Oct 26 2007

My Day with the Homeopaths – Part I

Yesterday I took part in a panel discussion titled, A Debate: Homeopathy – Quackery Or A Key To The Future of Medicine? hosted by the University of Connecticut Medical Center. You might think that the title is a bit of a false dichotomy, but in this case it is accurate, for the two sides of this debate occupied far ends of the belief spectrum with a wide gulf between us. Although I did not hear anything new from the homeopathy side, it was a very useful experience to hear both how they are formulating their claims and rationalizations these days, and the response and questions from the audience (which, by show of hands, was comprised at least half by practicing homeopaths).

The first two hours of the debate was really a serial lecture, and unfortunately I went first so I could only anticipate, and not respond to, what the homeopathy advocates had so say. This part of the panel discussion was webcast (and archived so you can still view it here), but the best part of the day was the hour of questions and answers after the serial lectures, and it is a shame that this part was not webcast. But I will reports the highlights here (and discuss it on next week’s episode of the SGU).

After my presentation on the extreme scientific implausibility of homeopathy, materials scientist Rustum Roy presented his completely unconvincing case for its plausibility. His strategy was to argue that the only significant scientific objection to homeopathy (other than the blind bias, prejudice, “homeophobia” – his term, and materialistic assumptions of scientists) is that homeopathic water does not contain any molecules of active ingredient. However, he argues, the key to material function is not composition but structure, so we should be looking at the structure of water and not what is in it.

He then followed with what he considers to be evidence for the long term structure of water. However, most of his evidence was completely irrelevant to the point. He talked about crystals and glass structure – which have nothing to do with water. He talked about Kanzius’s experiments with radiowaves weakening hydrogen and oxygen bonds so that it can be burned (he did not go so far as to imply that this could be a fuel, as Kanzius does), and I admit I completely failed to see the relevance of this to homeopathic preparations. And he presented evidence that water can create clusters of hydrogen bonding that last for hours. All of this, he argued, adds up to the fact that water can have a memory and contain information in its structure.

Roy is simply anomaly hunting and has not established that the transient effects he is seeing have any application to homeopathy (see here for a good overview). He did present one study of his own that looked at homeopathic preparations using spectroscopy, although this was with an ethanol base, not water. He claims it shows differences between different homeopathic dilutions and preparations. I pointed out, as many others have, that this study is worthless because he did not demonstrate that the different preparations (which were just obtained from a homeopathic company) had no chemical differences – to which he had no effective answer.

The water memory and water structure evidence at this point in time is at the level of the evidence for N-rays – namely there are scientists who are a-prior dedicated to the ideology that water has memory because they believe homeopathy works and they are diligently looking for and seeing anomalies, and then leaping far beyond the evidence to unjustified conclusions. Yet, they lack the one kind of evidence that would even approach being convincing – the ability to tell the difference in a blinded fashion between homeopathically treated water and regular water. Simple blinding ended the N-ray phenomenon is a single stroke. Homeopathy is too well established for a such a rapid death, but the water memory nonsense can be dealt with that way. If Roy and others want to be convincing they should demonstrate that they can identify homeopathic water in a blinded test with proper methods that rule out chemical differences or contaminants between the samples and also with enough replications to provide for proper statistics.

I also pointed out that Roy had only addressed one plausibility objection to homeopathy, while in my talk I enumerated a chain of implausibility. Specifically:

1) The “Law of Similars”, the notion that like cures like, has no basis in biology or the natural world. This is the product of a well known form of magical thinking known as sympathetic magic – the idea that causes resemble effects. Samuel Hahneman, the inventor of homeopathy, thought that the body would not allow two similar ailments to coexist in the body at the same time – but two centuries of medicine and biology has not discovered any such principle. Modern homeopaths explain this alleged effect as the body’s reaction to the homeopathic remedy, like immunization, but I pointed out that there is no immune response to homeopathic potions and there is no other mechanism for any such reaction, so this is just explaining the unknown with another unknown.

