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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