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SKEPTICALITY EPISODE 231

You‘ve got 80,000 hours in your career. How can you use them to solve the world’s most pressing problems? This week on Skepticality, Derek has a conversation with William MacAskill: a former Fulbright scholar at Princeton University, PhD at Oxford University, and founder of the Oxford’s Center for Effective Altruism and co-founder of 80,000 Hours, a service which helps you determine how best to use your time to do the most good. As a person who is deeply concerned with the effects of charitable giving, MacAskill set out to provide ways for people to give in the most effective manner possible. He discusses why it was important, for the charities he helped create, to have a scientific way to determine where funding and effort should best be directed for the most good.

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1857 painting by Alexander Beydeman (1826–1869) depicting historical figures and personifications of homeopathy, including the founder of homeopathy, Christian Friedrich Samuel Hahnemann (far right), observing the perceived brutality of allopathic medicine of the 19th century. Source.

About this week’s eSkeptic

You might ask why, as skeptics, we must continue to fight the same battles against quackery over and over again, long after the nonsense has been debunked. The short answer: because belief in nonsense persists. In this week’s eSkeptic, we present one of James Randi ’Twas Brillig… columns from Skeptic magazine issue 10.1 (2003), about the persistence of homeopathy, entitled: “The Great Dilution Delusion.”

You may also be interested in downloading our free PDF on Alternative Medicine by Harriet Hall, M.D. (The SkepDoc).

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The Great Dilution Delusion

by James Randi

On November 27, 2002, the BBC-TV program Horizon, featuring a test of homeopathy, was broadcast in the UK. Many viewers expressed their conviction that we’d heard the deathknell of this form of quackery; I disagreed. To explain my reluctance to join the funeral procession, I offer readers this: Oliver Wendell Holmes (1809–1894) was a celebrated physician, poet, humorist and professor of anatomy and physiology at Harvard, as well as the father of O.W.H. Junior (1841–1935), who became a renowned justice of the U.S. Supreme Court. In 1842, Senior wrote an essay, “Homeopathy and Its Kindred Delusions,” which had originally been presented by him as two lectures to the Boston Society for the Diffusion of Useful Knowledge. I present here two excerpts from the essay, to illustrate just how little the situation has changed in the last 160 years.

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In 1835 a public challenge was offered to the best-known Homeopathic physician in Paris to select any ten substances asserted to produce the most striking effects; to prepare them himself; to choose one by lot without knowing which of them he had taken, and try it upon himself or an intelligent and devoted Homeopathist, and, waiting his own time, to come forward and tell what substance had been employed. The challenge was at first accepted, but the acceptance was retracted before the time of trial arrived.

Sound familiar? In April of 1999, Nobel laureate Brian Josephson publicly challenged the American Physical Society (APS) to conduct tests of the claims of Dr. Jacques Benveniste in regard to homeopathy, at the same time predicting that the APS would fear to do so. I advised the APS to accept Josephson’s challenge, and they did so. They also offered to pay all costs of the tests. From that day to this— three years and seven months ago—we have not heard from either Brian Josephson, or Jacques Benveniste….

Holmes Senior concluded:

From all this I think it fair to conclude that the catalogues of symptoms attributed in Homeopathic works to the influence of various drugs upon healthy persons are not entitled to any confidence.

Exactly the decision I came to, long ago. But read on. Holmes, in his essay, described the thorough manner in which homeopathic claims had been examined. He compared the eventual results to those met with when magical “tractors”— devices said to “withdraw” diseases and invented by Dr. Elisha Perkins in 1801—were clearly shown to be pure quackery and yet persisted in Holmes’ time. Holmes:

Now to suppose that any trial can absolutely silence people, would be to forget the whole experience of the past. Dr. Haygarth and Dr. Alderson could not stop the sale of the five-guinea Tractors, although they proved that they could work the same miracles with pieces of wood and tobaccopipe. It takes time for truth to operate, as well as Homoeo–pathic globules. Many persons thought the results of these trials were decisive enough of the nullity of the treatment; those who wish to see the kind of special pleading and evasion by which it is attempted to cover results which, stated by the Homoeopathic Examiner itself, look exceedingly like a miserable failure, may consult the opening flourish of that Journal. I had not the intention to speak of these public trials at all, having abundant other evidence on the point. But I think it best, on the whole, to mention two of them in a few words—the one instituted at Naples and that of Andral.

