Homeopathy reconsidered

I used to think homeopathy was a daft idea. Take the whole dilution thing. In his splendid book How Mumbo-Jumbo Conquered the World, Francis Wheen pointed out that a typical dilution of 30C, (one part cure to 100³⁰ parts water) represents one single molecule of homeopathic ingredient diluted by more water than exists in all the world's oceans. The alleged active ingredient of the homeopathic cold and flu remedy oscillococcinum is, according to Wheen, 'duck's liver', 'diluted to an even more fantastic ratio of 200C.' That's one molecule, diluted by more molecules than exist in the entire observable universe.

It turns out, though, that Wheen was wrong about oscillococcinum. A manufacturer of homeopathic pills, Boiron, is currently making legal threats against an Italian blogger who dared to make fun of oscillococcinum. This piece of lawfare got a mention on quite a few web sites, including  a couple I follow, with links to some articles about oscillococcinum. Wheen was right about the absurd levels of dilution, but interestingly wrong about the allegedly active ingredient of oscillococcinum. Wheen thinks it's duck's liver. In fact, it's a bit more complicated than that:

In the 1919 flu epidemic a physician who did not understand that artifacts on the slide, probably bubbles, move randomly due to Brownian motion. Looking at the tissues of flu patients with a microscope, he found what he thought was not only the cause of influenza, but the cause of all diseases: small cocci (round balls) that oscillated under the microscope. He found these wiggling bubbles in all the tissues of all the ill people he examined and thought he discovered the true cause of all disease. Sigh. Yet another cause of all illness. He is the only person, before or since, to see these oscillating cocci. Hence the name. 

From Science-Based Medicine. Apparently, the researcher who "discovered" these oscillating cocci thought he'd seen a lot of them in duck livers. So homeopaths mashed up duck liver because they thought it contained flu-causing cocci, presumably on the homeopathic principle that "like cures like." Only it was a mistake. There is, literally, no such thing as oscillococcinum. The term "daft" no longer seems adequate.

Right, I think I've got my head round this. To make a best-selling homeopathic flu remedy:

1. Take an ingredient that doesn't exist.
2. Dilute it to a point where, even if it did exist, it would stop existing 
3. Add sugar and evaporate the water containing the non-existent trace of the non-existent ingredient to make a sugar pill.*
4. Flog sugar pills at whatever price the market will bear.

Wanna buy some?

*These are just the most outrageous stages of the process. As Guy Chapman points out in his detailed dissection of "the canonical quack remedy", 'Oscillococcinum exhibits fractal wrongness. However you zoom in on its errors, you just find more errors just as big.' Massive kudos for the phrase "fractal wrongness."

Duck hunting season still open

First, the Telegraph blew the whistle on Members of Parliament wasting taxpayer's money on duck islands. Now MPs are blowing the whistle on the National Health Service wasting taxpayer's money on quacks:

The NHS should stop funding homeopathy, MPs say.

The House of Commons Science and Technology Committee said using public money on the highly-diluted remedies could not be justified.

The cross-party group said there was no evidence beyond a placebo effect, when a patient gets better because of their belief that the treatment works...

It is thought about £4m a year is spent on homeopathy by the NHS, helping to fund four homeopathic hospitals in London, Bristol, Liverpool and Glasgow and numerous prescriptions.

Reports the BBC. Robert Wilson, of the British Association of Homeopathic Manufacturers is apparently 'disappointed'. Since every pound of public money squandered on this discredited nonsense is a pound not available for proper, effective treatments, his disappointment gives me immense pleasure and some hope for the future.

Alternatives

The last couple of times I’ve visited Glastonbury, I’ve had lunch at a rather good vegetarian café. The food’s better than the salty, processed mush which often passes for food in the UK, the atmosphere is relaxed and there’s an attractive courtyard garden round the back which is perfect for sitting out in on a sunny day.

I’m not a veggie myself, but I do understand the motivations of some vegetarians. There’s a lot of cruelty and suffering involved in packing the supermarket shelves with affordable meat. In terms of food production in a hungry world, you can produce a greater quantity of food by arable farming than you ever will by trying to turn the equivalent amount of plant material into animal flesh. Finally there are the health benefits of eating more fruit and veg. This is where I do part company with the veggies (especially the pale and sickly looking ones) – a lot of us would benefit from eating more fruit & veg and eating rather less meat, but cutting out meat (not to mention eggs and dairy) altogether doesn't seem like a good move. Meat & dairy are good sources of protein and iron and I’m not convinced that it’s easy to keep well whilst abandoning the omnivorous diet our bodies have evolved to run on.

