Monday, 26 July 2010

Government Policy on Homeopathy is...

My summary of the report
  • Yes we know homeopathy is worthless bullshit, but some people don't know or don't believe it's bullshit, so we'll let individual regions' trusts decide whether they want to spend public money on it. 
  • We promise to tell people it doesn't work though, but we'll still buy it for them with your money if they still want it after we've told them. 
  • It's too difficult to find out how much we're currently spending on it, so we won't bother. 
  • We'll continue to allow people to put indications on remedies, because it's better to have something rather than nothing on the label (even if that something is wrong), because at least then we can regulate how they are made. 
  • It's OK to lie to people about how these pills can cure minor self-limiting illnesses, and that probably won't lead to people thinking it works for Malaria or AIDS.
Fucking moronic cowards.

Please read the sci-tech evidence check report, if you haven't already.

Sunday, 11 July 2010

Homeopathy: it's natural.

Short answer:
  • No it isn't - it's extremely artificial and contrived.
  • Even if it were, something being "natural" is no guarantee of either effectiveness or harmlessness.
A little more:
As with the claim that homeopathy is an ancient tradition, I suspect the reason some make this assertion is due to a confusion of homeopathy with herbalism. It's important to remember that homeopathy is not herbalism; herbalists can at least genuinely claim that their treatments are "natural", for what it's worth, and unlike homeopathy many of them even have active ingredients.
All kinds of ingredients are used at the start of the homeopathic process, many of which may be considered natural, but the process of dilution and succussion is anything but. For a full description of the manufacturing process and it's origins, see my earlier post. And in any case, the idea that because something meets some arbitrary definition of "natural" does not necessarily mean it will work, or that it's somehow more in tune with your body and hence safer than any lab produced chemical. Go eat a handful of nightshade berries or fly agaric if you don't believe me1. This fallacy this particular claim falls under is the Appeal to Nature.
The only other things that could be meant by this claim of naturalness is that the remedy somehow stirs the body's natural defences into action, and I have dealt with that claim here.

1 Do not do this under any circumstances.

Homeopathy: Activates the body's own natural healing processes.

Short answer:
  • No it doesn't - there is no biologically plausible method for this to occur, and there is no credible evidence for it having ever occurred.
A little more:
This little number is often explained as operating a little like a vaccine; e.g. the remedy somehow tells the immune system "look for things that cause symptoms like this" and that stirs it into action. Of course this a completely false analogy, and it wouldn't work even if the analogy were valid.
Vaccines work by introducing a harmless form of an actual microbe into the body. The immune system produces antibodies against that microbe and this enables it to be prepared for invasion of the genuine microbe (or ones very like it) should it encounter it at a later date.
Homeopathic remedies with "potencies" beyond 12c do not contain anything other than water, and even below that the content is negligible. There is nothing present for the immune system to learn from. Even if there were still some of the original preparation present, this would not stir the immune system into life when encountering a genuine illness-inducing microbe. Most of the the "mother tinctures" for those homeopathic remedies that are used for microbial diseases bear no structural relationship to the actual cause of the malady, and thus immune system will not recognise the real thing when it arrives. Additionally remedies are rarely prescribed as preventatives (with the exception of "nosodes" like the one idiotically prescribed for malarial prophylaxis), there are usually given when the disease is already present and the immune system is already fighting the disease, and has no need of such activation.
Add to this the fact that homeopathic remedies are also prescribed for disorders where the immune system has little or no involvement (like anxiety or type-2 diabetes), and for auto-immune related disorders (coeliac disease, rheumatoid arthritis) where the problem is that the immune system perceives part of the sufferer's own body as an enemy, and all that is left is a supernatural explanation for homeopathy's supposed mechanism of action. Some would attempt to counter these arguments by saying the immune system thing is just an illustrative analogy. They are then hard pressed to described any plausible actual mechanism by which their claims may be substantiated. Homeopaths' talk of vital forces and miasmas is just medieval thinking, and this whole argument of activating the body's own natural defences is simply superficially plausible nonsense.

