Homeopathy, Nobel Prize Winners and Ignorance

Last week, I wrote about how I was having problems getting comments on at Huffington Post, specifically Ullman's pieces. Eventually, after complaining to Huffington Post, in conjunction with Sheldon, I was able to get a short comment on.

Ullman pulls out an old story, Luc Montagnier's whole "I believe in homeopathy" as proof that there must be something to it. It's not a new appeal by him, and the appeal to authority appears to be his favorite.

My favorite appeal to authority by Ullman is his video insisting that homeopathy is in the Bible:

In my initial response to the Montagnier piece, which was deleted, I wrote, in part: Appeal to authority at its most basic. So? Basic math has established that there aren't "extremely small doses" left. Even in 1996, Novella had a clear takedown of homeopathy: http://skepdigest.awardspace.us/Homeopathy.html. His thirty minute lecture in Medical Myths is even stronger, backed up by the latest research. This is 2009 is great at explaining: http://www.sciencebasedmedicine.org/?p=2558

Steven Novella isn't the only heavy-weight to break down Ullman's arguments. Orac has given serious attention to Ullman, as well as to Montagnier

As I pointed out recently, after having been awarded the Nobel Prize, Montagnier has gone woo. But not just woo, the most hilariously bogus woo of all, a woo that, for it to be true, would require that much of what we know about physics, chemistry, and biology be not just wrong, but spectacularly wrong. Yes, indeed, we're talking about homeopathy, although I only learned about the homeopathy angle in the context of discussing how Montagnier has decided to study dubious therapies for autistic children. Clearly, Montagnier has come down with the Nobel disease, as evidenced by his pursuit of autism quackery, his reporting that DNA can generate radio waves, and, above all, his embrace of homeopathy.
PZ Myers has also covered Montagnier's claims:

Montagnier claims in several papers that the DNA of pathogenic bacteria emits an electromagnetic signal, and further, that if you dilute that DNA homeopathically so that no DNA is actually present, the water continues to emit that same signal. Further, if you put two vials of homeopathically diluted EMS emitting water next to each other, the signal can move from one to another. And further, only bacteria and viruses pathogenic to humans produce this signal; ordinary E. colidoes not. It's madness piled upon madness.
There is no sensible explanation given for this phenomenon, only some wild-eyed speculation that "water molecules can form long polymers of dipoles associated by hydrogen bonds" that may be "self-maintained by the electromagnetic radiations they are emitting". More madness!

In the end I was able to get a short comment on, and there it sat all isolated until today when this comment was made:

I tried, with no success, to get a response on. Apparently Huffington Post's moderators on the woo posts (can't get comments on any homeopathy posts or Lanza posts) are intimidated by my responses.

I think most reasonable people would agree my comment is not ignorant. Reasonable people, examining the evidence regarding Montagnier's latest adventures, would conclude there is no evidence for his claims. Orac writes:

Not surprisingly, these experiments have not been published in the peer-reviewed literature; so it's impossible yet to determine what, exactly, Montagnier did and what he is claiming. In other words, we have publication by press release, a huge red flag for quackery or pseudoscience. A Nobel Laureate like Montagnier really should know better. Unfortunately, whatever led him to go woo apparently also led him to abandon standard scientific protocol for reporting experimental results to fellow scientists. Once you go woo, I guess, you don't come back.

So despite holisticdoc's assertion that "[T]he results are entirely reproducib­le and have been demonstrat­ed. What more evidence do you want?," the reality is that it Montagnier's claims haven't been demonstrated.  But of course, I'm not the one insisting that "Homeopathy is a system of medicine with incredible potential."

Critics of homeopathy do not rely on fallacious appeals to authority to support the claim that homeopathy is no more effective than placebo. They rely on the body of sound scientific studies showing that it doesn't work. They rely on the lack of scientific plausibility for being able to go beyond Avogadro's number. 

I especially  liked the conclusion to the argument by holisticdoc: "Homeopathy already has evidence, and now it is gaining credibilit­y. So, of course I understand why a dogmatic non-scientist such as yourself would be upset.”
Now, did I look upset, dogmatic, or non-scientific to you? 


Eric said...
This comment has been removed by the author.
Eric said...

(had to delete previous comment due to poor proof reading ;)

You sound very reasonable, scientific and motivated but not dogmatic, that last thing which would imply blind arrogance.

There is a major problem though with the scientific studies of homeopathy that I have encountered; they apply remedies according to allopathic practice, which would necessarily negate any possible insight into its efficacy.

