians prescribe Homoeopathics to farm animals and family pets with great success, I didn’t know animals could respond to placebo and don’t tell me it’s relative to the observer.”

    Listen, muppet, I am going to say this once and I am going to say this clearly;

    HOMEOPATHY DOES NOT WORK IN ANIMALS.

    However, I have seen plenty of evidence of homeopaths lying about its effects in animals and claiming success where none existed or many other perfectly sensible mechanisms explained why the animal was reported by vet or owner (get the import of that phrase?) to have improved at some arbitrary time point. Indeed it was just such an episode that triggered my initial interest in homeopathy and everything I have seen of veterinary homeopathy since that point has absolutely confirmed that it is all bunkum though I am constrained my my professional body to assert that it must all be innocent ignorance and misunderstanding.

    I spent a very jolly day in October on an Alt Med course. The presenter was very nice and apparently ‘scared shitless’ when my name appeared on the list of delegates (apologies for the self-aggrandisement, but this is actually true), so he picked his best case stories (that’s anecdotes to those of us inhabiting the real world) with which to lead his presentation. One: the fact of leading with anecdotes is itself revealing of the mindset involved. Two: they were singularly unimpressive, so even in their own terms were damp squibs. He did have the integrity to accept some simple facts, such as the complete absence of any homeopathic ‘provings’ in animals and the likelihood of mis-diagnosis in his apparent trump-card of an animal cured of “cancer”, but sadly this did not seem to dent his confidence.

    If I hear one more numpty believer trotting out the ridiculous canard that homeopathy must work because it works in animals then I might just have to tell them some of the actual horror stories.

    Perhaps any such numpty should visit this website;

    www.vetpath.co.uk/voodoo/

    p.s. There is a small literature of controlled trials in veterinary homeopathy. Every one shows a failure to have any useful effect.

    p.p.s. Numpty believers could reasonably ask why vet homeopathy routinely foregoes any pretence of individualisation in farm animals when this is, allegedly, such a key feature of this marvellous mode of therapy. Vet homeopathy is rife with the use of combination remedies and other assorted homeopathic heresies about which believers could also reasonably ask a whole host of rather critical questions. Well, I say “could reasonably ask”, they never actually do ask themselves any such tricky questions, which is, of course, one of the points that Ben was making.

    Smelling the coffee yet Budicius?

  137. raygirvan said,

    November 17, 2007 at 9:27 pm

    Your energies would be better employed investigating your own profession- one that sadly has attracted rapists, murderers and sadists to its ranks

    Like Crippen?

  138. Harlequin said,

    November 17, 2007 at 9:28 pm

    BSM > There is a small literature of controlled trials in veterinary homeopathy. Every one shows a failure to have any useful effect.

    Thanks for the link to your website. As there’s no search facility, I was unable to see whether you cite Albrecht H, Schtte A. Homeopathy versus antibiotics in metaphylaxis of infectious diseases: a clinical study in pig fattening and its significance to consumers.
    Altern Ther Health Med. 1999 Sep;5(5):64-8.

    “CONTEXT: Due to the conditions of modern industrial pig fattening in intensive livestock farms, 24% to 69% of the animals become ill. The antibiotic metaphylaxis that is routinely administered leads to several problems in animals, human health, and the environment. OBJECTIVE: To investigate whether a homeopathic metaphylaxis is effective and potentially useful for replacing antibiotic metaphylaxis. DESIGN: Animal subjects were divided into groups of 10 per pen, 2 pens sharing 1 trough. Twenty pigs were randomly assigned within a stall and were administered either antibiotics, homeopathy, or placebo. SETTING: A typical intensive livestock farm in Northern Germany. PARTICIPANTS: 1440 piglets. INTERVENTION: Homeopathic metaphylaxis is compared with placebo, the routine low-dose antibiotic metaphylaxis, and an antibiotic metaphylaxis in therapeutic dosage. MAIN OUTCOME MEASURES: Incidence of diseases in general and of diseases of the respiratory tract. RESULTS: Homeopathic metaphylaxis is significantly effective compared with placebo and routine low-dose antibiotic metaphylaxis for incidence of disease and rate of disease of the respiratory tract among the animals studied. Only by increasing the dosage of antibiotics to a therapeutic level does antibiotic metaphylaxis surpass homeopathic metaphylaxis. CONCLUSIONS: An unacceptably high percentage of pigs in modern livestock management become ill, suffering mainly from diseases of the respiratory tract. The routine antibiotic dosage of metaphylaxis is too low to be effective. As a result, the problems of resistance and danger to human health and the environment are increasing. To confirm whether antibiotic metaphylaxis may be replaced by homeopathic metaphylaxis, this study should be repeated independently.”

    I feel sure you’ve already demonstrated the pointlessness of replicating this RCT, with placebo and active controls, but it would be educational to hear you deconstruct it in this forum.

  139. Budicius said,

    November 17, 2007 at 10:28 pm

    I am not going to go into a long spiel about placebo and animals only to say that ultra high dilutions of Homoeopathics have demonstrated beneficial results in the lab on mice. Dr Aust, you seem like a polite reasonable person but do you not think that the same bias, fallacy and flawed methodology also at times exists in mainstreem journals?
    Some believe Homoeopathies success also lies in long consultations. There are Homoeopathic doctors in India,(Yes PV there are medically qualified doctors who practice Homoeopathy, maybe even your own GP prescribed you Homoeopathics without you knowing.) that see over 150 patients a day- men women and children with this high volume of patients they only spend a minute or so with each. These Homoeopaths are doing frontline cutting edge Homoeopathy, they are walking Materia Medicas that don’t spend hours repertorising a case, unlike Homoeopaths in the west that piss fart around with hour long consultations because they don’t have many patients.
    Big pharma loves to pay the media to expose Homoeopathy if a particular poorly researched meta- analysis shows unfavourable results in some studies or if a child dies under Homoeopathic treatment. Yet when children die under conventional treatment it’s all very hushed up not to mention phamaceutical companies experimenting with their new vaccines on children in Africa without parental consent with devastating results.

  140. BSM said,

    November 17, 2007 at 10:44 pm

    Harlequin

    I have read it but some time ago so I can’t remember off-hand all the problems.

    Number one is that it is not homeopathy by any sensible definition. It would be like trying to claim that surgery was an effective technique for repair of a broken bone based on a paper reporting a method that involved randomly stabbing the patient with a scalpel while the leg mended itself. The only resemblance to real surgery would be the use of the sharp instrument. However, it did use homeopathic dilutions, so yes if it was reliable and replicable it would lend some support for the reality of effects from content-free solvent.

    Number two and this, as I recall is the main one, is that it seemed to fit with the common pattern of comparing homeopathy with a useless and pointless conventional treatment and declaring its equivalence to be proof of homeopathy’s efficacy. No one cares whether homeopathy is as effective as antibiotic treatment for the treatment of the common cold. This was another of Ben’s points, which is yet another reason why his Guardian article was so good.

    I can’t remember whether it was adequately blinded.

    What I have found with the homs’ papers in general is that if they only feature in crap journals then they are utter crap not just a bit crap. If they weren’t glaringly awful they’d get them published outside their private ghetto of fanzines.

  141. BSM said,

    November 17, 2007 at 10:58 pm

    “I am not going to go into a long spiel about placebo and animals only to say that ultra high dilutions of Homoeopathics have demonstrated beneficial results in the lab on mice.”

    Have you read those lengthy papers concerning solvent that once contained Arsenic in mice? I have. Where would you like to begin?

    I’d like to start with the fact that the verum group were given an alcohol-based treatment but the “controls” were not. The researchers then measured effects on liver enzymes. Guess what, the verum group showed effects on their livers. Surprise, bloody surprise. Please, Budicius, try to keep up.

    It’s also not “homeo”pathy. It’s isopathy. But, as I said above, if it really showed an effect from solvent that once met a molecule of active ingredient it would have been interesting. But instead it’s just another bunch of homs showing they couldn’t get a science GCSE if they tried. It’s all in the controls, Budicius. It’s all in the controls. Once these have been cocked up you needn’t bother reading the rest of the paper.

    “These Homoeopaths are doing frontline cutting edge Homoeopathy, they are walking Materia Medicas that don’t spend hours repertorising a case, unlike Homoeopaths in the west that piss fart around with hour long consultations because they don’t have many patients.”

    Which would make homeopathy’s results amazingly robust under controlled trial conditions.

    Oops.

    Which way do you want to go, Budicius? Do you want to play the game that homeopathy is somehow beyond the realm of RCT’s or that it’ effects are so subtle and indistinct that RCT’s keep missing them? I’m happy either way, it’s just interesting to see which are your personal favourite forms of fallacious reasoning.

    Over to you…

  142. Dr Aust said,

    November 17, 2007 at 11:00 pm

    Budicius

    Bias, fallacy and flawed methodology can and sometimes do appear in mainstream journals. The differences are that:

    (i) There is a good chance the review process will actually weed the crap stuff out – and the more “top end” the journal, the more in-depth the reviewing. Typically two or even three other people in the same field for the things / places I publish.

    (ii) If you try and publish a “startling” or “paradigm-shifting” result based on shoddy methodology you are even more likely to get rumbled, as the reviewers will undoubtedly say “hang on, this goes against X other papers, so prove your methods work” (and, sometimes, show us why the others got the wrong results)

    (iii) Other people can, and will, repeat your experiments So if you used an an inaccurate or flawed method, did it wrong, finagled the results, or let your biases trick you you will be found out, and will look like an idiot – as was the case with Jacques Benveniste and “ultra-dilute” solutions.

    I would contend that none of the above are true for journals of AltMed and the papers that appear in them.

    Most of the dodgier mainstream science that does get through will appear in lesser journals. There are hierarchies of journals in all scientific fields, and one reason for the hierarchy is precisely the standard of evidence the journals demand, and the standard of “interrogation” the work is put through during peer review.

  143. BSM said,

    November 17, 2007 at 11:01 pm

    “I am not going to go into a long spiel about placebo and animals only to say that ultra high dilutions of Homoeopathics have demonstrated beneficial results in the lab on mice.”

    I ought also to have said, “Why are you not going into a long spiel?”. That’s what we’re here to do. I don’t mind what the length of your spiel is, but at the moment you’ve been blown out of the water and have shown no signs of being able to bale yourself out beyond trotting out yet more tired and second-hand urban myths.

  144. pv said,

    November 17, 2007 at 11:20 pm

    Homeopathy is complete tosh and I suppose it’s easy to throw one’s hands up in frustration at how such pernicious nonsense persists. But persist it does, and probably for many triflingly simple reasons.
    On reason I can think of is that no-one likes to admit to being taken in. Not only that, no-one really likes to think about the possibility they might have been taken in.
    There’s always a ready supply of the desperate and vulnerable. But there’s also a ready supply of well-meaning, intelligent but not necessarily appropriately informed suckers for stuff like homeopathy. And, if not plausible, homeopathy does seem to be an attractive proposition to people of a certain bent.
    No-one likes to be made a fool of, so I think people tend not to entertain the idea with regard to themselves. Homeopathy is such a preposterously and demonstrably idiotic idea that it would most likely make any remotely sensitive person feel an utter fool to have to admit to being taken in by it – especially since self-deception is probably the principal active ingredient. Yet many obviously are deceived.
    I think it’s simply that some people believe they couldn’t possibly be taken in by something so inane and what is in fact a con trick. So they believe there must be something else that makes homeopathy “work”. If you add this to the likelihood of their belief that what they think they have experienced (if anything at all) couldn’t possibly be the result of self deception, then I think they are very unlikely to be persuaded by any amount of evidence or reason, no matter how well supported. Then it becomes not just a matter of faith, but of necessity. That’s how I see it anyway.

    None of this excuses the the behaviour of homeopathic charlatans and their ridiculous cheerleaders or the disgraceful activities of the homeopaths’ marketing wing, the insufferable and SoH.

  145. chris lawson said,

    November 17, 2007 at 11:24 pm

    Harlequin, there are several basic flaws in that trial.

    1. It was not blinded at all.

    2. The outcome measures were highly subjective, eg. “signs of general lethargy” in the pigs. Not one of the five outcome measures was objective.

    3. The pigs were followed for only 11 days, not long enough to draw useful conclusions.

    4. The treatment arms were laid out in a way that would not be done today. That is, each treatment arm had its own control. By giving each treatment arm its own control, the study is essentially running four independent studies and therefore any comparison between arms is rendered highly dubious.

    5. There are obvious confounding factors that have not been identified. In the control group for antibiotic therapy, 100 out of 240 animals were marked as diseased. In comparison, the control groups for low-dose ab’s was 79/480 and the homeopath group was 88/480. Why this massive discrepancy in randomised control arms? It’s never discussed, let alone explained.

    5a. The stats are presented in a misleading way. I won’t go into details, but why for instance was the therapeutic ab arm given half the numbers of pigs to follow as the other two arms? There was a massive benefit in giving therapeutic antibiotics, but the authors claimed that there was no significant difference between therapeutic abs and homeopathy — having hobbled the antibiotic arm by giving it half the numbers and therefore much bigger confidence intervals.

    The problem with homeopathy is not that trials such as these get published (there are thousands of equally poor studies published in scientific and medical journals every week). The problem is (i) these poor studies are the cream of the homeopathic crop, whereas in medicine there is another tier of high-quality studies, (ii) these studies are held up by homeopaths as proof of effectiveness when the flaws are blindingly (sorry!) obvious, and (iii) all of the excuses that homeopaths use to wriggle out of negative findings (eg. “homeopathy is individualised” or “we help wellness overall, not reductionistic outcomes that can be measured in trials”) are conveniently forgotten when the findings are positive. Has any homeopath in the decade since this paper was published claimed that the results should be ignored because all pigs in each arm were treated the same or because the outcome measures were reductionist?

  146. losman said,

    November 17, 2007 at 11:32 pm

    I google-scholared the third of your references, and came to an article by the same authors plus some others in Lancet:
    “Are the clinical effects of homoeopathy placebo effects? Ameta-analysis of placebo-controlled trials” by Klaus Linde, Nicola Clausius, Gilbert Ramirez, Dieter Melchart, Florian Eitel, Larry V Hedges, Wayne B Jonas. I would just like to point out the following sentence in that article:
    “Discussion—The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homoeopathy arecompletely due to placebo.”

    I have a question/remark about these studies: given that physics as we know it says that dilutions of more than 10^-23 can’t have any effect, I would be interested in studies concerning only homeopathic remedies at dilutions of say 10^-14 to 10^-18. In this range it seems perfectly plausible that there might be a “vaccine” type effect.

  147. misterjohn said,

    November 18, 2007 at 12:21 am

    @losman
    If there was a “vaccine” effect at such high levels of dilutiopn, might it not be better to dilute the effective ingredient somewhat less.
    The homeopaths seem to think that a greater dilution produces a greater effect, however, perhaps because the water gets less forgetful if it has less to remember.

  148. Robert Carnegie said,

    November 18, 2007 at 2:10 am

    Is this sentence confused or is it me? “If, on the other hand, you prescribe homeopathy pills, but you don’t know that they perform any better than placebo in trials, then you are not familiar with the trial literature, and you are therefore incompetent to prescribe them.” To me this appears to contain one or both of the implications: (A) “homeopathy pills” do perform better in trials, or (B) you should not prescribe homeopathy pills unless you know that they perform better than placebo in trials.

    Each of these seems to disagree with the article as a whole, in which I seemed to find that (1) homeopathy pills do not perform better than placebo in trials properly executed and analysed, and (2) a practitioner may be able legitimately to prescribe them anyway. Of course the discrepancy disappears if the text is changed to say “they don’t perform any better than placebo in trials”.

    And my point 1 of course is consistent with a belief that “homeopathy pills” -are- placebo.

  149. Budicius said,

    November 18, 2007 at 4:09 am

    BSM your ill informed academic pomposity is nauseating. Carcinosin is included in William Boericke’s Homoeopathic Materia Medica even if its use is Isopathic and in this study it was used in combination with another Homoeopathic remedy Chelidonium. Also the other study I mentioned used the remedy Natrum Sulphuricum 200c well established in Homoeopathy.
    “However it did use homeopathic dilutions, so yes if it was reliable and replicable it would lend some support for the reality of effects from content-free solvent.” Not sure where you stand on the matter, do you believe in the possibility that high dilutions might work? If so I have some theories of my own as to how it works. But that’s the point there are theories flying around how high potency homoeopathy works, this is where Homoeopaths and Physicists need to unite and discover a unified theory and put to rest the quantum/electromagnetic effects of Homoeopathic medicines.
    Lets not forget that Homoeopaths also use very material doses of medicines also as in herbal tinctures. This is what divided homoeopaths into two camps in the early days- the low dilutionists and the high dilutionists. So do we hold onto low dilution material Homoeopathy and discard the practice of high dilution prescribing or do we discard both in the belief that like cannot cure like regardless of dilution level. Even though the father of Medicine Hippocrates said that likes could be cured by likes, and if the father of medicine is to be disbelieved then why make physicians take the Hippocratic oath?

  150. igb said,

    November 18, 2007 at 7:38 am

    “Big pharma loves to pay the media to expose Homoeopathy”

    It’s like having the religious nutters around for coffee, isn’t it? Just as their God allows them to explain any counter-argument as a mysterious way (earthquakes, Belsen, their child’s death) “Big Pharma” provides an unrefutable answer to anything for alt.med types. Such few as I’ve known are also suckers for perpetual motion (“the oil industry…”) and all the rest of the horrid scams that are based on two presumptions:

    * Monolithic enemies will reject advances in order to protect entrenched positions, acting with perfect consort; and

    * I am so clever that I can see the truth even though everyone else cannot.

    You see the monolithic enemies argument with the electrosensitivity nutters. They talk of “the telecommunications industry” as a single entity. I’ve worked in telecoms for twenty years and done my share of dealings with standards bodies, supplier forums and so on. The telecoms industry can’t decide if it wants tea or coffee for morning break, and getting two companies to agree to a one-page protocol spec is akin to the solution of the Middle East conflict. The idea that the industry could secretly conspire against consumers is preposterous: they couldn’t conspire to wear matching shirts two days running. Those with long memories and no pain reflex will be able to conjure X.400 to mind: THAT is the level of conspiracy the telecoms industry is capable of. If the industry is powerless in the face of Skype, what hope any conspiracy against consumers?

    Unless “Big Pharma” is quite unlike every other sector, its senior management simply couldn’t run a conspiracy. Too many people would know, and too many shareholders would find out. Look at the BA `dirty tricks’ campaign against Virgin: it operated for whole months before bringing about the inevitable downfall of its instigators.

    The “I am so clever” argument is popular amongst, say, 9/11 nutters. They posit a conspiracy so huge, so dangerous that it can manipulate physical evidence, kill those that threaten to reveal it, distort government policy and start wars. And yet it can’t stop slightly unwashed people in wholefood cafes talking about it. The point about secret conspiracies lies in the “secret” part. I always quote from the Joint Enquiry Team report into the Broxtowe `satanic abuse’ debacle at this point, answering the claim that the reason no evidence was found is because of the depth of secrecy `the conspiracy’ is capable of:

    “If you still wish to believe that it exists logically you would have to accept that an organisation has the unique ability to keep it secret. Even relatively secret organisations such as the Masons and the Mafia have never managed to achieve this. At least it would mean that the followers were extremely clever, powerful, wealthy, sophisticated people who could use their power and wealth to ensure privacy.

    If this is the case, as it must be, such people would hardly get involved with a family of ESN adults living on a council estate who are the subject of gossip by their neighbours, who are known to the police and who are subject to surveillance by the authorities.”

    If Homeopathy worked, Glaxo-Smithkline would (a) hold defensive patents and (b) be rubbing their hands in glee at the lower research costs and cheaper manufacturing. The idea that a global conspiracy binds medicine, drugs companies and regulators together, a conspiracy so secret that it is only known to every customer at your local wholefoods shop (and have you ever wondered why, if wholefoods are so healthy, the customers need so many supplements?) is simply preposterous. It has no explicative power, and makes “because God moves in mysterious ways” look like Wittgenstein.

  151. Moganero said,

    November 18, 2007 at 9:49 am

    igb, the customers don’t need the supplements but the shop probably does.
    Supplements, whether efficacious for bodily health or not, are definitely efficacious for the commercial health of the business selling them.
    A genuine whole food shop would not be selling supplements, they’re not wholefoods, and in almost all cases they probably wouldn’t be still in business.

  152. Mojo said,

    November 18, 2007 at 10:37 am

    Losman said, “I google-scholared the third of your references, and came to an article by the same authors plus some others in Lancet:
    “Are the clinical effects of homoeopathy placebo effects? Ameta-analysis of placebo-controlled trials” by Klaus Linde, Nicola Clausius, Gilbert Ramirez, Dieter Melchart, Florian Eitel, Larry V Hedges, Wayne B Jonas. I would just like to point out the following sentence in that article:
    “Discussion—The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homoeopathy are completely due to placebo.””

    The study also concluded that there was “insufficient evidence from these studies that homeopathy is clearly efficacious for any single clinical condition”, and called for more research. And that’s about as good as any meta-analysis ever gets for homoeopathy.

    You might also be interested in a second analysis of the same data as that one, by a team including four of the same authors, which concluded that “there was clear evidence that studies with better methodological quality tended to yield less positive results”.

    What does that tell you?

    See Linde et al, Impact of study quality on outcome in placebo-controlled trials of homeopathy, J Clin Epidemiol. 1999 Jul;52(7):631-6

  153. Weirdbeard said,

    November 18, 2007 at 11:11 am

    BSM said “Even though the father of Medicine Hippocrates said that likes could be cured by likes, and if the father of medicine is to be disbelieved then why make physicians take the Hippocratic oath?”

    Hippocrates lived thousands of years ago and I don’t think anyone except a nutcase would suggest that he was a great doctor by modern standards. Things have moved on a bit since Hippocrates was around. We have discovered a few things which he didn’t know about. Germs, for example. Or don’t you believe in germs?

  154. Weirdbeard said,

    November 18, 2007 at 11:12 am

    Sorry, it wasn’t BSM who said that. It was Budicius. My apologies to BSM for suggesting s/he might be missing a bit of brain.

  155. pv said,

    November 18, 2007 at 11:53 am

    igb said,

    November 18, 2007 at 7:38 am

    You see the monolithic enemies argument with the electrosensitivity nutters. They talk of “the telecommunications industry” as a single entity. I’ve worked in telecoms for twenty years and done my share of dealings with standards bodies, supplier forums and so on. The telecoms industry can’t decide if it wants tea or coffee for morning break, and getting two companies to agree to a one-page protocol spec is akin to the solution of the Middle East conflict. The idea that the industry could secretly conspire against consumers is preposterous: they couldn’t conspire to wear matching shirts two days running.

    So true. That’s our experience of the oil industry over the last couple of decades. The left hand doesn’t know what the right hand is doing. And even if industries like oil, pharmaceuticals, telecommunications could conspire against the purveyors of junk technology and medicine, there’s really no need to do so.

  156. Mojo said,

    November 18, 2007 at 12:12 pm

    Wierdbead said: “Things have moved on a bit since Hippocrates was around. We have discovered a few things which he didn’t know about. Germs, for example. Or don’t you believe in germs?”

    Hahnemann didn’t know about them either (the germ theory of disease postdated him), so homoeopathy doesn’t consider them to be a cause of disease.

    See also Avogadro’s constant.

  157. Weirdbeard said,

    November 18, 2007 at 12:40 pm

    Mojo: yes there’s rather a lot that Hahnemann didn’t know about back then which homeopaths seem quite happy to ignore. Mind you, Hahnemann didn’t know about quantum physics either but many homeopaths seem quite happy using that as an explanation for their nonsense (even though they don’t understand it). Not only do they cherry pick their data they do the same thing with the advances in knowledge over the past 200 years. Just like a religion in fact.

  158. BSM said,

    November 18, 2007 at 12:48 pm

    Budicius said;

    “BSM your ill informed academic pomposity is nauseating.”

    Well, so far it has trumped your false ideas. I’m afraid the awkward position you find yourself in is called “Being Wrong” and I see you have not responded to my comments on the mouse/arsenic paper.

    It was you that raised the subject. Perhaps you will show sufficient integrity to either apologise and acknowledge that the study was fatally flawed or produce some plausible defence of it.

    I’m afraid we see this utter failure to follow a logical discourse time and again with homeopaths.

    Homeopath makes daft claim. Daft claim is shot down. Homeopath ignores this, insults the other person and makes another daft claim.

    This is why they never learn.

    For the sake of clarification, of course content-free solvent has no biological effect. That postulate was safely tucked behind the word “If”. Is that clear enough for you?

    “Carcinosin is included in William Boericke’s Homoeopathic Materia Medica even if its use is Isopathic and in this study it was used in combination with another Homoeopathic remedy Chelidonium.”

    And how many blinded and randomised controlled trials did Boericke carry out before he included it in book? Give me a “Z”, give me an “E”, give me an “R”, give me an “O”. What have you got?

    But really, the first thing you should do in your next post is to graciously withdraw the mouse/arsenic study from the table.

    Over to you…

  159. BSM said,

    November 18, 2007 at 12:49 pm

    chris lawson, thanks for the demolition of that pig paper. It was a far more complete job than I had done.

  160. spk76 said,

    November 18, 2007 at 1:07 pm

    Budicius said: “…if the father of medicine is to be disbelieved then why make physicians take the Hippocratic oath”

    Indeed. That’s why they don’t. At least not in the UK, anyway. And thankfully so, since the Hippocratic Oath prohibits doctors from performing surgery and abortions, and demands that they educate their teachers’ children for free.

    As you rightly imply, modern medicine has the good sense to adapt and move on, whereas homeopathy is still stuck 200 years in the past.

  161. vinci said,

    November 18, 2007 at 3:15 pm

    Sorry to say that but i think you have totally missed the points. I would agree that a lot of homeopathy is nonsense. But one thing is clear: In the classical homeopathy you CANT prove a remedy by giving everybody the same medicine – because people with the same symptoms must get different remmedies. The only way one could provve parts of the theory is by giving people homeopathic remmedies that should give the some predefined symptoms (and not telling them what these should be or even that they get anything at all). I havent heard of such a study but i am also not on the edge in this topic. Just wanted to day that at least the studies you mentioned cant work with classical homeopathy for obvious reasons. OTOH I have wittnessed many cases where academic medicine has treated patients by their standards and could not help them at all. Maybe each scientific therapy can prove that it works and how it works – but this does not mean that it can really cure diseases – and if you look in the past doctors did all kind of ugly practices that medicine today denounces. But back then they stated that its them who can heal – just as you do now. if somebody has done the tests I decxribed above I would be happy if you can point me to some studies.

  162. spk76 said,

    November 18, 2007 at 3:20 pm

    vinci said: “Sorry to say that but i think you have totally missed the points. I would agree that a lot of homeopathy is nonsense. But one thing is clear: In the classical homeopathy you CANT prove a remedy by giving everybody the same medicine”

    I think you have totally missed the point. Or at least failed to read the article you are commenting on, which already addresses your concern. Here are the relevant parts again:

    “Here is a model trial for homeopathy. You take, say, 200 people, and divide them at random into two groups of 100. All of the patients visit their homeopath, they all get a homeopathic prescription at the end (because homeopaths love to prescribe pills even more than doctors) for whatever it is that the homeopath wants to prescribe, and all the patients take their prescription to the homeopathic pharmacy. Every patient can be prescribed something completely different, an “individualised” prescription – it doesn’t matter.

    Now here is the twist: one group gets the real homeopathy pills they were prescribed (whatever they were), and the patients in the other group are given fake sugar pills. Crucially, neither the patients, nor the people who meet them in the trial, know who is getting which treatment.

    This trial has been done, time and time again, with homeopathy, and when you do a trial like this, you find, overall, that the people getting the placebo sugar pills do just as well as those getting the real, posh, expensive, technical, magical homeopathy pills.”

  163. pv said,

    November 18, 2007 at 4:00 pm

    vinci said,

    November 18, 2007 at 3:15 pm

    Sorry to say that but i think you have totally missed the points. I would agree that a lot of homeopathy is nonsense.

    No. It’s all nonsense.

    And the fact that there are things we don’t know how to treat with evidence based medicine is hardly a defence of homeopathy. It merely means that it is currently outside the scope of human knowledge.
    It also seems by your comments that you haven’t a clue about how homeopathy is supposed to work. For a start, homeopathic “proving” is nothing to do with “proof” or “evidence” as understood by scientists or Western justice systems in the real world.
    And what do you mean by “scientific therapy”? Do you know what science is or do you have an independent definition?

    Here’s challenge. Give one incontrovertible example, with references, of a non-self-limiting condition being cured by homeopathic treatment. Here’s a few examples of such conditions in case you don’t know what is meant by “non-self-limiting”:
    AIDS, typhoid, emphysema, diabetes, hypothyroidism, peritonitis, septicaemia, diphtheria, smallpox, tetanus, ebola…

  164. pv said,

    November 18, 2007 at 4:03 pm

    …because people with the same symptoms must get different remmedies. The only way one could provve parts of the theory is by giving people homeopathic remmedies that should give the some predefined symptoms…

    Anyone notice the classical woo spelling?

  165. JoG said,

    November 18, 2007 at 4:59 pm

    Great article, Ben. Would be useful as a pamphlet. Like you say, evidence-based medicine is beautiful, elegant etc. and this article may convert some more people to that view.

  166. Finger waggler said,

    November 18, 2007 at 5:43 pm

    A superb bit of science writing, congratulations Ben. Chapeau.

    Now for the pessimism…

    Despite the good position in the Grauniads G2 section, it’s unlikely to result in the demise of these hopeopathy fools. Possibly because they might find the Grauniad a bit challenging, and lacking in woo-woo, so are unilkely to read it.

