Self-Awareness in Homeopathy Awareness Week

You might not think I am a ‘friend of homeopathy’, but as this is an important week, and any practice that can survive for over two hundred years is at least worth marking, if not celebrating, then I would like to reach out and see what we can agree on, homeopathists and the little black duck.

So, what can we agree on? I think there are lots of things.

1) People believe that homeopathy works. They report feeling better as a result of their interactions with homeopathists and homeopathy.

Yes, of course this is true. To call everyone who says that it ‘works for me’ is a liar would be absurd. And people really, strongly believe this. We can agree wholeheartedly on this.

2) There is strong disagreement as to whether this benefit is real or due to the placebo effect and other delusions.

Now don’t start an argument just yet! The point that I am making is that we can agree that there is this disagreement. It is a deep disagreement and passions run high on both sides.

3) Either homeopathy works or it doesn’t.

I think we have to agree this as I am not sure what the alternative is. I guess we might disagree as to what ‘works’ means, but let is stick to core principles of homeopathy – ‘like-cures-like’, dilution through potentization, allows people to experience faster healing, or better well being, than those people who might only take a placebo.

4) Quackery exists in this world and is widespread. People, either deluded or fraudulent, promise cures that have no basis in reality. People believe in this quackery, primarily due to wishful thinking, the placebo effect and through other logical fallacies.

I guess is the area that you might kick back on. But I think we would have to agree. Do you honestly believe that every medical claim ever made is real? Are all claimed alternative medicine methods effective? Are all historical methods effective, from blood-letting to trepanning?

Given the existence of quackery, and the reasons for its existence are well documented, should we not be guarded against such delusions and make best efforts to expose it? I hope we can agree on that.

5) If homeopathy does work, and we can understand why, then it would mean one of the biggest scientific revolutions in generations.

Homeopathic practice is incompatible with all we know about physics, chemistry and biology. Undisputed proof of homeopathic effectiveness would lead to Nobel prizes, riches and features in Hello! It is not just the ‘water memory’ effect that would be revolutionary if it were proven. There is a whole chain of questions that need to be answered and all have the potential to turn science on its head. Let me just to think of a few of these scientific questions:

– What is the biological basis behind ‘like-cures-like’. Is there are whole new part of the immune system that kicks in and we do not understand? How does the immune system know what the ‘like’ is supposed to target, e.g. a headache could be caused by dehydration or a brain-tumour.

– How do ‘provings’ really work? How do homeopathists stumble across just the right substances? How does a substance ‘fail’ a proving?

– Why are more dilute solutions more powerful? It is difficult to think of any other area in science where a principle like this is true.

– How do the active properties of the ingredient still manifest themselves after they have been diluted beyond the Avogadro limit? Chemistry is based on chemicals actually being present. In homeopathy they are not.

– If the memory effect is due to ‘water structures’, how do these structures stay stable for more than a fleeting moment. All our knowledge of water says that such structures are highly transient.

– If it is some weird quantum effect, then how come quantum physics says such macroscopic effects should be impossible?

– How does the water remember the key ingredient and not all the others the water has come in contact with throughout time?

– How does this memory get transferred to the sugar pill (if used in pill form). Does lactose have a similar property to water in this respect? Why not glass or plastic or cardboard or whatever other packaging is used?

– How does this memory then get transferred to the body and get delivered to the right parts of the body to take effect?

I could go on…

My point is, and I hope you agree, there is so much we just don’t understand about what is going on in homeopathy (if it works) and answering any of these questions could be revolutionary.

So, I think we have much to agree on – people claim it works, there is strong disagreement about why they claim it works, it ought to be provable one way or another, it needs to be proven as we might be falling foul of quackery and should we prove it works and find out how then we really would have a ‘miracle’ on our hands.

The main difference between us then is to explain point number one – why do people feel homeopathy works?

We can imagine two possible answers:

1) It really does work and homeopathy is a miraculous addition to science.
2) It works no better than a placebo, but the placebo effect, the regression fallacy and wishful thinking make people think it works.

Which is correct? How can we tell?

Evidence.

For me the answer is obvious. If option 1 were true then we would expect to see things in the world that we just do not see. Scientists can be greedily ambitious, like lots of people. Within the homeopathic community, we will find people with a strong scientific leaning and the ambition to make a name for themselves. We would see eager PhD students looking at the theory behind homeopathy and making discoveries of breathtaking proportions. We would have seen chemistry and biology transformed. Our understanding of ourselves overturned by homeopathic breakthroughs. We would see homeopathy not as an ‘alternative’ but as the herald of a great new science of matter, biology and health.

But we have not seen this, and this is strange. In every other area of medical and scientific knowledge there have been breakthroughs in understanding, to match the potential of the homeopathic breakthrough, that really have been revolutionary.