If I try to run an automobile on wine and then conclude engines can't run on ethanol, there is a problem.
Trying to fault homeopathy though by saying that those investigating "rely on the lack of scientific plausibility for being able to go beyond Avogadro's number" is not sound science at all. The element of surprise in the discovery of antibiotics or dynamite (no pun intended) shows that coercion of circumstance is an active principle in scientific discovery. Cautious, by the book science, is absolutely essential, but so is imagination and an openness to discovery.

I am not blind to the fact that homeopathy has nothing more than empirical evidence but the fact that we are only beginning to look at it scientifically should be taken in account as well. I will never make scientific claims for homeopathic remedies though I have been prescribing them for over twenty years. I will never tell a person, 'this remedy will cure you'. At best I can say, 'we can try this remedy and see if it helps'. The first order of business if a patient appears to pin their hopes on homeopathic cure is to dash those hopes and forsake them for the concerted effort of looking for solutions.
Placebo effect is not to be underestimated by the way. Whether in the school children asthma study from Britain that showed, if i recall correctly, a 30% reduction using placebo, or the fact that reduction of seizures in non-tractable epilepsy can be as high as 15% for placebo(excepting the over 50% reduction group) is worthy of investigation in itself.
By the way, as a prescriber of classical homeopathy for nearly twenty years, I have moved in the last two years to Reckeweg's style where Avogadro need not apply and found more consistent results. The future is still open.

KWombles said...

Thanks, Eric. I think there's a big difference between the way Ullman pushes his perspective and views the matter, and a thoughtful consideration as you've presented.

I don't dismiss the placebo effect; it is powerful, and we should look for ways to exploit it. That's not what Ullman's doing; he's exploiting people with arguments that are unsound.

Having read your blog and followed your journey, I absolutely respect the way you approach trying to safeguard and improve health. You know all too well that too often there are no answers in medicine, and often tremendous harm; I suspect the harm is often a result of callousness and indifference, as you faced recently.

A warm, caring, and compassionate demeanor has to go a long way; what can and should be considered is where homeopathy and naturopathic care are rendered in an atmosphere where the patient has ample time with the clinician, is offered reasonable advice and warnings, and then given homeopathic remedies, how does this compare to patients who are rushed through the a doctor's appointment in 15 minutes and bundled out the door with a scrip. It would be a complicated study, but there are good reasons to think, to paraphrase Steven Novella, to think that it is the nonspecific effects that might be behind improvement and not the specific treatment employed. We should study these.

KWombles said...

Mitchell and Webb have a skit on homeopathy, and at the end one says (again paraphrasing), sure we may help the occasional person with a mild problem. The danger lies in patients using alternative medication that does not work on serious ailments that can result in death without appropriate treatment. A lesser danger is the arrogance and absolute certainty that the folks I read have that homeopathy will heal all while traditional medicine has nothing to offer. They have a belief system that is fixed and not based on evidence, nor open to consideration.

Your approach does not reflect this. I see no absolutism in your approach. I see a thoughtful, deeply introspective man doing the best he can to improve the quality of life for his son, and by extension, his patients. I see a man who cares deeply and works tirelessly, despite exhaustion and a weary soul, to keep Segev as healthy as possible.

If it's the therapeutic relationship and the acceptance that some of life's travails are to be accepted; we age and parts wear down, and we must live with some aches and pains (and the support and the adjusted attitude) lead to improved perceptions about one's condition, then these are what clinicians should be exploiting.

My master's thesis was on individuals living with chronic pain and how personality traits, attributional style, and religious and spiritual beliefs impacted their quality of life. Another reasonable component to add and examine is how does a therapeutic relationship impact coping and quality of life.

I'm listening to a lecture series on the portrayal of medicine in literature, and one of the ideas presented is that modern doctors are no longer listening, no longer offering care of spirit (not his exact words, but the idea)--no longer healers.

I think there is a world of difference between a dedicated, hands-on care that you provide and the canned selling of unproven, unregulated remedies through websites that are as much promotion of the person (Mercola and Ullman) as they are of pills. One is about healing and helping (and accepting the limits and working with evidence-based medicine and unfortunately the less-than-rigorous-add-a-med-in guesswork) and the other is about profit and pushing an agenda that is patently not in people's best interests.

I hope that I make those distinctions clear, but I suspect I often do not as I am focused on rebutting Ullman's claims or Mercola's specifically.

The physician writers I respect the most would agree with you, exploiting placebo and nonspecific effects should be maximized and investigated; Novella would argue that where it is the non-specific effects and not the ritual/treatment, we should find a way to exploit those effects while removing the ritual and treatment.

Thanks, Eric, for providing a window into a different way to view someone who uses homeopathy to promote healing. I hope you and Segev are doing better, and that you have gotten a chance to sleep.