    Similarly, how can you get the message to the general public ? It’s the punters that occasionally dip into this nonsense that need to read this, and it wouldn’t surprise me if they were Daily Hate readers…

    I’d suggest that you e_mail the article to every one of the MPs that signed the EDM concerning NHS funding of homeopathy services. At least you might reduce the waste of our tax money on this nonsense.

  167. ben_stanley said,

    November 18, 2007 at 6:09 pm

    Great stuff sir, and worthy of all the plaudits above. I must admit when I read the Winterson ‘article’ (I use inverted commas advisedly) my first thought was ‘Just wait until Bad Science Guy gets hold of this!’ Lo and behold.

    I see I’m not the only one to have noticed that among my acquaintances there is a disturbing tendency to think that because homeopathy sounds kinda scientificy it must at least deserve the benefit of the doubt, yet usually this is accompanied by the conviction that it is some controversial branch of medicine that only differs from legitimate medicine in that it hasn’t been fully tested yet. I love that moment when you explain to someone what homeopathy actually is, and the jaw-brain connection lags for just the faintest of moments.

    And it’s always fun to see people get slapped down for talking authoritatively on something they clearly know nothing about. I will be cutting, pasting and forwarding this article to everyone I know.

  168. BSM said,

    November 18, 2007 at 7:02 pm

    “I see I’m not the only one to have noticed that among my acquaintances there is a disturbing tendency to think that because homeopathy sounds kinda scientificy it must at least deserve the benefit of the doubt,”

    It also wouldn’t be so bad if they didn’t take their fat smug Western selves of to Africa and pretend they can cure AIDS. It also wouldn’t be so bad if the clubs that they join, such as the Society of Homeopaths, actually did what their own rules tell them they should do.

    I dislike homeopathy, but I end up disliking homeopaths even more as I face their obfuscations, evasions and lies.

  169. pv said,

    November 18, 2007 at 8:32 pm

    #
    Finger waggler said,

    November 18, 2007 at 5:43 pm

    I’d suggest that you e_mail the article to every one of the MPs that signed the EDM concerning NHS funding of homeopathy services. At least you might reduce the waste of our tax money on this nonsense.

    I’m sure that’s tempting. But don’t you think it would be overrating their ability to comprehend it. MPs should be bright enough and sufficiently well informed to already know what a stinking pile of horse shit homeopathy is. It’s very troubling that so many of them are either so ignorant or so cynical that they signed the motion. These are people making serious decisions about the lives and futures of a nation – about fiscal, medical, technological and scientific issues that can affect whether people live prosperously or die in squalor and poverty. Yet here they are voting for continued State support for a bunch of quacks to deceive patients and defraud the tax payer.

  170. pv said,

    November 18, 2007 at 8:48 pm

    #
    Budicius said,

    November 18, 2007 at 4:09 am

    BSM your ill informed academic pomposity is nauseating.

    It ill behoves you, who appear to be completely taken in by a fairly transparent con trick, to accuse anyone of being ill informed. What is clear is that you regard “academic” as a derogatory word, which says very much about you.

    How about some clear and incontrovertible evidence that homeopathy works, instead of a pile of dubious anecdotes. Cases, evidence and references for the cure of non-self-limiting conditions, not “I saw something…”, or “my friend says…”, or “so and so wrote…”.

    Here’s an anecdote as convincing as any of yours, and it’s true. A school teacher I know swears homeopathy works, (1) because according to her it’s natural, (2) because there aren’t any side effects and (3) she gives homeopathic remedies to her children when they have colds or are feeling a bit under the weather. And they always say they feel better afterwards. So it must work. That’s the most rigorous testing of homeopathy yet and it’s all positive.
    Eight out of ten cats say their owners prefer it.

  171. BSM said,

    November 18, 2007 at 9:25 pm

    Did we break another homeopath? They are awfully fragile when impacted by hard facts and tough arguments.

  172. Ben Goldacre said,

    November 18, 2007 at 9:47 pm

    sorry for being quiet, i’ve been replying to a huge number of emails from homeopaths, patiently, but i basically can’t be bothered any more. i was in the middle of typing a reply to this one, which came to ben@badscience.net:

    <blockquote><strong>Re: Some dialogue from a Hx
    </strong>
    Dear Ben,

    I’m 43, married with two small children. I look after my kids half the week and work as a Homeopath the other half. I say work, I mean worked. You are ruining my life and many others like me. You are literally taking food and out of my children’s mouths. Okay, the emotional part over – you are a man of science and I would like to open a dialogue with you.

    I am a philosopher and to me, logic and reason is just one way of looking at the world. Empirical evidence is great and I think double blind trials on pharmaceutical drugs is great too. But, as you may know there is a lot of manipulation there and money plays a big part. You are right, Homeopathy either performs as well as or more poorly compared to placebo in these trials. Homeopathy does not work like drug medicine – chemistry/pharmaceuticals and you are right, it is an unfair closed argument to say that Hx is holistic and individualising and so cannot be trialled like this. It happens to be true. I would love science to find out how the remedies work – I do believe spectroscopy can see structures in water of remedies in some trials, not others. The important thing about the remedies, what makes them potent, I think is the succusion (banging) as well as the dilution. Three is no molecule, but there is something else. I call it the spirit of the thing that is potentised – science one day will be able to label it more appropriately. Science, let’s point out cannot say what electricity really is, yet we use it every day. Homeopathy is the same – it is the second largest medicine in the world and people go to it due to it’s efficacy. It’s not understood but it has bags and bags of clinical evidence. Indian Homeopathic Doctors cure serious pathology – they use X-rays for before and after. See the work of Rajan Sankaran. Same with Massimo Mangliavori in Italy. Look at the Bristol Homeopathic Hospital :

    The Bristol Homeopathic Hospital studied 23,000 patients between 1997 and 2003 and found that 70 percent reported “clinical improvement”.

    Ben, this is not placebo – we are talking permanent cures, deep pathology changed. We know about placebo and some use it when we want to make sure a patient feels benefited emotionally, but does not need another dose of medicine. Placebo is support and in my and every other decent Homeopath’s experience, the remedies work deeper, longer and over many complaints. Placebo it aint. And how does your dog or horse or cow try to please you by taking a pill? Clinical evidence proves Homeopathy works and it is not placebo. Oh yes, and how can it be dangerous if it is only placebo? Illogical!

    Which brings me back to the emotional bit. I was surprised that you look really nice in your picture – you are a Doctor – surely you have some caring qualities? Basically, for whatever reason ( books sales? journalistic career? sensationalism – making a name for yourself?) on a small point of science (Hx cannot be proved yet) you are destroying an alternative medicine that benefits so many people. You are destroying lives. I spent seven years training to be Homeopath at a great deal of sacrifice for my wife and family. You are for a small period of sensationalist journalism (the artwork in eh G2 piece was offensive and disgraceful) ruining that. Do you know the Hippocratic oath – first do no harm? Please have a good look at yourself, in your heart ( I know, sorry Frankenstein didn’t have one) and see what you feel about that, as simply put you are creating misery in my life.

    Please feel free to open up a dialogue with me Ben.

    Yours sincerely

    xxxxx

    </blockquote>

    then this arrived:

    <blockquote><strong>Re: mistake in e-mailing you
    </strong>
    My apologies Ben,

    I made a mistake e-mailing you as I now realise, having surfed the net, that you are part of a political campaign allied to The Lancet, to discredit and end Homeopathy due to the very positive World Health Organisation’s draft report into Homeopathy in 2005. This campaign of attack since then is part of the suppression of this report, which I will be obtaining and sending to the Papers. The report, if you have ever seen it, details how Homeopathy is the second leading choice of healthcare internationally and is used by 500 million people. You don’t mention that in your articles and I doubt very much due to the political nature of your campaign that you are open to any dialogue with a Homeopath!

    xxxxx

    it’s all so childish that even i, as a student of foolishness, cannot bear it.

  173. Jo said,

    November 18, 2007 at 10:26 pm

    I remember a similarly rubbish argument being offered to me by a randomly calling door to door salesman who thought I might like to attach some black box to my telephone to get cheaper calls.

    When I told him I’d be happy to consider his literature, look it up on the web and get back to him he told me that several hundred thousand people in the London area had already signed up and that my delaying might cost me cheaper calls ;-) (Also he claimed he had no such literature).

    500 million people using homeopathy is surely just 500 million people who don’t know any better. Actually I’m surprised the number isn’t higher…

  174. misterjohn said,

    November 18, 2007 at 11:24 pm

    @ Jo
    I got one of those black boxes, from Bell in fact, and it did help me save money. And I was in the London area at the time, so may have been among the several hundred thousand.
    But unlike homeopathy it wasn’t magic; it automatically dialled an access code for cheaper calls.
    I don’t use it now because I don’t live in London, and because I know an even cheaper way to make phone calls, using another access code.
    I can’t prove it’s cheaper; I know that my phone bills are a lot less than with BT.
    And at least there is scientific evidence that phoning different phone numbers can affect the bill you pay. And the data about charges is freely available from Ofcom, unlike the data about the content of Homeopathy degree courses.
    When are we going to get some solid research about the benefits of any of the many alternative “medicines” and “therapies” that plague the gullible, I wonder?

  175. pv said,

    November 18, 2007 at 11:26 pm

    Can I reply to xxxxxxxxxxx Please?

    Dear Mr xxxxxxxxx,
    Get a useful honest job.
    Yours sincerely,
    pv.

    PS. You wrote:
    <i>The Bristol Homeopathic Hospital studied 23,000 patients between 1997 and 2003 and found that 70 percent reported “clinical improvement”.</i>

    Are you suggesting a customer satisfaction survey is a serious study? Even if in your wildest dreams you could call it a study, what was wrong with the patients in the first place? And what is the patients’ competence to pronounce a “clinical” improvement? Surely we have medical doctors to assess a clinical state; or why do they study for all those years if patients can do their own clinical diagnoses?

  176. Jo said,

    November 18, 2007 at 11:43 pm

    It might have been a great black box but the guy didn’t give me anything that I could check for myself (no company details, no explanation of how it might work). He seemed to think evasiveness coupled with his argument that lots of other people had already signed up was sufficient to tempt me…

    Either way homeopathy’s still guff :-)

    I wonder if xxxxxxxxxx the homeopath can fuel his children with the sugar pills instead.

  177. pv said,

    November 18, 2007 at 11:46 pm

    Homeopathy is the second leading choice of healthcare internationally and is used by 500 million people

    I notice that too. I note he omits to mention the leading choice!

    It reminded that not so long ago geocentric was the leading choice for the model of the universe. Not only that but flat was the leading choice for the shape of the Earth (although not by scientists). Sky fairies are currently the leading choice for commissioners of beheadings, torture and mass murder (and Idiot Design theories). Actually, petitioning sky fairies is probably the third leading choice of health care which makes them more versatile than homeopathy. Obviously homeopathy is not so suitable for beheadings though it could conceivably be used for water torture and it’s effectiveness at individual killing has been proven (although it is rather slow and painful). Oh yes, and some homeopathic remedies might be useful in times of drought.

  178. jackpt said,

    November 19, 2007 at 2:29 am

    I’m surprised how few public responses to your article there have been from the ‘faces’ in the alt-med crowd. I reckon it’s because the article is so good they don’t want to draw attention to it.

    If the first email (#179) is an example of dialogue with homeopaths and contains that much self-contradiction and fallacy, I feel sorry for you having to respond to it. Must be very boring and depressing. You need a FAQ :).

  179. fiwallace said,

    November 19, 2007 at 8:05 am

    Let them explain this (from the Sydney Morning Herald):

    The NSW Coroner has found there is sufficient evidence for the Director of Public Prosecutions to consider laying charges against the parents of a baby who died after they treated her with homeopathic remedies.

    Gloria Thomas died in May 2002 in Sydney Children’s Hospital of sepsis, or bacterial infections.

    The nine-month-old, who was severely malnourished, had been suffering from such terrible eczema that much of her skin was split.

    The inquest at Glebe Coroner’s Court has been told the cracks in her skin caused the baby agonising pain and were a potential source of entry for the bacteria that killed her.

    Parents Thomas Sam, a homeopath, and IT professional Manju Samuel treated her with homeopathic remedies rather than her prescribed medication.

    State Coroner Mary Jerram terminated the inquest today after finding there was a reasonable prospect the evidence presented to the inquiry could convince a jury to convict “a known person or persons of a serious crime”.

    Ms Jerram said the evidence showed the known person or persons caused Gloria’s death and that their negligence warranted criminal punishment.

    “In my view there is a prima facie case to consider and there is a reasonable prospect that a jury would convict,” Ms Jerram said today.

    The coroner also recommended a central body be established for homeopaths in NSW with mandatory membership.

    Ms Jerram said such a system would have multiple benefits for the public.

    “I therefore recommend the NSW Department of Health consider introducing a mandatory system of registration for persons practising or wishing to practise homeopathy,” Ms Jerram said.

    The parents of the dead child were not present in court today.

  180. Finger waggler said,

    November 19, 2007 at 9:31 am

    The letter from xxxxxxxxx is quite illuminating, and it would take up too much space to try and deal with so much nonsense.

    However, what really surprises me most is the absolute faith he has that he has the right to defraud and lie to his patients with such little self reflection. This seems to be the key to differentiate between ‘quack science’ and ‘true science’. Those practicing medicine and ‘true’ science are willing to acknowledge the limitations of what they do, and keep an open mind. Those in the quack fields seem so certain that they are right, and it may be that the general public like this sort of certainty. Ben mentioned the paternalistic nature of doctors in the victorian age, yet it may be that Hx survives because of a subconscious desire for this sort of certainty.

    BTW, pv, i accept that MPs could use some more education, however, we need to try and educate the one’s we’ve got or work out how to elect clever people rather than merely populists. Ideas on a postcard please….

  181. Diotima said,

    November 19, 2007 at 10:05 am

    Could xxxxxxxxxxxxx remind us of the success of homeopathic remedies in ‘curing’ let us say, Polycythemia Vera? This is a very measurable condition, as the abnormally high red blood cell count is available in a simple blood test. If he has any information, I’m sure that the Haematology Department at UCH would like to know more.

  182. PaulD said,

    November 19, 2007 at 10:48 am

    I find these arguments above all so utterly tiresome and futile. It is obvious that people have their strongly held beliefs and others have their stongly held beliefs to the contrary. You skeptics seem to be convinced that you have the God given right(except God cannot exist because there’s no randomised control trial to prove It does) to be the moral champions of so called reason, whilst on the other hand all manner of health practioners caught on the intellectual hop are sent scurrying to try to defend what they feel to be true. You argue your respective philosophical high grounds and no-one convinces anyone who holds the opposite opinion of anything.
    And I say ‘opinion’ with venom. I am so sick of hearing opinion masquerading as scientific fact and sick of hearing scientific fact being used to support opinion. Homeopathy causes so much damage doaes it? Where’s the evidence? And by evidence I don’t mean the odd article that cherry picks some bad event with a hint of homeopathic bad practice in it – that is not a study, that is ANECDOTAL EVIDENCE. Homeopaths are apparently not allowed to put up anecdotal evidence as evidence of anything at all and yet skeptics pick on anecdotal evidence all the time to ‘prove’ the damage it is doing and therefore call for the end of it. If that is the case, lets use the same practice on conventional medicine, lets look at the anecdotal evidence of how much damage medicine causes. There’s so much damage being caused I wouldn’t know where to start. It’s well known that 10% of people that go into hospital come out with an ailment that they din’t go in with (so lets ban medicine?), it’s well known that high profile cases of clinical negligence hit the newspaper headlines on an alarmingly regular basis (ban medicine?), it’s well known that a ridiculous amount of apperently well trialled drugs are subsequently removed from use because of negative effects that weren’t found until they were put into widespread use (ban medicine?) and how risiculous is it simply to see the long lists of contraindications and side effects listed on all medicines which imply that they cause harm yet we are prepared to let some people suffer those harmful effects because it does the majority some good??!!!(ban medicine). And note, I say here ‘it’s well known’ with intention. I say it because I don’t have the evidence at my fingertips but all these things are true. I’m claiming them to be true and inviting people to do the studies to prove it (I don’t have the resources). But if we really want to do a systematic study of the harm homeopathy does then lets be fair and do the same to conventional medicine. If there is harm in homeopathy and it must therefore be banned then lets do the same with conventional medicine. Or better still, lets ban the one that causes the most harm. Do the studies and work it out. In the mean time, because the studies have not been done, DO NOT criticise homeopathy for being based on anecdotal evidence and then use the argument of anecdotal evidence to claim anything about it. This is bad science.
    And finally, the reason I am so angry about this is because I had asthma for 30 years. I was on the usual ventolin and becotide and it was steadily getting worse – the evidence suggests this is a typical pattern. One day I forgot my inhaler and ended up in accident and emergency at 2am tring to get my hands on one. They whisked me in and put me on a nebuliser ahead of the queue, because obviously asthma is a high priority in A&E. That’s when I realised I have got to do something about this. I went to my doctor and the advice (in fact insistence) was that I up the dose and realise that I must take the becotide daily for life. I didn’t accept that and went elsewhere, eventually I came to homeopathy. It took some time but I am now free from asthma. No drugs, no problem. What really annoys me is that if I were to listen to you skeptics and upholders of the ‘science is right’ religion, I would still be on inhalers and I can tell you that they make you feel awful. Don’t get me wrong, medicines have their place, I was happy to use the inhalers because they meant I could breathe but the side effects are shite and I simply didn’t want to be reliant on drugs for the rest of my life. And note I am not saying the drugs had a bad effect so lets ban them – that’s the sort of argument a skeptic would use, so I wouldn’t do that. I’m saying if you can be healthy why choose drugs?
    If you have your way, because of your high fullootin’ arguments, many more people will be required to toe the line and stay on those drugs for life. Many more will have to suffer the asthma because you successfully argued away an alternative for them. For this reason I think that these arguments are dangerous. I don’t care if you think I am deluded and homeopaths are deluded and it makes no sense, If I am deluded I am deluded and free from asthma and if I followed your way I would be deluded and on a lifetime of drugs. You are so concerned to be ‘right’ and to win some academic argument and people are going to suffer for that and you don’t care – let them suffer apparently. Well done, well argued, how clever. Sorry about you asthma sufferers.

  183. Diotima said,

    November 19, 2007 at 11:22 am

    PaulD. You are so angry I think that you should try a good swig of Bach’s rescue remedy, right now. I also have asthma and believe it or not the inhalers have done me a lot of good without side-effects and I have not suffered a serious attack for a very long time.

  184. Finger waggler said,

    November 19, 2007 at 11:37 am

    Add irony as required…

    It’s clear that PaulD is right and Diotima is wrong. Becuase PaulD says so. And i REALLY believe PaulD, as he shows such a good grasp of anecdotal versus statistically robust data. Also, PaulD is so fulsome in his argument, it simply must be true. Even if it isn’t.

  185. katem said,

    November 19, 2007 at 11:45 am

    Ben’s article is magnificent!

  186. PaulD said,

    November 19, 2007 at 11:46 am

    And your point?

    Are you saying choosing drugs is better than health? Or is it that your anecdotal evidence proves something? If so you have missed the point as so many others seem to. The point is: do not use anecdotal evidence to prove anything. My argument above is saying that I am angry because the studies have not been done and yet so many are jumping to conclusions, or as you said ‘your belief’ is such and such. Fine, have your belief, I have mine. I am aware that I am free from asthma. You apparently are prepared to put up with it. And more apparently you are prepared to live with it rather than try something that you somehow believe is non-effective. I can’t convince you it’s effective because you have your belief and that’s it, but I don’t have asthma. I know that. If you are a scientist, I don’t know if you are or not, you would have an open mind. I suspect there is no way I could convince you that it works and therefore because I think it worked for me you must think I am deluded. OK believe I am deluded if you wish. I am free from asthma.
    Now what I’m saying is believe what you want but don’t deprive others just because of your beliefs. If I listened to that argument I would still be on the inhalers and that is not acceptable.
    And by the way, I didn’t get attacks as such, I would have episodes of up to 6 weeks with possible relief for a few days in between. I don’t measure my freedom by ‘no attacks lately’, I measure it from no constant state of asthma. My inhalers went out of date years ago and I never replaced them. After more than 30 years of asthma and a clinical evidence supported prognosis that I will be on them for life, being free from asthma co-incided with homeopathic treatment. Go figure

  187. PaulD said,

    November 19, 2007 at 11:47 am

    that last comment referred to Diotima’s by the way

  188. Fralen said,

    November 19, 2007 at 11:55 am

    PaulD’s fury is as interesting as his misunderstanding of evidence. He is angry that anecdotal evidence is being used to damn homeopaths: but different claims require different kinds of substantiation.

    If you claim your pill is better than placebo, then you need a literature showing positive randomised controlled trials.

    If on the other hand your claim is that homeopaths are frequently irresponsible, or undermine the public understanding of science, then you need examples of that.

    Only a “moron” would demand randomised controlled trial evidence of poor regulation and ethical issues. This angry misunderstanding betrays an almost terrifying lack of basic nous and understanding.

  189. PaulD said,

    November 19, 2007 at 11:58 am

    Sorry Fingler but which bit is not true? Are you saying it’s not true and I actually do have asthma? I’m afraid that’s not the case. Or maybe you are suggesting that I am saying homeopathy is ‘true’. Look again, I never said that. I said I’m sick of anecdotal evidence masquerading as scientific fact. I’m saying use all the statistics and studies you want to try to support your belief, everyone else is doing the same and no-one is convincing the alternative views of anything different. However, your bias, if it is allowed to hold sway will cost people like me to suffer. If I had listened to you I would have to suffer long term asthma because you apparently want to make some argument about rationality. Nice argument, quaint belief, but I’m not going to suffer for it and I don’t see why others should either.

  190. Finger waggler said,

    November 19, 2007 at 12:01 pm

    PaulD, can i give you a tip about your arguments ?

    You state that we should not be swayed by anecdotal evidence, but then the majority of your screed is devoted to just that. Can you see the problem ?

    The trials have been done, Hx does not work (or at least is extremely unlikely to work), but it appears that you don’t want to believe it. That’s fine, but fortunately it’s not a view most people share.

  191. Dr T. fortunei said,

    November 19, 2007 at 12:01 pm

    Does anyone remember way back when stomach ulcers were serious and chronic conditions for many people? And loads of time and money were spent research the condition adn drugs to treat them?
    remember Zantac and all those other drugs?
    here’s a quote from Wikipedia:
    “Evidence has been accumulating to suggest that duodenal ulcers are also associated with H. pylori infection.[9][10] In 2005, Warren and Marshall were awarded the Nobel Prize in Medicine for their work on H. pylori.[11]”

    When Barry marshall first suggested that H. pylori caused peptic and duodenal ulcers he was literally laughed at by the medical community. But they didn’t go the AltMed route, they GOT THE EVIDENCE. (oh and the Nobel Prize…)
    PaulD, I hear your anger. Ihear that homeopathy worked for you. But I also hear that you don;t care WHY – and nor do you have to. But I am a taxpayer shelling out good money for a therapy entirely without evidence of efficacy. I have a right to know that my money is being spent wisely. If homeopathy is no better, no more effective than a placebo and is based on the ‘talk’ element, then why should my money not be spent on Cognitive Behavioural Therapy, which is increasingly evidence based and bloody hard to get on the NHS? A lot of people here have a lot of beliefs, but all of us on whatever “side” if that’s how you perceive it, should be keen to see the EVIDENCE.

  192. PaulD said,

    November 19, 2007 at 12:35 pm

    welcome to the argumentDr Fortunei and well spotted that to a large extent I don’t care why whatever happened to get me free from asthma, I just care that it did. But on the taxpayer argument, hey, me too, I pay taxes and do they pay for clinically unproven practices in the health service? Yes they do.
    I worked in Public Health medicine for 4 years in Wales and was privvy to all the journals that I have lost touch with and was part of the then new commissioning process which required us to make hard decisions about priorities. Scan the journals and you will see how many studies are being done on practices that are ingrained in the health system. the studies are being done AFTER the practices are in place. First they employ practices then they study them.
    I was working in Public Health when NICE was set up and why did they set up NICE? because they decided the evidence wasn’t there to support the new decision making proces (commisioning) whereby decisions had to be made on what would be funded and what would not in the NHS. Note THE EVIDENCE WAS NOT THERE. And I remember at least one study into coronory bypass operations that showed to a high statistical significance that the evidence was that those on the waiting list had a longer life expectancy than those that had the operation. Conclusion – put everyone on the waiting lists and stop the operations. Well, no that was not really the conclusion but the evidence was quite clear – coronary heart operations are massively expensive and are not actually justified on the basis of clinical evidence. But would we de-commission them – no.
    And then there are all the practices like health promotion that NICE have not yet got round to examining the evidence for, should we perhaps stop them until we get the evidence together?
    Evidence based medicine is a minefield when you really look into it.
    And generally throughout history, practices get put into place or phenomena are recognised and then science gets round to trying to explain them, not the other way round. Gravity was doing it’s stuff well before science got round to explaining it and I’m sure you wouldn’t have wanted us to ban gravity because there was no evidence for it? Or maybe you would, I don’t know. OK I’ll stop the sarcasm, the point is: what is existing today that is real but is as yet unexplained? Loads. there’s an interesting book out which I am reading and can’t remember the title of on what the greatest scientific thinkers of today believe to be the case but that science has not proved yet. If scientists can do it, no reason why others can’t – we can put forward what we think is real that science has not yet proved. For me (obviously) I believe homeoapthy worked for me and I believe science has not found out why yet. I’m not going to summise why it works I’m going to challenge science to find out why, not to turn away when so much can be gained.

  193. PaulD said,

    November 19, 2007 at 1:02 pm

    There you go again Fingler -“That’s fine, but fortunately it’s not a view most people share”. Where’s the evdience for this belief that most people think like you do? Do I see the point? Do You see the point?! Where the heck is your evidence that most people believe that?
    The World Health Organisation has pointed out that 5 million people use homeopahty worldwide and that is only those that use it not those that believe in it. But admittedly that is only from one study referenced by the world authority on health, maybe you have better evidence of how many believe what you believe?

    By the way – annoyed as I am, I’m quite enjoying todays debate. Nice to know there are people out there that care.I consider myself a rationalist, swayed by good science and I read the New Scientist as magazine of choice. And my original comments still stand.

  194. Budicius said,

    November 19, 2007 at 1:29 pm

    Well done Paul D. Come on Homoeopaths I need some moral support here.
    BSM you’re like an annoying mosquito that won’t go away. So you picked apart one study on mice, what about the other two good studies I mentioned in my first two posts- evasionist.

    This one should stir the pot a bit- Dana Ullman’s new book I think it’s called ‘The Homeopathic revolution, why famous people and cultural heros choose Homeopathy’. In it Ullman makes mention that Charles Darwin probably would not have written ‘The Origin of Species’ if it were not for the Homoeopathic treatment he sought for a stomach condition. Apparently Darwin wrote in his letters about consulting Homoeopaths. Whether he was a fan or not is not the point, he was successfully treated and I’m sure a great man like himself wouldn’t fall for the placebo efect given his familiarity with Homoeopathy.

    Why hasn’t there been any mention of this one- ‘Bizarre chemical discovery gives Homoeopathic hint’.Found at space.newscientist.com This Korean study shows how when solvents are diluted,molecules do not separate but come togethe as clusters and then larger aggregates. Pick this one apart BSM.

    Apparently some Indian Homoeopaths approached NASA officials with a proposal to take Homoeopathic remedy kits into outer space, for the life of me I can’t find the article online please help. So here we have Homoeopathy going physically to infinity and beyond in space travel which sort of makes sense given the expiry dates for homoeopathics are pretty much unknown and probably almost indefinite when stored in climate controlled environments.

    There is a Mathematical example of how Homoeopathic remedies may work on this here website. I know how much Dr Aust loves this article, the mathematics is above my head and the heads of some mathematicians but hey it’s a start.

    Someone said Homoeopaths don’t believe in germ theory of disease development yet the materia medicas have such remedies as Tuberculinum, Syphylinum, Medorrhinum etc.

    Almost everyday I hear trumpeted in the news ‘a new breakthrough in cancer research’ but no cure. Homoeopaths in some countries can’t legally claim to cure anything even if they know they can, the Homoeopathic literature supports this. For example in Dr J Compton Burnett’s little book ‘Curability of Tumours’ written in the 1890’s, that’s right way back then he was doing magnificent cures of Tumours. Even though the evidence is anectdotal don’t bullshit to me that it has no validity or relevance. Dr Burnett was a man of great character and repute and I’m sure would’nt falsify his results. Unless his book is to small for your academic minds to grasp study the history of how medicine came about mainly through observation, anectdotal evidence trial and error.

    Instead of beating around the bush with research and conjecture take it to the Government and have a plebiscite on the matter, I’m sure I know which way a well informed sympathetic public would vote.

    Ben, this article would have to be up there with one of the biggest piles of poorly researched misinformed pieces of rubbish I have ever read on Homoeopathy and you are the proud rooster that climbs upon it to crow. Shame shame shame.
    You have won nothing but disrespect from honourable God fearing members of the scientific community.

  195. muscleman said,

    November 19, 2007 at 1:32 pm

    Budicious the paper you cited:
    eCAM, doi:10.1093/ecam/nem067

    Is basically a pile of poo. For a start their numbers are far too low which means their stats are meaningless. I do not believe the error bars on their graphs, they are far, far too short. There is no mention in the paper about blinding the data. Did those who did the analysis know which samples they were working on? if they were blinded was it single or double?