2) Hahneman’s theory of disease, the miasma theory (the notion that all chronic illness is caused by external poisons or miasmas) – was pre-scientific and does not correlate with any known biology.

3) Homeopaths claim they treat the whole person, cashing in on the “holistic” marketing brand, but this contradicts the law of similars. They feel their remedies need to be individualized, taking into account many superficial characteristic of the patient, including personality. Yet they simultaneously claim that a specific remedy will treat a specific symptom based upon the law of similars. So this whole person approach is both implausible and internally inconsistent.

4) Hahneman and modern homeopaths also cling to “principles of cure” that include the notion that homeopathic treatments treat people from top down, the inside out, and starting with the most recent symptom. Such ideas, again, have no basis in any model of biology or disease.

5) The “law of infinitessimals” claims that extreme dilution increases the potency of the diluted substance, but only of the beneficial effects, while decreasing any harmful effects. There is no mechanism for separating out wanted and unwanted effects in this simple fashion. And, of course, two centuries of science confirms the common sense idea that dilution weakens potency.

6) Succussion is the principle that by shaking the homeopathic remedy at each dilution the “energy” or “essence” of the substance will be transferred to the water or alcohol. So in one manifestation homeopathy is just another form of energy medicine – relying on the claim of a vital energy that is unknown to science.

7) Roy and others try to rescue this problem that homeopathic remedies are chemically just water or ethanol with no active ingredient with the “water memory” argument. I pointed out that this just creates another chain of implausibility, starting with the fact that homeopathic water memory has not been established and there is no known mechanism by which liquid water (as opposed to solids) can maintain a biologically relevant complex three dimensional structure for any significant time. But also:

8) The process would have to distinguish the desired chemical from everything else that may be in the water – all contaminants and trace elements. In fact, there is no explanation for why everything that was previously diluted in any particular sample of water or ethanol would not still be there and therefore amplified by the dilution and succussion process.

9) Whatever information is alleged to be held in water structure would have to also be transferred to the sugar pills on which the drop of homeopathic water is placed, or at least survive the process.

10) Water memory would have to survive ingestion and absorption through the GI system into the body and transportation through the blood and to the tissues.

11) Drugs that are chemicals and proteins work because animal cells communicate with each other and regulate their function with chemical and protein signals. Drugs bind to receptors for such signals, activating or blocking them, or they block or modify the function of enzymes or otherwise alter biochemical reactions. Biologists have not discovered any “water memory” or homeopathic signals or receptors, nor anything that could plausibly serve as a receptor for water structure. There is no reason that our bodies would respond to homeopathic signals unless they were part of normal biological function in the first place.

12) Some homeopaths resort to quantum mechanics to explain the effects of homeopathic remedies, but this again is just an appeal to the unknown. Also, quantum effects are relevant at the subatomic level and maybe bleed over to the atomic level, but are not relevant to the macroscopic world or to biological systems.

So there is not just one level of extreme implausibility to homeopathy, but a chain of implausibility – a series of unknowns that have evaded scientific discovery for over two centuries that would all or mostly have to be true in order for homeopathy to work. Roy’s response was predictable and lame. He said, when I directly confronted him on this fact, that the dilution problem is what he hears 99% from scientists – a complete non sequitur. Roy wants to focus on that one objection because he feels (incorrectly) that he has the answer to it.

Roy also resorted to the standard defenses of pseudoscientific woo. He criticized my invocation of plausibility at all, saying that science only advances by considering the implausible – a straw man argument. Scientists consider the unknown, absolutely, and what I said cannot be construed otherwise. But Roy’s position is the equivalent of saying that we know nothing scientifically, that no ideas in science are better than any others, and that we cannot make probability statements about what is likely to be true. Roy is apparently undeterred by the fact that homeopathy is dependent upon a series of unknowns and highly implausible speculations, even after more than two hundred years.