Homeopathy flies in the face of the atomic nature of matter. Einstein was one of the first to publish papers that conclusively proved the existence of atoms. After that, geniuses like Curie and Rutherford showed how atoms were constructed. In the past hundred years, this knowledge has transformed our world, from the computer in front of you, to molecular genetics. Staggering, and all of it contradicts what homeopathists would have us believe. Where is the homeopathic contribution to the theory of matter?

Biology and medicine has seen similar outrageous leaps in understanding. After homeopathy was invented, we had Darwin show us that we were just animals that obeyed natural laws. Following on, we realised the nature of our genes driving evolution, and then the truly miraculous discovery of the nature of DNA – the code that makes life what it is. In medicine, we now fully understand the origin of many diseases and have been able to eradicate many of them, especially those that kill children. We can transplant blood and organs without our bodies rejecting these foreign bodies. We have anaesthetics that allow surgeons to do their business humanely. Where is homeopathy’s contribution to our understanding of life and preventing killer diseases? What fraction of the huge leap in life expectancy, experienced since the ‘discovery’ of homeopathy, has been due to homeopathy? Zilch?

And if you believe that homeopathy has given us longer, happier lives, then where is your evidence. How many childhood diseases has it wiped out? What surgical procedures does it enable? How many parasites does it kill? What advances in our understanding of nutrition and sanitation has it enabled? Where is the ‘miracle’ that the organisers of WHAW want us to believe in? (I can hear some answers trying to be formed, but they all contain the word ‘holistic‘. Try again, with numbers, diseases and references.)

But homeopathists complain that they are too busy healing people to worry about such matters. I find that attitude alarming and it is rather scraping the barrel of excuses. In all other fields of medicine, or at least those that have made great leaps forward, we find practitioners who devote significant parts of their time to research and understanding – pushing back our knowledge and improving the science of what they do. It is through this understanding that new insights are made that lead to new advances in care. More lives are saved. People live longer and better lives. If homeopathy is real, then surely an understanding of its workings could lead to insights that could propel health care to new dizzy heights. The potential to reduce human suffering could be immense. Are you homeopaths really too busy? To not be funding research, from the profits homeopaths make, and actively addressing the research problems, looks narrow-minded, negligent and even immoral.

And what of the experimental evidence? OK, yes – there are studies that show homeopathy works better than a placebo. They are plastered all over homeopathy sites. But – and this is a big but – you would expect this too even if homeopathy was rubbish. Let me explain why. Most trials always give a confidence in their results. When they do the statistics on their data, they will count a study as ‘positive’ if there is a 95% chance that the result was not due to chance. Hence, out of 20 studies on a techique that did not work, you might find 1 that showed a positive result. And this is the study that gets paraded around. When all studies are looked at together, positive and negative, the conclusion is that there is no effect over the placebo. There are far too many high quality results that show this and only a few good quality ones that do not. Oh, and plenty of poor quality experiments that show a positive result that ought to be binned.

And when homeopathists do rarely publish a high quality study that shows a negative result, the mental gymnastics gone through to explain this away are hilarious. See orac’s comments on a trial of homeopathy (Jacobs J, Guthrie BL et al. 2006) on children with diarrhea. The result of this careful study was that the homeopathic treatment was no better than a placebo. But the homeopath authors do not conclude that homeopath did not work, they speculate the tablets had not been stored properly or that the wrong combination of sugar pills was made. At no point do they propose as a possibility that homeopathy can have absolutely no effect on a third-world child with the squits. And joking aside, diarrhea kills hundreds of thousands of children around the world, so intellectual honesty in studies like this, is not an optional add-on.

It appears obvious that the only rational conclusion you can make on homeopathy is that it is just an elaborately prepared and administered placebo. To think otherwise requires lot of special pleading about why the evidence for its success is so patchy, why so little advance has been made in two hundred years, and why homeopathic theory contradicts just about all of physics, chemistry and biology. Rather than having to accept the true ‘miracle’ of homeopathy, it is much simpler to accept that what we see is the effects of the placebo at work. Only those desperate to believe it works, or those have invested much of their life and world model in homeopathy, or the plain daft, stick to the irrational belief.

So, what of World Homeopathy Awareness Week and the desire of homeopaths to celebrate the ‘miracles of homeopathy’? Surely, if awareness is to be raised, then a little awareness at home might be a good place to start. Self-awareness of the failure of homeopathy might be the first sign of a maturing profession. After all, there have been two hundred years for the profession to mature and yet there is virtually no debate within the community at the abject failures of the theory an practice of homeopathy to advance beyond its 18th century roots.

If any homeopathists have read this far, I would be amazed. The ‘la la la – can’t hear you’ attitude to criticism is not only unbefitting of a supposedly mature health care profession, but also has life critical implications. Can such a community police itself? Can such a community be trusted to offer medical advice to people who may be seriously ill?

These are questions that would be addressed in World Homeopathy Self-Awareness Week – if such a thing existed.

********************************************************************

For an update and media enquiries, see the latest Homeopathy Awareness Week post.