    As it happens I have worked on carcinogenesis in mice, bowel cancer in fact and reviewed many papers in the literature and this one is very, poor. Which of course is why it is in CAM and not a proper peer reviewed scientific journal. If it had been submitted there the referees would have made exactly the same criticisms I have.

    If I had been sent this paper to referee I would insist that they increase the numbers in each group and do it all properly blinded with the unbliding happenning only after ALL the data have been collected. And I would wish to know what those error bars are (+/- 1SD? standard error of the mean? or what).

    And I admire their honesty about breaking the vial of 200C, but that is no way to do science. Start again and do it properly. Otherwise it is not worth doing.

  196. Scooby said,

    November 19, 2007 at 1:44 pm

    PaulD wrote:

    “And generally throughout history, practices get put into place or phenomena are recognised and then science gets round to trying to explain them, not the other way round.”

    And in the 197 years since Hannemann published The Oregan of the Healing Art nothing approaching science has been proposed that actually explains how homeopathy works as it’s adherents claim. Quite the opposite applies, as the development of scientific understanding has made it clear how
    unlikely there is to be anything to it. The best homeopaths seem to be able to do is to invoke Quantum theory (though they don’t understand it) or propose something vague about water memory.

    If properly designed randomised trials of homeopathy achieved significent results over placebo in 1 in 20 trials there still would be no proof there was anything in it – for a 95% confidence that would be expected – I’ve seen no evidence that they can even be this good.

    If homoeopathy is as good as it’s proponents believe why is it so difficult to show anything in a rigorously designed experiment?

    As for 5 million people using homoeopathy, I’m not sure that it can be claimed they believe in it – I used to take Gelsenium for colds and Arnica for bruising. Not because I believed in homoeopathy, but because people I trusted had recommended them, if I’d give any thought to it I would have assumed they were some form of pharmaceutical From the classical homoeopath view these won’t have done anything, as they were not tailored to me, from a rational perspective they didn’t contain anything so could have no effect.

    I also have questions about homoepathic quality control – if succession and dilution are so important, should these not be subject to a formal independent audit process? If this does happen, I’d be grateful for some info on the approach,

  197. superburger said,

    November 19, 2007 at 1:45 pm

    (posted elsewhere btw)

    Hey paulD/budicious,

    It seems that you agree with the notion that the claims of homeopathy can be tested by scientific methods.

    If that’s true, can you describe, roughly, an experiment that *would* convince you that the effects of homeopathy are a placebo response?

    if homeopathy’s claims are true, then there must exist such an experiment and a result – in the same way one can conceive an experiment to test whether or not carbon dioxide is needed for green-plant respiration?

  198. Scooby said,

    November 19, 2007 at 1:55 pm

    Budicius

    “Apparently Darwin wrote in his letters about consulting Homoeopaths. Whether he was a fan or not is not the point, he was successfully treated and I’m sure a great man like himself wouldn’t fall for the placebo efect given his familiarity with Homoeopathy.”

    Darwin, C. R. to Darwin, S. E., [19 Mar 1849]

    “I grieve to say that Dr Gully gives me homoœopathic medicines three times a day, which I take obediently without an atom of faith”

    www.darwinproject.ac.uk/darwinletters/calendar/entry-1234.html

    (With thanks to the Little Black Duck)

  199. Bogusman said,

    November 19, 2007 at 1:58 pm

    PaulD,

    Although I profoundly disagree with your basic premise, you are raising some very important points about the difficulty of applying evidence-based practice in an environment where politics is a significant driver.

    And you are also correct that “conventional” medicine and health administration have a distinctly mixed record in many areas. The scientific process however is fundamentally self-correcting as evidence can be replicated – or not – and other workers can repeat experiments. If the accepted theory is found wanting it can be modified. This happens literally all of the time. The big problem through comes when public policy is involved. Political thought, unlike scientific thought is not so open to testing and revision. And when politicians are in charge it can become very inexpedient to change accepted practice – especially if there are votes in it. I think that this is a huge issue and as far as I know there has never been a political system in the history of the world that has really got to grips with this.

    Thing is though – agreeing that there are problems with the established system doesn’t automatically mean that any given alternative is better. Especially when the alternative is completely unsupported by evidence.

  200. muscleman said,

    November 19, 2007 at 2:08 pm

    Oh and we are not told what sex the mice were, how mice for each group were selected. How their weight changed during the experiment. Data analysed by weight. They also have no readout of how effective their oral carcinogens are other than how much cancer they cause and that is one of their data points, doh! And why didn’t the mice who did not get the 200C get pure water instead?

    To expand on why I do not believe their variance. The study I did used Min1 mice, which carry the same mutation in the Apc gene which causes familial bowel cancer in humans. Some of them also carried an inducible transgene. But the cancer bit was endemic. We also did both males and females. The rate of cancer (count and measure of polyp size) was not different between groups due to great variance in the data, it was extremely noisy.

    Oh and we had an independent way of measuring transgene induction and I was blinded. So I fail to see how oral administration of a carcinogen can be less noisy than genetic determinism.

  201. PaulD said,

    November 19, 2007 at 2:12 pm

    I agree with Muscleman. No way to do science. Start again and do it properly. Otherwise it is not worth doing. Apply that to all disciplines and I think we have the basis of real dialogue.

    But now I’m getting drawn into the debate that I said I was not interested in – how or why it works.

    I’m going to have to leave this debate for today as I have to go soon but I want to put a last bit in. It is clear as I said in my first piece that we will bandy papers about, tear down each other’s ‘evidence’ and shout our claims from the moral highground till we’re blue in the face. Nobody will budge. Well let me be the first to offer to budge. I am going to sit back here (be back tomorrow actually) and let you convince me that homeopathy doesn’t work. I will honestly and genuinely consider the evidence on its merits and am prepared to be swayed. Only thing is, I want sound scientific proof that homeopathy does not work – because I am a rationalist.
    So if you have any evidence I must warn you there are certain categories that are not going to be considered:
    Category 1 is the Anecdotal Evidence approach – anything that essentially says we believe it doesn’t work because we believe it doesn’t. Included here would be erroneous opinionated conclusions drawn from scientific evidence
    Category 2 is the No Evidence of Effectiveness approach. Obviously no evidence of effectiveness is not evidence of non-effectiveness – so no studies which have demonstrated ‘no evidence of effectiveness’ please as they don’t go anywhere towards proving non-effectiveness
    Category 3 is the Off the Topic approach. Kee[p to the topic of proof that it doesn’t work – not studies that show people believe certain things about homoepathy or studies looking at the history of science and no need even to go as far as to show WHY it apparently does not work. Stick to the point and keep it simple please, i.e. proof that it doesn’t work.

    So there you go. Show me the scientific studies that have shown that homeopathy does not work and I’ll consider it.

    Fralen above urged us to substantiate our claims. This is my agreement with that – substantiate your claims that homeopathy doesn’t work with good sound scientific proof that it doesn’t and I am listening.

    I look forward to tomorrow

  202. Fralen said,

    November 19, 2007 at 2:16 pm

    you are very keen to tell us what kinds of evidence are not acceptable to you.

    PaulD, what kind of evidence would convince you that homeopathy works no better than placebo?

    (obviously we’ve established that you are incapable of engaging in a discussion about whether on balance a large meta-analysis can exclude type II error.)

  203. thekumquat said,

    November 19, 2007 at 2:18 pm

    Scooby said “I used to take…Arnica for bruising. Not because I believed in homoeopathy, but because people I trusted had recommended them, if I’d give any thought to it I would have assumed they were some form of pharmaceutical”

    I recently looked at the homeopathic remedies on sale in my local chemist to see what was on the ingredients lists.

    I was surprised to see that the Arnica one contained ‘10% Arnica’, unlike all the others which were water (plus whatever at 3-100C dilution…)

    Most of the otherwise-intelligent people I encounter who say “homeopathy worked for me” have used arnica, and only later tried others on the grounds that that worked.

    Coincidence?

  204. Bogusman said,

    November 19, 2007 at 2:21 pm

    I’m just a humble Physics BSc working in the IT industry, so some of you biology/medicine/philosophy types will have to help me out on PaulD’s point 2.

    How do you prove non-effectiveness except by setting up trial where the proposed intervention is measured against something else – active or placebo or doing nothing at all? If the intervention under test performs worse than doing nothing at all, isn’t its ineffectiveness demonstrated? And if you do it enough times with the same result can’t it be considered proven?

  205. Scooby said,

    November 19, 2007 at 2:22 pm

    Thanks – I’m now confused.

    From the ever reliable source of Wikipedia:

    “In herbal medicine, Arnica usually refers to Arnica montana, a mountain plant used for relief of bruises, stiffness, and muscle soreness. Arnica is widely used as a salve for bruises and sprains [1], and sometimes as a tincture [2], for the same anti-inflammatory, pain-relieving purposes. Tablets are also available. In homeopathy it has a wider use.[1] ”

    Is it used in homeopathy for the same uses as the herbal form? Anyone know?

  206. Fralen said,

    November 19, 2007 at 2:25 pm

    Bogusman: it’s called Type II Error (missing a genuine effect due to small sample size).

    You exclude it by

    (a) a power calculation before doing your trial, you calculate what effect size is claimed, and do the maths on how many subjects you’d need to prove it didnt happen, beforehand. Eg if homeopaths claim that homeopathy *always* works, then ten subjects where it doesnt work, out of 20, is enough to prove that claim wrong

    (b) Examining the totality of the evidence and coming to what Bradford Hill called “a verdict”. Eg, all the negative meta-analyses, the fact that the more methodologically sound a trial is the more likely it is to give homeopathy a placebo only result, combined with the implausibility, all adds up etc

  207. Fralen said,

    November 19, 2007 at 2:27 pm

    Amusingly (a) is hampered by homeopaths doing their own trials.

    They’re such idiots they don’t do power calculations beforehand.

    It’s almost…. as if… they’re only doing research for show, rather than to get the true answer….

  208. emmer said,

    November 19, 2007 at 2:31 pm

    I thought xxxxxxxxxxx’s email summed up beautifully why homeopaths will find it very difficult to engage with a debate about the validity of their practice. Not the ‘why it works’ bit, or the ‘here’s the evidence’ bit, but the investment in training – seven years in xxxxxxxxxx’s case – and the loss of a professional identity as a societally respected healer. If xxxxxxx took the evidence on board and retrained in a different profession it would be very difficult for him not to feel ashamed of the years spent dispensing sham remedies, with all the knowledge he has accrued, and the satisfaction he has gained from perceiving that his patients have benefitted suddenly worthless.

    PaulD, I’m asthamatic too. I am very grateful to modern medicine for my inhalers, but though I am skeptical of homeopathy I do think my doctors could have been more proactive about giving holistic advice about how to manage the condition. It’s never been suggested to me for example that I hoover regularly, eat sensibly, manage my stress levels or try specific breathing techniques, but I’ve found this all helps. Do be aware that severety of asthma symptoms can cycle over several years – if I were you I’d keep a ventolin inhaler hanging around just in case.

  209. wewillfixit said,

    November 19, 2007 at 2:43 pm

    I haven’t had an asthma attack or needed to use any inhalers for a long time either. This coincided with me dying my hair. Therefore it is obvious that dying ones hair cures asthma…

  210. TheBigCheese said,

    November 19, 2007 at 2:48 pm

    “Budicius said: Apparently Darwin wrote in his letters about consulting Homoeopaths. Whether he was a fan or not is not the point, he was successfully treated and I’m sure a great man like himself wouldn’t fall for the placebo efect given his familiarity with Homoeopathy.”

    I think you’ve managed to demonstrate a fundamental misunderstanding of the placebo effect here. People don’t ‘fall’ for the placebo effect in the way they would fall for say a card trick. In order for the placebo effect to work, a person has to believe that they are taking an effective treatment, therefore if Darwin took homeopathic remedies a genuinely believed it to be nonsense (as indicated above) then any improvement could not be attributed to placebo. However, typically for a homeopath, you have failed to provide any evidence that the treatments were in any way effective.

    Am I the only one who thinks that 5 million people in the world (less than 0.1% of the population) using homeopathy is a satisfyingly small amount? I haven’t read the WHO report but if homeopathy is as well respected around the world as its supporters claim then this seems to be very low indeed. The homeopaths are very keen on citing India as a country that has accepted homeopathy as a central part of its medical system but if these reported 5 million patients were all in India it would only be around 0.5% of its population – not exactly wide acceptance.

    The homeopaths like to talk as if there is a scientific conspiracy against them led by doctors and pharmaceutical companies. However, in my experience, doctors and even pharma companies are merely interested in treatments that work and can be consistantly demonstrated to work. As Ben’s article elegantly deomnstrates, if homeopathy is tested under proper scintific conditions then it cannot be shown to be any better than placebo. If it was a pharmaceutical it would fail in clinical trials and – importantly – be recorded as a failure.

  211. TheBigCheese said,

    November 19, 2007 at 3:07 pm

    PaulD:

    A guy I used to play football with had asthma for a long time but over the course of a few months a few years ago his symptoms began to lessen until he was, effectively, free the condition. His only change in lifestyle? He took started drinking and going to the pub. Did the smokey atmosphere and Guiness sort him out? No.

    The human body and the way it deals with the diseases and conditions that it experiences are vastly complex and will most likely never be fully understood. You say that you “went elsewhere and eventually came to homeopathy” what were the other things you tried? Could your recovery infact be due to some changes in habit and lifestyle? That’s not to say that homeopathy didn’t ‘cure’ you (I have no way of proving it did or didn’t just like you) but surely you have to accept the posiblity that the homeopathy had nothing to do with it.

  212. Neil Desperandum said,

    November 19, 2007 at 3:31 pm

    PaulD said

    So there you go. Show me the scientific studies that have shown that homeopathy does not work and I’ll consider it.

    um… they’re in Ben’s article. Consider these.

    1 Kleijnen J, Knipschild P, ter Riet G. Clinical trials of homoeopathy. BMJ 1991;
    302: 316–23.

    2 Boissel JP, Cucherat M, Haugh M, Gauthier E. Critical literature review on the
    effectiveness of homoeopathy: overview of data from homoeopathic
    medicine trials. Brussels, Belgium: Homoeopathic Medicine Research Group.
    Report to the European Commission. 1996: 195–210.

    3 Linde K, Melchart D. Randomized controlled trials of individualized
    homeopathy: a state-of-the-art review. J Alter Complement Med 1998;
    4: 371–88.

    4 Cucherat M, Haugh MC, Gooch M, Boissel JP. Evidence of clinical efficacy of
    homeopathy: a meta-analysis of clinical trials. Eur J Clin Pharmacol 2000;
    56: 27–33.

    5 Shang A, Huwiler-Müntener K, Nartey L, et al. Are the clinical effects of
    homoeopathy placebo effects? Comparative study of placebo-controlled
    trials of homoeopathy and allopathy. Lancet 2005; 366: 726–32.

  213. muscleman said,

    November 19, 2007 at 3:44 pm

    Well said BigCheese. My asthma got better because I moved to Scotland from London (I am allergic to London levels of air pollution) and by running. I find the deep breathing strenuous exercise induces helps to clear my lungs. If I have not run for a few weeks, after my first couple of runs I will cough for several hours. This did not work in London because the air stimulus was too strong. On holiday up here I found I could run up mountains without using my inhaler.

    As a result of these changes I have not puffed an inhaler in months, in fact my inhaler is out of date and I am not particularly bothered by that. If your asthma is not exercise induced then exercise can be positively beneficial. In addition having a better social life can reduce your stress levels. So pub going can help asthma in that way.

  214. AlexC said,

    November 19, 2007 at 3:52 pm

    @Budicius (201)
    I’m not sure what you were pointing at when you said

    “There is a Mathematical example of how Homoeopathic remedies may work on this here website.” [the new scientist website?],

    but please, please tell me it wasn’t Lisi’s proposed unification of GR with the standard model as a connection on a principal bundle over E8 (www.arxiv.org/abs/0711.0770)…

    p.s. great article Ben.

  215. DrJon said,

    November 19, 2007 at 3:53 pm

    Re 201

    “you’re like an annoying mosquito that won’t go away”

    This reminds me of Socrates being the gadfly of the Athenians – high praise indeed! May the mosquito of science keep on stinging people out of their ignorance.

  216. igb said,

    November 19, 2007 at 4:06 pm

    “ Apparently Darwin wrote in his letters about consulting Homoeopaths. Whether he was a fan or not is not the point, he was successfully treated and I’m sure a great man like himself wouldn’t fall for the placebo efect given his familiarity with Homoeopathy.”

    Great man believes in nonsense? Newton believed in numerology, hence the somewhat dubious distinction between indigo and violet to bump the number of colours in the spectrum up to the critical seven. I don’t have to take gravity and numerology as a package deal. Shockley spent more than half his life trying to show that black people were inherently stupid, but that doesn’t mean I need to replace all the transistors in my radio.

    Great men also fail to see things are not nonsense. Einstein and QM, Hoyle and Big Bang. That doesn’t invalidate QM or Big Bang, both of which have ample evidence.

    And most unsavourily, unsavoury people advocate what some people see as good ideas. Hitler advocated vegetarianism: that doesn’t mean that failure to eat meat turns you into a genocidal dictator.

  217. BSM said,

    November 19, 2007 at 4:46 pm

    muscleman said;

    “Is basically a pile of poo. For a start their numbers are far too low which means their stats are meaningless. I do not believe the error bars on their graphs, they are far, far too short. There is no mention in the paper about blinding the data. Did those who did the analysis know which samples they were working on? if they were blinded was it single or double?”

    Budicius,

    I have just wasted another 15mins of my life reading a crappy sCAM paper only to find that if I’d read a little further down this page I’d have found that muscleman had done the job already.

    As muscleman has said, their numbers are just too low to report any conclusion on carcinogenesis. n=6!!

    Their error bars on the data that are continuous variables are literally unbelievable. Since you claim to be able to understand scientific papers I assume you know what s.e.m. means. With n=6, s.e.m. is calculated by dividing the group variance by 2.45. With biological data those tiny error bars are literally impossible. Something very funny is going on. Bear in mind that at d120, 3 of their verum group had neoplastic livers and 3 did not, yet the s.e.m. reported for the various parameters are often

  218. raygirvan said,

    November 19, 2007 at 4:55 pm

    Apparently Darwin wrote in his letters about consulting Homoeopaths. Whether he was a fan or not is not the point, he was successfully treated and I’m sure a great man like himself wouldn’t fall for the placebo efect given his familiarity with Homoeopathy

    The Quackometer has covered this one already, filed under “standard quack tactic of false historical celebrity endrosement”: Charles Darwin and Homeopathy. From Darwin’s letters, it’s perfectly clear that he went to give Gully’s water cure a try, but didn’t buy into the homeopathy.

  219. thekumquat said,

    November 19, 2007 at 4:59 pm

    re arnica, Scoobt asked: Is it used in homeopathy for the same uses as the herbal form? Anyone know?

    No idea, but this stuff was being sold along with all the other names in a little bottle as part of a homeopathic ‘medicines’ plastic display.

    Do you think I could buy it and complain to Trading Standards that this homeopathic remedy contains too much arnica and thus isn’t a ‘real’ homeopathic remedy?

  220. le canard noir said,

    November 19, 2007 at 5:01 pm

    Darwin did not believe in homeopathy. In fact, he openly ridiculed it.

    I hope I have done a thorough debunking of this silly myth here:

    quackometer.net/blog/2007/08/charles-darwin-and-homeopathy.html

  221. walden said,

    November 19, 2007 at 5:02 pm

    @PaulD

    well thank you for giving people the chance to prove homeopathy doesn’t work. BUT… surely homeopaths should have to prove it IS effective, rather than the other way around? Is that not rational?

  222. BSM said,

    November 19, 2007 at 5:03 pm

    “It is clear as I said in my first piece that we will bandy papers about, tear down each other’s ‘evidence’ and shout our claims from the moral highground till we’re blue in the face. Nobody will budge. Well let me be the first to offer to budge. I am going to sit back here (be back tomorrow actually) and let you convince me that homeopathy doesn’t work. I will honestly and genuinely consider the evidence on its merits and am prepared to be swayed. Only thing is, I want sound scientific proof that homeopathy does not work – because I am a rationalist.”

    You have that sound evidence, PaulD, it’s in the meta-analyses. Homeopathy doesn’t work. Be grateful that you are no longer asthmatic but it was not the homeopathy. You are either the fortunate beneficiary of an eventual spontaneous amelioration or there are other factors at play, such as lifestyle changes, which you have chosen not to share with us.

    In your opening criticism of conventional medicine the one thing have have utterly failed to acknowledge is that there needs to be a risk-benefit analysis of all medical treatment. Real medicine has benefits and it has risks. The doctor’s job is to optimise that ratio.

    Homeopathy has zero benefit from its little sugar pills. So, the opponents of homeopathy only require to show a few cases of harm caused through the use of homeopathy for the for the risk:benefit ratio to be infinite.

    We choose to be generous to homeopaths and allow that they might create some genuine benefit as counsellors. This puts something into the good side of the balance.

    However, homeopaths tell themselves and insist to the world at large that they can cure HIV/AIDS and prevent malaria. This keeps the risk:benefit ratio firmly tending to infinity. That is why they are dangerous in their delusions.

  223. BSM said,

    November 19, 2007 at 5:04 pm

    BOLLOCKs! Lost the last line of post 223

    It should have said

    Bear in mind that at d120, 3 of their verum group had neoplastic livers and 3 did not, yet the s.e.m. reported for the various parameters are often

  224. used to be jdc said,

    November 19, 2007 at 5:08 pm

    Re www.badscience.net/2007/11/a-kind-of-magic/#comment-18336

    “This Korean study shows how when solvents are diluted,molecules do not separate but come togethe as clusters and then larger aggregates. Pick this one apart BSM.”

    Well, I’m not BSM and I’m not smart enough to pick anything apart – but I do have a question (and I do like to stick my nose into other people’s arguments).

    How does the theory of molecules clustering in water make homeopathy plausible?
    If the molecules of the active substance did cluster together in water, wouldn’t that mean that only, say, 1 in 10^23 remedies would contain any active ingredient and the other remedies would contain no molecules at all. Wouldn’t that make homeopathy the world’s worst lottery? I’m probably completely wrong, but I’m sure someone will correct my mistake(s).

  225. used to be jdc said,

    November 19, 2007 at 5:11 pm

    “BOLLOCKs! Lost the last line of post 223″

    BSM – are you using ‘greater than’ or ‘less than’ signs? I’ve cut a few posts short doing that.

  226. BSM said,

    November 19, 2007 at 5:23 pm

    “Why hasn’t there been any mention of this one- ‘Bizarre chemical discovery gives Homoeopathic hint’.Found at space.newscientist.com This Korean study shows how when solvents are diluted,molecules do not separate but come togethe as clusters and then larger aggregates. Pick this one apart BSM.”

    I’m afraid this is more than a little sad. Those interested in science have no problem at all with there being a whole host of interesting physicochemical behaviours in solvents, but it has no bearing whatsoever on homeopathy except as another laughable example of homeopaths’ need to clutch at straws of real science to try to claim legitimacy.

    I expect you’ll find this impressive;

    www.bio-resonance.com/elybra.htm

    “Our engineers have researched and developed a new system of digital encoding whereby the “signature” or resonant pattern of homoeopathic remedies has been digitally encoded and stored on a revolutionary new software programme. By selecting one, or a complex of remedies, which can be from the regular homoeopathic materia medica or a remedy from the herbal section or viral section etc., the stored digital signals are decoded back into a special field in the device. A bottle filled with non-medicated pills or tablets, moistened with distilled water is placed in the device where it is potentised with the resonant pattern. This process can be compared to how music is stored on a CD. Music in the form of digital signals is stored on the CD and then converted back into analogue signals through the CD player.”

    Is that nice and sciency for you? Perhaps you might ask how its inventors came to think they could detect these supposed ‘resonant pattern[s]’.

    Meanwhile, to return to the Korean water thing;

    1. We already know the mechanisms behind homeopathy: coincidental recovery, placebo effect, misrepresentation.

    2. Picosecond-duration structures in water have no relevance to the alleged permanent imprinting of specific information into a solvent and even less when that solvent has been evaporated from a lactose tablet.

  227. BSM said,

    November 19, 2007 at 5:25 pm

    “BOLLOCKs! Lost the last line of post 223″
    BSM – are you using ‘greater than’ or ‘less than’ signs? I’ve cut a few posts short doing that.

    DOUBLE BOLLOCKS!

    You’re right,

    Let’s try it long-hand

    Bear in mind that at d120, 3 of their verum group had neoplastic livers and 3 did not, yet the s.e.m. reported for the various parameters are often LESS THAN 5%.

    Got there in the end.

  228. BSM said,

    November 19, 2007 at 5:36 pm

    used to be jdc said;

    “How does the theory of molecules clustering in water make homeopathy plausible?
    If the molecules of the active substance did cluster together in water, wouldn’t that mean that only, say, 1 in 10^23 remedies would contain any active ingredient and the other remedies would contain no molecules at all. Wouldn’t that make homeopathy the world’s worst lottery? I’m probably completely wrong, but I’m sure someone will correct my mistake(s).”

    Clusters are supposed (by the homeopaths and no one else) to beget more clusters with perfect faithfulness through multiple dilution cycles. It really doesn’t merit a second thought.

    For these water clusters to be the mechanism behind homeopathy they would have to do several impossible things before breakfast every day. The main problem is that they would have to defeat the Second Law of Thermodynamics by maintaining their information content perfectly over long periods despite external perturbations.

    They would also have to know which memory they’re supposed to store in spite of the fact that by the second or third dilution step the contaminants in the solvent already are at a higher concentration than the remedy molecules. In the rational world, we recognise this process. It is called “rinsing” and is familiar to those of us engaged in the mysterious activity known as “doing the washing up”. Spooky. One really needs to be careful taking the coffee cups out of the dishwasher, they contain so much caffeine potency they might explode in your hands when you next add water.

    Homeopaths fanciful ideas of mechanism are like just-so stories.

    DON’T TAKE HOMEOPATHS’ IDEAS TOO LITERALLY THEY CAN CAUSE SERIOUS OUTBREAKS OF HILARITY.

  229. BSM said,

    November 19, 2007 at 5:45 pm

    Budicius said;

    “Someone said Homoeopaths don’t believe in germ theory of disease development yet the materia medicas have such remedies as Tuberculinum, Syphylinum, Medorrhinum etc.”

    Of for goodness sake. It doesn’t take a germ theory of disease to take some snot from a person with a disease that has been called tuberculosis or syphilis and turn it into a homeopathic remedy.

    The names came first the germs were found later. The germs were found by real doctors who then used that advance in knowledge to create real treatments. Meanwhile homeopaths kept on diluting and shaking the snot and pretending it was medicine while their patients sickened and died just as before.

    I have asked this elsewhere, but Africa is now infested with homeopaths pretending to cure HIV/AIDS. If it was as damn well effective as they say it is, it should have gone away by now. Has it? Peter Chappel claims that he can play a homeopathic digital audio file over the radio to rid Africa of AIDS. Has he done so? What’s he waiting for?

  230. pv said,

    November 19, 2007 at 6:55 pm

    Someone said Homoeopaths don’t believe in germ theory of disease development

    Could have been me. I wrote before, Budicius doesn’t seem to understand how homeopathy is supposed to work.
    And can someone here please explain to our homeopathy cheerleaders what a self-limiting ailment is, so they might begin to understand why homeopathy could “appear” to work without actually doing anything at all.

  231. kingshiner said,

    November 19, 2007 at 7:03 pm

    PaulD, I agree with you, mainstream medicine has no reason to get all high and mighty, most of what’s done has very little evidence base. It’s no-one’s fault really, we’re just coming slowly to the end of the medical Dark Ages. But conventional medicine is trying to do something about it; criticising, abandoning deference to antiquity, dismantling damaging cartels (I mean trying to wrest power away from people with a vested interest in treating, and towards those charged with improving public health) and so on. This much, at least, modern medicine can be proud of, and much of it is based on science. So why are you ‘sick of hearing scientific fact being used to support opinion’? Surely there’s nothing to object to about that?

  232. Ben Goldacre said,

    November 19, 2007 at 7:08 pm

    it’s just one comedy moment after another on this thread. one minute the homeopaths are coming with the classic one liners like “i’m sick of hearing scientific fact being used to support opinion”

    and then the next minute, oh no, hang on, actually i want to be sick:

    www.smh.com.au/articles/2007/11/19/1195321684868.html?s_cid=rss_

    Baby death: call for homeopath rules

    November 19, 2007 – 5:33PM

    The NSW Coroner has found there is sufficient evidence for the Director of Public Prosecutions to consider laying charges against the parents of a baby who died after they treated her with homeopathic remedies.

    Gloria Thomas died in May 2002 in Sydney Children’s Hospital of sepsis, or bacterial infections.

    The nine-month-old, who was severely malnourished, had been suffering from such terrible eczema that much of her skin was split.

    The inquest at Glebe Coroner’s Court has been told the cracks in her skin caused the baby agonising pain and were a potential source of entry for the bacteria that killed her.

    Parents Thomas Sam, a homeopath, and IT professional Manju Samuel treated her with homeopathic remedies rather than her prescribed medication.

    State Coroner Mary Jerram terminated the inquest today after finding there was a reasonable prospect the evidence presented to the inquiry could convince a jury to convict “a known person or persons of a serious crime”.

    Ms Jerram said the evidence showed the known person or persons caused Gloria’s death and that their negligence warranted criminal punishment.

    “In my view there is a prima facie case to consider and there is a reasonable prospect that a jury would convict,” Ms Jerram said today.

    The coroner also recommended a central body be established for homeopaths in NSW with mandatory membership.