To better understand where Rustum Roy is coming from I will relate that during the Q&A he pronounced that the “materialist paradigm is dead.” His evidence for this profound pronouncement was the charlatan faith healer from Brazil, John of God. Roy would have us abandon the hard won foundations of science because he was bamboozled by a second rate conjurer. Randi has already done a fine job of exposing John of God’s claims for the trickery they are. (BTW – Dr. Mehment Oz also fell for John of God’s chicanery and refers to it as evidence for his brand of woo.)

Roy also displayed the usual hostility toward conventional medicine, and even tried to argue that clinical medicine is not “real science.” – He specifically advocated that we do not use the word “science” when discussing clinical evidence. Meanwhile, he demonstrated that he does not understand the basics of clinical science, such as the need for and effects of randomization in a clinical trial. This is nothing but the misguided claim that “my science is better than your science” (an argument from authority and ad hominem logical fallacy rolled into one). He wants us to accept his pronouncements on homeopathy because he is a materials scientist, and that is real science, and he can comfortably dismiss biological and medical arguments because that’s not real science anyway.

The entire day was certainly an adventure in logical fallacies and hopelessly muddied thinking. But the best is yet to come. On Monday I will post Part II of this entry, covering the clinical evidence part of the debate.

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21 responses so far

21 Responses to “My Day with the Homeopaths – Part I”

  1. Blake Staceyon 26 Oct 2007 at 4:05 pm

    Your eighth point is headed by a sunglass-sporting smiley face. It actually looks pretty darn cool.

  2. Marcon 26 Oct 2007 at 5:00 pm

    Might want to disable smilies there. Other than that, great. Can’t wait for other part.

  3. Skeptykon 26 Oct 2007 at 5:28 pm

    Thanks for doing this, Steve. I know that the skeptisphere has been abuz with the debate about whether we should debate pseudoscientists (and I am of three minds on the topic), but when it comes to homeopathy, I think time is ripe for hitting this quackery hard. The fallacies and misunderstanding used to argue for homeopathy are applicable to so much of CAM. Raising the dissonance within the users is a good thing.

    Homeopathy is so very silly, yet still so few folks in the general public are aware of just what it is. When I ask folks, they usually give a very vague response using one or both of these words: “natural” and “herbal”. When I explain the basics, they are incredulous, think I’m talking bollocks, or give me their personal testimonial/FOAF tale.

    Scary that homeopathy is being given such a free ride:

    *endowed departments at several med schools,
    *coverage by some insurance and employee benefit programs,
    *sold in pharmacies, (big chains, boutique “wellness” pharms)
    *practitioners licensed in many states, (presumed legitimacy)
    *NCCAM-funded research (often crap research, wildly biased interpretations)

    Planting seeds of dissonance, drop by drop, argument by argument, includes some carefully selected debates.

    So thanks. Looking fwd to the rest of the post.

  4. Evan Bernsteinon 26 Oct 2007 at 8:19 pm

    Steve, you forgot to mention a few things:

    Roy started by attacking you in his opening remarks – he had a powerpoint with 2 of your quotes, so he came prepared to try and knock you down a peg (in his mind). An ad homenim attack.

    His powepoint presentations were numerous, nearly impossible to read, colorful (I’ll give him that), and effectively, a diversion tactic -in my opinion.

    He also seemed to get flustered at the last 2-3 minutes with you and him seated at the table together – a sign that you had him dead to rights on the points you made about his presentation, and he was squirmish.

    Well done, Steve.

  5. deciuson 27 Oct 2007 at 5:33 am

    What a beautiful exercise in logic. Congratulations, Steven.

  6. apgaylardon 27 Oct 2007 at 6:52 am

    Great work. Thanks for the name check. Homeopathy needs confronting. In the UK Batchelor of Science degrees are now offered by some universities in this nonsense. The NHS still funds some homeopathic hospitals; though this, thankfully, seems to be under some threat.

