Yes, I know I have been writing about homeopathy a lot recently. I am consciously making this one of my main topics of interest for 2011. Homeopathy is one phenomenon where the disconnect between public and official acceptance and the level of pseudoscience is greatest. It is also an area where acceptance is often based upon simply not understanding what homeopathy really is. If scientists keep beating the drum about how unscientific homeopathy is, perhaps we can have some effect on public belief and policy. Perhaps this is just wishful thinking, but then so is all activism.

Today I have some good news to report. The Canadian program, Marketplace, did an excellent piece on homeopathy. (You view it on YouTube in two parts: part I and part II.) Usually such mainstream media attention to homeopathy and similar topics falls into the trap of false balance – telling both sides and letting the audience decide. This is a reasonable journalistic default for political and social topics, but not for science. In science there is a level of objectivity and the logic and evidence is not always balanced on two sides of an issue. We don’t need to “balance” the opinions of an astronomer with the illogical ravings of an astrologer.

Fortunately, the Marketplace program did not default to the false balance mode.  Rather they took the far more appropriate consumer protection angle – which is the format of this particular show. I was especially happy about this because I have been saying for years that consumer protection advocates need to realize that fake medicine (so-called complementary and alternative medicine or CAM) is a huge consumer protection issue. Regulations meant to protect consumers from fraud and harm are being systematically weakened in the favor of product manufacturers and distributors and practitioners. It is a scandal worse than anything Ralph Nader has taken on in the past, and yet he seems to be nowhere on this topic.

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For those “shruggies” who still cling to the naive notion that there is no harm in worthless medicine, we have an update on promotion of homeopathic products for the prevention of malaria in sub saharan Africa. The General Pharmaceutical Council (GPhC) of the UK decided to drop their investigation of complaints against pharmacies that were recommending worthless treatments instead of proven and effective drugs for malaria prophylaxis.

Homeopathy is a prescientific philosophy-based system of treatment whose central ideas have been long discredited. Preparations are diluted to the point that there is essentially no active ingredients left behind, and so they are literally nothing but sugar pills or placebos. What’s more, there has been extensive clinical studies of homeopathy, most of it useless, but the well-controlled trials show that homeopathy does not work – for anything.

I did a literature search for homeopathic studies with malaria, and found one animal study published in the journal Homeopathy. The methods are pretty sparse, but there is no indication of blinding, and in any case the study is in mice, not people. Despite the highly preliminary nature of this one study, the authors conclude:

Although the mechanism of action is unknown, these agents would be good candidates as alternative or complementary medications in the treatment of malaria.

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The one thing that is more absurd than homeopathy is the regulation of homeopathic products (at least in the US). Because of timely political pressure, homeopathic products were essentially grandfathered in to FDA approval. They do not require any testing for safety and effectiveness.

Here is NCCAM’s summary of homeopathic regulations in the US:

Homeopathic remedies are prepared according to the guidelines of the Homeopathic Pharmacopeia of the United States (HPUS), which was written into law in the Federal Food, Drug, and Cosmetic Act in 1938. Homeopathic remedies are regulated in the same manner as nonprescription, over-the-counter (OTC) drugs. However, because homeopathic products contain little or no active ingredients, they do not have to undergo the same safety and efficacy testing as prescription and new OTC drugs.

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Recent the following question appeared in my Topic Suggestion thread:

hi dr novella,

though a little past the time of your debate with homeopaths at the University of Connecticut Health Center: A Debate: Homeopathy – Quackery Or A Key To The Future of Medicine? (2007), i’m wondering why in your response to the actual debate on your blog you respond in the comments section to a post:

“The bottom line is that homeopathy is a tangle of magical thinking, every element of which lacks a theoretical or empirical basis.”

i’m unsure how you can make this statement when Dr. Rustom Roy disproved one of your main arguments, that homeopathic medicines are merely placebos, showed evidence that the structure and thus function of water can be changed for extended periods of time. this evidence presented refutes that the remedies are merely water, the inert substance that we all think it is. your quote above entirely ignores and contradicts the evidence that was shown to you.

this would be an interesting topic of discussion.

thanks.

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Homeopathy is on the ropes in the UK. Earlier in the year The House of Commons Science and Technology Committee (STC) released a report, Evidence Check 2: Homeopathy, essentially saying that homeopathy is bunk and should no longer be supported. Recently representatives of the British Medical Association (BMA) condemned homeopathy as “witchcraft.”

Now the BMA is going one step further – calling for a ban on homeopathy in the UK. They do not want homeopathy to be illegal, but they want a ban on any National Health Service (NHS) support for homeopathy. The NHS currently spends about 20 million pounds a year on homeopathic remedies (about 0.01% of the NHS budget) and maintains four homeopathic hospitals. This is a small amount overall – but anything spent on homeopathy is a waste. More importantly, as the BMA notes, homeopathy has “‘no place in the modern health service.’

The BMA specifically recommends that the NHS stop paying for homeopathic treatments, and that doctors in training can no longer receive any of that training at any of the four homeopathic hospitals, as they are not compatible with modern “evidence-based” medicine. They also suggest that homeopathic remedies should not be sold in pharmacies unless they are clearly labeled as placebos, rather than medicine.