There have been few names in the medical profession, for the last half century, so widely known throughout the world of science as that of M. Esquirol, whose life was devoted to the treatment of insanity, and who was without a rival in that department of practical medicine. It is from an analysis communicated by him to the Gazette Médicale de Paris that I derive my acquaintance with the account of the trial at Naples by Dr. Panvini, physician to the Hospital della Pace. This account seems to be entirely deserving of credit. Ten patients were set apart, and not allowed to take any [homeopathic] medicine at all—much against the wish of the Homoeopathic physician.

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All of them got well, and of course all of them would have been claimed as triumphs if they had been submitted to the treatment. Six other slight cases (each of which is specified) got well under the Homoeopathic treatment—but with none of its asserted specific effects being manifested. All the rest were cases of grave disease; and so far as the trial, which was interrupted about the fortieth day, extended, the patients grew worse, or received no benefit. A case is reported on the page before me of a soldier affected with acute inflammation in the chest, who took successively aconite, bryonia, nux vomica, and pulsatilla, [all popular homeopathic remedies, then and today] and after thirty-eight days of treatment remained without any important change in his disease.

The Homoeopathic physician who treated these patients was M. de Horatiis, who had the previous year been announcing his wonderful cures. And M. Esquirol asserted to the Academy of Medicine in 1835, that this M. de Horatiis, who is one of the prominent personages in the Examiner’s Manifesto published in 1840, had subsequently renounced Homoeopathy. I may remark, by the way, that this same periodical, which is so very easy in explaining away the results of these trials, makes a mistake of only six years or a little more as to the time when this trial at Naples was instituted.

M. Andral, the “eminent and very enlightened allopathist” [orthodox physician] of the “Homoeopathic Examiner,” made the following statement in March, 1835, to the Academy of Medicine:

“I have submitted this doctrine to experiment; I can reckon at this time from one hundred and thirty to one hundred and forty cases, recorded with perfect fairness, in a great hospital, under the eye of numerous witnesses; to avoid every objection I obtained my remedies of M. Guibourt, who keeps a Homoeopathic pharmacy, and whose strict exactness is well known; the regimen has been scrupulously observed, and I obtained from the sisters attached to the hospital a special regimen, such as Hahnemann orders. I was told, however, some months since, that I had not been faithful to all the rules of the doctrine. I therefore took the trouble to begin again; I have studied the practice of the Parisian Homoeopathists, as I had studied their books, and I became convinced that they treated their patients as I had treated mine, and I affirm that I have been as rigorously exact in the treatment as any other person.”

And Andral expressly asserts the entire nullity of the influence of all the Homoeopathic remedies tried by him in modifying, so far as he could observe, the progress or termination of the diseases. It deserves notice that he experimented with the most lauded substances—cinchona, aconite, mercury, bryonia, belladonna. Aconite, for instance, he says he administered in more than forty cases of that collection of feverish symptoms in which it exerts so much power—according to Hahnemann—and in not one of them did it have the slightest influence, the pulse and heat remaining as before.

One could certainly expect that after such comprehensive and authoritative testing had resulted in total failure, homeopathy would immediately have vanished from the further consideration of the profession and the public. But to quote from Dr. Holmes (above): “to suppose that any trial can absolutely silence people, would be to forget the whole experience of the past.” Homeopathy is still with us, and no doubt will survive any contrary evidence, simply because there is a huge commercial aspect to its continued existence, along with wide ignorance of how to judge these matters.

As powerful, comprehensive, and evidential as the BBC Horizon program was—and we’re very happy that a major network has actually extended itself to do the testing procedure— history tells us that the homeopathic community, those with heavy financial and philosophical interests in supporting this quackery, will rally, regroup, and begin obfuscating wildly to neutralize this damning research. They certainly cannot deny those behind it: top-notch medical, biophysical, and biochemical authorities, using the very best experimental standards, and adopting a firm statistical conclusion. But they will squirm and mumble, wriggle and grumble, complaining that it just had to be something wrong with the experimental procedure, not the theory itself.