Still, two out of three good reasons to go veggie ain’t bad. I just wish that a lot of the other stuff being promoted in Glastonbury was as understandable as vegetarianism. The café I’ve mentioned is surrounded by shops selling books on ley lines, crystal healing, faries, homeopathy, colour healing and a host of other unlikely-sounding subjects. The small ads in the shop windows are for services such as angel readings (whatever they might be), reflexology, tarot readings, feng shui advice, clairvoyant services, Chakra balancing and astrology.

I’ve no doubt that a lot of the people offering and consuming these volumes and services are sweet, gentle, fluffy, would’t-harm-a-fly people, but I still can’t escape the conclusion that what they’re getting involved in here is a load of gibberish.. I’ve tried dipping into some of this stuff, just to try and find out what people are getting out of it, but it leaves me completely baffled.

Flicking through Whispering Winds of Change by New Age Guru Stuart Wilde, for example, I read that the average speed of humanity circa 1700A.D. was lower than it is today “perhaps hovering at twelve thousand cycles per second”), but the band of separation between the highest and the lowest was not great. By 1960, apparently, human and etheric metaphysical vibrational speeds were spread over a much broader band of between twelve to fifty thousand cycles per second. “Etheric” apparently refers to the electromagnetic field produced by the human body. According to Wilde, you can train yourself to see the etheric energy field surrounding people by concentrating on your peripheral vision and tilting your head slightly. If you want to try this at home, dusk is allegedly the best time to see etheric energy. Oh, and it’s also important to remember that the vibrational speed is only a hypothetical speed – “of course”, Wilde points out, the real speed must be much higher, since “light oscillates at the very high frequency of about 10¹⁵ cycles per second” but apparently we don’t need the real speed to understand the concept - “a hypothetical speed will do.”

Make sense of that if you can. There are a few places in the book where he expresses himself a bit more clearly – at one point he suggests that by the simple measure of abolishing all taxes we would all be a lot richer. At least it’s a bold, simple and easily grasped idea, although I suspect that economics of running a functioning state without any form of revenue might be a little more difficult than he seems to think. Come to think of it, he might have been suggesting that we should allow the state to collapse and let the evolving Planetary Group Soul take over its functions – I can’t say for sure because after a immersing myself in this stream of New Age Speak for a little while, I was losing the capacity for rational thought.

What a very strange set of things for any sane person to believe in. I’m indebted to a number web sites and blogs for tirelessly picking though a lot of this sort of stuff so I don’t have to – Ben Goldacre’s splendid Bad Science Column is always a welcome antidote to the tide of nonsense and I was impressed by a fairly recent post at I Kid You Not with some thoughts on visiting a New Age shop.

Why do people believe in this stuff? I don’t know, but we don’t live in an ideal world. I’m guessing that belief in an “alternative” set of values and beliefs is the reaction of people unsatisfied with society as it is, with its meaningless jobs, unsatisfactory relationships, relentless commercialism, atomised society, eroding civil liberties, the obfuscation of democracy with spin and manipulative half truths, environmental degradation, poverty, war and injustice. Not a bad impulse – I wouldn’t give you tuppence for anybody who didn’t want the world to be a bit better than that. But what seems to have happened is that somehow rationality has taken the blame for all that’s wrong with the world and abandoning critical thought has become the “alternative” prescription for everything that’s gone wrong. And that’s profoundly worrying, because critical thought and trying to see the world as it really is, are absolutely necessary for anyone who wants to change things for the better.

Knowing what’s really going on is the best start if you want to change things. An example from the recent history of ideas springs to mind. When autistic spectrum disorders were first identified, psychiatrists and psychoanalysts developed a theory to account for the symptoms. They hypothesised that autism in children was caused by cold, perfectionist parents, who didn’t emotionally nurture their offspring. There was even a shorthand term for a parent who “caused” her child’s autism – the “refrigerator mother” (sorry mum, but it's all your fault). A plausible enough theory for the “open-minded” to accept. Unfortunately, it proved to be dead wrong.

The precise causes of autism are still not well understood, but subsequent research has shown the condition to be caused by physical problems in brain development, perhaps associated with mutations and the interaction of different genes. Although researchers don’t know exactly what leads to these effects, it’s now as certain as any fact can be that the problem exists at the level of the physical structure of the brain and has a genetic component. The current understanding of the true basis of Autism only emerged in the 1970s and slowly began to come into the mainstream thereafter, although the syndrome had been recognised since the 1940s.
So, for at least 30 years, parents who were distressed by their childrens’ strange behaviour, who were struggling to understand what was going on, trying to communicate with and support their child were being consistently mis-diagnosed. They were having the agony of being unable to interact with their own children compounded by being told that the problem stemmed from their own lack of parental affection and intimacy. All in the name of a theory that turned out not to stand up.

