Dec 23 2009

More Homeopathy Apologetics

It seems that one criterion to being a practicing homeopath is the requirement to publicly embarrass oneself .  Dana Ullman now regularly does this over at the Huffington Post. Dr. Werner, however, in a single YouTube video, may have won for the most embarrassing homeopathy nonsense of the year.  Her mutilation of Einstein and relativity is self-parody.

Here’s another one from John Benneth – the science of homeopathy. He discusses the latest nonsense about “nanocrystalloids” in homeopathic remedies which emit radio frequencies. This is just empty jargon to jazz up the same false claims of homeopaths that their remedies contain the energy signature or essence of what was diluted in them. But this is not supported by any reputable science.

And here is the recent review by The Parliamentary Science and Technology Select Committee on homeopathy in the UK where Robert Wilson of the British Association of Homeopathic Manufacturers admits that there is no evidence to support the effectiveness of homeopathic remedies, but they sell them anyway.

And now, Amy L. Lansky, PhD, a computer scientist and now homeopathy proponent, writing for (a site that promotes every sort of medicine – as long as it is unscientific), decides to enter the fray for the most embarrassing homeopathy apologetics.  After a bit of whining about persecution, she attacks homeopathy’s critics, referring to a recent editorial by Michael Baum and Edzard Ernst:

Not surprisingly, their commentary also reflects a complete ignorance of homeopathy and the range of studies that support its effectiveness. For example, their article incorrectly uses the term “potentation” instead of “potentization” for the method used to create homeopathic remedies (more on this later). The authors also insist on citing a single negative meta-analysis study that has already been shown to be methodologically flawed, while ignoring many positive studies in respected publications, including two other meta-analyses that showed positive results.

Calling Edzard Ernst completely ignorant of homeopathy is rich. He is not a computer scientist like Lansky, but an actual professor of complementary and alternative medicine (if you search PubMed on Ernst E and Homeopathy, you will find more than 70 peer-reviewed published articles by Ernst). He has thoroughly studied the evidence for homeopathy, from a sympathetic point of view, but was simply appalled by the grossly unscientific nature of homeopathy.

Picking on the editorial for using the term “potentation” instead of “potentization” is just absurd – not to mention a non-sequitur. It is not a substantive criticism. Meanwhile  Lansky claims that Edzard cites “a single negative meta-analysis.” This is a demonstrable lie (or such appallingly sloppy scholarship that there is functionally no difference). In the commentary Lansky is referring to, Should We Maintain an Open Mind about Homeopathy? – there are several relevant references to back up the claim that the evidence does not support the efficacy of homeopathic remedies for any indication, not just a single meta-analysis.

I think the meta-analysis Lanksy is referring to is – Shang A, Huwiler-Muntener K, Nartey L, et al. Are the clinical effects of homeopathy placebo effects? Comparative study of placebo-controlled trials of homeopathy and allopathy. Lancet. 2005;366:726-732. This analysis certainly does call into question whether there is any effect in homeopathic concoctions above and beyond placebo effects. It was not a perfect study – no study is, and meta-analyses are always very tricky. But the basic conclusions of the study are valid.

But that is far from the most significant reference cited by Baum and Ernst, who also cited three systematic reviews of homeopathy. Perhaps Lanksy does not know what a systematic review is – by definition they are systematic – they look at all the evidence. In fact, one of the references was to – Ernst E. A systematic review of systematic reviews of homeopathy. Br J Clin Pharmacol. 2002;54:577-582. That’s right – a systematic review of systematic reviews conducted by Ernst himself. It doesn’t get more thorough than that. From the abstract:

Eleven independent systematic reviews were located. Collectively they failed to provide strong evidence in favour of homeopathy. In particular, there was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. Similarly, there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo. It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice.

So Ernst, by referring to his review of reviews, was actually citing eleven published systematic reviews of homeopathy. This review was done in 2002, so he also included a more recent systematic review from 2007 – also negative. Yet Lanksy accuses Ernst, essentially, of cherry picking. Then proceeds to cherry pick a few positive studies herself. This is the kind of astounding intellectual malfeasance we have come to expect from homeopaths and their apologists.

Lansky then explains for us how homeopathy works:

Homeopathic practice is based on a single law of therapeutics called the Law of Similars. This law states that a substance that can cause the symptoms of a disease can also cure it. In fact, that’s exactly what word “homeopathy” means: similar (“homeo”) suffering (“pathy”). For example, one reason that the remedy Coffea Cruda (made from coffee) can be curative for insomnia is that coffee can cause sleeplessness. Interestingly, allopaths sometimes utilize the Law of Similars, but are unaware of it when they do and are perplexed by the phenomenon.

Ask any conventional doctor why Ritalin (a substance that would normally cause hyperactivity) can treat hyperactivity in children, and they’ll scratch their heads in confusion. Ask a homeopath, and it’s a no-brainer: the Law of Similars.

Well, I am a “conventional” doctor and my head remains unscratched. There is, in fact, nothing paradoxical about the mechanism of Ritalin or other CNS stimulants in the treatment of ADHD at all – if you actually know something about it. The AD part of the diagnosis is attention deficit – a deficit of brain activity related to focused attention. Stimulating brain activity therefore allows for increased attention.