    The “Memory of Water” issue of the journal Homeopathy has been pretty comprehensively debunked. [my short summary of good posts: http://apgaylard.wordpress.com/2007/10/12/homeopathy-and-the-memory-of-water-going-round-in-circles/#comment-19

    I waded through all the papers and the collection seems to be a compendium of begging the question, not comparing like with like, straw man bashing, straw clutching, quantum flap-doodle, non-sequitur, mishandled references, poor experimental technique, bias, wishful thinking and ignoring the obvious. There is nothing in there that gives water the powerful and selective memory homeopathy requires. It's unfathomable that this sort of work appeared in a "peer-reviewed" (which peers one wonders?) journal published by a major scientific publisher.

    This Rustum Roy fellow seems to get everywhere. I've been following the "burning salt water" debacle, as well as the "memory of water" delusion. I didn't expect one man to stand astride both fantasies.

    It's really odd that he mentioned Kanzias' extraordinary claims. He has been quoted in the automotive press as saying that: "No hard research has been conducted as yet -- it's only been a few months since the water first caught fire " [http://www.motortrend.com/features/editorial/112_0711_technologue/]. In the same piece he even said that he had not met Kanzias [see http://www.rustumroy.com/response_to_email.htm for an apparent contradiction.] Given this it’s an insight into the strengths of his claims that he throws it in during a debate with you?

  7. Nickon 27 Oct 2007 at 8:10 am

    A very interesting read and debate, though I do agree it’s a shame that the question and answer part wasn’t included. A prepared lecture is one thing but how someone answers questions that weren’t prepared usually says a lot more.

    Either way, I did have a few remarks about some of your points mentioned here.

    Namely the points about holism, where you seem to be mixing a few things up. From what I know of the matter you appear to use a rather extreme and passed by definition of Holism. Modern Holistic ideas, especially in medicine, are much more toned down. From what I gather they describe themselves exactly as you mention in your fourth point, only it’s from the outside inwards. They take a look at the whole system, hence the many questions a homeopath will ask, and prepare a treatment based on that. So by that definition Homeopaths can definitely consider themselves holistic.

    Which leads me to your fourth point. I understand that the Top Down (Holism) and Bottom Up (Reductionism) approaches are simply two different ways of looking at the same biological content. One starts from the whole and works it’s way down to the smaller components, translated to practiced medicine this means they’ll treat the symptoms as a whole .. a general practice in many medicinal areas, including our western, scientific medicine. It’s only relatively recent that medication and therapies are leaning towards the Bottom Up approaches, where science attempts to figure out the smallest elements that may cause the disease and try to straighten them out. The problem with these molecular therapies is that they usually only focus on one aspect, where as most illnesses have several different aspects and mechanisms that can be potential sources.

    Either way, I don’t understand how one can argue that either one of these two approaches are unfounded by biology or science. They both start from the same scientific knowledge.

    As for your last point, are you certain that quantum effects are irrelevant when it comes to biological systems? Or would this just be an argument based on the limitations of current scientific knowledge in that field? To me it seems to be rather unlogical, and against reductionism by the way, that a small particle loses it’s effect when ‘zooming out’.

    P.S.:

    I’m not taking a stand for or against Homeopathy, just wanted to point out a few weak points, by my understanding, in your arguments.

    You’ll also have to excuse me for any spelling or gramatical errors I made here, english is not my native language.

  8. Steven Novellaon 27 Oct 2007 at 10:56 pm

    Nick,

    The problem with the concept of holistic is how it is applied. Modern medicine is holistic, in the reasonable sense of considering the whole person and how the whole biological system works together. We treat patients, not just symptoms (that’s just CAM propaganda).

    But homeopaths use the term holistic to mean that they include superficial aspects of the person, such as whether or not they enjoy listening to classical music, in determining the optimal treatment. This is not a reasonable whole person approach, this is not a biological top down approach – it’s ritual and magic.

