The Lower Quote, As If You Didn't Know, Is By Richard Dawkins, Son.

Wednesday, January 15, 2014

Dana Ullman's "The Case For Homeopathy" Examined

Dana Ullman, "Mr. Homeopathic", has written an article for the Huffington Post addressing some questions about his chosen field while throwing spears of vitriol at skeptics who do not think the evidence is sufficient to warrant belief in homeopathy. Let's take a look at that post and the evidence he provides to see if it stands solidly upon its metaphorical feet.

He begins by stating that the U.S.A. is resistant to homeopathy and is 37th in the world with respect to its health care system. France, by his contrast, is first and ~40% of the population use homeopathy and ~30% of docs there prescribe it. This does not take into account the myriad other factors that relate to a country's health care system (diet, lifestyle, activity levels, etc...) or that the gullibility of doctors relating to their ignorance of chemistry and pharmacology is likely to be more relevant here than anything else. The general population would have the idea that homeopathy is just another "natural" way to cure conditions and diseases, which is how homeopathy is marketed.

Ullman says:
The fact that homeopathy became extremely popular during the 19th century primarily because of its impressive successes in treating the infectious disease epidemics that raged during that time is a fact that is totally ignored by skeptics.
This is not "ignored by skeptics". Homeopathy seemed effective in treating infectious diseases in the 19th century because most people didn't die from the self-limiting conditions they contracted and giving them nothing (i.e. homeopathy) was safer than the invasive medical treatments of the day. It's an easy mistake to make, especially when you have an agenda.

Ullman goes on to say that there are more than, "150 placebo controlled clinical studies, most of which have shown positive results, either compared with a placebo or compared with a conventional drug." However, as Kimball Atwood points out on Science Based Medicine, "The 'supportive research' section of the article may look impressive to the naïve reader. In fact, some of the references support the non-efficacy of homeopathy and the others are hopelessly flawed." I'm sure "Big Pharma" has paid Atwood off for the article.

Moving slightly onward with the article, we see Ullman state that, "testing...homeopathic medicines on cell cultures, plants, animals, physics experiments, and chemistry trials have shown statistically significant effects." One of the references he lists is to a PubMed trial whose conclusion states: "Even experiments with a high methodological standard could demonstrate an effect of high potencies. No positive result was stable enough to be reproduced by all investigators. A general adoption of succussed controls, randomization and blinding would strengthen the evidence of future experiments." So, sure, you could call that "statistically significant", but I would lean heavily towards "more careful research is necessary before making grand claims." Call me old fashioned if you will.

The article then goes into a discussion of hormesis, the idea that small doses of a harmful substance (usually referring to radiation) can provide helpful effects. Ullman compares this to homeopathy and says that skeptics are silent on the topic. I would have a slightly different opinion. See posts on Quackometer and Science Based Medicine to start.

Ullman has two references with respect to hormesis. Reference 17 leads to this PubMed article which mentions homeopathic "medicine" once, speaking only to its "bitter" rivalry with actual medicine. Reference 18 when searched leads to articles written by Ullman himself, or to a homeopathic website - no research.

Look at this quote:
The doses of homeopathic medicines that are commonly sold in health food stores and pharmacies throughout the world are in a similar low dosage range to the thousands of hormesis studies on low-dose effects
A common homeopathic dilution is 30C. That means that a 1:100 dilution has been repeated 30 times. If you check Wikipedia on this matter, you'll see that that means: "1 ml of a solution which has gone through a 30C dilution is mathematically equivalent to 1 ml diluted into 1054 m3 - a cube of water measuring 1,000,000,000,000,000,000 (1018) metres per side, which is about 106 light years. When spherical, then it would be a ball of 131.1 light years in diameter. Thus, homeopathic remedies of standard potencies contain, almost certainly, only water (or alcohol, as well as sugar and other nontherapeutic ingredients)." Not exactly akin to the traditional dose/response curve you see with hormesis. Sorry, Mr. Ullman, this fails the sniff test.

A description of how homeopathy works follows where Ullman says:
Each medicine is made in double-distilled water in a glass test-tube, diluted in a 1:10 or 1:100 solution that is vigorously shaken 40 or more times. Then, this process of dilution and succussion (vigorous shaking) is repeated 3, 6, 12, 30, 200, 1,000, or more times. Although one would think that one is diluting out whatever was in the original solution, the immense worldwide experience using homeopathic medicines over the past 200 years proves otherwise.
No, it does not prove otherwise. At all. The original solution is being diluted out and if you think otherwise, the burden of proof is on you to show the evidence and collect your Nobel Prize in chemistry. If you can't do that - which neither you nor any other researcher has done - then we're pretty much done here.

Ah, except that were not...dammit.