Even the hyperactivity part responds to stimulants, partly because of increased focus. But also, the frontal lobes of the brain are responsible for inhibiting our urges and behaviors. Frontal lobe activity, especially what is called “executive function,” is decreased in those with ADHD. Stimulants increase the activity of the frontal lobes – they increase the inhibition that is essential to executive function, and thereby decrease the hyperactivity.

What Lansky derides as “allopathy” (a derogatory term only used by enemies of science-based medicine) derives from basic-science knowledge of how the brain works, and what is dysfunctional in those exhibiting a specific set of signs and symptoms. This is followed up by clinical studies showing clear efficacy for treatments based upon our basic-science models of neuroscience and ADHD specifically.

Lansky clearly made no attempt to understand any of this prior to spouting off about what conventional doctors “know.”

What is homeopathy based on? Lansky gives us only a made up “law” – the Law of Similars. But that is not an explanation at all, just an assertion. There is no such thing as a law of similars. It is based on no knowledge of chemistry or biology. Two centuries of scientific investigation following the invention of homeopathy has failed to provide a jot of evidence for any such phenomenon. It is based entirely on superstition – specifically sympathetic magic, which was a common belief system in pre-scientific cultures.

And how, exactly, does Lanksy think this made up law explains the action of Ritalin?

Regarding the homeopathic preparation of coffee for the treatment of insomnia, I believe James Randi demonstrated the absurdity of this specific claim by downing an entire box of this preparation without the slightest bit of drowsiness.

Next she attacks mainstream medicine and the use of pharmaceuticals:

Of course, homeopaths add fuel to the fire. The fundamental philosophy of homeopathy implies that the primary tools of allopathy are harmful. In particular, homeopaths believe that suppressing symptoms with anti-pathic drugs – drugs that oppose the symptoms of a disease rather than mimic them – cannot cure and can even do harm. If a symptom is suppressed – for example, if a seasonal allergy is suppressed by an antihistamine – it is only temporarily palliated.

This is a gross mischaracterization of modern medicine – but is a standard canard of alternative medicine critics of science-based medicine. Not all treatments in medicine are symptomatic. Many are curative. Antibiotics for infections and eradicate the infection. Insulin for diabetes is not treating symptoms – it is replacing a missing or insufficient hormone to reestablish proper glucose balance. Some treatments are preventive – such as medication to reduce high blood pressure, or aspirin to prevent heart attacks or strokes. There are many more examples.

But much of modern medicine is considered symptomatic – but this should not be derided at all. If a patient is having seizures because of damage to the brain, and I give them a drug to prevent the seizures I have not cured them, but I have stopped the significant manifestation of the injury.

And of course, her claims are based upon the assumption that homeopathic preparations do anything – but the evidence (as well as basic science) clearly indicates that they do not.

She continues:

Unfortunately, if a substance succeeds in completely suppressing a symptom, there may be an illusion of “cure,” but the real result is more sinister. Another key tenet of homeopathy is that the true result of suppression is a deepening of the underlying disease state – because the energy of the disease is now forced to manifest in a more serious way.

Right – this is a “tenet” of homeopathy, just like a tenet of any faith. It is a belief, nothing more. Again – there is no reductionist basic science on which this is based. What is the “energy of the disease?” Where is the evidence to support this assertion? This is nothing but magical thinking.

And, of course, experienced clinicians are well aware of the real risks of masking symptoms while not addressing an underlying condition. This is basic clinical skill. Homeopaths have nothing legitimate to say about science-based medicine, so they are content to attack their “allopathic” straw men.

She then touts homeopathy as a system of treatment for poor countries. Exploiting poor nations who are suffering from serious health issues was something that even motivated the World Health Organization out of their usual torpor to make it clear they do not support homeopathy to treat the diseases that plague the third world.They specifically denounced homeopathy for the treatment of TB, diarrhea, malaria, and HIV/AIDS.


There is so much more nonsense, but it always takes longer to clear up misinformation than to0 spread it. Lansky concludes with this:

The skeptics manage to create a lot of smoke in an effort to hide homeopathy from public view.

Wrong. Skeptics are trying to expose homeopathy – the real homeopathy – to the public. We want the public to know exactly what homeopathy is – superstitious nonsense. We want them to know that homeopathic preparations are typically diluted to such a degree that no active ingredient is left. We want it made clear that the principles of homeopathy are little more than old superstitions and magical belief, dressed up with some modern-sounding jargon.

And we certainly want them to understand the evidence-based for homeopathy. Systematic review after systematic review has failed to demonstrate any effect for homeopathic concoctions beyond the placebo effect. They are, essentially, placebos being sold as if they were real medicine. And further, homeopaths and their apologists, in order to further their sales, attack science-based medicine – doubling down on their deception and malfeasance.

The smoke is all coming from the homeopaths, and we only want to clear it away, to have an honest scientific assessment of homeopathy. If that were to take place, it would vanish overnight.

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