    Ms Jerram said such a system would have multiple benefits for the public.

    “I therefore recommend the NSW Department of Health consider introducing a mandatory system of registration for persons practising or wishing to practise homeopathy,” Ms Jerram said.

    The parents of the dead child were not present in court today.

  233. Budicius said,

    November 19, 2007 at 7:17 pm

    Alex C- I’m pretty sure the mathematical proposal is on this here Bad Science website done by a bloke from Harvard with the surname Annick.

  234. emmer said,

    November 19, 2007 at 7:18 pm

    Can somebody remind me why the NHS began funding homeopathic treatment in the first place?

  235. BSM said,

    November 19, 2007 at 7:53 pm

    Ben

    “i’m sick of hearing scientific fact being used to support opinion”

    I think that is probably the homeopath’s motto.

    Damn those facts! What we want is more unsubstantiated opinion.

    Pack of 30 sugar pills? £7.99, please.

  236. Finger waggler said,

    November 19, 2007 at 8:34 pm

    @PaulD
    PaulD said,
    November 19, 2007 at 1:02 pm
    There you go again Fingler -”That’s fine, but fortunately it’s not a view most people share”. Where’s the evdience for this belief that most people think like you do? Do I see the point? Do You see the point?! Where the heck is your evidence that most people believe that?
    The World Health Organisation has pointed out that 5 million people use homeopahty worldwide and that is only those that use it not those that believe in it.

    Groan.

    OK it’s my fault. As i typed the offending line it did cross my mind that you’d ask me where i got my ‘data’ from. But then i thought, no, surely he can’t selectively respond to just that bit ? I mean, he’s totally hoist by his own petard… at least in regard to subjective evidence. And if he does ask for the precise numbers, surely he’ll realise that 5 million people out of a total of around 6 billion is a rather small proportion. So, i will have to admit that the statement you take exception to is merely my opinion, and not a fact. Worse, i’ll admit that i’m wrong quite a lot of the time, but in this case i suspect i’m right!

    PaulD, there’s a few people who have mentioned the extreme selectivity of the Alt-med protagonists, and you are merely confirming this sterotype. I can feel a waggle coming on…nurse, the screens !

  237. Dr Aust said,

    November 19, 2007 at 9:05 pm

    Muscleman and BSM…

    Since I have a link to the eCAM Alt “carcinogenesis” paper over in my blog in part two of my rant about AltMed journals, I am tempted to re-post your analysis there… suitably attributed, of course… if that’s OK with you two.

  238. Dr Aust said,

    November 19, 2007 at 9:11 pm

    PS Could I also suggest the two of you post a letter pointing out all the manifest shortcomings of this study to eCAM’s “comments thread” for the paper? Or send it to the editor?

  239. PaulD said,

    November 19, 2007 at 9:33 pm

    Hi All I’m back. And naturally there are a few points I’d like to respond to.
    Bogusman said,
    ….I think that this is a huge issue and as far as I know there has never been a political system in the history of the world that has really got to grips with this.
    Thing is though – agreeing that there are problems with the established system doesn’t automatically mean that any given alternative is better. Especially when the alternative is completely unsupported by evidence.

    I agree. The problems in the established system does not mean an alternative is better. I am just pointing out that there are indeed problems in the system and in my opinion they are being glossed over.

    Homeopathy is not meant to be an alternative, it is, in my opinion anyway, complementary. I just get disturbed when people put up this view that the established system is best when they are not prepared to consider the options (I’m not saying you are doing that as you seem to be quite rational) Worse than that, it is obvious from most of the comments that strong views are held by people who patently haven’t got a clue what it is or what it does. And yes the evidence for homoepathy is limited at this stage in history. It does not have the benefit of the colossal time and money put into the conventional side. I would love however to do a cost benefit analysis of NHS practice in total and see if it really is as rosy as it is portrayed. The Health Economists started that work about 15 yrs ago, I don’t know if they made any headway.
    But anyway, yes I agree with you.

  240. spk76 said,

    November 19, 2007 at 9:38 pm

    Homeopathy, for all the personal anecdotes of efficacy, just simply fails to stand up to close scrutiny. Every positive result can be put down to one or other or more likely a combination of:

    1. regression to the mean (many conditions, especially long-term chronic ones (those favoured by homeopathic and most other alternative therapists) wax and wane between periods of complete or partial remission and outbreaks of severe exacerbation, whilst mostly treading an average baseline. People go to real doctors during acute exacerbations and may turn to CAMsters in desperation, by which time their condition has settled down again to the mean level or even gone into remission, often with the additional help of real medicine)

    2. fluctuation of symptoms

    3. the effect of conventional treatments taken at the same time

    4. experimental design flaws and errors

    5. observer, recall and selection bias (e.g. people retrospectively mistakenly ascribe their improved condition to their homeopathic treatment, whilst conveniently neglecting the other factors contributing to the “cure” and ignoring the occasions when the homeopathy failed, i.e. confusing correlation with causation)

    6. the natural history of the conditions being treated

    7. habituation (many conditions, such as hay fever, eczema and asthma, eventually remit (children are often said to “grow out” of them) – what is really happening is a decrease in response to the stimuli due to repetition, i.e. the body slowly resets its thermostat, so to speak. This is why people may complain of having hay fever for years, having tried all the treatments, and then one day they no longer have it.)

    8. small sample sizes of statistical invalidity

    9. uncritical reporting of unreliable anecdotes

    10. delusion, denial, deceit and fraud

    And as for the placebo effect – that is just another way of saying “no effect”, i.e. when a treatment is described as being no better than placebo, it doesn’t mean that it at least has some minimal benefit and is therefore worthwhile; what it actually means is that there is no measurable benefit whatsoever above giving nothing.

    With regard to homeopathy being successful (as a placebo) in non-serious illness, it is important to understand that the mistakenly perceived beneficial outcomes of homeopathic remedies are merely a consequence of their being used to treat minor, self-limiting or chronic relapsing/remitting ailments.

    Generally, the kinds of conditions that most people use homeopathy for would get better or at least remit on their own anyway (allergies, hay fever, eczema, minor skin complaints, mild pain, insomnia etc., many of which having seasonal and emotional/psychological/stress-related components), and homeopathy offers nothing but disappointment, at best, death at worst, for those with severe and acute conditions (cancer, septicaemia, HIV/AIDS, meningitis, malaria etc.)

    In short, homeopaths trick patients into temporarily reinterpreting their symptoms due to a transient change in expectation and belief. Placebo effects are often erroneously thought of as having a kind of mystical or magical healing effect outside of conventional science/medicine or (like homeopathy) a yet to be eluciated physiological basis – but they do not. Homeopathy and placebo are not cures, they are nothing.

    Placebo effect = no effect. Homeopathy = placebo. Understood?

  241. PaulD said,

    November 19, 2007 at 9:48 pm

    Bogusman Also said,
    How do you prove non-effectiveness except by setting up trial where the proposed intervention is measured against something else – active or placebo or doing nothing at all? If the intervention under test performs worse than doing nothing at all, isn’t its ineffectiveness demonstrated? And if you do it enough times with the same result can’t it be considered proven?

    You have highlighted the point I was trying to make. “If the intervention under test performs worse than doing nothing at all, isn’t its ineffectiveness demonstrated?”. The answer is no, not at all. All the study shows is whether the hypothesis is upheld or not. Say the question in hand is that ‘homeopathy is effective above and beyond placebo’ A negative response here gives the conclusion that the hypothesis is not supported. It does NOT give any evidence that homeopathy does not work. It is simply evidence that the hypothesis was not upheld. My point is, I want to see the studies that had the hypothesis that homeopathy does not work and were subsequently proven to be the case.

    I haven’t seen any yet

    “And if you do it enough times with the same result can’t it be considered proven?” I’m afraid not. As I said, no evidence of effectiveness is not evidence of non-effectiveness. The skeptics out there are familiar with the book the Black Swan, (and will probably come back with a yawn at this point)if you are not I’d recommend it. In there his basic premise is that black swans were considered an impossibility until they were come across in Australia. In all the sightings of swans over thousands of years in the west the ‘evidence’ supported the hypothesis that swans were white and black swans were an impossibility. Then they found them.
    So, to make a claim that something is NOT effective or does NOT exist, you need more than an accumulation of points to prove it, hence I am asking people out there to prove it does not work.

  242. PaulD said,

    November 19, 2007 at 9:52 pm

    Fralen said,

    Examining the totality of the evidence and coming to what Bradford Hill called “a verdict”. Eg, all the negative meta-analyses, the fact that the more methodologically sound a trial is the more likely it is to give homeopathy a placebo only result, combined with the implausibility, all adds up etc

    Yes yes of course but there has to be a significant body of evidence for this to be applied and in the available meta analyses to date the significant body of evidence is not there in homeopathy. As for the meta analyses themselves, I’m not going back over the arguments to show the problems with them. Suffice to say the studies they examined were not what I am asking for i.e. proof that homeopathy does not work. And please don’t say that collectively they are proof.

  243. PaulD said,

    November 19, 2007 at 10:01 pm

    As for the asthma question…
    emmer said,
    PaulD, I’m asthamatic too….. It’s never been suggested to me for example that I hoover regularly, eat sensibly, manage my stress levels or try specific breathing techniques, but I’ve found this all helps. Do be aware that severety of asthma
    symptoms can cycle over several years – if I were you I’d keep a ventolin inhaler hanging around just in case.

    Thanks for the concern. I share your query about the level of advice given and yes asthma can cycle. Can you imagine in the 30 odd years I had it how much ‘advice’ I was given? Since I got it at age 7 I was told I would probably grow out of it at age 14 (the cycle idea)by my doctor and when that didn’t happen it was to be 21. When that didn’t happen I think they gave up. And you know, at one visit my doctor actually told me: try eating more chips! That’s when I realised they were grasping at straws and I needed to put up with it. So mine is not a cycling type of asthma but having had it so long I can tell you that I know a thing or two about asthma. Best not to get into this though because it is becoming the old anecdotal evidence again. I only brought it up as an example of how there is another way to the conventional wisdom and I am so grateful that I took it.

  244. don_pedro said,

    November 19, 2007 at 10:16 pm

    Your response is a bit like someone being mated, in chess, only repeatedly protesting, “ah but is it really mate? Prove it!”

    And then, when the proof is given, starting again, with “ah, but is it really proof? Prove it!”

    And so on. Ad tedium.

  245. PaulD said,

    November 19, 2007 at 10:47 pm

    walden said,
    well thank you for giving people the chance to prove homeopathy doesn’t work. BUT… surely homeopaths should have to prove it IS effective, rather than the other way around? Is that not rational?

    Well no, that’s my point entirely, I was saying that I don’t believe we’ll get anywhere in the argument of will it work or won’t it, so as a parting shot for the day I was saying OK lets use the conditions of the arguments usually used against homeopathy and ask that instead of trying to prove it works, lets see you prove it doesn’t. Apply the same criteria i.e. not anecdotal, no evidence is not evidence of non-effectiveness and stick to the point – the point being prove the hypothesis that homeopathy does not work.
    You see there are homoepaths out there trying their best to prove it works and I agree that if they are making such claims they should back it up with acceptably sound ecidence. However, there is a counter claim out there that homeoapthy does not work and if you hold to such a claim you too should provide the acceptably sound evidence to back it up. The arguments I’m seeing are often along the lines of it couldn’t possibly so it doesn’t. This is bad science so show me the good science that proves it doesn’t work. Simple question really and I would have thought fair enough.

  246. PaulD said,

    November 19, 2007 at 10:58 pm

    BSM said,
    “Be grateful that you are no longer asthmatic but it was not the homeopathy. You are either the fortunate beneficiary of an eventual spontaneous amelioration or there are other factors at play, such as lifestyle changes, which you have chosen not to share with us”.

    Well there you go, another one who knows better than me what I went through. And I have shared all that I understand to be relevant – happy to explain more if required.

    “…the one thing you have utterly failed to acknowledge is that there needs to be a risk-benefit analysis of all medical treatment. Real medicine has benefits and it has risks. The doctor’s job is to optimise that ratio.”
    To that I can only say Ha!
    Have a look at Ivan Illich’s work. He looked at the cost benefit ratio of medicine and it came out as a negative – this is not my view because I think medical practice is amazing in what it has achieved I am very impressed with the achievments of medics – but he did the work.

    “Homeopathy has zero benefit from its little sugar pills. So, the opponents of homeopathy only require to show a few cases of harm caused through the use of homeopathy for the for the risk:benefit ratio to be infinite.”
    wrong – they need to take into account the benefits and I’m telling you, if you look into it properly it’s massive. But hey that’s only the opinion of a fortunate beneficiary of an eventual spontaneous amelioration.

    “We choose to be generous to homeopaths and allow that they might create some genuine benefit as counsellors. This puts something into the good side of the balance.”
    thanks for being so generous

  247. PaulD said,

    November 19, 2007 at 11:30 pm

    So finally for tonight…

    Ben Goldacre said,

    it’s just one comedy moment after another on this thread. one minute the homeopaths are coming with the classic one liners like “i’m sick of hearing scientific fact being used to support opinion”

    Ah well, there you go, happy to provide comedy moments for you.
    But anyway, That was a good interview today on the Irish radio. If I understand your key theme correctly your concern is not so much that homeopathy is (in your opinion) placebo but that homeopaths are not self regulating adequately. I’d have to agree. Not about the placebo belief, but we can leave that alone for now, – about the regulation. I too believe there are practices out there that are not very sound and the regulating bodies should be doing more about it. However, in their defence I would say, as I did above, that they are in their infancy and appropriate systems have to be developed and this has to take time. And yes they have to learn to self criticise in journals etc. But they are not going to reach the standards of the mediacl council in the near future – they just haven’t got the financial or other resources and sheer numbers that the medical establishment has.
    You are probably aware I expect that when X rays were first used for medical purposes it was for removal of unwanted hair. It was doctors that pioneered it’s use for removal of facial hair and the medical establishment failed to curtail the practitioners until severe damage started to become evident and even then the main doctor in point carried on practicing. The point is that the medics have a vast experience of self regulation but it has come about from years of experience some of which has not exactly been sound and above board. The homeopaths do not yet have the advantage of this experience.
    We need to find ways of milking the vast potential of homeopathy whilst ensuring it is regulated to acceptable standards. To that end we should be having honest discourse and somehow get around this current squabbling that seems to be going on.

  248. dissonance said,

    November 19, 2007 at 11:52 pm

    Get rid of it before it has got off the starting blocks?
    its had two hundred bloody years.

  249. pv said,

    November 20, 2007 at 12:01 am

    PaulD, what’s the mechanism by which homeopathy could have cured your asthma?
    And I wish you’d stop calling homeopathy a “Profession”, or even “medicine”. It’s as daft as referring to the Mafia as “financial advisors”, or school students as “clients”.

    You wrote:
    Well no, that’s my point entirely, I was saying that I don’t believe we’ll get anywhere in the argument of will it work or won’t it, so as a parting shot for the day I was saying OK lets use the conditions of the arguments usually used against homeopathy and ask that instead of trying to prove it works, lets see you prove it doesn’t. Apply the same criteria i.e. not anecdotal, no evidence is not evidence of non-effectiveness and stick to the point – the point being prove the hypothesis that homeopathy does not work.
    You see there are homoepaths out there trying their best to prove it works and I agree that if they are making such claims they should back it up with acceptably sound ecidence. However, there is a counter claim out there that homeoapthy does not work and if you hold to such a claim you too should provide the acceptably sound evidence to back it up. The arguments I’m seeing are often along the lines of it couldn’t possibly so it doesn’t. This is bad science so show me the good science that proves it doesn’t work. Simple question really and I would have thought fair enough.

    I don’t mean to be rude (I don’t know you) but that is just about the most fantastic bit of prevaricatory claptrap I’ve read in a long time. You do know what “prevarication” is I presume.
    If only the pharmaceutical industry could get away with the same tripe.

  250. pv said,

    November 20, 2007 at 12:15 am

    #
    dissonance said,

    November 19, 2007 at 11:52 pm

    Get rid of it before it has got off the starting blocks?
    its had two hundred bloody years.

    Indeed. He like other homeopathy cheerleaders seems to be woefully ignorant about the object of his cheerleading.

  251. AlexG said,

    November 20, 2007 at 12:24 am

    PaulD, asking for proof that homeopathy doesn’t work is asking for the logically impossible. If an RCT shows homeopathy not to be effective compared to placebo and/or no treatment, then sure, that’s not proof it doesn’t work because another more rigorous trial might show an effect.

    And if that trial shows no benefit of homeopathy in comparison to placebo/control then that’s not proof it doesn’t work either because another even more rigorous trial might show an effect.

    Etc.

  252. Ben Goldacre said,

    November 20, 2007 at 12:32 am

    Hi PaulD, ever thought about starting a blog?

    That was an interesting chat with your colleage Suzi Duff on Irish radio this evening, i might hook out the mp3 for a homeopathy media roundup. You say that homeopaths should have special treatment and allowances with regard to regulation because they have not been around long enough.

    I’m not sure how special you can expect or would need that treatment to be.

    GMC fees are £290 a year. The Society of Homeopaths charge their members between £350 and £500. They organise conferences on HIV around the work of a man who believes he can rid HIV from Africa by playing tunes on the radio, and for that reason alone I would have little faith in them as a regulator protecting the public, even discounting everything else I know about their activities.

    Perhaps you could tell us what the Irish Society of Homeopaths charge their members, and what regulatory activity they engage in to protect the public.

    After your colleague Suzi Duff reassured me on the radio about their regulatory activities I went to have a quick look at the ISHOM website.

    www.ishom.com/

    There is absolutely nothing on that website about a code of conduct.

    There is absolutely nothing on that website about how to complain as a patient if you have concerns.

    There is absolutely nothing on that website about how complaints are investigated.

    There is absolutely nothing on that website about previous complaints, or any evidence of a transparent complaints process.

    There is absolutely nothing on that website about how the Irish Society of Homeopaths ensure that their members abide by their code of conduct.

    And most crucially, there is absolutely nothing on that website about how the ISOH ensure that members of the public are fully informed and aware of what they can expect and how to raise concerns about ISOH members if they feel that they have been medically harmed, sexually or financially exploited, or any of the huge number of things that can tragically and occasionally go wrong between any kind of health practitioner and patient, regardless of discipline.

    I’m sorry you feel that you’ve not had enough money from the international conspiracy of Bilderberg lizards who run the pharmaceutical and banking systems (and of course pay me in brown envelopes because homeopaths are so important), but frankly, after reading through the ISOH website and finding nothing, for anyone to claim that the homeopaths and specifically the ISOH have made any effort whatsoever to perform any kind of regulatory role – in fact for them to claim that they are even attempting to do so – is incomprehensible and bizarre.

    I hope you can assure us that you will raise this extremely important issue with the ISOH urgently and get back to us with any improvements they pledge to make.

  253. jackpt said,

    November 20, 2007 at 2:36 am

    Ah, so that’s where this picture of Ben came from. It all makes sense now :).

  254. jackpt said,

    November 20, 2007 at 2:37 am

    This picture. Damn keyboards.

  255. Budicius said,

    November 20, 2007 at 3:08 am

    The death of a nine month old baby attributed to Homoeopathy is very tragic and upsetting. It upsets me to see that some of my fellow Homoeopaths in Australia and abroad still don’t know their limits. If a nine month old baby doesn’t initially respond to Homoeopathic treatment for eczema in its early stages say in one week, then you can no longer fuck around with Homoeopathy but expertise from Dermatologists needs to be sought. I understand some cancer patients well informed about Homoeopathy and its serial dilutions seek its treatment, should Homoeopaths refuse to treat?

    Homoeopathy through the phone lines, radionics, on CD’s etc, to any scientifically minded Homoeopath is a crock. Get back to real scientific Hahnemanian Homoeopathy with well proven remedies. These practices only divide the Homoeopathic community even further, until we eventually dilute and succuss ourselves into oblivion. We need to sort the wheat from the chaff and set some standards.

    I don’t care if people treat with magnets or Fish slappin’, just know your limits.

  256. bazvic said,

    November 20, 2007 at 7:31 am

    “scientifically minded Homoeopath”

    an oxymoron ?

  257. Gimpy said,

    November 20, 2007 at 8:22 am

    Ben, re 260, you didn’t do your research first? Elementary error assuming homeopaths regulate themselves.
    It seems that Suzi Duff has studied under Homeopathy for Aids and Malaria advocate, Jeremy Sherr. I wonder what other of his bad habits she has acquired. Jeremy of course is an internationally respected FSHom, a fellow of the SoH, but according to them he is not a member so is not bound by a code of ethics.

  258. JQH said,

    November 20, 2007 at 8:54 am

    PaulD said:-

    “I’m sick of scientific fact being used tyo support opinion”

    So what do you think should be used to support opinion?

  259. Bogusman said,

    November 20, 2007 at 9:58 am

    PaulD said
    “the profession of nursing is relatively new, midwifery newer again”

    As I may have mentioned here before, Mrs B is a practicing midwife, and if I have learned anything very much from living with her as she trained and practiced, it is that midwifery is one of the professions with a plausible claim to being the oldest one of all.

    Its professional body in the UK, the RCM, has been around since 1881 but of course the practice of midwifery goes back way, way beyond that – probably to somewhere in Africa about 40,000 years ago.

    Probably not all that important in the overall context of this discussion but I couldn’t let it pass.

    Pavlovian or what?

  260. Diotima said,

    November 20, 2007 at 10:11 am

    Midwifery is an established profession in the Biblical Apocrypha; when the Virgin Mary is about to give birth a midwife named Salome (no relation) turns up. When Joseph asks who she is she replies ‘I am a midwife of the Hebrews’. M.R. James dates this ‘Infancy Gospel’ to the second century A.D. But as Bogusman points out the profession is much older than this.
    I see from today’s Guardian letters page that Ben has been urged to be nicer to homeopaths. Perhaps we should have a National ‘Be Nice to Homeopaths’ week?

  261. PaulD said,

    November 20, 2007 at 10:17 am

    Ben Goldacre said:
    “Hi PaulD, ever thought about starting a blog?”

    Not really – Looks like too much trouble to me, but I imagine it is good for your purposes as no doubt you are compiling rantings to use for some purpose. Nice to dip in but I haven’t the time.

    “That was an interesting chat with your colleage Suzi Duff on Irish radio this evening, i might hook out the mp3 for a homeopathy media roundup. You say that homeopaths should have special treatment and allowances with regard to regulation because they have not been around long enough.”

    Not special treatment, just a recognition that they are in the early stages of professional development. I’m saying treat them like medicine was at the same stage in their professional development.
    PV said it has been around for 200 yrs – no, I was talking about the profession, not the discipline. the Irish Society was set up in 1990. Unfortunately they are just developing a new website and there are plans to get more up there. The one you looked at is the old site which has not been decommissioned yet. See www.irishhomeopathy.ie Admittedly the level of regulation that you are asking for is not demonstrated on the site yet (it ony went live a few weeks ago) but I’m sure Suzi will supply you with information about those items you listed.
    And yes, the British Society seem to have shot themselves in the foot by planning such a conference but I don’t know about that, maybe it’s better to air such practices publicly to give people the chance to see if there is anything in what the guy is saying rather than dismissing it out of hand?
    Maybe not, I don’t know.

    As for

    AlexG who said,

    “PaulD, asking for proof that homeopathy doesn’t work is asking for the logically impossible. If an RCT shows homeopathy not to be effective compared to placebo and/or no treatment, then sure, that’s not proof it doesn’t work because another more rigorous trial might show an effect.

    And if that trial shows no benefit of homeopathy in comparison to placebo/control then that’s not proof it doesn’t work either because another even more rigorous trial might show an effect.”

    Well done and you seem to have spotted what no-one else did. Asking for proof that homeopathy doesn’t work is asking for the logically impossible. Read that again carefully. Asking for proof is impossible. YOU CANNOT PROVE HOMEOPATHY DOES NOT WORK.

    Good morning all.

  262. Alan Synnott said,

    November 20, 2007 at 10:31 am

    You also cannot prove that the following claim is untrue: I flew to work today under my own steam, Heroes-style. Got out of bed, got dressed, jumped into the air and flew to my office. No matter what you say, I can always counter it with another claim (I wasn’t seen because I was invisible or whatever). The burden of proof, as has been stated so many times on this forum, is on the individual making the extraordinary claim; in this case I would have to do a little flying to prove myself.

  263. spike said,

    November 20, 2007 at 10:40 am

    PaulD, whilst you are quite happy, and even correct to say that we can’t prove that homeopathy doesn’t work, do you have any evidence, given your rules, that it does? A plausible mechanism?

    Or should my revolutionary new treatment based on healing through the intervention of the horn of the IPU (bbhhh) be given the same level of regard that you seem content to demand for homeopathy? After all, you can’t prove that it doesn’t work. I will admit that the organisations stated aims are to take your money, and then laugh. But they are new, and should be given special leeway, shouldn’t they?

  264. Diotima said,

    November 20, 2007 at 10:43 am

    PaulD. You also cannot ‘prove’ that prayer does not work. A friend organised some group prayers for my health three years ago and believes that the group prayers rather than the skill of an electrophysiologist cured my atrial flutter. I do like to think of those Baptists in the Cumberland Mountains in Maryland praying for me. An old friend who has gone in for alternative medicine has an even smarter notion, ‘non local healing’. You tell him your health problem and then, thousands of miles away, he concentrates on it and it is cured. He takes payment by Pay Pal, but offers no refunds.

  265. Budicius said,

    November 20, 2007 at 10:48 am

    Dr Aust. In one of my posts I referred to you as a polite reasonable person, but I can never think the same about you again. Infact I’m furious.
    You kindly ask Muscleman and BSM if you can re-post their analysis on your Part two of my rant about Altmed journals.
    Yet you do not ask for my consent to re-post my comments to your site draust.wordpress.com ‘At the risk of repeating myself: more on AltMedjournals’.

    I demand an apology.

  266. TheBigCheese said,

    November 20, 2007 at 11:03 am

    PaulD said: “The point is that the medics have a vast experience of self regulation but it has come about from years of experience some of which has not exactly been sound and above board. The homeopaths do not yet have the advantage of this experience.”

    I’m not really sure that is the point. Homeopaths profess to be healers of some sort and should therefore be held up to the same standards as those in the medical profession – much of their self-regulation could be based on the experience of the medical profession. They are unwilling to set high standards because they know their profession would fail to meet them.

    The process by which a pharmaceutical is developed is long and drawn out – involving thousands of people and many thousands of tests to show that a drug is effective (i.e. has more effect than placebo) and safe. The process of clinical trials through which a drug must pass in order to reach the market are rigorous and – importantly – transparent. The manufacture of any subsequent drug (and infact any drugs used in the trials themselves) is strictly controlled by a series of stringent regulations (GMP, GLP etc…) all of which must be adhered to.

    The process of producing a homeopathic remedy, it seems, merely involves printing out a label that says “Homeopathic Remedy” with no requirement to show efficacy or quality. If homeopathy wants to be taken seriously then it must follow the same principals as conventional medicine i.e. prove their remedy works consistantly via properly designed controlled testing and prove that it is manufactured under properly controlled and regulated conditions.

  267. AlanR said,

    November 20, 2007 at 11:21 am

    PaulD said
    Asking for proof that homeopathy doesn’t work is asking for the logically impossible. Read that again carefully. Asking for proof is impossible. YOU CANNOT PROVE HOMEOPATHY DOES NOT WORK.

    Well, I am the inventor of rotational healing. In case you don’t know, this involves the patient rotating (or being rotated) at precise times of the day, resulting in the realignment of the patient’s chi due to interactions with the earth’s magnetic field. A few trials have been performed, unfortunately indicating no evidence of an effect beyond placebo. But YOU CANNOT PROVE ROTATIONAL HEALING DOES NOT WORK.

    However, I am reasonable enough to agree that tax payers’ money should be spent on healing techniques that have been shown to work, rather than rotational healing. I also realize it would be dangerous for me to make unsupported claims about my techniques and for me to attempt to persuade people to forgo conventional treatment in favour of rotational healing would be plain wrong.

    (Just in case anyone gets any ideas, rotational healing is fictional and any healing benefits received purely coincidental.)

  268. igb said,

    November 20, 2007 at 11:37 am

    “You are probably aware I expect that when X rays were first used for medical purposes it was for removal of unwanted hair. ”

    Not really. Early X Ray technicians started to lose their hair. Quacks saw that as a new angle. They were already in use for imaging in the 19th century, while hair removal was in vogue in the 1920s.

  269. Diotima said,

    November 20, 2007 at 1:04 pm

    AlexG My point entirely. After all who can say it is the case that a very senior Electrophysioligist (Thank you Martin Loewe!)did the work or this improvement in my health derived from my friend’s group prayers in Maryland?

  270. Bogusman said,

    November 20, 2007 at 1:18 pm

    This is what I was worried about yesterday when I asked how do you prove ineffectiveness? I rather feared then that the answer Fralen gave (although perfectly reasonable to me) would not meet PaulD’s needs. That’s why I included a plea to any philosophers in the forum, just in case they might have some insight on how to square this circle. I suspect that subsequent discussion just goes to show that is very unlikely.

  271. PaulD said,

    November 20, 2007 at 1:37 pm

    Alex G, Alan R, Spike, Alan G and Diotima, now you’re getting it.

    “The burden of proof, as has been stated so many times on this forum, is on the individual making the extraordinary claim” that may have been stated but it is not entirely true. The burden of proof is on the individual making ANY claim. It’s simple – you make a claim, where’s your evidence.