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No, I am not talking about homeopathic suicide, which is entirely benign (except to the reputation of homeopathy). Rather, every now and then a prominent case pops up in which someone dies of a treatable condition because they chose (or their caregivers chose) to rely exclusively on homeopathy or some other alternative treatment. Since most homeopathic preparations are literally nothing but water and wishful thinking, they typically do not cause direct toxicity (hence the “homeopathic suicide” stunts of skeptics). Most of the harm from homeopathy comes from something far more insidious – confusing people with appealing medical fairy tales.

These cases also occur on a backdrop of inadequate regulation. Essentially those who wish to make money by practicing medicine without proper training have managed to soften the laws so that they are able to practice medicine without proper training. The usual defenders of consumers against rapacious industry are so beguiled by the touchy-feely rhetoric of promoters, that they have been entirely asleep at the switch. The results are predictable.

The latest case to come to media attention comes from down under – Penelope Dingle from Perth Australia, according to local news reports, was diagnosed with colon cancer in 2003. Her doctors gave her a good chance of survival with standard therapy – surgery to remove the cancer, and chemotherapy to mop up any loose cells and reduce the risk of recurrence. It is not a pleasant prospect, but with modern care it’s not too bad, and it buys in many cases a greatly improved quality and duration of life. Penelope Dingle, however, chose to refuse all science-based treatment and opted instead for a regimen of diet and homeopathic treatment.

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This is homeopathy awareness week – and like some other science bloggers I want the public to be as aware of homeopathy as possible. I want the public to be aware of the fact that homeopathy is based upon the “law of similars” – which is nothing more than the ancient superstition of sympathetic magic. I want the public to be aware of the fact that most homeopathic solutions are diluted far past the point where there is likely to be a single molecule of active ingredient left – and therefore claims for the homeopathic “law of infinitesimals” violates the law of mass action and the laws of thermodynamics.

I also do not want to silence homeopaths, as some have suggested. I want them to speak for themselves – every time a homeopath opens their mouth they make my job easier. Right now Dana Ullman, the ultimate online homeopathy apologist, is spewing incoherent nonsense in the comments at Science-Based Medicine. You also have to see Dr. Warner’s brilliant explanation for how homeopathy works (every time someone watches this video Einstein’s corpse cries.)

And now John Benneth is becoming the energizer bunny of hilarious YouTube videos. Seriously, this is beyond parody. Nothing’s better than homeopathy explained by a raving…well, take a look for yourself. I am slightly embarrassed to have Benneth as my new nemesis. I preferred Egnor – at least he was coherent at times and didn’t come off as a drunk who just rolled out of bed. With Egnor you could play “Spot the Logical Fallacy” and it would be challenging at times. Benneth makes it too easy.

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You may recall I recently discussed the incoherent rant of homeopath John Benneth, attacking defenders of science-based medicine. His tactic was clear – rather than discussing the scientific evidence, he chose to launch a personal attack against those who have the audacity to disagree with him.

This kind of behavior seems to becoming more common as the defenders of nonsense are being called out in public. Most recently an exhaustive review of the evidence for homeopathy led the UK Science and Technology Committee to conclude that homeopathy should not work, it does not work, and all public support for homeopathy and homeopathy research should be halted.

The simple fact is that homeopathic remedies are not remedies at all. They are nothing but water, with (in most cases) any active ingredients diluted to such a degree that nothing but water remains. Further, clinical studies, when viewed in total and not cherry picked, show that homeopathy (not surprisingly) does not work. The underlying principles of homeopathy, such as like cures like, is nothing but magical superstition.

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It’s been a bad year for homeopathy, and it’s still February. The 10^23 campaign has been making a proper mockery of the magical medicine that is homeopathy, capped off with their mass homeopathic “overdose.” In Australia skeptics have been taking homeopathic websites to task for making unsupported health claims. And in the UK there has been increasing pressure to question NHS support for homeopathy – most recently the House of Commons Science and Technology Committee concluded that homeopathy is nothing more than an elaborate placebo and the NHS should completely defund and remove any support for homeopathy. This could be a death blow to homeopathy in the UK, and provide support for similar efforts elsewhere.

Last year was no better. Most memorable was this comedy sketch by Mitchell and Webb, who nicely skewered homeopaths and other cranks. When comedians are not ridiculing them, homeopaths were doing a fine job of lampooning themselves – the best is this video where Dr. Werner tries to explain how homeopathy works – pure comedy gold. Of course the best real explanation for how homeopathy works is here.

Even before the House Committee presented its final report, the embarrassing moments were being immortalized on YouTube, for example the head of a major UK pharmaceutical chain admitting that they market homeopathic products with full knowledge that they don’t work.

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6.022137 × 10^23 – that’s Avogadro’s number. It’s the number of atoms or molecules of a substance in a number of grams of that substance equal to its atomic mass. So 1 gram of elemental hydrogen or 12 grams of carbon12 will have Avogadro’s number of atoms. This amount is also called a mole – so a mole of anything has Avogadro’s number of elementary particles – a mole of water has Avogadro’s number of water molecules.

Amedeo Avogadro first came up with the concept in 1811. In 1895 the number was first estimated by Josef Loschmidt, and when referring to the mass of an ideal gas is called the Loschmidt constant, but the number itself in 1909 was named in honor of Avogadro.

Samuel Hahnemann invented the principles of homeopathy (he “discovered” nothing, it turns out) in the 1790s and published his first article on the topic in 1796. So you see – Hahnemann could not have known about Avogadro’s number, in principle or in name, at least when he invented homeopathy. He died in 1843, long after the scientific community knew that his “law of infinitesimals” was rubbish.

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