Monday, September 04, 2006

Looking for a solution, dilution or illusion…

` Anders Bonde (another skeptic with an apparent fondness for writing long articles) has written a museful article about homeopathy and his inquiries of, if anyone should be so inclined to read. Here is most of it:

...This introduction brings me to the subject of homeopathy: A controversial concept of medicine with a large following, widespread popularity, even public and legislative support - and a theoretical foundation which is logically inconsistent and self-contradictory to an extent that borders on (or transgresses) the absurd.

Less than a decade ago I genuinely believed that homeopathy was a genuine, scientifically-proven medical procedure - I had even used Over-The-Counter (OTC) homeopathic remedies against common cold and hayfever, and had believed that "it [homeopathy] worked". But then I had not investigated the facts of the matter at all - I had relied purely on the sales pitches of the manufacturers of homeopathic remedies, and on the anecdotes of friends and family. And on the fallibility of my own senses and reasoning.

More or less by chance - I guess I was just curiously prompted by my then-girlfriend's view on the matter - one fine day I did a Google search on "homeopathy". What I found baffled me: The descriptions of the homeopathic principles could not possibly, from what I had learned about physics and chemistry, be reconciled with modern science. How, then, could it be that homeopathy appeared to work for so many people and how could its application be so widespread - complete with colorful brochures and all? Either it just "worked", or else some other mechanism was at large here. So, I set out to investigate the matter, with the aid of that untiring servant, The Internet.

By coincidence (yes, I do believe in coincidences!), my then-girlfriend, later to become my wife, was, and is, an ardent supporter of homeopathy. This allowed me to observe the phenomenon at rather close quarters, but more on that later. I was, and am, puzzled by the fact that I could not find anywhere on the Internet any properly conducted scientific research that had proven that any homeopathic remedy has any direct physiological effect - at least not any that I've been able to find in hundreds of hits, links and references, and yet people I care for, trust and believe to be genuine will swear that it "works". How could that be? Was I overlooking something?

One thing I did notice, not on the Internet, but right in front of me, though I have so far unfortunately not applied any thorough scientific recording of my observations (Shame on me - I may do so from now on), was that whether my wife, who gets intermittent attacks of a migraine-like condition typically lasting a day or two, takes her homeopathic remedies or not, the course of the migraine attacks are always more or less identical.
` But she remembers when she took the remedy - "the migraine was gone within a day or so" - but she does not recall when she did not take the homeopathic remedy. I can't tell when or whether she does or does not use the homeopathic remedy for her migraine - I only know when she tells me, or if I happen to see her taking it, but she says she only uses it when she happens to have some in her possession when an attack comes along, or after a day or two into an unusually lengthy attack. I admit this is anecdotal evidence, so you can skip it and move on if you are so inclined. I say I am observing confusion of cause and correlation, confirmation bias and wishful thinking, combined with natural remission, at work here - I don't even think placebo is needed to explain my wife's response to the remedy. I also think she is wasting some of our household money on the stuff - and that she may inadvertently overlook a more serious condition and neglect the need for proper treatment.
` As for my own use of OTC homeopathic remedies? Looking back, a cold always lasts from a few days to a week or two, and you can't stem it, whether you take any homeopathic or "traditional" remedy or not. It just doesn't make any difference - the cold always goes away after a few days - untreated or not. As do attacks of hayfever, although antihistamines do work. Even Benveniste knows that - as he has inadvertently proven, I guess, in his "proof" of homeopathy?

Needless to say, my wife and I have had (and have) the odd argument about the issue of homeopathy (and other "alternative"/faith versus science debates). It surprises me, however, that she didn't know who Hahnemann was, or the levels of dilution being used. Methinks that one of the reasons, other than the mental mechanisms mentioned above, that she believes in homeopathy, and why most other people who do so, is that they are simply unfamiliar with the, well, absurd principal claims of homeopathy. I may be naïve (no, I am naïve), but I believe that if people were educated about the absurd claims of homeopathy, then more people would address it critically and discover what I now claim to be its true nature: Homeopathy may rightly be considered to be the greatest scam in medical history.

Back to my investigations: Another thing I did notice was that Internet sites and organizations supportive of homeopathy tend to have very few links to high quality research, unlike sites critical of homeopathy, and they tend to include the research of one J. Benveniste as proof positive of physical evidence supportive of homeopathy. I looked up the references to articles in "Nature" - and found that the sites, that I found, supportive of homeopathy only referred to the first article in Nature (333,816; 1988) - not to the subsequent articles. Were they trying to hide something?

In order to satisfy my curiosity, and perhaps to counter any suspicion of "dirty underwear" being intentionally kept from public scrutiny, I wrote (by email) an enquiry to one of the leading manufacturers and purveyors of homeopathic remedies in Denmark, Bioforce.