    I have stated early on in my argument yesterday that we can argue this till we are blue in the face because I believe there are sound trials that show homeopathy works (not how but that it does) and others clearly want to ignore those or say there is no such thing. So be it. I am not going to try to convince anyone it works because there’s no point – you won’t be convinced. So I shifted tack and said OK you lot are so convinced that homeopathy DOESN’T work (I see that opinion being stated all over this blog) I thought I’d give you a little challenge and ask you to use scientific investigation to prove it doesn’t. The claim is there, where’s that proof?

    Instead of giving that evidence some have resorted to ridicule. Again.

    But as was pointed out by Alex G, actually it is impossible for science to prove a negative. In fact it is impossible for science to ‘prove’ anything as it has an inherent weakness in that department. It can only give a probability that any given experiment would show the same results if repeated. Maths gives proofs, science does not. Philosophy aims in parts to lead to logical proofs, science cannot. it can show evidence that it is very unlikely, until the thing happens (Black Swan) and then the scientific theory is re-written.
    Think about it – science cannot prove maths, it cannot even comment on mathematical equations. Mathemeticians do not use science to work out their equations because it is in the wrong ontological field. Science has one or two inbuilt fallibilities, one of which is that it can’t proove anything.
    So where does that leave us? Well one thing it leaves us with a situation where you cannot logically prove homeopathy does not work with science, yet so many people out there are claiming that the experiments and meta-analyses prove it to be the case, when they actually don’t. Hence my comment on opinion masquerading as science.

    you could always try abuse though – that might change my mind and make me see (your) reason

    And yes Alex – it means you can’t convince me, just as I couldn’t in my lifetime convince you. But as I discussed yesterday with someone about my asthma, I was challenged to at least recognise that it could have been placebo. I acknowledged that, now can you at least recognise that it could have been homeopathy? I’m guessing not.
    This is such a shame. I say again the choice to keep having asthma rather than explore outside one’s box is a pity. As Ben said on the radio, he would not ban homeopathy because people seem to get something out of it. And you know what, I don’t care if it is the pill, I don’t care if it is placebo and I don’t care if it is shown to be the homeopath patient interaction. Even if it were purely placebo (it’s not) that is commonly 30% effective and if you can get 30% of asthma sufferers not to have asthma any more by having a homeopathic-induced placebo effect why on earth would you want to stop that happening? 30 years in my case of conventional treatment with no placebo effect followed by freedom from it by what you call placebo effect. If it is placebo I got that from homeopathy not from conventional medicine. Why do you want to prolong suffering?

  272. cat said,

    November 20, 2007 at 1:40 pm

    “(Just in case anyone gets any ideas, rotational healing is fictional and any healing benefits received purely coincidental.)”

    AlanR, I defy you to prove that statement.

  273. Fralen said,

    November 20, 2007 at 1:44 pm

    PaulD, you want to give out placebos, be my guest.

    But nobody from the homeopathy industry has talked about the ethics of that.

    And your own organisation has failed, INEXCUSABLY, to do anything sensible about regulation. There is nothing on that web page, I looked. That’s contemptible and it should be your absolute highest priority, not writing long and rather childish posts about how nobody can prove to you that you can’t fly.

  274. pv said,

    November 20, 2007 at 1:45 pm

    According to PaulD’s logic, every claim must be assumed to be true until it can be proved untrue. Or something like that. He has not the most basic understanding of the world about him and I wish him luck in a court of law if ever (hypothetically) he is accused of molesting children. He would soon see that his liberty would depend on his accusers not being able to prove their case because he would certainly not be able to prove his innocence. This is why in a British court of law you are presumed innocent until proven guilty.
    It is never possible to prove a negative, only to infer it from the lack of evidence for the contrary. Of course one has to make some proper and objective effort to find that evidence. PaulD probably knows this and is trying to be clever, in the naive way that a five-year old mind does. If he doesn’t know this then he isn’t very bright.

  275. cat said,

    November 20, 2007 at 1:47 pm

    PaulD said

    “I was challenged to at least recognise that it could have been placebo. I acknowledged that, now can you at least recognise that it could have been homeopathy?”

    The placebo effect has been clinically shown to be real. Homeopathy has not been shown clinically to do anything other than occasionally match placebo effect. Think.

  276. Fralen said,

    November 20, 2007 at 1:49 pm

    pv, I don’t think anyone here should be distracting PaulD from his more important work ensuring that the Irish Society of Homeopaths start protecting the public.

    That’s incredible, nothing on the ISHOM site about how to complain, nothing about the code of conduct, nothing. And these laughable excuses about not being around for long enough. It’s incredible. Just incredible. And incredibly dangerous.

  277. Bogusman said,

    November 20, 2007 at 1:55 pm

    PaulD,

    You are quite right about the inability of science to prove anything at all for all eternity. This is the now widely-accepted view articulated by Popper.

    There are legions of examples from the history of science. Newtonian mechanics is a structure of great beauty and provides us with the tools to build our world. Until 150 years ago or thereabouts it would have been accepted as scientifically proven. Not until Einstein and others began to consider systems that were outside the ability of people to measure until then did it start to emerge that in some circumstances Newtonian mechanics was insufficient to describe the world.

    Now, this is the point.

    Einstein built on new observations that were made by Michaelson and Morley amongst others, and validated by other experimentalists. Only when a body of evidence had been built could Relativity take its place as a valid theory of the physical world. This evidence was accepted by the scientists of the day because it was repeatable, the experimenters described their work and explored possible sources of error.

    That is what homeopathy – or any other theory – needs to do. Build a body of reliable evidence that may be understood only if the theory is correct, or at least more nearly correct than what has gone before. And that is what most of the contributors to this site want to see.

    Most of us (not all) have some kind of science background and I hope that we would be able to change our thinking if we were to see that reliable evidence.

  278. wilsontown said,

    November 20, 2007 at 1:57 pm

    This is all very interesting, but surely the point is that it is possible to conduct trials that assess the effectiveness of homeopathy. When these trials have been done, and done properly, they have shown no benefit for homeopathy beyond placebo. Sure, that isn’t definitive 100% proof that homeopathy doesn’t work. But it is very good evidence that it doesn’t work. Having evaluated that evidence, I’m happy to conclude that the trials that have been done are consistent with homeopathic treatments ‘working’ through the placebo effect.

    Now, if good evidence appears that homeopathy can have some effect beyond placebo, I’m willing to reconsider that conclusion. But I’ll not be holding my breath.

  279. Fralen said,

    November 20, 2007 at 1:57 pm

    Sorry, I couldn’t quite see in all those long posts about how we cannot prove that he cannot fly, did PaulD make a clear firm pledge that he would urgently lobby the Irish Society of Homeopaths to proactively get information out to the public about how to make a complaint?

  280. sexitoni said,

    November 20, 2007 at 1:59 pm

    Hi PaulD

    Don’t think anyone mentioned Avogadro yet so we’ll try that as evidence that Homeopathy shouldn’t work.

    Hahnemann first proposed homeopathy in 1796 before the nature of atoms, molecules and so on was understood.

    Loschmidt was the first to estimate what became the Avogadro Constant in 1865 – that 1 mole of a substance contains approx 6 x 10 to the power of 23 atoms/molecules.

    So, for example, the number of H2O molecules in 18 grams of water is 6 followed by 23 zeroes, 18 being the molecular weight of the H2O molecule.

    Yet the dilution factors involved in Homeopathy, as explained in Ben’s post, e.g. 30C or a 1 followed by 60 zeroes is a dilution so far beyond the Avogadro constant that itis as good as impossible for even one single atom/molecule of the original substance to remain.

    Hahnemann did not know about the Avogadro Constant so the homeopaths had to literally invent the concept of ‘water having a memory’ to get over the logical hurdle of the Avogadro constant.

    You basically have to suspend the laws of physics to believe homeopathy has any definable mechanism for working. All you have left is blind faith.

    How can that not stretch its credibility to breaking point in your eyes?

  281. Bogusman said,

    November 20, 2007 at 2:01 pm

    Sorry. There is no a in Michelson
    (hangs head in shame)

  282. AdamAnt said,

    November 20, 2007 at 2:05 pm

    PaulD:

    “it means you can’t convince me, just as I couldn’t in my lifetime convince you”

    I think this is actually the point, you could convince me (and I think everybody on this forum) if you provided the evidence. You don’t. When you provide studies which you say are convincing then they get demolished by the people on this forum. All it would take would be a large, properly performed, double blinded trial. Again what evidence would convince you?

  283. BrickWall said,

    November 20, 2007 at 2:07 pm

    As Fralen says lets keep the targets simple for PaulD to reach for, after all its taken them 17 years to produce their empty of usefulness website.

    That’s IT project delay of PFI proportions!

  284. pv said,

    November 20, 2007 at 2:17 pm

    #
    Fralen said,

    November 20, 2007 at 1:49 pm

    pv, I don’t think anyone here should be distracting PaulD from his more important work ensuring that the Irish Society of Homeopaths start protecting the public.

    That’s incredible, nothing on the ISHOM site about how to complain, nothing about the code of conduct, nothing. And these laughable excuses about not being around for long enough. It’s incredible. Just incredible. And incredibly dangerous.

    Even if they had a code of ethics and some procedure for complaints, they wouldn’t do any more than the SoH. To do so would be to admit homeopathy is baseless and consequently fraudulent. For them a code of ethics is no more than window dressing. They don’t have one and we complain about it. Then they have one and ignore it, and we complain about it. That they don’t have a code of ethics or ignore it if they have one is merely more evidence of the fundamental dishonesty of homeopathy.
    Really it needs to be legislated out of existence or officially recognised as the vehicle for fraud it undoubtedly is.

  285. MarkE said,

    November 20, 2007 at 2:21 pm

    The new ISOH website isn’t much better than the old one for information about its self-regulation. The only relevant references on www.irishhomeopathy.ie that I can find are in the “The Society” and “Education and Training” pages and merely say that all members are obliged to abide by the Society’s Code of Ethics and should have up-to-date insurance. Surely even in “a few weeks” it should be possible to provide, say, a pdf of the Code of Ethics? And if a regulatory procedure already exists it should similarly not be particularly time-consuming to link to it, especially if you’re going to give assurances on national radio about regulatory procedures.

  286. AlanR said,

    November 20, 2007 at 2:56 pm

    AlanR said: “(Just in case anyone gets any ideas, rotational healing is fictional and any healing benefits received purely coincidental.)”

    and cat replied: “AlanR, I defy you to prove that statement.”

    Darn it! You’re right! My first post and all. I make up the term “rotational healing” and then find it used in computer role-playing games and “rotational therapy” used for real.

    Ah well, I should have said “rotational therapy, as described, is to the best of my knowledge fictional, since I just made it up. It may have real healing benefit, and I defy anyone to prove to me that it doesn’t!”

  287. AlexG said,

    November 20, 2007 at 3:20 pm

    Well, it certainly got busy in here at lunchtime.

    PaulD, as AdamAnt said, you could certainly convince me and others of the positive effects of homeopathy. Unlike yourself by your own admission I am not immune to evidence contradicting my current point of view.

    I think the difference between us is that it’s not enough for me to “believe there are sound trials that show (X) works”. I’d need to have an answer for e.g. the meta-analyses that contradict my belief in order to maintain it.

  288. AlanR said,

    November 20, 2007 at 3:38 pm

    PaulD said: “The burden of proof is on the individual making ANY claim.”

    Um, could you prove that please?

    Sorry, couldn’t resist. Seriously though, what, I suspect, concerns many of us is the unsubstantiated claims of homeopathists. As you rightly say, when homeopathists make such claims, the burden of proof is on them.

    In addition, while the philosophical discussion about the nature of scientific proof is interesting, there is also a more pragmatic side to the discussion – that of policy:

    Would you prefer tax payers’ money to be spent on medicine with strong evidence of efficacy, or on medicine that cannot be proven to be useless but has little evidence of success beyond placebo?

    Is it acceptable for practitioners to over-sell their medicines, giving the idea to impressionable people that the treatment is more effective than it really is?

    In the real world, such questions need to be answered, without the extreme level of proof that you seem to require.

    (The questions apply equally well to conventional medicine of course – I am reminded of some of the advertisements on TV for various cold remedies – and the second question is interesting as it ties in with Ben’s discussion about the use of placebos.)

  289. superburger said,

    November 20, 2007 at 4:04 pm

    PaulD = troll. Yawn.

  290. muscleman said,

    November 20, 2007 at 4:41 pm

    Dr Aust feel free to repost my comments on the paper in CAM.

  291. jetleg said,

    November 20, 2007 at 5:00 pm

    Hi,

    1) If we assume that homeopathy is only placebo… A person is unable to induce a placebo effect on himself by will. Placebo effect has real benefits for the patient. Therefore a person that will take homeopathy will experience the placebo effect and will benefit from it. So going to a homeopath will result in benefit. Do you agree?

    2) Ben writes that “The mysteries of the interaction between body and mind are far more complex than ”

    What is the evidence that the mind influences the body?

    And how can that be explained, given that biological proccesses can be reduced into physical ones, and there is no place for “influence of the mind” in physics?

  292. PaulD said,

    November 20, 2007 at 5:02 pm

    Bogusman said,

    “PaulD,

    You are quite right about the inability of science to prove anything at all for all eternity. This is the now widely-accepted view articulated by Popper.

    Now, this is the point……

    evidence was accepted by the scientists of the day because it was repeatable, the experimenters described their work and explored possible sources of error.
    That is what homeopathy – or any other theory – needs to do. Build a body of reliable evidence that may be understood only if the theory is correct, or at least more nearly correct than what has gone before. And that is what most of the contributors to this site want to see.”

    And that is what I want to see, so we’ll build the evidence base over the coming years and we’ll develop the profession as we go. It will be slower than the medical profession as it doesn’t have the resources to do it.

    And
    AdamAnt said,

    “I think this is actually the point, you could convince me (and I think everybody on this forum) if you provided the evidence. You don’t. When you provide studies which you say are convincing then they get demolished by the people on this forum. All it would take would be a large, properly performed, double blinded trial. Again what evidence would convince you?”

    My point was actually that I am prepared to consider it is placebo, are you prepared to consider it is not. I’m taking a step backwards and suggesting that if there isn’t even the recognition that homeopathy COULD work, then what evidence would convince you? Without even the notion that it is a possibility, where’s the objectivity. The trials are there, they are valid, you will rubbish them and we rubbish your meta-analyses and so it goes on, we convince no-one of anything. I asked if you would take the step of consdiering that it MAY be a possibility that it works, the answer I’m getting is, no – prove it first then we’ll think it is a possibility. That is not an acceptance that it MAY work that is just an adamant dead end.

    And on that note I ama afraid I have to leave – no time to put into this any more. Much as I am enjoying hearing these opinions.

    I will by the way get onto the Irish Society to get the neccessaries onto their website as I think it is an omission – they have the stuff they just haven’t got it up there yet.

    have a good debate and thanks for the airspace.

  293. pv said,

    November 20, 2007 at 5:11 pm

    What is the evidence that the mind influences the body?

    If by “mind” you mean the brain, it’s the body’s only controller as far as I know.

    Anyone heard of the expression “scared shitless”?

    Or how about alopecia or psoriasis being triggered by stress? As a long term sufferer of both, and having consulted a few (non-woo) specialists on both, I think it’s fairly well established that even if stress isn’t the real cause (because they are both auto-immune problems) it can be a factor in the actual triggering mechanism.

    Btw, can anyone enlighten me on the meaning of the expression: “boost the immune system”?

  294. pv said,

    November 20, 2007 at 5:25 pm

    Sorry about all the bold stuff. My bad html.

  295. AlexG said,

    November 20, 2007 at 7:03 pm

    I’m having trouble resolving this:

    “My point was actually that I am prepared to consider[homeopathy] is placebo”

    with this:

    “you can’t convince me”.

  296. AdamAnt said,

    November 20, 2007 at 7:40 pm

    PaulD, you asked if I would consider that homeopathy works better than a placebo. The answer is sure, but given the evidence then I will live my life as if it doesn’t.

    Can I ask you if a trial such as the one outlined in Bens article would convince you? i.e. homeopaths sitting with patients and providing prescriptions which would then be provided by a pharmacist who doesn’t know if he is giving a placebo or not.

    If not could you outline a trial that you would find satisfactory to prove the effectivness one way or the other.

    btw I appreciate you coming on to discuss this and hope you have time to answer.

  297. pv said,

    November 20, 2007 at 7:45 pm

    AlexG said,

    November 20, 2007 at 7:03 pm

    I’m having trouble resolving this:

    “My point was actually that I am prepared to consider[homeopathy] is placebo”

    with this:

    “you can’t convince me”.

    I shouldn’t think he has any trouble with it, joined up thinking not being his area of expertise. Anyway, mutually exclusive and conflicting ideas are stock ingredients of all woo, not least homeopathy, so it’s not like he’s being inconsistent in his other-worldly scheme of things.

  298. BSM said,

    November 20, 2007 at 10:06 pm

    Dr Aust said;

    “I am tempted to re-post your analysis there… suitably attributed, of course… if that’s OK with you two.”

    Please do.

  299. BSM said,

    November 20, 2007 at 10:10 pm

    Budicius said;

    “Homoeopathy through the phone lines, radionics, on CD’s etc, to any scientifically minded Homoeopath is a crock. Get back to real scientific Hahnemanian Homoeopathy with well proven remedies.”

    Absolutely hilarious. And I bet you don’t even see why that is so funny, so I’ll explain.

    All the muppets selling and using these crackpot devices think they are curing patients with them. The basis for their belief is EXACTLY THE SAME AS YOURS, yet you baldly assert it is a “crock”.

    Look in the mirror, Budicius. Those crackpot beliefs are indistinguishable from yours.

    I’m tempted to say, “Gotcha”, and I never like to resist such temptation so, “GOTCHA!”

  300. ips said,

    November 20, 2007 at 10:31 pm

    As has been said before an excellent well thought out article.
    The Moerman book you referenced is excellent –here is an article he wrote which covers the main points regarding placebo mechanisms.

    www.annals.org/cgi/content/full/136/6/471

    Dylan Evans also writes well and this pdf of his may help the debate a little.

    www.dylan.org.uk/placebo.pdf

    I have no doubt that homeopathic ‘consultations’ work for many of the reasons that are often lacking in a busy NHS setting but this is covered by Moerman .Anthropology is perhaps a better resource for debate than ‘science’ in these cases and a light hearted autobiographical account is the Suburban Shaman by Helman reviewed here arts.independent.co.uk/books/reviews/article342771.ece

  301. Robert Carnegie said,

    November 20, 2007 at 10:34 pm

    Uh, prove to me that the guy -selling- homeopathic CDs and MP3 downloads really believes he is providing anything with more science-cred than a placebo, a plausible story. Didn’t someone find that the homeopathic MP3 was byte-identical to the untreated file?

    Ben does want us to acknowledge the value of a well-formed placebo…

  302. emmer said,

    November 20, 2007 at 11:07 pm

    Thank you for posting the excellent Moerman link ips; whether or not the word placebo is always helpful or accurate has been bothering me for a while – I like ‘meaning response’ a lot. Interesting that an appropriate word hadn’t already been invented for such a significant and complex effect.

  303. emmer said,

    November 20, 2007 at 11:17 pm

    PS. you can ‘look inside’ his book on amazon – and now I want to buy it, but surely it is wrong to buy *two* books because of a single Guardian column?

  304. ips said,

    November 21, 2007 at 7:44 am

    emmer –if you are interested in this side of life have a read of anything by David Morris, the biocultural model of placebo and this review might be interesting to you?
    www.bmj.com/cgi/content/full/320/7227/125/a
    I am doing my MA project on the meaning response and ‘placebo’ reactions –a complex subject but interesting . I am surprised the Homeopathy course is a MSc –I can see these kinds of things being similar to psychotherapy -effective sometimes via body language/exploration of ‘narrative’ and empathy – an ‘art’ but surely not a reductionist and meaurable science?

  305. wewillfixit said,

    November 21, 2007 at 9:53 am

    PaulD: Imagine that a parmaceutical companry started to market some pills as a treatment for asthma without any studies being done (for the sake of argument, the pills have no side effects). Some people who use the pills happen to get better afterwards and attribute this to the pills. They then do some studies which seem to show their pills have an effect. Later studies show no effect and the earlier studies are shown to be poorer methodologically than the newer ones.

    Should the pharmaceutical company withdraw the pills as a treatment for asthma, or would you think it acceptable for them to say “Well, you can’t prove that the pills don’t work. Some people have got better and while it may have been a placebo effect, you should accept the possibility that it wasn’t. Therefore we are going to continue to market the pills for asthma, and doctors will continue to prescribe them.”?

  306. Budicius said,

    November 21, 2007 at 11:05 am

    Mosquito, is that you I can hear buzzing in my ear again? Those nuts who claim what they do is scientific and what I know to be scientific are two very different things. In Boericke’s materia medica beneath the heading Syphilinum is (The Syphilitic Virus- A Nosode), although we know it is not a virus but a spirochete atleast the Homoeopaths at the time acknowledged a living entity to be the cause of the disease. GOTCHA!

    You people insult the intelligence of every free thinking scientist that conduct studies on mice with Homoeopathics, not to mention the Korean chemists and their discovery of molecule clusters in diluted solvent.

    So there are 500 million people in the world receiving Homoeopathic treatment and growing, guess we need to build more Homoeopathic hospitals to cater for the demand.

    Don’t be bitter if a young medical graduate well versed in science decides to take up the practice of Homoeopathy, all they seek is truth. Many medical doctors have taken it up in the past and some still will in the future.

    Homoeopathy has emerged from its infancy and is slowly developing into a respectable grand art and science thanks to the research from highly qualified scientists.

    And by the way Hahnemann was well aware of Avagadro’s number.

  307. AdamAnt said,

    November 21, 2007 at 11:16 am

    And by the way Hahnemann was well aware of Avagadro’s number.

    Remarkable man given that Avagadros number was postulated by Loschmidt 23 years after Hahnemann died

    Mosquito, is that you I can hear buzzing in my ear again?

    Yes! And I’m a malaria carrier. Care to take some sugar pills now.

  308. DrJon said,

    November 21, 2007 at 11:21 am

    Budicius: “And by the way Hahnemann was well aware of Avagadro’s number.”

    The value of the number (that became Avagadro’s number) was first indicated by Johann Josef Loschmidt who, in 1865, computed the number of particles in one cubic centimetre of gas in standard conditions.

    Christian Friedrich Samuel Hahnemann died on the 2nd of July in 1843.

    Do I have to spell this out?

    Also, see my previous comment re gadflys, mosquitoes, and Socrates :)

  309. DrJon said,

    November 21, 2007 at 11:22 am

    The population of India, a bastion of homeopathic treatment, is 1.12 billion. I don’t think there’s a rush to built homeopathic anything.

  310. 8839 said,

    November 21, 2007 at 11:25 am

    Congratulations on the honorary JREF membership.

  311. JQH said,

    November 21, 2007 at 11:37 am

    Just re-read the text of the email from xxxxxxxxxxxxx to Ben. Seems to be saying that Ben should not expose quackery because that would stop quacks earning a living.

    Presumably he thinks Guardian Money should stop exposing financial scams as by doing so they are depriving the scamsters of their income.

  312. AlexG said,

    November 21, 2007 at 11:43 am

    Hello Budicius, I wondered if you could clarify something I’ve found during a very brief Google search.

    books.google.co.uk/books?id=X99xF4Jy5WYC&dq=Materia+Medica+Boericke+&pg=PP1&ots=S7E3-cerJB&sig=uc64ajAdHFjutSY7bJqfVTnUriQ&prev=http://www.google.co.uk/search%3Fhl%3Den%26q%3DMateria%2BMedica%2BBoericke%2B%26meta%3D&sa=X&oi=print&ct=result&cd=1&cad=legacy#PPR10,M1

    (sorry for the length)Is that the same Boericke’s Materia Medica you referred to? You’ll note the date of the preface is June, 1927. Could you explain the discrepancy with the brief biography on this individual:

    www.bartleby.net/65/no/NoguchiH.html

    who isolated the relevant spirochete in 1913?

  313. Budicius said,

    November 21, 2007 at 12:35 pm

    I do apolagise I must have an inaccurate reference to avagadros number.

  314. Budicius said,

    November 21, 2007 at 12:45 pm

    Atleast I am one Homoeopath that admits to when he stuffs up and apolagises.

    Dr Aust, I am still waiting for an apology from you.

  315. BSM said,

    November 21, 2007 at 1:05 pm

    Budicius said;

    “Mosquito, is that you I can hear buzzing in my ear again? Those nuts who claim what they do is scientific and what I know to be scientific are two very different things. ”

    I’m sorry, but what is “scientific” about the way that one bunch of homeopaths practice and what is not “scientific” about the manufacturer of this machine;

    www.bio-resonance.com/elybra.htm

    whom you appear to describe as “nuts”.

    Is the manufacturer of this machine;

    www.remedydevices.com/

    also “nuts”. She has many testimonials from practising homeopaths. Are they “nuts”

    Peter Chappel is a Fellow of the Society of Homeopaths. He claims he can cure HIV/AIDS with an mp3 file of a homeopathic remedy. Is he “nuts”?

    I know a number of veterinary homeopaths diagnose their cases by radionics. Are they “nuts”?

    Budicius said;

    “You people insult the intelligence of every free thinking scientist that conduct studies on mice with Homoeopath”

    I haven’t seen much evidence of intelligence. I see a badly written paper from a badly performed study that could only be published in a homeopathic fanzine because of its methodological failings. I have not insulted the Kkoreans who found their that water molecules may cluster. I have insulted you by pointing out that this piece of information is UTTERLY IRRELEVANT to homeopathy. That’s something altogether different.

    Buducius said;

    “In Boericke’s materia medica beneath the heading Syphilinum is (The Syphilitic Virus- A Nosode), although we know it is not a virus but a spirochete atleast the Homoeopaths at the time acknowledged a living entity to be the cause of the disease. GOTCHA!”

    That’s not a “gotcha”. At best it would be an irrelevant fact. Unfortunately, AlexG (hi Alex) has pointed out that it is untrue. So it is an irrelevant misrepresentation or untruth.

    Now that’s a GOTCHA.

    So, Budicius, every claim you have made here about the alleged scientific base of homeopathy has either been based on bad data or simply an irrelevance. That doesn’t leave much.

    Let me remind you of what you said when you first posted here;

    “The success of Homoeopathy is obviously in its clinical results and by way of individualized treatment and not in poorly organised double blind clinical trials. ”

    Well, the alleged successes of those you are happy to describe as “nuts” are regarded by them as being obvious in their clinical results JUST LIKE YOURS.

    So, come now, I’d like to know more about how you tell a nut from a homeopath. I can’t see any difference. More to the point, why are they “nuts” and you are not?

  316. Harlequin said,

    November 21, 2007 at 2:36 pm

    When Shang et al did a metaanalysis of 110 homeopathy trials, homeopathy was significantly better than placebo. When they restricted it to high quality trials (n=20?), homeopathy was significantly better than placebo. They then restricted it to large, high quality trials (n=8), and claimed they were no better than placebo. Does anyone here know which 8 homeopathy RCTs were selected?

  317. spk76 said,

    November 21, 2007 at 5:30 pm

    Back on the parallel Guardian thread, we have a homeopath coming up with this gem:

    “Currently I rate homeopathy third in line after crop circles and the alien abduction as a candidate for receiving the embrace of the scientific establishment.”

    Me too…

    blogs.guardian.co.uk/science/2007/11/homeopathy_have_your_say.html

  318. pv said,

    November 21, 2007 at 5:31 pm

    #
    Budicius said,

    November 21, 2007 at 12:35 pm

    I do apolagise I must have an inaccurate reference to avagadros number.
    #
    Budicius said,

    November 21, 2007 at 12:45 pm

    Atleast I am one Homoeopath that admits to when he stuffs up and apolagises.

    It’s all in the spelling.
    Why is it that woos aren’t only deluded, but illiterate too?

  319. pv said,

    November 21, 2007 at 5:36 pm

    I do apolagise I must have an inaccurate reference to avagadros number.

    Does this almost certainly less than honest statement remind anyone of a troll, of JREF and BadScience infamy?

  320. used to be jdc said,

    November 21, 2007 at 6:09 pm

    “Does this almost certainly less than honest statement remind anyone of a troll, of JREF and BadScience infamy?”

    Yes, but forchrissake don’T Mention his name.

  321. Budicius said,

    November 21, 2007 at 8:46 pm

    BSM- Scientific is ‘Classical Homoeopathy’ founded by the pioneers of Homoeopathy. So back then they used words like ‘Vital Force’ which would be akin to electromagnetic fields. I don’t think those other nuts have done ‘provings’ with their mp3 players.

    Isaac Golden has also done a 15 year study on Homoeoprophylaxis with excellent results, I believe he used potencies of 200c and above.

  322. Mojo said,

    November 21, 2007 at 9:43 pm

    Has he managed to get his results published anywhere? I don’t see anything on Pubmed.

  323. pv said,

    November 21, 2007 at 10:05 pm

    Budicius said,

    November 21, 2007 at 8:46 pm

    BSM- Scientific is ‘Classical Homoeopathy’ founded by the pioneers of Homoeopathy. So back then they used words like ‘Vital Force’ which would be akin to electromagnetic fields.

    Well, firstly, your word order is of the independently eccentric variety so I’m wondering whether English is your first language or if you learnt it off the label of a homeopathic preparation bottle. Secondly, can you provide a reference or two for your assertion that vital force is “akin” to electromagnetic fields. Or are you once again presenting the dreams and speculations of your fertile imagination as fact?
    Thirdly, do you know yet who Avogadro was? Note the spelling. And do you know what number he’s famous for?