    Regarding quantum mechanics, I am not certain of anything – no one is. My point is that quantum effects have not been observed at the biological or macroscopic level, current models of quantum theory do not allow for such effects (largely due to decoherence) and therefore quantum theory cannot be invoked as an explanation for homeopathy. This is explaining one implausible unknown with another implausible unknown – that does not raise the plausibility of the unknown.

  9. marblueon 28 Oct 2007 at 1:39 pm

    A terrific post. I’m sorry I don’t get to see the video of the Q and A. My guess is no homeopath will sit down with you for another debate.

    This piece by Shankar Vedantam in the Washington Post seems to indicate that there’s nothing that can be done to convince those so firmly entrenched to change their minds.

    “Deliberate deception among humans…requires effort. It requires you to hold both the truth and the untruth in your mind, and consciously suppress the truth….

    Self-deception..offers a way around this psychological hurdle. If you can make yourself believe the untruth, for example, by marshaling evidence that supports your view and ignoring evidence that contradicts your position, it becomes that much easier to persuade others.”

    http://www.washingtonpost.com/wp-dyn/content/article/2007/04/29/AR2007042901152.html?referrer=delicious

    Keep up the good work. Individuals, like yourself, reached me and convinced me. If it wasn’t for these individuals, I would still be living in the land of self-deception.

  10. [...] discussion on homeopathy hosted by UCONN. It was an interesting experience, as I knew it would be. In part I of my report from the conference I talked about the plausibility arguments against homeopathy and Dr. Rustom [...]

  11. Roseon 30 Oct 2007 at 4:24 pm

    It’s always interesting to listen to someone’s voice so much on the radio (or, in this case, a podcast) and then finally see them lecture and be able to put a face to the voice!

    I think you did really well. Thanks for posting this.

  12. pvon 30 Oct 2007 at 8:03 pm

    Maybe Roy’s talks should be called the Rustum Roy Religion Show, because homeopathy bears all the hallmarks of a religion. There is a leader, a bible, commandments and rituals, church leaders, followers, an aversion to self reflection, an abhorrence of evidence… dishonesty!

  13. m-mischiefon 03 Nov 2007 at 4:28 pm

    Go Snov! you have to argue against the same irritating fallacious arguments time and time again and yet you still have a full head of hair.

  14. [...] of Connecticut Health Center (where a “debate” about homeopathy was recently [...]

  15. [...] quantum theory at the macroscopic level for some of the most amazing woo you’ve ever seen, or Rustum Roy’s claims for the “memory of water.” Indeed, if you want to find out just how [...]

  16. [...] Reports of the Demise of Materialism Are Premature – Part II Published by Steven Novella under Skepticism Comments: 0 [...]

  17. [...] Dr. Andrew Weil, and that King of Water Woo, particularly pseudoscientific arguments for homeopathy, Dr. Rustum Roy. Truly, this was an Unholy Trinity of Pseudoscience, and the results were very predictable. In [...]

  18. joand1on 29 Nov 2012 at 12:39 am

    I’m assuming all of you know alot more about homeopathy and/or science than I do, but I have been reading alot about alternative medicine since my grandson was diagnosed with autism. Since traditional medicine can’t come up with a reason why it exists or offer any hope for improvement through pharmaceutical drugs, I am opening my mind for other treatments. Have any of you actually spoken with actual patients who have tried homeopathy? Just because you can’t “prove” scientifically why something works, doesn’t mean it doesn’t work! One book I’ve just finished reading is “The impossible cure” by Dr. Amy Lansky, PHD (Doctorate in computer science). She only became involved in alternative medicine when her son developed autism. Being a concerned Mom will certainly expand your scientific mind to other options. Homeopathy was very well known and practiced in the States in the 1800′s, sucessfully. When pharmaceutical companies began coming up with their “miracle” drugs, it became “easier” to just take an aspirin or whatever for your ailment. So many of the drugs simply surpress symptons, but don’t eliminate the cause. and of course, homeopathic remedies cost very little, so who want’s to finance a “study” on these. trust me, pharmaceutical companies are NOT your friends! Can you say, “Big Money?” Whenever I hear anyone speaking negatively about homeopathy, I have to ask them, “Is your opinion based on knowledge or personal experience?” Have you listened to both sides of the story with an OPEN mind??