Ullman repeats that homeopathy uses, "extremely small doses" of medicines. This is incorrect because if you'll re-read the Wikipedia link above, there is the highest probability that not one molecule of the original substance will remain in the vial. He claims, "modern-day immunology and allergy treatments derive from the primary principle of homeopathy". No, they don't. Immunology uses small but actual, measurable amounts of attenuated virii to achieve antibody production in the body by stimulating a response. Homeopathy uses no measurable amount of a selected substance to achieve a response opposite to that which the substance causes when given in large doses.

Oh yes, the argument from popularity! Ullman says:
The fact that so many highly respected people and cultural heroes over the past 200 years have used and advocated for homeopathy provides additional evidence for this medical system.
Nope. Not even a bit.
Some of these cultural heroes include eleven U.S. Presidents, six popes, JD Rockefeller, Charles Darwin, Mother Teresa, Mahatma Gandhi, and scores of literary greats, corporate leaders, sports superstars, world-class musicians, and monarchs from virtually every European country.
You may notice, as I did, that this list is notably lacking in chemists. Weird, huh?

Ullman cites homeopathy's use in parts of the world as a positive and evidence for efficacy. His 21st reference is to a Lancet article (Prasad R. Homoeopathy booming in India. Lancet, 370:November 17, 2007,1679-80.) but when you search it, the first result is to here where you see Indian oncologists lamenting the use of Traditional, Complementary and Alternative Medicines (TCAM). They conclude:
Overall, early diagnosis and intervention is critical for effective treatment of many malignancies. Delays in presentation related to the use of TCAM may be an important factor relating to the high rates of advanced disease on presentation and low survival rates in the care of Indian cancer patients. Further research is needed to explore the reasons for using TCAM and to ensure existing issues of delays in help seeking are addressed.
Not exactly a ringing endorsement of homeopathy.

So this piece isn't book-length, I have to here skip ahead to what Ullman calls, "A Simple Challenge to Skeptics". He rails on about how homeopathy actually works, you guys, and here's some more references! Oh, his 34th reference is to an article in Chest, discussed at Science Based Medicine here with a fun back and forth in the comments between Ullman and the authors/readers. Ullman's actual "challenge" is stated thusly:
I personally challenge ANY skeptic of homeopathy to try to maintain a family practice and only dispense "sugar pills," rather than real homeopathic medicines. My challenge is simple: while seeing a wide variety of children and adults with various acute and chronic problems, take them off all of their conventional drugs (with the exception of insulin and a small selection of drugs of "medical necessity"), and prescribe only sugar pills...for just one week.
Does anyone else see the problem with this? Ding! It would be completely unethical! Correct! Ullman also overlooks the fact that it's not just that people are getting no actual medicine from homeopathy, but they are getting care, seeming proficiency, a good story of how it (supposedly) works, history, and ritual. It's the same reasons that acupuncture might seem to work, even though it doesn't matter where or even if you insert the needles

You know you're not dealing with greatness when he quotes Deepak Chopra gushingly. He refers to "closed-minded" skeptics who just aren't open to the evidence. We are called "denialists" and, as Chopra said, are "dedicated to the suppression of curiosity." Quite the contrary, I would say. Science is all about curiosity and being open to new ideas, provided said ideas are sound and don't raise more questions than they answer. Then you have to put your new idea on a stand and let everyone try to knock it off; the longer it stays on the pedestal, the stronger an idea you have (think General Relativity or quantum mechanics).

There is nothing in science more exciting than being wrong. The best way for a chemist to get famous, make a career for him/herself, and gain the respect of their peers would be to prove the mechanism for homeopathy and show a repeatable, reliable experiment that is undeniable. Dana Ullman doesn't seem to realise this fact and continues to launch ad hominem attacks against his foes while decrying the same. He picks fights and then yells about being bullied. This is not a scientific mind - it's diluted.

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5 Barbaric Yawps:

At 15/1/14 11:25 am, Blogger Account Closed said...

Well done sir.

At 15/1/14 12:06 pm, Blogger Heathen Mike said...


At 16/1/14 1:12 am, Blogger Fall Garlic said...

I like the "diluted" instead of "deluded" at the end. A nice barb at the homepath. I wonder if he will catch that and be as sorely stung as he should be.

At 17/1/14 3:55 am, Anonymous Woody said...

I like this post, Mike. Your grip on science and understanding of the scientific method (a method I've grown fond of) is refreshing. I agree that maligning skeptics with the worst of the believers' own faults is so typical and common, it's almost as boring as their
(un)scientific reasons for believing in and spending money on unsupported dreams.

We skeptics don't ask much, do we, just for the evidence to be real, homeopathy has had all the chance in the world to win us over but hasn't yet impressed me.

At 21/1/14 4:12 am, Anonymous Diane Clark said...

I believe in the potential value of homeopathy. To be honest, I am a kind of person who feels better immediately after I after a clinic or see a doctor wearing a uniform. That's why I'm sure that homeopathy m9ght have just perfect effects for me


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