    Btw. You aren’t Bubblefish are you? It just that your style is oh so vaguely reminiscent.

  324. pv said,

    November 21, 2007 at 10:08 pm

    And another thing. Homeopathy was pioneered by one man, Samuel Hahnemann. Who were the others you had in mind?

  325. pv said,

    November 21, 2007 at 10:11 pm

    #
    used to be jdc said,

    November 21, 2007 at 6:09 pm

    “Does this almost certainly less than honest statement remind anyone of a troll, of JREF and BadScience infamy?”

    Yes, but forchrissake don’T Mention his name.

    Sorry, jdc. Couldn’t resist! :-)

  326. BSM said,

    November 21, 2007 at 10:37 pm

    “And another thing. Homeopathy was pioneered by one man, Samuel Hahnemann. Who were the others you had in mind?”

    Well, it’s said that Hahnemann stole his ideas from others, but I don’t wish to go any further into this really because it just plays into their arguments from authority and antiquity fallacies. it really doesn’t matter who came up with the basic idea 200 years or more of advancements in knowledge have shown it should have been left behind by now.

  327. BSM said,

    November 21, 2007 at 10:48 pm

    Budicius;

    “BSM- Scientific is ‘Classical Homoeopathy’ founded by the pioneers of Homoeopathy.”

    Says you, but so what. Why is what you call Classical Homeopathy any more scientific than any of the other nuts in the basket?

    What is scientific about provings anyway? Though, in any case, and as I reminded you, your core claim is that clinical experience validates the therapy. Many fruitloops make exactly that same claim. Why is your clinical experience any more valid than theirs?

    Budicius said;

    “So back then they used words like ‘Vital Force’ which would be akin to electromagnetic fields.”

    Would it? How do you know? How has it been measured? A number of your “nuts” sell machines that claim to measure that exact thing. Are they not “nuts” when you need them to help you claim that the mythical “Vital Force” is something to do with electromagnetism.

    You must get whiplash sometimes with the speed with which your goalposts shift. You should probably take some arnica for that.

    Budicius said;

    “Isaac Golden has also done a 15 year study on Homoeoprophylaxis with excellent results, I believe he used potencies of 200c and above.”

    Has he now? Well, if it is more than just another load of glossy toilet-paper he’ll have had it published somewhere decent after critical review. Where would that be? The Journal of Urban Myths does not count as an acceptable reference source.

    Budicius, face one simple fact. Every time you take refuge in the claim that clinical experience in some way validates the claims of homeopathy we are going to instantly refute that claim with an illustration of someone even you define as a nutter using the same ploy. It is no more valid for them than it is for you. Your basic problem is that you have drawn an arbitrary cut-off around what you want to be true. Unfortunately what is really true pays no heed to that.

  328. Budicius said,

    November 21, 2007 at 10:50 pm

    Mojo- I only know that he has written a book on Homoeoprophylaxis, dunno if there are any journal articles.

  329. BSM said,

    November 21, 2007 at 11:03 pm

    Budicius

    I really think you don’t get it.

    Homeopathy is supported by a mountain of biased anecdote where every single case is better explained by other mechanisms. We know that because its basic mechanistic claims are at odds with all of the rest of science and because it utterly fails to show any real effect when the ‘real’ little sugar pills are replaced with ‘blank’ little sugar pills.

    If ‘real’ sugar pills and ‘blank’ sugar pills are indistinguishable in their effects then the specific unique claim of homeopathy is falsified. Your therapy consists of counselling AND NOTHING MORE.

    There you are, 2 paragraphs and 90 words. That’s all it takes to say all that needs to be said about homeopathy, but unfortunately you and your colleagues are so emotionally and financially vested in denying those very simple facts that you choose to spend your lives defending a lie and are prepared to go through endless mental contortions to preserve the false belief around which you have built your lives. More than anything else I find this deeply sad. You live in a fascinating world full of genuinely amazing things but you would rather waste your time on a lie.

    Life is not a rehearsal and you are acting in the wrong play.

    Ah well, you can lead a woo to water but you can’t make them think.

  330. BSM said,

    November 21, 2007 at 11:07 pm

    “Mojo- I only know that he has written a book on Homoeoprophylaxis, dunno if there are any journal articles.”

    Or in other words, it’s another load of old cock being used to flog books.

    Be sure to get back to us when he moves from the role of fiction author and has done some controlled trials.

  331. BSM said,

    November 21, 2007 at 11:45 pm

    No, no, it gets better,

    Here’s a link to Golden’s whole thesis.

    adt.lib.swin.edu.au/uploads/approved/adt-VSWT20050228.150047/public/02whole.pdf

    To be fair, he does acknowledge the weaknesses of his approach;

    “The research upon which this thesis is based represents primarily and [sic] observational design with some prospective elements, but without a concomitant comparison group recruited similarly from the community” (page 86)

    Now, what do we say about this?

    It’s a common tactic of the homs at the more rationally minded end of the spectrum to genuinely want scientific credibility. But time and again they do these pilot study type of projects and go through the ritual of acknowledging the limitations of this type of study, but the controlled trials never get done, or they get done and are found to be negative.

    However, what lingers in the woo-sphere are those initial studies, which homeopathy’s fans and wannabes then cite as if they were valid evidence.

    On other occasions the homs generate observational studies for reasons that look much more like a deliberate attempt to mislead the public as to what counts as evidence, hence the appalling Spence study and its atrocious misrepresentation by the Faculty of Homoepathy (trusthomeopathy.org).

    www.trusthomeopathy.org/csArticles/articles/000000/000080.htm

    “Homeopathy improves health of 70% of follow-up patients in study” No it doesn’t and they have no right to say that.

    Trust homeopathy? Bollocks should we).

    More recently they have played the same trick with a veterinary study.

    That press release has mysteriously disappeared from the FacHom website. But I saved a copy.

    “Pilot study suggests homeopathy is effective in treating pets with common diseases”

    No it didn’t. What it showed was that suitably trained homeopaths could record data on and Excel spreadsheet. Apparently this warrants a publication and a press release. Even the authors were more careful in what they said than the FacHom.

    RT Mathie, L Hansen, MF Elliott and J Hoare: Conclusions: Systematic recording of data by veterinarians in clinical practice is
    feasible and capable of informing future research in veterinary homeopathy.
    I wonder if that’s why the press release has vanished.

    FacHom:
    Pilot study suggests homeopathy is effective in treating pets with common diseases

    The phrase “liar liar pants on fire” springs unbidden to my mind.

  332. pv said,

    November 21, 2007 at 11:52 pm

    From the late Prof. Richard P Feynman, on the subject of science:

    We are trying to prove ourselves wrong as quickly as possible, because only in that way can we find progress.

    Compare and contrast that honest assessment of a real scientist, about his work, with the obstinate ramblings of those who defend Homeopathy and all other junk “medicine” and quackery.

  333. Budicius said,

    November 22, 2007 at 12:05 am

    PV- I am absatively posolutely peeved off with your pedantic attacks on my semi-illiteracy. You never amaze to cease me.

  334. Budicius said,

    November 22, 2007 at 12:12 am

    Anectdotal evidence and testimonials seems to be the way of the future, just look at those hour long infomercials.

  335. pv said,

    November 22, 2007 at 12:13 am

    #
    BSM said,

    November 21, 2007 at 10:37 pm

    “And another thing. Homeopathy was pioneered by one man, Samuel Hahnemann. Who were the others you had in mind?”

    Well, it’s said that Hahnemann stole his ideas from others, but I don’t wish to go any further into this really because it just plays into their arguments from authority and antiquity fallacies. it really doesn’t matter who came up with the basic idea 200 years or more of advancements in knowledge have shown it should have been left behind by now.

    I agree. I was responding to the idea that it was a team of pioneers, as if it were some grand promotional exercise. I understood that, irrespective of who Hahnemann stole his ideas from, it was basically him trying it out on himself and subsequently treating his own patients. Everyone else who practised it was essentially a follower of the revered leader and his biblical text.
    I know I’m being repetitive here but it bears so many of the hallmarks of a religion, and the believers so many of the blindly obstinate and un-self-critical attitudes, that, to all intents and purposes, it is one – a religion.

  336. pv said,

    November 22, 2007 at 12:17 am

    #
    Budicius said,

    November 22, 2007 at 12:05 am

    PV- I am absatively posolutely peeved off with your pedantic attacks on my semi-illiteracy. You never amaze to cease me.

    #
    Budicius said,

    November 22, 2007 at 12:12 am

    Anectdotal evidence and testimonials seems to be the way of the future, just look at those hour long infomercials.

    Officially outed as a troll. Bubblefish.

  337. pv said,

    November 22, 2007 at 12:19 am

    TROLL FEEDING TIME IS OVER

  338. BSM said,

    November 22, 2007 at 12:23 am

    “Officially outed as a troll. Bubblefish.”

    Bubblefish? As an occasional visitor I’m not up to speed on this. Could you elaborate a little.

    Are we dealing in troll= time waster who does not believe in what they post but just do it to get a rise out of other posters, or troll= time-waster who genuinely believes in crackpot ideas but will post anything the hell that pops into their tiny mind but with no intention of trying to defend their position in any meaningful way.

    But hey, I quite like rehearsing the arguments anyway, so for short periods I can also live with troll= sounding-board to bounce ideas and humour off.

  339. Budicius said,

    November 22, 2007 at 12:32 am

    Another pioneer I was thinking of was Dr Constantine Hering who ‘proved’ many new remedies and discovered the the ‘Law of Cure’.

  340. BSM said,

    November 22, 2007 at 12:34 am

    “Another pioneer I was thinking of was Dr Constantine Hering who ‘proved’ many new remedies and discovered the the ‘Law of Cure’.”

    Sorry, grown-ups talking. I’d like to hear what pv has to say next.

  341. pv said,

    November 22, 2007 at 12:46 am

    Bubblefish is an infamous troll on JREF, and his alter ego TM used to conduct himself in same inane way on the BadScience forums. See if you can work your way through this thread at JREF for a flavour of Bubblefish at his most idiotic. You’ll see he doesn’t need much encouragement. TM can be found by searching the BadScience forum. Btw, his real name is Rome Viharo.

  342. pv said,

    November 22, 2007 at 1:00 am

    BSM, to be honest I have no idea if Budicius and Bubble are one and the same. But they display exactly the same persistent boneheadedness, bad spelling, poor excuses and general ignorance, that they might as well be. Wikipedia, which he loves to trawl through and misquote, is his friend – as you’ll find out.
    Bubblefish is a poor little show biz boy from Los Angeles and his real talents are for time-wasting, taking loads of drugs and making dreadfully amateurish home movies which he likes to upload to youtube.

  343. Budicius said,

    November 22, 2007 at 2:32 am

    PV- I am in no way related to Bubblefish and he features nowhere in ‘Arthurian Legends’ as far as I know.

  344. BSM said,

    November 22, 2007 at 8:18 am

    pv said;

    “BSM, to be honest I have no idea if Budicius and Bubble are one and the same.”

    Certainly, Budicius has ceased responding to reasoned argument so the point is moot. Without even the illusion of progress or variation in his side of the exchange (I wouldn’t grant it the name ‘debate’) there is nothing to respond to anyway.

    I’ve never yet seen a homeopath follow any of these arguments to their logical conclusion because that would mean abandoning one of the defining features of their lives and the ones who are brazen enough to try to persist through forum debates are effectively by definition the most entrenched. The best that one can hope for is that casual observers see them making fools of themselves are led to question any belief they have in homeopathy.

    In that regard, it’s been commented both by Ben’s e-mail correspondent and elsewhere that homeopathic business has been suffering recently from all the bad publicity. I wonder if that is true. Does anyone here know?

  345. DrJ said,

    November 22, 2007 at 10:30 am

    this was posted on DC’s improbable science:
    dcscience.net/?p=197

    well worth a read.

  346. BSM said,

    November 22, 2007 at 10:41 am

    “this was posted on DC’s improbable science:
    dcscience.net/?p=197
    well worth a read.”

    That was what I was thinking of, but I wouldn’t trust “Dr B” to tell me whether water was wet so I wonder whether we have any other lines of evidence.

  347. wewillfixit said,

    November 22, 2007 at 10:57 am

    pv – there is no way that is Bubblefish. He couldn’t go this long without mention of the word “mystery” or using the words “true”, “false”, “objective” and “subjective” in ways that are completely unrecognisable.

  348. JQH said,

    November 22, 2007 at 11:28 am

    Nor has he invoked chi/qi or threatened us with legal action for disagreeing with him.

    Do you think Bubblebrain might be working for the SoH’s PR Department?

  349. Fralen said,

    November 22, 2007 at 11:30 am

    No, you are not allowed to disagree with the SoH, they would have sued by now.

  350. kim said,

    November 22, 2007 at 11:53 am

    I see there’s a reply to Ben in the Comment is Free bit of the graun today:

    commentisfree.guardian.co.uk/denis_maceoin/2007/11/your_ignorance_is_showing.html

  351. pv said,

    November 22, 2007 at 1:58 pm

    #
    wewillfixit said,

    November 22, 2007 at 10:57 am

    pv – there is no way that is Bubblefish. He couldn’t go this long without mention of the word “mystery” or using the words “true”, “false”, “objective” and “subjective” in ways that are completely unrecognisable.

    Give it time. ;-)

    #
    JQH said,

    November 22, 2007 at 11:28 am

    Nor has he invoked chi/qi or threatened us with legal action for disagreeing with him.

    I became suspicious when I saw this:
    #
    Budicius said,

    November 21, 2007 at 12:35 pm

    I do apolagise I must have an inaccurate reference to avagadros number.

    Then I realised, apart from the consistent misspellings of “apologise” and Avogadro”, he seemed to be presenting all these tenuously related tit-bits of information as if he was searching Wikipedia for stuff to throw into the fire, so to speak, but not really understanding what he was finding (just like Bubble). So I figured he was just making it all up to string everyone along, as trolls do.
    I’m not convinced either way about who he is, but he is a troll, and we shouldn’t feed him.

  352. BSM said,

    November 22, 2007 at 2:17 pm

    “I’m not convinced either way about who he is, but he is a troll, and we shouldn’t feed him”

    I dropped my paperbag in the duckpond and all my troll-nuts were in it, so its no good him snuffling through the bars of his cage now.

  353. Scooby said,

    November 22, 2007 at 2:18 pm

    Kim,

    Denis MacEoin somehow managed to omit from the Guardian article that he is married to a homeopath, and that he has written at least two articles for the Journal of the Society of Homeopaths.

    Not quite the sceptic he’d like to portray himself as.

  354. pv said,

    November 22, 2007 at 4:29 pm

    Scooby said,

    November 22, 2007 at 2:18 pm

    Kim,

    Denis MacEoin somehow managed to omit from the Guardian article that he is married to a homeopath, and that he has written at least two articles for the Journal of the Society of Homeopaths.

    Not quite the sceptic he’d like to portray himself as.

    The abilities to mislead and be disingenuous seem to be requisite homeopathic skills. The question is, is it deliberately misleading and disingenuous or merely incompetence? Given the quantity and frequency of misleading statements emanating from the minds of the defenders of homeopathy (SoH, Denis MacEoin etc.), one could be forgiven for thinking it is deliberate. If it isn’t deliberate then it surely is most shockingly and appallingly deluded and incompetent.

  355. DrJ said,

    November 22, 2007 at 5:37 pm

    I had a read through Denis MacEoin’s article and the comments underneath; did he even read Ben’s article or did his wife paraphrase it for him?

    The trouble with these CiF ‘debates’ is that they get hopelessly off topic within 2 or 3 posts, and withing 10 posts the debate was basically a continuation of the previous thread.

    There is absolutely no way that homeopaths / sympathisers can be properly challenged as they can pick and choose who they respond to and ignore the actual difficult questions.

    Can we apply for some funding to do the study Ben suggested. If these homeopaths are genuinely interested in gaining scientific acceptance they should be more than happy to put up the cash.

  356. quietstorm said,

    November 22, 2007 at 8:34 pm

    Is the issue here that there haven’t been enough high-quality trials performed with the correct constraints? Or is it simply that some people refuse to “believe” them?

    I agree that the results of a trial should be reproducible, so let’s get some funded. Homeopathy makes an awful lot of money, the NHS are thinking about using scant resources to provide it to the general public – how can we bring it to the attention of the funding councils to ensure that proper, convincing research gets done?

    I thought about suggesting a “Downing Street E-petition”, but then remembered that we probably want as little meddling as possible by government-types in the decisions made by the funding councils….

    OR… is it the case that the relevant funding council DOES get approached by people who wish to do those kinds of trials, but they refuse funding because the studies have been done already, and there’s no need to repeat them?

  357. aphasia said,

    November 22, 2007 at 9:00 pm

    Wow, Denis MacEoin’s article is even worse than Winterson’s. It’s good that the Graun provides balanced coverage but printing a badly written piece of rhetoric isn’t what the situation called for.

  358. jamrifis said,

    November 22, 2007 at 9:47 pm

    Denis MacEoin, Andrew Collins, Craig Sams. Some people are very fortunate in their enemies.

  359. Hmmm said,

    November 22, 2007 at 10:34 pm

    quietstorm,

    It’s up to the homeopaths to fund the research IMO – why should public bodies waste a penny on their delusions?

    By research I mean proper RCTs – not the type of customer satisfaction survey they have recently touted as evidence.

  360. quietstorm said,

    November 22, 2007 at 11:44 pm

    Hmmm,

    Except I can’t see research funding coming from homeopaths to perform an objective study.

    You’re correct of course, research money is precious, if the study has been done already (and, re-reading Dr Goldacre’s original text, I see it has been done more than once) then there’s no need to use the money to re-do it.

    However, the homeopaths’ “delusions” are stealing a great deal of money from ordinary people. It’s all very well saying “buyer beware” in these situations, but the public needs to be protected from the snake-oil salesmen, in whichever guise they choose. To the scientifically less-literate MP/civil servant who is directing public policy, the evidence needs to be presented loud and clear. I was just wondering whether a little money upfront now might save a lot of money later on for those who would otherwise be taken in by homeopathy’s claims (and this seems to include the NHS).

  361. pv said,

    November 23, 2007 at 12:37 am

    Homeopaths deliberately avoid doing properly controlled studies.The reason they insist on other people such as Government paying for them, I think, is precisely so they can accuse the organisers of the studies of being biassed against them.
    Anyway, the studies have been done and homeopaths predictably don’t like the results, so they deny they exist.
    I agree, although homeopathy might be physically harmless in that it contains no medically active ingredient, is harmful in a host of other no less important ways. It is irrational and anti-science. Its promoters routinely misrepresent science and evidence based medicine. It encourages ill people to shun proper diagnosis and evidence based treatment – in which sense it is physically harmful. It is based on falsehood and encourages belief in falsehoods. Practising for money is effectively fraudulent.
    What I would like to know is why august institutions like the Royal Society together with the various professional medical bodies and journals like the Lancet and BMJ aren’t making a big fuss about it to Government. Health resources are limited yet ignorant or cynical MPs are for various reasons announcing themselves in favour of provision of homeopathy on the NHS. In the meantime homeopaths and their cheerleaders, encouraged by their marketing chiefs, are weaving tapestries of deceit and obfuscations in order to protect their fragile vanities and their fraudulent incomes.

  362. BSM said,

    November 23, 2007 at 8:22 am

    “is harmful in a host of other no less important ways. It is irrational and anti-science. Its promoters routinely misrepresent science and evidence based medicine”

    and they trail off to Africa to create AIDS clinics. Now there is the potential for actual serious harm as well as the political harm it does via giving the HIV-denialists added credibility.

  363. TimW said,

    November 23, 2007 at 11:11 am

    @woodpecker…

    Tufty??

  364. pv said,

    November 23, 2007 at 1:50 pm

    woodpecker said,

    November 23, 2007 at 6:37 am

    I (as Tufty) tried to bring some sense to another blog (see link below) by citing this one. It might be interesting for readers to see the views of people who actually believe in homeopathic remedies, and how they react to being advised that these remedies might not be what they think they are.

    www.cottagesmallholder.com/?p=511

    Pathologically credulous might be one description of them. The biblical literalists of the medical world, who score -5 on a scale of 1 to 10 for critical thinking.

    I particularly liked the comment of one contributor who wrote that homeopathy is coming under attack for “reasons too complicated…”! Like absence of evidence in favour, overwhelming evidence against, together with the contravention of physical laws – that’s all too complicated. Oh, ffs, you wouldn’t want to overtax their collective single grey cell!

  365. ips said,

    November 23, 2007 at 4:44 pm

    Dylan Evans in his well written book Placebo -The Belief Effect discusses the theories of Homeopathy and its incompatibility with current science . He states (p152) we are faced with a stark choice:either homeopathy is simply a placebo, or the whole of physics and chemistry as we know them are false.
    This has been stated throughout this discussion. However, what strikes me is that the topic is more interesting than the fact that homeopathy is implausible.
    There is a rise in fundamentalism in many areas of life where religion clashes with science and this debate seems similar. As Richard Holloway (previously Bishop of Edinburgh) suggested religion is like poetry, full of metaphor and myth but increasingly tries to use this mythology to explain literally what is going on ( the refusal to accept darwinian ideas in schools in some parts of the U.S for example).
    Medicine is complex and there are many facets of medicine which are in no way ‘scientific’ despite what many people like to think . It is a human discipline which is overwhelmed by human suffering (particualry and increasingly so in General Practice settings) which cannot be defined in a reductionist sense.
    In many ways Illich I believe was correct -people are condtioned to get something not do something .jech.bmj.com/cgi/content/full/57/12/935
    The solution or inert vapour acts as a seal and in many cases many conventional medicines do the same given the fact that many people come along for the consultation- the script is a seal and often not that important (see the human effect in medicine -Dixon and Sweeny)
    The belief effect must surely play a part in the effects of many interventions which are deemed to be logically sensible but given scruitiny are shown to be placebos( certain types of arthsrocopic knee surgery for example which have not been ‘stopped’ since Moseleys research a few years ago)
    In times of trouble people want an explanation and a hand up and the indvidualised consultation and enhanced super placebo likely facilitates many. I have visited a Homeopathic Hospital and was very impressed by the building , ethos and the consultation skills. Many patients with things like intractible pain and medically unexplained symptoms are i believe better served by the homeopathic ethos than the current merry go round that is the usual fare in the NHS.
    However, these things need some open minded discussion . I think homeopathy helps people in limited ways which is well covered by Evans book. Trying to prove how it works scientifically seems pointless but discussing why people who practice homeopathy have more success with some problems is interesting and may broaden the discussion to include less tangible aspects of medicine and human interaction?

  366. pv said,

    November 23, 2007 at 5:50 pm

    The belief effect must surely play a part in the effects of many interventions which are deemed to be logically sensible but given scruitiny are shown to be placebos( certain types of arthsrocopic knee surgery for example which have not been ’stopped’ since Moseleys research a few years ago)
    In times of trouble people want an explanation and a hand up and the indvidualised consultation and enhanced super placebo likely facilitates many. I have visited a Homeopathic Hospital and was very impressed by the building , ethos and the consultation skills. Many patients with things like intractible pain and medically unexplained symptoms are i believe better served by the homeopathic ethos than the current merry go round that is the usual fare in the NHS.
    However, these things need some open minded discussion . I think homeopathy helps people in limited ways which is well covered by Evans book. Trying to prove how it works scientifically seems pointless but discussing why people who practice homeopathy have more success with some problems is interesting and may broaden the discussion to include less tangible aspects of medicine and human interaction?

    “Counselling”, I think we call it, which is available on the NHS.
    I have made the challenge many times for anyone to give an example, with references, where a non-self-limiting condition has been incontrovertibly cured by homeopathy. The silence is deafening, because there are none. Self-limiting conditions, by definition, need no cure and anyway those such as the common cold don’t have one. Homeopathy’s success lies in fooling a believer that their cold wouldn’t have got better without intervention. To put it another way, homeopathy’s success lies.
    Also there is a reason that you don’t find homeopaths practising in a hospital’s A&E department. It’s because there’s a good chance that the people who go there might actually have something wrong with them outside the scope of a gentle chat and expensive prescription for magic water and sugar pills.
    If it wasn’t unethical it might be a good idea to set up a homeopathic A&E department at a major city hospital, without access to any of that evil “allopathic” stuff.

  367. Bogusman said,

    November 23, 2007 at 6:36 pm

    How about setting up a homeopathic A&E right next door to a conventional one. Then give the patients (or their relatives if they are unconscious) the choice of which one to enter?

  368. ips said,

    November 23, 2007 at 6:37 pm

    www.sciam.com/article.cfm?articleId=000E0FA8-01BB-1D2E-96D7809EC588EEDF

    Here is the knee (‘placebo’) study with an interesting last paragraph – the results of this haven’t altered practice much.
    People ‘demand’ and often get treatments for self limiting condtions all the time hence the overprescription of many types of medication including antibiotics.
    I thnk your example regarding A+E is a bit extreme.
    I am not a Homeopath and have little interest in trying to explain it in scientfic terms(other than perhaps lookng at PET scanning and cortisol levels perhaps) but find the reasons why people get benefit from it interesting.
    There is a recent paper suggesting that even when people realise that their treatment was a placebo it makes little difference and they still benefit and remain happy with the outcome.

  369. pv said,

    November 23, 2007 at 7:15 pm

    Trying to prove how it works scientifically seems pointless…

    But it’s already reasonably well understood, and understanding it seems far from pointless. The real point is that homeopaths refuse to accept what the evidence does support. They have nothing to offer themselves except to repeat the mantra, “we need more tests”, to which I say “why not do them yourselves?”.

  370. pv said,

    November 23, 2007 at 7:25 pm

    I thnk your example regarding A+E is a bit extreme.

    Why?

    People ‘demand’ and often get treatments for self limiting condtions all the time hence the overprescription of many types of medication including antibiotics.

    I have no doubt this is true, and the over-prescription and inappropriate prescription of antibiotics has been well documented and publicised.
    I would put it to you that when a GP refuses to prescribe an antibiotic for a condition for which it would have no effect, the patient might well be persuaded to seek the help of a homeopath – because “conventional medicine can’t help”. My gripe with homeopaths is they routinely mislead and deceive. And they are accountable to no-one. When GP’s do the same they are, rightly, castigated for it (often, unfortunately and rather ironically, by the same people who defend homeopathy).

  371. almud said,

    November 23, 2007 at 8:02 pm

    BG writes :
    “So we know that four sugar pills a day will clear up ulcers quicker than two sugar pills, we know that a saltwater injection is a more effective treatment for pain than a sugar pill, we know that green sugar pills are more effective for anxiety than red, and we know that brand packaging on painkillers increases pain relief.”

    Well , many homeopaths know this too !
    But why do they maintain the old-fashioned Design of the Pills :
    The Homeopathic Remedies are as big as the eye of a grasshoper, they are either blue nor red ..they are not brand packaging …. they do not smell …they do not taste …they do not cost much …and often I become from the homeopath only one dose (3 or 5 globule) …and I always must think disapointed
    ” How can ‘this kind of nothing ‘ help me ? It is not possible ! ” ….but I never was disapointed !

  372. pv said,

    November 23, 2007 at 9:11 pm

    and often I become from the homeopath only one dose (3 or 5 globule)

    Beg pardon?

  373. almud said,

    November 23, 2007 at 10:06 pm

    Hello pv – sorry, english is not my native language.
    My idea is : The rules of placebo effect are : much is better ( ‘four sugar pills a day better than two’ ) , injection (with saltwater) is more effective, colour gives sense, brand packaging and price are important … You approve that Homeopathy is maximum placebo !.
    But Homeopathy do not bother about these Placebo rules at all : the pills are small , the pacient takes the Pills not often – sometimes a pacient takes only one dose ( 3-5 globules) or a dose every 8 weeks or rarer …the pills are very cheap …..injections are unusual .. . and so on .
    My opinion is that all these factors are so, that they rather inhibit the placebo .. So why do you reduce Homeopathy to Placebo (or less) ?

  374. used to be jdc said,

    November 23, 2007 at 10:36 pm

    “So why do you reduce Homeopathy to Placebo (or less) ?”

    Because when homeopathy is compared to placebo in well-designed trials there’s no difference between placebo and homeopathic treatment.

  375. used to be jdc said,

    November 23, 2007 at 10:39 pm

    “My opinion is that all these factors are so, that they rather inhibit the placebo ..”

    Could it be the case that the ritual involved in traditional homeopathy and the mysticism associated with homeopathy heighten the placebo effect? Just a thought.

  376. fiwallace said,

    November 23, 2007 at 11:05 pm

    homeoweb.free.fr/

    Homeopaths sans frontiers!

    Somebody told me about this because they thought it was a spoof. I have an awful feeling that it isn’t.

    Can anyone enlighten me?

  377. quietstorm said,

    November 23, 2007 at 11:10 pm

    sorry – bit off topic, but back to Hmmm’s post regarding The Prince’s Foundation for Integrated Health – you’ve hit the nail on the head. I also felt that the only way forward was to ensure that those on both sides agree on the form of the trial before it takes place. But I have my cynical head on today, and I feel that there would be no such agreement. Those homeopaths who genuinely would like to see some scientific explanation for what they perceive to happen are vastly outnumbered by those who think that the way to win an argument is simply to shout loudest.

    How do you argue with that? We can’t make people be rational… all we can do is ensure that those people are not making decisions that could cost millions of pounds.

  378. quietstorm said,

    November 23, 2007 at 11:12 pm

    sorry, it’s not all about the money, I meant, “make decisions that could have a detrimental effect to people’s lives”, as people have reminded us, the same homeopaths who peddle sugar pills can advise vulnerable people to shun conventional treatments. This practice is dangerous.