  19. Steven Novellaon 29 Nov 2012 at 9:29 am

    jo – let me address your points as they are common pro-CAM propaganda points:

    1 – It is not just that we cannot prove how homeopathy works. Our current science indicates that homeopathy cannot possibly work, and in fact it does not work. It’s been studied – it doesn’t work.

    2 – Clinical trials involve people who have taken homeopathic products. They count. Anecdotal information from individual patients, however, are not very helpful. They tend to be overwhelmed with bias and illusion. What we can say from such experiences, however, is that there is no “home run” from homeopathy – no big cures, only vague symptom relief easily explainable as placebo.

    3 – The concerned mom gambit – irrelevant to the evidence.

    4 – You assume homeopathy was practiced successfully in the past. There is no good evidence for this – no compelling evidence that homeopathy ever worked for anything.

    5 – Homeopathy was not displaced by the pharmaceutical industry. It was displaced by modern science.

    6 – Homeopathy is a multi-billion dollar industry with its own “big pharma” companies like Boiron. They are just not required to study homeopathic products the same way pharmaceuticals are. But – homeopathy has been widely studied, and again – they don’t work.

    7 – Finally, the “open mind” gambit. This is not about having an open mind. It’s about understanding science and how to evaluate evidence properly. The better the quality of the evidence, the more likely it is to show that homeopathy does not work, and the best evidence all shows that it doesn’t.

  20. ChrisHon 29 Nov 2012 at 11:17 am

    joadn1:

    I’ve just finished reading is “The impossible cure” by Dr. Amy Lansky, PHD (Doctorate in computer science).

    Some important information about Dr. Lansky (you at least know she has no medical training): Her son was never formally diagnosed.

    There are many kids with speech and language disorder that are not autism. That includes my younger son who was actually taken to a speech language pathologist and diagnosed with dysphasia. After speech therapy from students at the university’s training clinic his vocabulary went from very below his age (three then), to appropriate for a four year old in one year. He is a normal college student.

    For more information on autism, from parents and those with autism see:
    http://www.thinkingautismguide.com/

    And if you really want to use homeopathy, try saving money and making your own:
    http://skepticfamily.com/2010/11/18/make-your-own-homeopathic-remedies-and-play-dough/

    :-)

    And on a more serious note, here is some additional reading from parents of autistic children, and one with cerebral palsy:

    Unstrange Minds by R.R. Grinker
    Not Even Wrong: A Father’s Journey into the Lost History of Autism by Paul Collins
    No Time for Jello by Berneen Bratt

    I have a longer list, because I have spent many many many hours in medical room waiting rooms because my oldest son is disabled. That includes ten years of speech therapy (he did not recover like his younger brother). With him it started with neonatal seizures that did not stop until he was given phenobarbital. I defy you to treat seizures with homeopathy.

  21. ChrisHon 29 Nov 2012 at 11:25 am

    I should explain that I spent my son’s first four years trying to find out more about his speech disorder and seizures (he had more later while sick with a now vaccine preventable disease), so I checked out almost every book in the library on speech/language disorders (including deafness, like Train Go Sorry by Leah Cohen), seizures, and neurology (lots of Oliver Sacks). This was before there was the internet.

    The result is that I don’t read much fiction anymore, and my list of recommended books is very long. But for some good reading, check out the reviews from Dr. Novella’s other group blog:
    http://www.sciencebasedmedicine.org/index.php/category/book-review/

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