Saturday, 10 July 2010

Homeopathy: it worked for me! (or someone else of my acquaintance)

Short answer:
  • No it didn't - You got better on your own, or as a result of some other intervention.
A little more:
I'm afraid you have fallen for the fallacy known somewhat ostentatiously as "Post Hoc Ergo Propter Hoc" (after this therefore because of this) or "false cause". It was not the homeopathic remedy that effected your cure. It is likely that your ailment was of a trivial nature such as a cold, flu, headache, bruise, mouth ulcer or somesuch. These things go away on their own. It is also possible that your ailment is one of a cyclical nature, that has periods when it is severe, and intervals where it is less so. If you took the remedy during a bad stretch, a moderate period is sure to follow, and you will attribute the improvement to homeopathy. Homeopaths even have a get out clause for when you take their remedy and the affliction has not yet reached its peak; they call this a healing crisis, claiming the action of your body, triggered by the remedy to fight the disease temporarily causes symptoms to appear worse, before they get better. This ensures that whether your symptoms increase or decrease, you still think it was the remedy that did it, when in actual fact it was simply the natural course of the ailment.
Perhaps you have benefited from the placebo effect, where you feel better simply for believing you have been given a treatment and the attention you received from an apparently qualified physician.
If the disease you recovered from was more serious, then perhaps you were also receiving conventional treatment but were frustrated with the speed of results, or believed it has failed, and so took a homeopathic remedy, and you subsequently recovered. It was the conventional treatment that worked, you just hadn't waited long enough. If you weren't receiving any other treatment, then you were very lucky; sometimes seemingly miraculous recoveries occur by purely natural, if hidden or inexplicable means.
If you still think homeopathy cured you, try to think how you would tell the difference between a natural self-effected cure, or one brought on by the remedy your homeopath gave you?
If you were using homeopathy as prophylaxis, say for malaria, then you were unknowingly exposing yourself to risk while completely unprotected, and were simply lucky.

Homeopathy: it's an ancient practice/it's been in use for hundreds/thousands of years!

Short answer: 
  • It's not an ancient practice, it was invented by a failed German Physician in 1796, only just over 200 years ago.
  • So what? People in the past were wrong about a lot of things.
A little more:
The ancient practice argument would be invalid if it were true, but also is just plain wrong. Here's my full post on the history of homeopathy. I suspect the reason that some people attribute homeopathy with a much longer history is that they mistakenly equate it with herbalism, which is a whole different kettle of bullshit, but that parts of which might have at least some basis in truth.
The fallacy at work here is The Appeal to Tradition. To paraphrase Tim Minchin, just because ideas are tenacious it doesn't mean that they're worthy. Our predecessors were wrong about a great many things for a very long time: the earth is at the centre of the universe; powdered tiger penis will make you virile; the universe is only 8000 years old; fires, floods, earthquakes and volcanoes are the acts of angry gods or spirits. The longevity of an idea or practice gives no credence to its veracity. Samuel Hahnemann, the inventor of homeopathy, quit medicine largely because he saw that the practice of bloodletting was killing more than it saved, and bloodletting had been standard practice for nearly every illness for around 2000 years. Among his faults Sam clearly did not count susceptibility to the this particular error of reasoning.  The fact is that homeopathy was never properly proven to work in the fist place; the many people since then who have believed homeopathy helped them or others were just as deluded as modern practitioners/patients, and their opinions should not influence us now.

A new approach to homeopathy.

No it's nothing radical, it's just that my articles were getting a bit long (I've got about 6 unfinished ones here all with pages of text) and it wouldn't have been the punchy answers I wanted. The answers to the homeopathic drivel were getting lost in all the explanation and required interpretation. Plus I spent Ages writing an article about what makes a good clinical trial and then the NHS go and publish one before I get around to finalising it. Mine was funnier ;) and had more about bias, but theirs is more authoritative.
So what I've decided to do is a series of punchy little articles each of which starts with a common homeopathic canard (no not the duck they use to make oscillococcinum), then a short response, and then a slightly longer response and some background info.
Hopefully, with an index, it should prove to be a slightly better resource.