  379. pv said,

    November 23, 2007 at 11:23 pm

    used to be jdc said,

    November 23, 2007 at 10:39 pm

    Could it be the case that the ritual involved in traditional homeopathy and the mysticism associated with homeopathy heighten the placebo effect? Just a thought.

    A rhetorical question I’m sure. ;-)

    As any parent with young children will likely attest, we use the placebo is used to great effect at every opportunity; sometimes several times a week. Children are particularly susceptible to the reassuring voices of authority (mummy and daddy), especially in times of high anxiety. Tummy aches, nosebleeds, colds and fevers, not to mention the odd scratch and bruise. The ritual and the words are everything, occasionally assisted by a drop of magic water (from the tap) and maybe sugar. Of course it doesn’t always work immediately but that’s the point of constant reassurance.

    I have become aware recently, during the course of torturing myself reading loads of blather on homeopathy forums, that rather many visits to the homeopath are for anxiety related problems. Quel surprise! And that a fair few believe homeopathy “works” because their children’s colds get better. Extraordinary – that the colds of children with anxiety wracked parents can’t possibly get better without outside help. Does anyone else think that neurotic, angst ridden parents aren’t very reassuring?

    This is how homeopathy “works” though, by allaying the fears and anxiety of the patient. No more, no less. All very childlike I’m sure but, if weight of anecdote counts (homeopathy’s preferred form of evidence) and my own experience is to be believed, it’s very true.

  380. pv said,

    November 23, 2007 at 11:24 pm

    ‘scuse typos above!

  381. almud said,

    November 23, 2007 at 11:29 pm

    used to be jdc :
    “Could it be the case that the ritual involved in traditional homeopathy and the mysticism associated with homeopathy heighten the placebo effect? Just a thought”

    well , but the rules of Placebo are defined and verified in double blind clinical trials and we discust about these rules – we do not want to redifine them. The most of patients do not know much about involved rituals, homeopathy as a cience…Better said they know nothing , they just are or feel ill …they make no difference between homeopathy or allopathy or phythotherapy or…something else ..

  382. BSM said,

    November 24, 2007 at 12:17 am

    www.cottagesmallholder.com/?p=511

    Sticking to the woodland creatures theme, I went as ‘mouse’. (pending moderation)

  383. BSM said,

    November 24, 2007 at 12:24 am

    almud said;

    “So why do you reduce Homeopathy to Placebo (or less) ?”

    Because homeopathy is a complete package evolved brilliantly to maximise placebo effect from the authoritarian tone of its practitioners to the mysterious Latin names of its remedies.

    It is a beautifully optimised scam; an iteratively self-organised system built from random elements selected to separate its believers from reality while making them money at the same time.

  384. DrJon said,

    November 24, 2007 at 9:52 am

    Denis MacEoin has replied to the criticisms of his CiF piece… by ignoring them! Hurrah for rational debate! Actually I find this rather depressing, and MacEoins distortions show how unscientific he really is :(

    I suppose it’s time I added a comment to this thread. I put up a short article designed to provoke some sort of rational debate about a contentious scientific subject. I expected criticism, but I also expected reason, balance, and informed debate. I received the criticism in bucketloads, but none of the other things. Instead of a reasoned discussion, there is — if you will scroll down — little but invective, vitriol, spleen, and anger. I do not think I have read a single comment here that has been anything but bellicose, with vituperative language, ignorance parading as knowledge, and arrogance masquerading as scientific insight. This has not been a rational debate, and anyone who thinks it has should read back carefully. I am all too aware of what it is: this is the language, long familiar to me, of religious intemperance, the voice of orthodoxy screaming for the blood of heretics — and, let me tell you, it is rank. I have read a comment in which someone suggests that my appearance shows that homeopathy really is harmful. How clever and astute! Others have drawn attention to religious beliefs I left behind in 1980: was it not enough that my article spelled out the fact that I am a sceptic and rationalist? Many have seen cause for sneering in referring to my original academic background. What the hell has that got to do with the arguments I advance above? I write as someone trained and experienced in academic rigour and rational argument, and as someone with a reasonable knowledge of homeopathy. I did not claim in my piece to be a scientist, nor did I wade in to the vast area of scientific specificities — something I’m not qualified to do. But I am very well qualified to spot humbug, cant and smart-aleckness. In Ben Goldacre’s piece, he mentioned veterinary homeopathy and dismissed it by claiming that pets respond to being taken special treatment, and that this too was placebo. This is obvious irrationality. Goldacre cannot advance a shred of evidence for what is, at face value, a very unlikely claim. And he makes a fatal mistake. Sir Karl Popper, the great philosopher of science, argues that we must not be content to tackle our opponents on their weakest points, but to debate them on their strongest. How then does that claim to placebo match something that is common practice in veterinary homeopathy on farms: the treatment of herds of dairy cows using remedies placed in their drinking water? Placebo? That is much more difficult to believe than accepting that homeopathic remedies do in fact work.

    I don’t think anyone actually grasped what I was saying about the problem with RCTs using just ‘simple’ homeopathy. Many of you argued that, since the orthodox RCT is perfect in some way, it was only proper for homeopathy to fit it, rather than develop a more complex form of RCT that might fit homeopathy. The first attitude is exactly what exponents of an orthodoxy advance when challenged by unfamiliar phenomena (read Thomas Kuhn on this). If homeopathy works, then it will prompt a paradigm shift in our understanding of medicine. Since there is a lot of prima facie evidence that it does work, it is incumbent on scientists to devise tests that treat it just ly. They must stick to Popper’s principle of falsification, trying as hard as possible to prove homeopathy wrong, while being alert to evidence that it is a real phenomenon.

    Someone suggested that there was no need for Ben Goldacre or anyone else to know much about homeopathy in order to investigate and disprove it. Really? Let me show the bareness of this argument. Very recently, I authored a report on British Islam for a leading think tank. Let’s assume I knew next to nothing about Islam: could I have dealt with raw materials in several languages and written an analysis that required a knowledge of the historical and theological background. Of course not. The reason I was selected to write the report in the first place was my knowledge of the subject. Nothing can excuse Goldacre’s inexperience of homeopathy as a practical medical discipline. Why are there so many doctor homeopaths? It is usually because they watched other homeopaths at work, gained some knowledge of the subject, and went on to immerse themselves in it. Goldacre has, to the best of my knowledge, held himself aloof from acquiring the knowledge and hands-on experience that would fit him to pursue accurate research in the subject.

    This debate is not going to go away. Google the British Homeopathic Association and find on their website a very damning analysis of Goldacre’s Lancet article. As yourself why Goldacre left out of his analysis one of the most important meta-analyses of homeopathic trials, a Lancet review that showed homeopathy achieving very high percentages of success. Until this becomes a proper two-sided debate in which all information is deployed, it will remain loud, boorish, and meretricious, and will get us nowhere near the truth.

    Sorry for the length.

  385. Nightscream said,

    November 24, 2007 at 1:06 pm

    Hi. I’m new here; I came here through a link on the JREF main page.

    The article was a fairly good read, but it didn’t seem to cover any new ground.

    So why it titled “The End of Homeopathy?” From this title, I was expecting to read something about a news development, perhaps a report stating that homeopathy is on the decline, or something. Am I missing something here?

    Thanks.

  386. almud said,

    November 24, 2007 at 1:55 pm

    BSM said :

    “Because homeopathy is a complete package evolved brilliantly to maximise placebo effect from the authoritarian tone of its practitioners to the mysterious Latin names of its remedies.”

    Homeopathy does not try to maximise its placebo effect using Latin names !
    80 % of the homeopathic remedies are from plants and they maintain their names : as Arnica Montana, Calendula Officinalis, Hypericum Perforatum and so on .
    Sometimes they are prepared from animals and they maintain their names too : Blatta americana (American cockroach), Blatta orientalis (Indian cockroach), Culex (Mosquito culex), Apis melifica (Honey Bee), Cimex (Bed-bug), Formica (Red ant), Vespa (Wasp), etc.

    Sometimes they are prepared from minerals and the names are simplest : Anthracinum, Graphites, Hecla lava ( is lava from the volcano Hecla)
    Mica, Silicea, etc.

    Where is the Mistery ????

    The Practitioners do not have a more authoritarian tone as other medical doctors …Why should they have it ?

    Homeopathy finds its first roots recorded in the writings of Hippocrates (c.470-400 bc)
    He wrote that “Disease is eliminated through remedies able to produce similar symptoms.”
    These ideas were later rediscovered by Dr. Samuel Hahnemann (1755-1843) who, through a process of experimental and scientific discovery, largely developed what Homeopathic medicine is today.

  387. pv said,

    November 24, 2007 at 3:50 pm

    Where is the Mistery ????

    Is there a homeopathic cure for homeopathic spelling and homeopathic grammar, and those bloody homeopathic question marks?

    The reference to Hippocrates is pure woo appeal to authority and the “wisdom of the ancients”. Kindly state what else Hippocrates and the ancients knew, then explain why the average age during his time was closer to 30 years – when, in addition to famine, pestilence and wars, people died from what today would be very minor infections. Even half a century ago, worldwide, most people died before they were 50 years old.

    Here’s a list of life expectancies worldwide through the ages according to Hofstra University, New York:

    Average Life Expectancy Worldwide (2006 = 66
    Late 19th Century in Western Europe = 37
    Medieval Britain (400 – 1500 AD) = 33
    Classical Greece and Rome (500 BC – 400 AD) = 28
    Bronze Age (3,500 – 1,200 BC) = 18
    Neolithic (8,500 – 3,500 BC) = 20
    Upper Paleolithic (40,000 – 10,000 BC) = 33
    Neanderthal (350,000 – 25,000 BC) = 20

  388. pv said,

    November 24, 2007 at 3:56 pm

    Sorry about the link.
    Try this:
    www.people.hofstra.edu/
    or
    people.hofstra.edu/Jean-paul_Rodrigue/downloads/Geog%20102%20Topic%202.ppt

  389. almud said,

    November 24, 2007 at 5:04 pm

    Hello pv – sorry, english is not my native language . I do not use it everyday , I learned it in the school – I told this yesterday .
    I wanted to comment only this column about Homeopathy because it is very interesting.
    If you speak german I could write you in german …It is also not my native language but I know it very good .
    Samuel Hahnemann founded homeopathy about 200 years ago.
    And Homeopathy does not affirm that it can mend every illness.
    Hippocrates just had the idea
    “Disease is eliminated through remedies able to produce similar symptoms.”
    There were no homeopathic remedies before Hahnemann …

    Would you like to continue a little bit more in German ?
    I understand English but I am not so good in saying or writing

  390. almud said,

    November 24, 2007 at 5:27 pm

    Nightscream said
    “The article was a fairly good read, but it didn’t seem to cover any new ground.

    So why it titled “The End of Homeopathy?” ”

    yes you are right ! Nothing new but very good written .

  391. ultracrepidarian said,

    November 24, 2007 at 5:41 pm

    Greetings! My first comment here, although I’m a regular Bad Science reader and usually put in a shove for rationality in the rucks and mauls of the CiF homeopathy threads.

    spk76 suggested on CiF that Denis MacEoin’s piece might be a joke by the CiF subeditors….given that “Denis MacEoin” is an anagram of “no sane medic I”, he might have a point….

  392. pv said,

    November 24, 2007 at 5:49 pm

    almud said,

    November 24, 2007 at 5:04 pm

    Hippocrates just had the idea
    “Disease is eliminated through remedies able to produce similar symptoms.”
    There were no homeopathic remedies before Hahnemann …

    It was incorrect in the time of Hippocrates and was still incorrect in Hahnenmann’s time. It remains just as incorrect and ludicrous today. There is not a shred of evidence to support the absurd assertion that like treats like but a mountain of evidence to contradict it.
    According to the ridiculous logic you support one could eat a strong curry to cure appendicitis.
    Medicine and knowledge of disease have moved on since Hahnenmann, however much you might choose to ignore that fact.
    As I have asked many times now, how about an incontrovertible example, with references, where homeopathy has cured a non-self-limiting condition. One will do.

    Regarding your spelling and grammar, if English is not your first language, here’s a tip:
    read what others have written, especially those you are quoting.

  393. pv said,

    November 24, 2007 at 6:07 pm

    Almud, you omitted to respond to this:

    Kindly state what else Hippocrates and the ancients knew, then explain why the average age during his time was closer to 30 years – when, in addition to famine, pestilence and wars, people died from what today would be very minor infections. Even half a century ago, worldwide, most people died before they were 50 years old.

    Also, as pointed out in the figures I quoted, the average lifespan in Western Europe during the latter part of the 19th century was 37 years. Homeopathy was invented 200 years ago.
    I believe the average lifespan for men and women in Western Europe is currently in excess of 70 years, principally because of improved standards of hygiene and advances in modern medicine such as vaccination programmes, antibiotics and medical/surgical procedures. There is no evidence to even remotely suggest that homeopathy has played a part in this. In fact, what is understood of homeopathy (which is pretty much everything) would suggest the lifespan of the average Western European would be very much closer to 150 years ago, if all we had to rely on were magic water and sugar pills.

  394. almud said,

    November 24, 2007 at 6:26 pm

    Well I think that
    the discovery of the importance of hygiene was the first step against the mortality !
    I also do not negate the merits of alopathy …but I do not agree when you try to reduce Homeopathy to Placebo (or less) !”
    Your tip about spelling and grammar is good but I want to say what I think ..not to repeat nonsense

  395. almud said,

    November 24, 2007 at 7:13 pm

    PV you omitted to respond my question – I asked you yesterday

    November 23, 2007 at 10:06 pm

  396. pv said,

    November 24, 2007 at 11:48 pm

    “Your tip about spelling and grammar is good but I want to say what I think ..not to repeat nonsense”

    My irony meter just went off the scale.

    It really doesn’t matter what you think about placebos and homeopathy. You have no shred evidence to support you. The facts are what they are, not what you want them to be. So you carry on believing.
    You haven’t asked any questions and you are very predictably and understandably still avoiding the issue.
    Give me one (just one) incontrovertible example, with references, of homeopathy curing a non-self-limiting condition. You’ve got 200 years of patients to choose from. Go on. Just one incontrovertible example.
    Otherwise stop trolling.

  397. Diotima said,

    November 25, 2007 at 4:47 pm

    Almud: how confident would you be if you were to treat a person with cholera (‘rice water’ faeces well in evidence) with homeopathy?

  398. isitmedicine said,

    November 25, 2007 at 11:04 pm

    I’m not too great at correctly interpreting sarcasm on forums like these. Can someone confirm whether Elizabeth Biagi’s email above is genuine, or as I first thought, a ‘hilarious’ “HELLO I am a Homeopath, I so stupid!!!” joke?

  399. scotlyn said,

    November 26, 2007 at 11:01 am

    The Big Cheese – I think – said this a good while back: “I think you’ve managed to demonstrate a fundamental misunderstanding of the placebo effect here. People don’t ‘fall’ for the placebo effect in the way they would fall for say a card trick. In order for the placebo effect to work, a person has to believe that they are taking an effective treatment, therefore if Darwin took homeopathic remedies a genuinely believed it to be nonsense (as indicated above) then any improvement could not be attributed to placebo.” I wonder if this proposition – that “for the placebo effect to work, a person has to believe that they are taking an effective treatment” has actually been tested. The placebo effect is real, repeatable, measurable and demonstrable, and therefore counts as evidence. But, as Ben has pointed out – and I’m waiting for the very interesting discussion promised on this point – the mechanism behind the effect itself is poorly understood, but fascinating. It seems to me that the propositions that either 1) belief is a precondition for this effect, or that 2) scepticism would annihilate this effect have not been sufficiently tested to be asserted with as much confidence as is evident here, and therefore must be treated as untested hypotheses. One way these could be tested is as follows – enlist some humanities graduates (we must have some uses!) to design questionnaires to test the expectations of all participants in an RCDBT (for anything at all, doesn’t matter) prior to the trial. Score the answers on a continuum from “credulous” to “sceptical” – then seal data + scores until the end of the trial. The interesting question will then be to find out how well those who improved solely by means of the placebo effect scored on a measure of their prior expectations. Personally, I’ll keep an open mind on this until the evidence is in. (Sorry this post is so long, folks.)

  400. scotlyn said,

    November 26, 2007 at 11:03 am

    Ps interesting implication in Big Cheese’s comment – that if a sceptic gets relief from a remedy they do not believe in – the effect cannot be placebo and therefore must be due to the effectiveness of the remedy itself – do you stand over this implication?

  401. bazvic said,

    November 26, 2007 at 2:43 pm

    Here is an easy test for homeopathy.

    Choose a common complaint, eg winter colds.

    Ask a homeopath to “potentise” a water reservoir (eg Birmingham gets its water mostly from the elan valley reservoirs). As I understand it this would make it super powerful..

    Compare the reported incidence of the complaint for the “treated” population vs those that were not.

    Since skeptics assert the homeopathic remedy is just water there can be no ethical problems from the skeptics’ side..

    The sample size should be in the millions so it would be easy to work out if it worked or not.

    Is there a flaw here?

  402. almud said,

    November 26, 2007 at 4:10 pm

    Hello PV , just because you permantly emphasize any spelling mistake , I want to correct you in spelling the name HAHNEMANN
    pv said
    November 16, 2007 at 11:52 pm
    ” They have a god or leader in Samuel Hahnenmann. ”
    November 24, 2007 at 5:49 pm
    ” …and was still incorrect in Hahnenmann’s time…”
    “Medicine and knowledge of disease have moved on since Hahnenmann, …”
    His name is Dr. Samuel Hahnemann ! Do you notice the difference ? The 6-th letter , the N, in your spelling is too much !
    Bad spelling ? Permanent error ? General ignorance ?
    You asked me before …and I answer you now :
    I am sorry , there is no homeopathic cure neither for bad spelling nor ignorance !
    Here’s a tip:
    read what others have written, especially those you are quoting.
    Do you recognise these sentences ? They are all yours !
    You used them all the time against anyone who did not agree in blaming the Homeopathy.

  403. almud said,

    November 26, 2007 at 4:27 pm

    Diotima : I respect both Alopathy and Homeopathy !? I should use both ! Have you heard about Nosodes ? Have you heard about living Nosodes ?

  404. pv said,

    November 26, 2007 at 5:54 pm

    almud said,

    November 26, 2007 at 4:10 pm

    Here’s a tip:
    read what others have written, especially those you are quoting.
    Do you recognise these sentences ? They are all yours !
    You used them all the time against anyone who did not agree in blaming the Homeopathy

    All the time, eh? Apart from the ONE time I addressed it to you perhaps you’d like to give some examples, in this thread or any other?

    Thought not.

    So, how about that unequivocal example of homeopathy curing a non-self-limiting condition you were going to give?
    I’m still waiting while you’re fabricating stories, making preposterous accusations and generally dreaming up brainless ways to avoid answering a simple request. Happy trolling.

  405. almud said,

    November 26, 2007 at 9:54 pm

    pv said :

    “All the time, eh? Apart from the ONE time I addressed it to you perhaps you’d like to give some examples, in this thread or any other? ”

    Yes , I ‘ d be glad to ! You acted here all the time as a speller -Google’s is a better one !

    Here you are ! Some of your remarks , please !

    pv said :
    November 18, 2007 at 4:03 pm
    “Anyone notice the classical woo spelling …
    November 21, 2007 at 5:31 pm
    “It’s all in the spelling.Why is it that woos aren’t only deluded, but illiterate too?
    November 22, 2007 at 1:00 am
    “But they display exactly the same persistent boneheadedness, bad spelling, poor excuses and general ignorance, that they might as well be. ”
    November 22, 2007 at 1:58 pm
    “Then I realised, apart from the consistent misspellings of “apologise” and ..”
    November 24, 2007 at 3:50 pm
    “Is there a homeopathic cure for homeopathic spelling and homeopathic grammar, and those bloody homeopathic question marks?”

    This is enough , isn’t it ? If not, just read what you wrote in this thread …

    And by the way in the same sentence, wrote Budicius the name Hahnemann error-free ! But you saw only his bad spelling of Avogadro !
    Budicius said :
    “And …. Hahnemann was well aware of Avagadro’s number….”

    AND Budicius apologised himself for this error !

  406. almud said,

    November 26, 2007 at 10:31 pm

    pv said :
    “So, how about that unequivocal example of homeopathy curing a non-self-limiting condition you were going to give?”

    Just search for smallpox , peritonitis, tetanus …+ Homeopathy …you will find a plenty of … If truth or lie …I do not know !
    I have a “disappointing experience with mainstream medicine ” that’s why I am interessed in homeopathy and only cumulative to alopathy ! Content ?

  407. almud said,

    November 26, 2007 at 10:39 pm

    excuse me allopathy of course !

  408. TintheM said,

    November 27, 2007 at 12:34 am

    almud
    1) From your post on November 24, 2007 at 1:55 pm
    ‘BSM said :
    “Because homeopathy is a complete package evolved brilliantly to maximise placebo effect from the authoritarian tone of its practitioners to the mysterious Latin names of its remedies.”
    Homeopathy does not try to maximise its placebo effect using Latin names !
    80 % of the homeopathic remedies are from plants and they maintain their names : as Arnica Montana, Calendula Officinalis, Hypericum Perforatum and so on .’
    These all sound Latin to me, as do the others you list. The point BSM was making was that homeopathy disguises itself in authoritative clothes: it uses Latin-sounding names, because that makes it sound like real medicine, and like the conditions it pretends to treat. It gives it the appearance of authority. On top of this, Latin is a dead language, no longer spoken, so, as other posters have pointed out, this is an implicit appeal to authority through antiquity, of the kind ‘the ancients like Hippocrates used it, therefore it must be good’. This is not an argument and carries no weight. Even if 2,500 years ago Hippocrates had used something like homeopathy – and he didn’t – that would not be evidence that it works.

    2) On November 23, at 8.02pm you said:
    ‘The Homeopathic Remedies are as big as the eye of a grasshoper, they are either blue nor red ..they are not brand packaging …. they do not smell …they do not taste …they do not cost much …and often I become from the homeopath only one dose (3 or 5 globule) …and I always must think disapointed
    ” How can ‘this kind of nothing ‘ help me ? It is not possible ! ” ….but I never was disapointed !’
    This completely supports homeopathy’s disguise of authority. To the homeophile, homeopathic ‘remedies’ are unlike nasty conventional medicine, which they see as unnatural synthetic ‘chemicals’. The small size and simplicity of homeopathic pills emphasizes how pure and ‘natural’ they are. Small, modest, odourless – humble and pure – they must be good. Do you imagine many people would take homeopathic pills if they were large luminous yellow pills which tasted of bubblegum?

    3) You refer to ‘alopathy’ as opposed to homeopathy, but this is a meaningless term and a further example of homeopathy falsely claiming authority for itself. I would be interested to hear exactly how you define the term ‘allopathy’. It seems to be a way of dishonestly elevating homeopathy to the same level as real medicine by giving them ‘equal-type’ names. Real medicine however is not a single approach, and develops and absorbs any new techniques or approaches that can be shown to work. If homeopathy could be shown to work, it would become part of real medicine, but by labelling real medicine ‘allopathy’, homeophiles can pretend that there are two rival schools of thought on an issue, and then that one school (allopathy, backed by nasty big pharma companies) is stifling natural, pure wholesome homeopathy. This is another dishonest tactic.

    4) You have not yet answered Diotima’s question of November 25 at 4:47 pm
    ‘Almud: how confident would you be if you were to treat a person with cholera (’rice water’ faeces well in evidence) with homeopathy?’

    5) Or PV’s question of November 24, 2007 at 11:48 pm (and other times):
    ‘Give me one (just one) incontrovertible example, with references, of homeopathy curing a non-self-limiting condition. ‘
    To which you replied on 26 November at 10.31pm:
    ‘Just search for smallpox , peritonitis, tetanus …+ Homeopathy…’
    Giving a list of conditions and telling other people to search for them isn’t an argument. It’s lazy, arrogant and dishonest. If you have evidence, show it.

  409. pv said,

    November 27, 2007 at 1:04 am

    #
    almud said,

    November 26, 2007 at 10:31 pm

    pv said :
    “So, how about that unequivocal example of homeopathy curing a non-self-limiting condition you were going to give?”

    Just search for smallpox , peritonitis, tetanus …+ Homeopathy …you will find a plenty of … If truth or lie …I do not know !
    I have a “disappointing experience with mainstream medicine ” that’s why I am interessed in homeopathy and only cumulative to alopathy ! Content ?

    I’ll take that as a “no”, then. You don’t have a clue really, do you? But I suppose you have at least been kind enough to confirm that:

    If truth or lie …I do not know !

    I would have thought that would have been easy question for you to answer, so confidently have you written about the abilities and efficacy of homeopathy. But I’m not even sure you understand the question. Instead of answering it you indulge in a bit dishonest obfuscation so typical of homeopaths and their disciples. It’s no surprise at all, but shame on you nevertheless.

  410. pv said,

    November 27, 2007 at 1:18 am

    almud said,

    November 26, 2007 at 4:10 pm

    Here’s a tip:
    read what others have written, especially those you are quoting.
    Do you recognise these sentences ? They are all yours !
    You used them all the time against anyone who did not agree in blaming the Homeopathy

    Then:

    pv said :

    All the time, eh? Apart from the ONE time I addressed it to you perhaps you’d like to give some examples, in this thread or any other?

    Then:

    almud said,

    November 26, 2007 at 9:54 pm

    Yes , I ‘ d be glad to ! You acted here all the time as a speller -Google’s is a better one !

    Here you are ! Some of your remarks , please !

    pv said :
    November 18, 2007 at 4:03 pm
    “Anyone notice the classical woo spelling …
    November 21, 2007 at 5:31 pm
    “It’s all in the spelling.Why is it that woos aren’t only deluded, but illiterate too?
    November 22, 2007 at 1:00 am
    “But they display exactly the same persistent boneheadedness, bad spelling, poor excuses and general ignorance, that they might as well be. ”
    November 22, 2007 at 1:58 pm
    “Then I realised, apart from the consistent misspellings of “apologise” and ..”
    November 24, 2007 at 3:50 pm
    “Is there a homeopathic cure for homeopathic spelling and homeopathic grammar, and those bloody homeopathic question marks?”

    Not only can’t you spell, or give a straight answer to a straight question, it seems you can’t read what you type either. No wonder you can be persuaded to pay for water and sugar pills masquerading as medicine.

  411. BSM said,

    November 27, 2007 at 9:55 am

    ” Instead of answering it you indulge in a bit dishonest obfuscation so typical of homeopaths and their disciples. It’s no surprise at all, but shame on you nevertheless.”

    See, this is my problem. I don’t like homeopathy because as a system it contains so many faslehoods, but what is morally worse is the actions of homeopaths themselves whose first reflex when questioned about these inherent problems is to obfuscate and lie.

    That is the really pernicious effect of homeopathy as a belief system. In order to sustain that belief its adherents must become immoral. That immorality, interestingly, appears to be in exact proportion to their tendency to make public statements on the subject. If they merely held these beliefs privately they can be in innocent error, but once they become public advocates they have to tell a succession of lies and engage in deliberate obfuscation to deflect the criticism. That’s what I find so personally offensive about homeopathy.

  412. Bogusman said,

    November 27, 2007 at 10:24 am

    Can we have a truce in the spelling wars? Online forums (fora?) are hardly noted for their high standards of presentation, and if someone is genuinely operating in their second or third language we should all cut them some slack.

    There are plenty of substantive things to take issue with.

    (Says Bogusman, willfully ending his sentence with a preposition)

  413. BSM said,

    November 27, 2007 at 11:12 am

    “(Says Bogusman, willfully ending his sentence with a preposition)”

    Except that he actually ended with a parenthesis and no full-stop.

    :-)

    Sorry, that could go on forever.

  414. pv said,

    November 27, 2007 at 2:02 pm

    Bogusman said,

    November 27, 2007 at 10:24 am

    Can we have a truce in the spelling wars? Online forums (fora?) are hardly noted for their high standards of presentation, and if someone is genuinely operating in their second or third language we should all cut them some slack.

    There are plenty of substantive things to take issue with.

    Notwithstanding that Internet forums (it’s an Anglicised word)aren’t bastions of literacy, for various reasons, I think if one observes the on-line world of sCAM and quackery then idiosyncratic spelling does seem to be a substantial part of the package. I think it says rather a lot about clarity of thought and understanding. Compare it with the on-line world of science and academia, where you might find typos but far less independently styled orthography. The reason for this, I think, is rather obvious.

  415. Diotima said,

    November 27, 2007 at 2:57 pm

    Almud: I think that Cholera might prove a challenge to a believer; unless you rehydrate dramatically (litres and litres of water)and replace salts you will have a very dead patient. As for Nosodes, I don’t fancy the notion of injecting a person suffering from Cholera with a solution of what? Their own very infectious faeces?
    In the great Irish Cholera epidemic of 1831, whiskey enemas were used, to little effect. But perhaps, on the suppository principle, the patients absorbed a bit and died happier.

  416. almud said,

    November 28, 2007 at 1:10 pm

    Hello Diotima , you don’t fancy the notion of injecting a person suffering from Cholera with a solution of their own very infectious faeces?
    But you can test every nosode on me, if the remedy is homeopathic prepared and potency greater than 12 C . Let us use homeopathic recommendations for nosodes and take 30C or greater .
    You can try to contaminate me using a a remedy prepared starting with a substance at your option .

    Are you still thinking about ’rice water’ faeces ?