My questions were:

1. It is not stated on your website what documentation Danish law requires regarding safety and therapeutic efficacy of homeopathic remedies. Can you assist me on this matter, and ought this not be stated on your website?
2. I cannot see the levels of dilution for the various remedies on your website. Can you inform me about this, or provide me links to where I can find such information?
3. If the levels of dilution should be so great that the presence of the assumed active ingredient in the solution is at or below the threshold levels for what can be physically detected, how can it then be ensured that the active ingredient is indeed present in the solvent, and thereby ensure that it is capable of having a physiological effect when administered to the patient?
4. Can you provide references to a correctly executed scientific investigation (randomized placebo controlled double blind testing, with predetermined levels of statistical significance and predefined success and failure criteria) that can confirm efficacy of homeopathic remedies that cannot be attributed to placebo effects and/or natural progression/remission of the disease and/or the presence of other substances in the homeopathic remedy, and/or the application of other therapeutic modalities in conjunction with the homeopathic treatment?
5. In the event homeopathic remedies do have a physiological effect on the human organism, could you then kindly provide references to descriptions of any documented mechanisms of any such physiological effect?
6. Assuming that the purported principles for homeopathy are valid, would it then not be reasonable to assume that there are lots of pollutants, which have not been or cannot have been accounted for, in both tap water as well as in homeopathic remedies - and would the validity of the homeopathic principles then not imply that lower threshold values for, for instance, pesticide remnants in drinking water are more detrimental to human health than higher threshold values, as the homeopathic principle states that the higher the dilution, the greater the physiological effect?

Kind Regards,
Anders W. Bonde

PS: I am in no way affiliated with the pharmaceutical industry - I am merely an ordinary consumer looking for information.

This is the reply I received:

Thank you for your enquiry to Gerda Sørensen regarding homeopathic products, to which I will try to respond.

  1. The legal requirements pertaining to homeopathic remedies may be found The proclamation is No. 632 dated July 5, 1994, which is the current one that applies.
  2. On Tabacum, which is a single substance remedy, the dilution is stated as D6. The others are complex remedies [i.e. containing more than one substance in one dilution], and we have not stated dilutions for those. You are always welcome to contact us with further enquiries about the individual products. You will, of course, also find the dilution stated on the containers of the products.
  3. The father of homeopathy was Samuel Hahnemann. He discovered that the smaller doses that are administered of the original substance, the better [sic] the homeopathic remedy works. Manufacturers of homeopathic remedies have to be approved as manufacturers of pharmaceuticals. Our supplier has this approval, and that is that is the guarantee that the remedies meet the principles of Hahnemann [sic]. Our products are produced according to the traditional homeopathic principles.
  4. This is not described in the aforementioned proclamation, by which we abide. There are special rules for the approval of naturopathic and homeopathic remedies in this country [Denmark], as the character of these remedies differ from that of traditional pharmaceuticals. Controlled double blind/placebo testing is described in the requirements for traditional pharmaceuticals.[sic] [...Hello?]
  5. The principle of homeopathic remedies is that [substance] which induces [certain] symptoms in its neat state is cured by the same substance in dilution. (See the attachment: "What is homeopathy").
  6. All this pertains to the requirements of the authorities to the products - if it is considered a problem I am convinced that relevant requirements will be imposed in the future. Work is currently in progress on a "homeopathic directive", which we are eagerly anticipating. Perhaps this new directive will be able to answer some of your questions.

Kind Regards,
Bente Holm

[After 'What is Homeopathy?']...I am not going to tire the reader of this article by commenting in detail my every question, every reply (or lack of) and the statement "what is homeopathy" - I'll let the reader draw his or her own conclusions from the communication. However, apart from the plain bullshit (sorry, New Age Techno babble) and the appeals to popularity, the overriding impression I am left with is this:

Either the supporters and purveyors of homeopathy are hapless, naïve amateurs driven by good intent and wishful thinking, or else they are downright frauds. I tend to think they are a mix of both. Unfortunately, legislators appear to have been duped by the homeopathic industry, which is no small fish. And more worrying, perhaps, is the fact that educated medical doctors are also in on the scam. In my humble opinion, the judgment of any medical doctor supportive of homeopathy is questionable - unless, of course, the good doctor knows it is placebo and administers it as such. Yes, as I stated elsewhere, I am naïve.

Still, consider just how much of a remedy would be sold if the label read along the lines of: "The effects or side effects of this remedy have not been physically substantiated or documented in any way. However, we guarantee - on The Bible - that it works. That is assuming you have a positive opinion of the product, or you are not too inquisitive. Otherwise we can't help you, sorry. And you won't get your money back". Well, that was mere speculation.

This, however, is a real beauty from The School of Classical Homeopathy in Kalundborg, Denmark" (emphasis mine):

Applicants shall be able to persevere with their studies, be able to cultivate an open and tolerant mind, be interested in people and seek to understand the nature of life and the World as it is. Applicants must be free from dogma and fixed opinions, and recognize the necessity of [personal?] development. Prior education is not a guarantee for compliance with these requirements, and absence of prior education is not necessarily a hindrance. What is needed is the faculty for intensive study."