Here are a few samples of the more than 900 questions that arrived for me following the Horizon broadcast last Tuesday:

If some labs are creating positive results for homoeopathy and it is shown that water does not have memory should we be worried that many labs are not rigorous enough to be looking after our health?

Do you think that the results have anything to do with determinism? In a similar way to the Schrödinger’s Cat scenario?

Is there something wrong with science if it has to always prove how things work, not just that they work (repeatable observation of a phenomenon)?

Do you personally believe in any pseudosciences?

If homeopathy works, surely drinking one glass of water will cure me of everything, after all, it will have been in contact with most substances at some point. What do you think?

No comments on the above….

Concerning the excellent handling of the homeopathic claims by Horizon, I repeat another caveat of Dr. Holmes: “realize the entire futility of attempting to silence this asserted science by the flattest and most peremptory results of experiment. Were all the hospital physicians of Europe and America to devote themselves, for the requisite period, to this sole pursuit, and were their results to be unanimous as to the total worthlessness of the whole system in practice, this slippery delusion would slide through their fingers without the slightest discomposure.”

The transcript of the Horizon program can be seen at: http://www.bbc.co.uk/science/horizon/2002/homeopathytrans.shtml.

I urge you to read the entire Holmes account, at http://www.quackwatch.org/01QuackeryRelatedTopics/holmes.html and get the whole matter in perspective. If you’ve not yet been exposed to pseudoscience at its very weirdest, you’re in for a shock. This, friends, is what homeopathy is all about…. END


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9 Comments »

9 Comments

  1. Bob Pease says:

    I once was halfway serious about making some bumper stickers saying
    “HOMEOPATHY is THEFT”

    The best outcome that I could have expected is that my car would be sprayed with homeopathic acid by BELIEVERS.

    In real life, much more serious damage would have been done to my car and “America Sucks” would have been safer.

    The “New Age ” stuff is not NEW at all ( except for getting worse) since 1914
    when my great aunts were into Spook Chasing and associated blither as
    Socialites in Canon City Colorado, Having been educated at Harvard and hardly the Small-town Babbit Wife stereotypes.

    I an am Associate (non-member) of a Unitarian Church in Denver.
    You might think that “High Church” liberals are the last refuge for Scientific thought.
    Actually the “new Age” blither is accepted almost as Dogma ( Along with Yoga Chakras and Magic Energy Flapdoodle) , and I need to keep a low profile about this, or I can get branded as “Intolerant” or “Close-(sic) Minded”

    Meanwhile lotsa folks are taking Magick Water for $3000 per liter and neglecting Medical treatment.

    Beats Me

    Dr. Latero Piensolado, Hp.D

  2. James Weseman says:

    Coincidentally, I just yesterday started reading Bad Science by Ben Goldacre, and had just finished the chapter on Homeopathy last night. I heartily recommend the book, and particularly the material on the “theory of water memory” and the dilution factors for “active ingredients” in the Homeopathic pharmacopeia.

    In standard preparations the dilutions are expressed as 30C (a 1:100 dilution repeated 30 times; or as expressed differently 10^60-fold). In not even the most extreme cases, 200C Homeopathic dilutions are employed, or more than would be necessary to eliminate every atom in the known universe by “an enormously huge margin” (his words). I quote: “To look at it another way, the universe contains about 3X10^80 cubic meters of storage space (ideal for starting a family); if it were filled with water and one molecule of active ingredient, this would make for a rather paltry 55C dilution.”

    Yet somehow the water retains a “memory” of the molecule that once touched it (a “suggestive dent”), yet apparently has forgotten every other molecule it ever touched during its existence in the history of the universe.

    Inane blather? Of course, but so is every pseudoscience and, come to that, every theistic religion. Yet such will always be with us. You can’t reason away a belief that wasn’t derived by reason.

    Sad.

  3. Bad Boy Scientist says:

    The most striking thing in this issue of eSkeptic was the preface to the article on homeopathy – they acknowledge that they keep debunking the same stuff over and over because people continue to believe in this stuff.