Compared to some new age explanations of the world, the “refrigerator mother” theory wasn’t particularly wacky – especially given the fact that the tools needed to uncover the true explanation of the condition weren’t available when autism was first identified as a condition. If a theory which has a ring of plausibility about it can be so damaging and counterproductive, what hope can we have from the scribblings of new age gurus whose respect for critical thinking seems to be non-existent? However benevolent your intentions, subscribing to any weird theory about the world which floats your boat isn’t a neutral act. If what you believe in, or cause other people to believe in, is factually wrong, or plain bizarre, then acting on it at best won’t change this unsatisfactory world of ours for the better and at worst could cause the sort of distress suffered by those so-called “refrigerator mothers”, labelled and stigmatised by psychoanalytic gurus who were utterly confident in their particular pet theories.

Homeopaths challenged to substantiate claims, flounce off in a huff

Here's something interesting I saw on the New Scientist website the other day. There's £10,000 on offer to the enterprising homeopath who can provide convincing evidence that homeopathy actually works. All the practitioner would have to do is submit homeopathic medicines to a clinical trial, where half of the patients receive the homeopathic preparation, half a placebo.

Apparently, a spokesperson for the Alliance of Registered Homeopaths is offended by the suggestion that somebody might want to actually test the claims made for homeopathy. "We have nothing to prove, and certainly not to people with closed minds," a representative of the homeopaths' trade association spluttered.

They can refuse to submit their claims to rigorous scrutiny if they want, but I'm not convinced by the homeopaths' refusal to be tested, any more than I am by Labour's refusal to debate civil liberties in the by election triggered by David Davis' resignation. In both cases, the official position is "we're not going to dignify this stunt by engaging in the contest" - i.e. they're already losing the debate and are reduced to the PR equivalent of sticking their fingers in their ears, singing "la, la, la, not listening" and chanting "we're not talking to you, you smell," having run out of rational arguments.

I've got two particular grounds for wanting the homeopaths to "put up or shut up":

1. I've no scientific training, but even I can grasp that one of the basic claims of homeopathy is quite astonishing. Homeopathic remedies contain just a trace of the active ingredient, being diluted down to a level where, often, not a single molecule of that ingredient remains in the solution. In other words, homeopaths claim to be able to treat medical conditions with something that no existing form of chemical analysis can distinguish from distilled water. If true, that would be amazing.

If of water really retains a "memory" of substances it has once been in contact with, eventually some chemist will be walking off with a Nobel Prize for demonstrating this effect in a reproducible experiment, and rewriting the text books. It might happen, but I'm not holding my breath. Extraordinary claims like that require extraordinary evidence.

To borrow an example, if I met somebody at a party who told me that he drives a Ford Fiesta, I probably wouldn't question his claim - I've seen many people driving Ford Fiestas with my own eyes and, as Tom Jones would say, it's not unusual. If I met someone at a party who told me that he drives an interplanetary flying saucer, I might be a bit more skeptical. I haven't seen anybody driving a flying saucer and I don't believe that a such a thing as a workable flying saucer exists - as far as I know the nearest thing ever created was a cool-looking Canadian prototype flying disc called the Avrocar, which was cancelled after a few wobbly test flights demonstrated that the craft was unstable when it got more than a few feet off the ground. So as far as I'm concerned, the homeopathic space cadets have got something to prove; either show me your flying saucer, or bugger off back to the mother ship.

2. As someone who pays my National Insurance contributions (with a brief interruption - I've been between jobs for the past two weeks, but start my new one on Monday), I'm paying for some of this stuff. As the British Homeopathic Association boasts here, homeopathy has been available on the National Health Service since the NHS was founded in 1948. There are, apparently, five NHS Homeopathic Hospitals and some General Practitioners will refer patients for homeopathic treatments.

Resources in the NHS are stretched notoriously thinly, so I would expect the minimum standard for a treatment which is funded by public money to be some convincing evidence that it works better than a placebo. As far as I'm aware, properly-conducted trials have never been able to demonstrate this. Until they do, homeopaths, you do have something to prove to all of us whose money funds homeopathy on the NHS and to every patient denied an effective treatment, tested in clinical trials, because some of the money which might have paid for it went to publicly funded homeopathy instead.

So, homeopaths, take up the challenge, prove yourselves right, the skeptics wrong and rub our noses in it if you like. If you can't, then put your toys back in the pram and play nicely.