Hand on heart: Who doesn't subscribe to some dogma or fixed opinion? I don't think further comment is required - other than the human mind is indeed a fickle thing…Even in 2003.

Assuming "the truth" is the truth - and considering the potentials of potencies…

Let's think for a minute about the implications of the claims of homeopathy as if they were true facts. The following are questions that should be asked not by a layman such as myself, but by the supporters and purveyors of homeopathy. And by legislators:

  • Assuming the dilution "works" long after the original molecules, ions or atoms of the "original" substance are gone, how can it be ensured that no "vibrations" are left over from other, unwanted and unaccounted for substances that the "carrier" substance (typically water or alcohol) was once in contact with while being generally shaken and stirred about?
  • Can effects of natural succussion be ruled out, eliminated or counteracted? Most, if not all, water molecules in the natural cycle are vigorously "succussed" by natural means at some time or another; by the breaking surf, by rainfall, by waterfalls, by aeration of drinking water, by stirring during cooking or by other preparation of nutrients, by transportation and by sewage treatment
  • How can it be ensured that not a single (or more) "unwelcome" molecule, atom or ion has been introduced into the "carrier" substance - or even into the "active" substance (few substances are 100% pure and 100% consistent in makeup) at some point in the dynamization process or before? Both water and alcohol are powerful solvents and will readily "pick up" a broad scope of molecules, atoms and ions along the way - through piping, containers, valves and their seals. With the high levels of dilution of the most potent remedies, the probability of the sometime presence of unwanted and unaccounted for substances is greatly increased. How is this dealt with?
  • Eventually the "carrier" water of the homeopathic remedy leaves the body of the patient and returns to the natural cycle. How do we counter this accumulation of increasingly potent homeopathic remedies in our environment? Should the breath, sweat, urine and feces of homeopathic patients, like that of some "traditional" patients undergoing chemo or radiotherapy, be treated as toxic waste? Any such issues can, btw, readily be tested in closed-circuit environments, for instance aboard the International Space Station.
  • How are unwanted homeopathic remedies disposed of? Dilution in vast amounts of water will only increase the potency, and they cannot be incinerated, as the resulting water vapor will pollute the environment; to counter the spreading of potensized water vapor in the environment, it will need to be recondensed during incineration, which brings us back to square one. It seems the only option is in sealed depots, like nuclear waste.
  • How is the apparatus of the facilities that manufacture homeopathic remedies cleaned without either introducing "pollutants" into the apparatus, or without having to deal with large amounts of highly potent waste material? See previous question.
  • With like curing like, and higher dilution being more potent, will, for instance, a large dose of plutonium cure a slight plutonium poisoning, and a highly diluted dose cure a near fatal case of plutonium poisoning?
  • On a brighter note: I know this is a trade secret, but, pray, tell us about the nature of your methods, since they could be so beneficial to society in so many other ways, not least in the areas of "main stream" medicine, toxicology, drinking water treatment, fertilization and sewage processing. Not to mention storage and communication of data: Consider the possibility of the liquid computer - it always fits into your pocket, or glove box or whatever - or transmission of data through water mains and sewers. The mind boggles at the prospects.

Summing up

Just by considering the primary claims of homeopathy, and by studying the response I got from Bioforce, I am sure that any sensible reader with an open, but critical, mind and an average level of education can think of further relevant questions and observations of this nature. But can, or will the supporters and purveyors of homeopathy provide the answers? I doubt it - because they should have done so long ago, but haven't. "So what", it may be argued, "as long as it works, it doesn't matter how it works". Wrong, I say, when one considers the implications of the unanswered questions above. It is time our legislators took a genuine interest in these matters. Society is throwing good money after bad with homeopathy - what does warrant further scientific investigation, however, is the fickle human mind. With increasing scientific knowledge of the workings of the human mind and its interaction with the body, perhaps one day we can crate a placebo so efficient that it works on 100% of the population.

` Actually, I can answer some of those questions with these: Homeopaths say that remedies can only be made by people, not random processes; and that remedies have no effect on anyone unless they have a need for it - and only to the extent that they need it, so there is no such thing as poisoning oneself or overdosing.
` Well, that's a handy loophole. That's probably because no one has ever died of too much remedy. (Consistent with something that is safe and ineffective.)
` Interestingly, I could have participated in a study of Qr. Olsen's about proving eucalyptus or something, but since there was no monetary incentive, I declined. Now I wish I had, though, because I think it would have been somewhat amusing.


Galtron said...

That's a lot of strange possibilities, though there are some things they will not generally believe. -There is a logic to their madness, though I do not know what it is. For example, this one homeopath who says it's possible to make computer disks by storing data in water gets funny looks from the rest.

Also, I like that - He asked for them to cite some real double-blind, placebo trials, and their answer was 'we don't need no stinkin' medical trials - this is naturopathy.' HA ha ha ha haaaa!

S E E Quine said...

` Tee hee... I must look into computer discs made of water. Sounds like a good thing to make fun of.
` (I know, the attitude isn't admirable, but I just can't resist.)