    Does anyone other than me see this as an indication that our approach is all wrong?

    I have long felt that skeptics movements need to partner with natural allies such as science literacy groups (e.g. museums, Project ASTRO, etc) and consumer watchdog groups. That way we can start lighting candles instead of merely cursing at the darkness.

    Just my thoughts…

    • Bob Pease says:

      This seems to be :Preaching to the Choir” to me.

      The belief in Magick and Pseudoscience is widespread in
      “Educated” middle class folks.

      The failure of U.S.” Educational System” is not looking at De Facto “ethnic” Segregation or doing an
      “emperor”s new clothes” number on us all

      I haven’t given up but I dunno what telling folks that they believe in horse pucky will do
      How about them Rockies this season ??

      Bob Pease

  4. Jerry says:

    Homeopathy is based on a false premise to begin with – like cures like. The fact that you then take these substances and dilute them. The 30C dilution (about 10 to the -60) was the dilution advocated by the founder of homeopathy for most purposes: on average, this would require giving two billion doses per second to six billion people for 4 billion years to deliver a single molecule of the original material to any patient. So even if like cured like, no like is being delivered to have any effect. Of course, then you get into the fantasy world of “vital energy, “succession,” and higher dilutions having increased potency thereby.

    What homeopathy had going for it in the beginning was that by having no effect, it was often better than the results obtained through the extant heroic medical treatments of the time, involving bleeding, blistering, and doses of poison.

  5. Tony says:

    Thanks for another good article, Randi.

    Is it possible to reveal the mistakes and biases that Prof. Ennis and Dr. Benveniste made in their experiments? From the transcript of the Horizon program it sounds they were quite thorough in re-checking the results and were highly sure they were right before going public. Both were calling themselves disbelievers in homeopathy, so presumably were not cheating, at least consciously.

    And yet Amazing Randi was able to amazingly easy prove them wrong. Just by blinding test vials. My question is what exactly these experimenters were doing to check the results of their own tests before the results were published, and before homeopathy got extra support from that publicity, and before they were debunked?

    My second question is about “memory of water”. Well, what exactly is that? No one seems to bother explaining, as if it is something every respectful gentleman should now :)

    Cheers,
    Tony.

  6. Tony says:

    :)
    I just got a crazy idea about homeopathy. It should be heavily promoted to the drug dealers. Yes, all that stuff about memory of water, saved on sugar crystals.

    Imagine a drug dealer who sells cocaine-30C, heroin-28C, marijuana-18C, MDM-20C, morphine-30C.
    Will he be arrested in airport for trafficking, 20 kg of homeopathic drugs? How would you like a guy to be executed somewhere in Malaysia for smuggling what seemingly appeared as 3 kg of simple sugar, packed in condoms and swallowed.
    Or how do you like this. A man was hiding a bag with homeopathic cocaine-30C in the kitchen, and after his wife re-stocked sugar, he cannot decide which is which?

    The recipe of happiness will be so simple. Take a bit of tapped water (it surely was in contact with any imaginable substances), sprinkle it on sugar, make a wish, and swallow.

    Take care,
    Tony

  7. Jay says:

    Talking about “the deatknell of homeopathy” seems to me even more beside the point than homeopathy itself. Here in Spain, it has just received endorsement by the government -it’ll be covered by health insurance, and advertising it will be legalised: http://sociedad.elpais.com/sociedad/2013/12/02/actualidad/1386015772_167699.html (in Spanish).

    In fact, I’m in two minds about the thing myself. It’s quackery alright, but patients may just get a tad upset when you prescribe something called “Placebine”, even when such non-medication may well be the best way to deal with them. Give it a homeopathic name, and the placebo effect is enhanced by complicated-sounding names and a guarantee that it’s a “natural remedy”. As I see it, homeopathy is a great way to enable doctors to prescribe placebos where advisable without actually telling the patient that that’s what they’re doing, and homeopathic guidelines for dealing with patients, as far as all that taking your time and trying to understand the patient as a person are sound. Homeopathy only becomes problematic when people with serious problems who could be helped using serious means, abandon their treatment in favour of it.

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