    I’m feeling generous, today ..try with a cocktail of infected tissue , faeces, stinking ichor…everything … AIDS, Ebola, typhoid, diphtheria, smallpox, tetanus, cholera …
    My only condition is to be a homeopathic preparation with potency 30 C or more.
    I expect no compensation if I die , I pay my funeral alone…

  417. pv said,

    November 28, 2007 at 1:29 pm

    Almud, give me one (just one) incontrovertible example, with references, of homeopathy curing a non-self-limiting condition.

    You can’t can you, and you aren’t honest enough to admit it. Judging by your last post you know full well that homeopathy does not and cannot work:

    I’m feeling generous, today ..try with a cocktail of infected tissue , faeces, stinking ichor…everything … AIDS, Ebola, typhoid, diphtheria, smallpox, tetanus, cholera …
    My only condition is to be a homeopathic preparation with potency 30 C or more.
    I expect no compensation if I die , I pay my funeral alone…

    Exactly, nothing at all. Your attempt at comedy rather indicates you are trolling.

  418. almud said,

    November 28, 2007 at 3:02 pm

    PV : I trust that homeopathy has no side effects . Perhaps you agree ?
    On contrary , even when feeling generous, I would not agree to test Orochol or other vaccines without an indication or necessity – I do not trust their side effects , they are not funny !

  419. pv said,

    November 28, 2007 at 4:48 pm

    almud , give me one (just one) incontrovertible example, with references, of homeopathy curing a non-self-limiting condition.

  420. almud said,

    November 28, 2007 at 5:49 pm

    hello pv,
    You ask for ONE incontrovertible example. This is not possible ! ONE is a singular value.
    Incontrovertible implies statistical research … you usualy need 20-80 for Phase I of a clinical trial , then 100-300 for Phase II and 1,000 – 5,000 for Phase III
    ONE is every report …you find a lot if you search.

    Do you agree that Homeopathy has absolutely no side effects ?

  421. pv said,

    November 28, 2007 at 6:32 pm

    almud , if you can read, give me one (just one) incontrovertible example, with references, of homeopathy curing a non-self-limiting condition.

  422. pv said,

    November 28, 2007 at 6:49 pm

    Do you agree that Homeopathy has absolutely no side effects ?

    It’s an entirely irrelevant question. However, since you persist with your amusingly simple diversions, homeopathic preparations have absolutely

    no

    active ingredients therefore absolutely no medicinal effects (either wanted or unwanted). I should add that drumming your fingers on a table for two seconds has no side effects. Blinking once has no side effects. Drinking 5mls of tap water has no side effects. Now having established that you have an obsession with side effects, perhaps you would be kind enough to answer the request:
    give me one (just one) incontrovertible example, with references, of homeopathy curing a non-self-limiting condition, or stop trolling.

  423. almud said,

    November 28, 2007 at 7:12 pm

    I do really want to know because I do not understand , why does BG consider 5% with a negative result as a “very, very low ” figure ?

    “How big is the problem of publication bias in alternative medicine? Well now, in 1995, only 1% of all articles published in alternative medicine journals gave a negative result. The most recent figure is 5% negative. This is very, very low”

    Homeopaths or the homeopathic companies do not have negative results.
    They can have neutral results but I never never heard about negative side effects or so !
    Do you have a tip about finding these studies ?

  424. pv said,

    November 28, 2007 at 8:10 pm

    almud, give me one (just one) incontrovertible example, with references, of homeopathy curing a non-self-limiting condition.

  425. wewillfixit said,

    November 28, 2007 at 8:17 pm

    Almud – a negative result in a clinical trial would not necessarily be one in which the treatment was shown to have negative effects. A negative result would just be one in which the treatment group performed no better than the group who recieved a dummy pill (placebo).

    And for an incontrovertible example of homeopathy curing a non self limiting condition, you don’t need more than one case, or any statistics. You would just need a properly written up example of a person with a definite diagnosis of something that doesn’t go away on its own which when treated with homeopathy went away. For example my mam has Addison’s disease. Her adrenal glands do not produce the corticosteroids that the body needs. Without an external source of corticosteroids, she would die. Addison’s disease does not just get better. So if you were to find a properly written up case of someone with Addison’s disease who was treated with homeopathy and then no longer had any need to take corticosteroids, that would be he sort of thing pv was asking for.

  426. Mojo said,

    November 28, 2007 at 9:27 pm

    @pv: “Blinking once has no side effects.”

    Apart from total (albeit very short-lived) loss of vision.

  427. pv said,

    November 28, 2007 at 9:57 pm

    wewillfixit said,

    November 28, 2007 at 8:17 pm

    Almud – a negative result in a clinical trial would not necessarily be one in which the treatment was shown to have negative effects. A negative result would just be one in which the treatment group performed no better than the group who recieved a dummy pill (placebo).

    I don’t think this is going to help almud’s understanding really.
    He’s embarked on a course of homeopathic prevarication to avoid the central issue because admitting there has never been a single case of such a homeopathic cure would be to admit that homeopathy is just a bunch of made up stuff. And that would be would be unbearable when he’s invested so much of his credulity in it.

  428. pv said,

    November 28, 2007 at 10:08 pm

    #
    Mojo said,

    November 28, 2007 at 9:27 pm

    @pv: “Blinking once has no side effects.”

    Apart from total (albeit very short-lived) loss of vision.

    Ah, yes. Homeopathic blindness. I didn’t think of that.

  429. Ben Goldacre said,

    November 28, 2007 at 10:50 pm

    you know i hate to meddle, but i wonder if you could cool it just ever so slightly, pv?

  430. Robert Carnegie said,

    November 29, 2007 at 12:11 am

    I think that asking for “just one example” is not fair, because if homeopathy does come up with one then you’ll still, rightly, say no. Real effects in science are demonstrated with repeated observations.

    I’ll say again, we get too impressed with the dilution-makes-stronger-effect angle of modern homeopathy, which admittedly is very ridiculous. We overlook the homeopathic theory of causes of disease and treatments o

  431. Robert Carnegie said,

    November 29, 2007 at 12:19 am

    - theory of causes of disease and treatments of disease, which is just wrong and stupid. It’s a quack theory just like the random application of magnets, electricity, radioactive material – a juack theory hundreds of years old, but not improved by that.

  432. pv said,

    November 29, 2007 at 1:08 am

    you know i hate to meddle, but i wonder if you could cool it just ever so slightly, pv?

    Yes Sir. :-)

  433. Superdora said,

    November 29, 2007 at 8:23 am

    Embarassingly, the University of the Aegean (a relatively recent state university in Greece) has introduced a master’s degree in homeopathy! See www.syros.aegean.gr/homeopathy/

  434. almud said,

    November 29, 2007 at 2:46 pm

    wewillfixit said : “Almud – a negative result in a clinical trial would not necessarily be one in which the treatment was shown to have negative effects….”

    The complete figures are : 5% negative , 52% neutral and 43% positive. So I think that the negative group has really a negative signification ! – and I want to know more about the facts …What did they tested and examined to have negative effects ?
    More, BG writes about this 5% “This is very, very low.” !
    I wonder , why does BG expect much more than 5% negative effects from … nothing ? It is not consistent to explain that in the pill is nothing BUT negative effects are expected ! 5% is very low !

    Thank you for your example wewillfixit ! . Well I do not think that homeopathy works in Addison’s disease …As I know homeopathy can only support an existing intrinsic healing process and acts so such as ‘a catalysts’.
    I never read a plausible explanation about how homeopathy works.
    I use homeopathy just for me, just “smiling and thinking it is a joke , it does not work, it cannot work , it is nothing !” … and I am surprised that it works !
    (@PV please do not break me into pieces ! It is just too simply for you to do this and please try to resist the temptation. This explanation is ridiculous . I know this without
    your poignant sarcasm )

    I said from the very beginning , I never was disappointed with homeopathy …nevertheless I still cannot believe that it works !
    One of you (BSM ? , TintheM ?) spoke about “the mysterious Latin names of the remedies”.
    The Latin names of the remedies are not mysterious . During the 18th century, the Swedish naturalist Carl Linnaeus (Carl von Linne) developed the binomial nomenclature ( popularly known as the “Latin name”) to classify and organize plants and animals (Systema Naturae in 1758) . He set the standards for future scientists, standards that are as pertinent now as they were then.
    Dr. Hahnemann wrote his ‘ Organon der rationellen Heilkunde ‘ in 1810.
    The homeopathic remedies ( 80% of them ) are from plants and they maintain the names of the Plant : as Arnica Montana, Calendula Officinalis, …
    YES TintheM, the Names sound Latin , they are Latin but not because Hahnemann searched ‘ authoritative clothes’ for his remedies !
    It was the language for the Science at that time ..It does not have any association with trying to obtain a Placebo !
    Later , ( 1832 ) , dr. Schluessler developed 12 Cell Salts …their names are Salt 1, Salt 2 , Salt 3 …Salt 12 . In the meantime, further twelve salts have been added to the therapy giving 24 in all. (Salt 13…Salt 24) These names are simplest ..and the remedies work too ! The Latin Names of the remedies do not explain their existence and effects for over 200 years !
    Does Merck halt Vioxx sales only till they find a better name ? Do not cry, Vioxx you will be fine ! Your Daddy is rich , you get ‘authoritative clothes’ from Dior !

  435. pv said,

    November 29, 2007 at 3:46 pm

    Robert Carnegie said,

    November 29, 2007 at 12:11 am

    I think that asking for “just one example” is not fair, because if homeopathy does come up with one then you’ll still, rightly, say no. Real effects in science are demonstrated with repeated observations.

    Robert, I did say it had to be “incontrovertible”.

  436. jrichardn said,

    November 29, 2007 at 11:11 pm

    Love your stuff. Tiny little note that James Randi is actually a Canadian! (We have to hang onto them even if they emigrate!) All the best!

  437. Paul42 said,

    November 30, 2007 at 8:16 am

    Hello,

    This is my first post. I’ve been reading for ages tho…

    Enough is enough.

    I’ve applied for a prospectus for the University of Westminster’s Homeopathy Degree.

    I’ve also sent emails to some actual homeopaths that I found on google referencing this article….

    Watch this space…

    Cheers and keep up the good work etc…

    Paul.

  438. almud said,

    December 1, 2007 at 4:47 pm

    Diotima, he is absolutely right.

  439. Robert Carnegie said,

    December 2, 2007 at 12:43 am

    Rewind on this thing:

    “Give one incontrovertible example, with references, of a non-self-limiting condition being cured by homeopathic treatment. Here’s a few examples of such conditions in case you don’t know what is meant by “non-self-limiting”:
    AIDS, typhoid, emphysema, diabetes, hypothyroidism, peritonitis, septicaemia, diphtheria, smallpox, tetanus, ebola…”

    People may get better of some of these things. Indeed no homeopathy users have suffered smallpox for a while now. They cracked it! Also, homeopathy “properly” practised provides one certain good: clean water.

    I don’t think science works on the “incontrovertible” data point, but on repeated consistent results. This eliminates misdiagnosis and forgery…

    Are you asking them to prove that the patient was cured by the action of homeopathy? A lot of medicine doesn’t have that level of certainty on individual cases.

  440. Diotima said,

    December 4, 2007 at 12:04 pm

    Almud: I remain puzzled as to why homeopathic treatment is out for AF (long considered a benign condition, until the risk of stroke as identified) and perfctly appropriate for Cholera, or indeed Ebola fever.

  441. used to be jdc said,

    December 4, 2007 at 1:26 pm

    The Observer last Sunday reported on cholera in Iraq. Perhaps homeopaths will now flock to Baghdad to cure this outbreak with some magic water.
    observer.guardian.co.uk/world/story/0,,2220529,00.html

    I’m also concerned by the homeopaths pushing magic water for malaria. Especially when it costs two days’ wages to buy “dextrose solution for rehydration, quinine and cannula”. www.guardian.co.uk/katine/2007/dec/02/1

    Not forgetting the Malaria alert for Brits from 2004: www.guardian.co.uk/travel/2004/may/30/travelnews.observerescapesection1

  442. BSM said,

    December 17, 2007 at 4:11 pm

    Almud has left the building!

  443. mybad said,

    December 22, 2007 at 11:39 am

    If you didn’t know how funny homeopathy really is, read the article ‘Homeopathy Go Home’ at www.roughgang.com

  444. abandonnship said,

    December 28, 2007 at 4:16 am

    This post makes me happy (and also a little frustrated) in a way no man has for quite a long time.

  445. almud said,

    January 15, 2008 at 1:48 pm

    “Do not fear to be eccentric in opinion, for every opinion now accepted was once eccentric. ”
    Bertrand Russell

  446. JoanCrawford said,

    January 24, 2008 at 1:47 pm

    Almud, you are the last Japanese soldier.

    The war is over, and you lost.

  447. G04T_DFA said,

    January 30, 2008 at 2:18 am

    Evenin all, just a few drive-by comments. Scientific proof is rigorous, but not infallible; an element of belief is required. I believe that science is very, very good at producing and analysing results. Why? because I KNOW that nitric oxide is a vasodilator. It is shown that the more you add, the more relaxed muscle becomes. (within the curve etc, in the absence of inhibition in some form so on…). From this, it can be concluded that if someone has very constricted blood vessels, a lack of nitric oxide production could be the cause. More investigation needed. This thinking is very reliable in natural science; it brings us the microchip, the television, the defibrilator, the cortical steroids for asthma. Why are these ideas accepted? An alternative method may be explored, but these devices and the ideas they are based on demonstrate robust proof for themselves; evidence is not a matter of opinion, it simply is. Any argument is of procedure or a lack of validity on this basis.
    In this way, my beliefs (by which i mean my understandings of how certain things happen or what they are doing there to begin with) are influenced by what I see, and what I make of them in my head. A doctor can show me how many people have died as a result of a certain surgical procedure, or tell me what possibly connects them (did they all smoke? were they infected pre-operation?). In this way, scientific belief is justified; questioning it has a history of obtaining knowledge in science…via investigation, clearly supporting or refuting the hypotheses concerned. “Dont believe it?” says science, “try it yourself as I did and you should find the same. If you do not, it is either chance or there is an alternative explanation. Is my idea flawed, or not implemented correctly, leading to a false result?” This is how eccentric becomes commonplace. Science is not a man far away telling you what to think. It is a method of answering natural problems with a way of finding an explanation, usually with he point being to change things for the percieved better through a known means of action. Through this chain of thought, i could conclude that solid understanding of stuff through seeing (like lions like the taste of meat, that falling off a really big cliff usually kills animals) and experimentation (all the cows off the cliff are dead. Almost every time), consistant results appear. If they do not, maybe I must reexamine aspects of my inquiry, but at least I can see the lions chasing the cows off the cliff (or not as they are all off eating potato dishes.) Thus, homeopathy is not really homeopathy; it is simply potential active ingredients; if they dont work, they dont work. If they do, there should be a marked result. If there isnt, why? If it does not pass this test, i’l feel a little duped.
    I could rant on about concentration I guess, but aside from extrapolating that very low or high [ingredient] is somehow different (which is a bad idea, extrapolation lies outside knowns) I will say that the scientifically established drugs cope with potency being a clear issue; more has more effect, until it maxes out or until something interferes. Homeopathic remedies dont seem to offer clear explanations. This is why I cant spend money on them. You could sell me an elvis clock with swinging legs on the honest claim that I will think its entertaining for a bit, but I doubt you could sell me a leap of faith that he was a priest (for example, no mockery) on the basis that I am somehow affected by the swinging legs thing. In other words, a volume of knowledge to back stuff up and transparency is a good thing. We all do so much, nobody can prove stuff alone that drug companies invest millions in. At least if theyre lying it will probably be spotted by someone, or at least criticised. At which point it may respond within the lines of inquiry directed by the criticism. Homeopathy could be rife with frauds and we’d never know, because of many reasons, such as human error, or attempts to sell expensively refined ingredients without volumes of evidence in its defence.The reasons are manifold really, but theres a couple. If theres a global conspiracy in science to constantly mislead, why is our lifespan going up, our health linked to lifestyle and our children in central london getting fresh water and not cholera. If homeopathy does work (not derisive, “if” is used as a logical operator here), it should be perfectly capable of silencing criticsm with some difficult-to-deny demonstration, with subsequent defense ideologically (oh yeah, read in this thread that double blinds are not very good or something according to some supporters of homeopathy. No problem, and not that this is directed at anyone, but isnt it the best way, I mean, the best way to do it is so that no-one knows so no-one can make it up, right? Please, prove me wrong (im not sarcastic), or argue that double blind effectively messes up the results to such a degree that using it is a liability in supporting hypotheses through its influence on data. Caveat; saying it is bad does not make it bad. Just give me some reasons as to why double blind is not appropriate for seperating active from placebo. Again, no-ones arguing that homeopathy can cure renal failure, (and if you do, then maybe you should do what those australians did to prove the cause of stomach ulcers and NO INSULT this is just a legal way of testing a premise that would be thrown away due to risk to safety of others. That way we can all see it at work is all), but if it does have a beneficial effect on people without pathologising every day ups and downs to the degree that it causes ignorance detrimental to safety or happiness (possibly truth, i like to know truth, but what does it matter to others? that varies), I will use it where its needed. Without parenthesis and my rampant train of thinkin, if homeopathy does help people without doing society or the individual a disfavour in any real way, and you can show me and tell me what is really going on, and I can ask you about it and not be misled, it works. Otherwise, youre maybe hiding from something? Maybe sometimes the honest man has nothing to hide.
    Thanks for reading if you could be arsed. My style is difficult to read maybe. Just know that I dont represent homeopathy, or science, I just have had to examine things in my life and this is how I establish whether or not something is to be believed. Sadly, most hoemopathic remedies do not convince me. Dont call me closed minded. Answer my criticsm if present in its context and show me otherwise. Thats what I think science is about.

  448. G04T_DFA said,

    January 30, 2008 at 2:19 am

    damn that didnt look that long. Dont bother if it looks like a rant or something I guess, i wouldnt blame you :P

  449. g8or said,

    February 12, 2008 at 10:42 am

    Ok guys, but what do you make of these;

    www.pbhrfindia.org/index.php/Publications-Presentations/Papers/Posters-presented-in-Conferences/Meetings/Papers/Posters-presented-in-Conferences/Meetings.html

    Ruta 6 selectively induces cell death in brain cancer cells; www.pbhrfindia.org/images/stories/pdf/ruta6.pdf

    www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=12963976&dopt=AbstractPlus

    www.fidelibus.com/SOL-BRAIN.htm

    www.pbhrfindia.org/index.php/Case-Studies/Cure-of-Brain-Tumor/Cure-of-Brain-Tumor.html

    cheers!

  450. g8or said,

    February 12, 2008 at 11:08 am

    Homeopathy Cures Brain Tumours

    INTERNATIONAL JOURNAL OF ONCOLOGY 23: 975-982, 2003
    975

    “Ruta 6 selectively induces cell death in brain cancer cells but
    proliferation in normal peripheral blood lymphocytes:
    A novel treatment for human brain cancer”

    Download free article here;
    www.pbhrfindia.org/images/stories/pdf/ruta6.pdf

  451. Jo said,

    March 21, 2008 at 12:51 pm

    The fabulously excellent RadioLab podcasts have one on Placebo with a brief interview with Daniel Moerman.
    www.wnyc.org/shows/radiolab/episodes/2007/05/18

    I highly recommend their podcasts – they’re funny and beautifully edited with very good use of music and sound effects. There’s a lovely bit with Fabrizio Benedetti in this one.

    I’ve just received Moerman’s book as a birthday treat, and was surprised to see his name here as I’d previously heard of him only as the author of Native American Ethnobotany database: herb.umd.umich.edu/

  452. jonathanhearsey said,

    July 6, 2008 at 8:10 pm

    Brilliant – just brilliant.

    Well done, Dr. Goldacre.

    After attending my final ever anti-vaccination seminar recently

    jonathanhearsey.com/?p=34

    I’d love you to write a paper of similar magnitude on the subject of vaccinations.

    Keep up the good work,

    JH

  453. JQH said,

    November 1, 2008 at 5:00 pm

    The fact that medieval theologians (Note: theologians, not scientists) opposed Copernicus is hardly proof that 21st century doctors (a completely different group) are wrong about homeopathy (a completely different subject.

  454. sumalat said,

    January 20, 2009 at 4:03 pm

    Was a sceptic as much as any of you till my son was born. He suffered from a very bad skin condition which our modern medicines and medicos failed to alleviate. In fact it was when he started worsening that I very reluctantly took him to a homeopath at the insistance of a relative. Placebo! yes, it does exist for us adults, but, how do you explain a baby of 10 months age respond favourably to treatment by “mind over matter” ( for that matter the placebo effect itself should prompt us to wonder that we do not understand a lot of what goes on in and around us. The mind can heal, you say, wow, please explain the same to me. I am all ears). My son is 12 years old now and has been a “homeo kid”. His skin condition is kept at bay even today by homeo. He is very radiant and healthy. To contrast my sisters colleague had a daughter with dermatitis which was treated by various allopathic drugs including UV radiation etc. The trauma the poor child went through before she died at age 9 I do not want to describe. It was the very treatment that she went through which was responsible for her misery and ultimately death.This is not to dilute any of your anti homeo comments but to just state what I did for this science which we cannot explain but to which I am very grateful.

  455. jim hicks said,

    February 24, 2009 at 3:25 am

    a fellow nearby has achieved an awareness that permits him to ‘see’ illness and ‘see’ cures. —
    he and his wife were offering hope to some whom the doctors could no longer help. —
    one wonders if he could ‘see’ cures in homeopathic items. —
    there is a ‘muscle test’ i have seen demonsrtated.

    Spirit and Engrams [Dianetics]
    play a monster role in human
    wellness. there may not be a large enough potential financial gain for anyone to
    quantify these influences.
    whatever works eh ?? love all – jimhicks36@junodotcalm ;-)

  456. jim hicks said,

    February 24, 2009 at 3:26 am

    a fellow nearby has achieved an awareness that permits him to ‘see’ illness and ‘see’ cures. —
    he and his wife were offering hope to some whom the doctors could no longer help. —
    one wonders if he could ‘see’ cures in homeopathic items. —
    there is a ‘muscle test’ i have seen demonsrtated.

    Spirit and Engrams [Dianetics]
    play a monster role in human
    wellness. there may not be a large enough potential financial gain for anyone to
    quantify these influences.
    whatever works eh ?? love all – jimhicks36atjunodotcalm ;-)

  457. zappa said,

    May 9, 2009 at 12:48 pm

    Found this harrowing story which illustrates the dangers of bad science…en.wikinews.org/wiki/Parents_prosecuted_after_homeopathic_treatment_leads_to_daughter%27s_death

  458. JamieT said,

    August 1, 2009 at 8:13 pm

    A lot has been written but look at this
    www.homeopathy-soh.org/whats-new/singlereg/default.aspx
    Nothing will stop them being official, and all that to protect the public. Unless anything is done it seems all that you have said is hot air
    Jamie

  459. LeiLa said,

    August 25, 2009 at 1:19 am

    Ben Goldacre?

    If you could please pm me i would be very greatful i would like to ask a couple of questions regarding your article.

    Leila

  460. diudiu said,

    December 21, 2009 at 5:39 am

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  461. vvd said,

    December 24, 2009 at 11:41 pm

    I do not understand those who enjoy its natural-scientific illiteracy, and it seeks to demonstrate. So I do not understand the author of this article.
    Do you not think about this:
    1. If homeopathy takes a powerful placebo effect, why this effect does not show (or almost never shown) antibiotic to cure the disease, where the antibiotic is not effective, for example, herpes?
    2. Why homeopathy cures infants who were not able to cure allopathy? Their parents believed in allopathy less than in homeopathy? Why did they first tortured their children allopathy? Why “parental suggestion” effectively in homeopathic treatment, but not effective in allopathic?
    3. Why homeopathy cure alcoholics who do not even know that their food and drink, add the medicine?
    4. Why homeopathy heals animals, including, just picked up on the street?
    Did you know that any molecule faced each other remember the rest of your life, or at least, not yet undergo new collisions with comparable parameters, even if after they are on different galaxies? It is known to any physics. What prevents this universal effect manifest itself in homeopathy?
    You just embarrassed that the quantum teleportation has been proved in the early nineteenth century, and not at the end of the twentieth?

  462. vvd said,

    December 24, 2009 at 11:50 pm

    * the rest of their lives…

  463. Snuggie said,

    February 5, 2010 at 8:46 am

    Snuggie blanket Snuggie blanket
    blanket with sleeves blanket with sleeves

  464. ThatOneChick said,

    May 9, 2010 at 4:30 pm

    Great evidence, and very well supported, but there’s one thing that you didn’t touch on. What about homeopathic veterinarians? How do you explain animals being cured by homeopathic remedies?

  465. BokChoy said,

    June 28, 2010 at 7:26 am

    Hi, for my school, I’m doing a project on Homeopathy.
    I loved your article and agree with you but a question, In the section where you said stuff about the dilutions you said (quote)”On the Society of Homeopaths site, in their “What is homeopathy?” section, they say that “30C contains less than 1 part per million of the original substance.””
    I agree with it but I tried looking for that on the Society of Homeopath’s website but I found nothing.
    Could you please help me? I would like to use this statement but I need the reference.

  466. ellieban said,

    July 16, 2010 at 9:11 am

    BokChoy,

    This post is two and a half years old, my guess is the SoH have changed their page by now. You could try the waybackmachine, otherwise you’re going to have to find your reference elsewhere, I’m sure there are plenty of places to chose from still :/

  467. ellieban said,

    July 16, 2010 at 9:13 am

    In fact, they haven’t. It’s here: www.homeopathy-soh.org/about-homeopathy/about-your-remedy/

  468. Woo said,

    August 1, 2010 at 11:59 pm

    I am seriously late to the party here.

    You’re a good writer Ben and I would not disagree with any scientific opinion of homeopathy from the point of view of science – it is perfectly logical.

    Personally though I found this article to be laced with prejudice and contempt – and not objectivity. I’m not a homeopath.

    I was sceptical about homeopathy before I actually tried it – that is, went to see a homeopath not just buy something from Boots.

    1. I took the remedy. The symptoms which I had had for a year cleared in 2 days. A “normal” doctor was not able to do anything for it.

    2. About 3 weeks later the symptoms returned. I took the same remedy (perhaps a different potency). I had to stop taking the remedy because my dreams had become psychedelically terrifying – and lucid. The dreams stopped when I stopped taking the remedy. The “side effects” that transpired were in fact consistent with that remedy. I did not know this beforehand. I had a similar change in the nature of my dreams in the first remedy also.

    Sure this is personal experience – hardly a double blind trial but for me at least defeats the placebo argument as a catch all explanation for any positive effects of homeopathy.

    Homeopathy treats the person – 2 people with the same symptoms may be prescribed different remedies. If this is the case how can homeopathy ever use the “drug trial” as an effective way of testing its efficacy.

  469. psydev said,

    September 15, 2010 at 11:33 pm

    A friend of mine started taking a homepathic form of “birth control” and stopped taking her regular birth control pills. Unsurprisingly, she became pregnant soon after and had a very traumatic abortion and experienced great stress with her family when she told them.

    We must understand there are real consequences to people, for letting this medical quackery go on unchecked.

  470. rosross said,

    February 16, 2012 at 5:24 am

    The biggest problem with this article is that it makes Ben Goldacre look bad – both as a doctor and a journalist.
    Your explanation of the placebo effect is facile and I am astonished you would resort to such manipulation to simply seek to make a point.
    You also have clearly no real idea of how homeopathy works. To suggest that homeopaths like prescribing pills more than doctors is simply laughable. Most visits to the doctor take less than 20 minutes and in most cases people walk away with a prescription which will have them taking pills for weeks or months and which in many cases are ultimately re-prescribed so they can be taking pills for years.
    An initial homeopathic appointment takes from 1.5 to 2 hours and subsequent appointments take from 1 to 1.5 hours. A pill is usually given but often one pill and that is the only one until the patient returns in one, two or three months.
    It is bad science and bad journalism and bad medicine to take the extremes of a healing methodology as you have done here and to seek to discredit the entire methodology – one older than modern medicine actually. If we were to take the medical quacks which allopathy has produced in its history and continues to produce and to take into account the hundreds of thousands who die around the world every year and the hundreds of thousands who are hospitalised through iatrogenic (doctor-induced) causes, often from the prescribed pharmaceuticals, then your medicine would look even worse than the healing methodologies you seek to discredit.
    You seem an intelligent young man Ben. Your obsessive fear and hatred of homeopathy is irrational. There must be a reason. I would only ask if you have ever actually studied it or taken the time to see a qualified homeopath and tried it for yourself. Homeopathy is actually very effective with obsessions and fears.
    In the meantime I am not sure how much time you have to work as a doctor given the effort and passion you put into attempting to discredit a healing methodology which is centuries old, which harms none and which is actually increasing in use around the world but clearly your demands as a doctor impact your ability to properly research and write as a journalist.
    The indications are that you are performing poorly on all fronts – perhaps you are spreading yourself too thin. Either commit to journalism and become a better researcher and writer or commit to medicine and take the time to explore traditional healing methodologies like homeopathy and acupuncture, as many qualified doctors do, and make a difference.
    Pouring out these diatribes only make you look foolish.

  471. liviahull said,

    June 17, 2012 at 10:41 am

    @rossros – of course, how predictable. Why not launch a personal attack on Ben Goldacre instead of keeping the discussion within the subject: evidence that homeopathy works better than a placebo.

  472. celtic_child said,

    September 19, 2013 at 7:12 pm

    Hello:
    Just wanted to say “sorry for coming so late to the party”
    I have enjoyed all the info. both Intelligent and ignorant(I don’t intend that as an insult, it just means that someone does not know something.)
    I will formulate a proper submission in regard to my personal experience with homeopathy. All I can say at the moment is that I am absolutely on one side of the fence.