Fake medicine and AIDS denial are ‘charitable’

[BPSDB] Richard Wilson wrote this about a registered charity that is actively promoting AIDS denial.

This reminded me that, last year, I wrote to the same Charity Commission to complain about Frontline Homeopathy, which collects funds to promote homeopathy as “as an effective, low cost primary health care system” in developing countries. I got this reply. The Commission’s criterion is ‘charitable’, which apparently has nothing to do with ‘true’ or ‘effective’.

Thank you for your request.

The Commission’s policy on registering charities who pursue practices which constitute alternative and complimentary medicine was made following our Decision on the application for registered charity status from the National Federation of Spiritual Healers. Please see the link below for more details (you may need to scroll down to see the specific case and our findings).

www.charitycommission.gov.uk/tcc/issueguidesum.asp

I trust you will find this useful.

Perhaps this is matter for another campaign by bloggers?

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Homeopathy Awareness Week: The facts of life

[BPSDB] Here’s a description of the process for producing a homeopathic remedy, as described on Wikipedia:

…homeopaths use a process called “dynamisation” or “potentisation” whereby the remedy is diluted with alcohol or distilled water and then vigorously shaken by ten hard strikes against an elastic body in a process called “succussion”. … During the process of potentisation, homeopaths believe that the vital energy of the diluted substance is activated and its energy released by vigorous shaking of the substance.

… A 2C dilution requires a substance to be diluted to one part in one hundred, and then some of that diluted solution diluted by a further factor of one hundred. This works out to one part of the original solution mixed into 9,999 parts (100 × 100 -1) of the diluent. A 6C dilution repeats this process six times, ending up with the original material diluted by a factor of 100-6 = 10-12. Higher dilutions follow the same pattern. In homeopathy, a solution that is more dilute is described as having a higher potency, and more dilute substances are considered by homeopaths to be stronger and deeper-acting remedies. The end product is often so diluted that it is indistinguishable from the dilutant (pure water, sugar or alcohol).

Now for some real science, what you learn in chemistry at school. A ‘mole’ of any substance – for water 1 mole is 18 grams – contains approximately 6 × 1023 molecules of the substance, that’s 6 followed by twenty-three zeros (6 × 1023 is called the Avogadro constant).

That seems an awfully large number of molecules, but if you carry out the homeopathic dilution you soon reduce the concentration of the substance to effectively nothing. Suppose you start the homeopathic preparation with about a tenth of a mole of the active ingredient in 100 ml, by the time you have a 12C remedy (diluting by 100 twelve times) there is only, on average, approximately one molecule in every 100 ml. Homeopaths typically use 30C or even 200C solutions. Once you get to those dilutions, there is absolutely no chance of finding any of the original remedy in a sample. Such a homeopathic remedy consists only of the inert basis substances (water, alcohol, sugar, chalk etc.) that are used for making the dose or pill, like the placebos that clinicians use in tests.

Kate Chatfield of the Society of Homeopaths was asked by a House of Lords Select Committee:

“Is it possible to distinguish between homeopathic drugs after they have been diluted? Is there any means of distinguishing one from the other?”

She replied:

“Only by the label.”

Exactly.

Nevertheless, homeopaths still claim that the dilution process somehow makes a “remedy” more effective, even hinting at danger if the “strong” remedies fall into untrained hands. How this happens appears to be magic, the same way magic happens in the Harry Potter books. A few more scientifically-minded homeopaths have tried to come up with a pseudoscientific explanation called “memory of water”, but they have yet to put even a proper theory to this name, let alone find any evidence that it exists.

For the sake of argument, let’s just assume that the homeopaths are right, and that succussion does turn the material that you started with into an effective “remedy”. By the homeopathic “principle” that “like cures like”, the homeopathic solution should produce the symptoms of the disease that the “remedy” is used to treat.

In practice, even the very purest available water contains parts per trillion or parts per billion of numerous impurities. These chemical substances are in the water because the world we live in is made out of chemicals (they are not necessarily man-made pollution). Typical impurities would be common ions like sodium, chloride (that is, salt), calcium, magnesium,  iron and sulphate. There are likely tens of thousands of impurities in the form of molecules and ions at this level or lower. We don’t expect homeopathic “remedies” to be prepared with water this pure, which is expensive water used for chemical analysis and other experiments in labs requiring high accuracy. We happily drink water with higher levels of impurities than this – at those levels they have no significant affect on the human body.

So, even if a homeopathic “remedy” is prepared with the very purest available water, there may still be something like 1012 (1,000,000,000,000) molecules each of numerous impurities in a 30C or a 200C remedy and this level cannot be reduced. Of those molecules, some molecules of each impurity have been through the whole dilution/succussion cycle, so the impurities have been “potentised” too. So a homeopathic “remedy” ought actually to deliver the effect of many thousands of uncontrolled chemical substances. Fortunately it doesn’t – imagine drinking potentised Epsom salts. That’s because the whole idea of “potentising” is nonsense.

Even worse, if homeopathy were true, it would be potentially one of the most polluting industrial processes. Suppose the homeopath dilutes a commercial 6C “remedy” to 30C for a patient, each time diluting 1 ml to 100ml. Each stage generates 99ml of by-product, each more “potentised” than the next. That’s 24 × 99 ml, almost two and a half litres of stuff that supposedly will induce symptoms, and more than enough for treating the most hypochondriac of patients. It’s even worse for a 200C remedy – you would have almost 20 litres to dispose of.  How much of this strong magic water is flushed away and finds itself back in our water supply?  Fortunately, you could drink a lot of 200C and the only symptom you would get is a strong desire to pee.

The homeopathic manufacturer Helios has a catalogue that is good for a laugh. It consists mainly of lower “potencies” that your friendly local homeopath can make into “remedies” for you. Helios’s Excrementum can, for example, presumably does actually contain a small amount of dog shit. Sooner you than me. Marc Abrahams has more about this.

Yes. Be aware  of homeopathy. It’s homeopathetic nonsense.

Analysing the chiropractors’ statements

[BPSDB]There seems not to have been much comment on the press statement by the British Chiropractic Association on 7 May about the libel case against Simon Singh. This appears to be highly misleading. It reads in part:

In April 2008 Simon Singh published an article in the Guardian newspaper and on Guardian Online in the course of which he wrote that:

“the British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying, even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments.”

The BCA asked Dr Singh to retract his allegations because they are factually wrong, defamatory and damaging to the BCA’s reputation. Dr Singh refused to do so.

In July 2008, the BCA issued libel proceedings against Dr Singh. He defended his position and the case has been continuing.

At a hearing on 7 May 2009 in the Royal Courts of Justice before Mr Justice Eady, Dr Singh’s submissions that what he published was not defamatory and that it was fair comment were roundly rejected by the Judge. Mr Justice Eady held:

1. that what Dr Singh had published was defamatory of the BCA in exactly the way the BCA had claimed; and

2. that Dr Singh’s allegations were not comment but were serious defamatory allegations of fact against the BCA.

Dr Singh’s application for permission to appeal to the Court of Appeal was refused by the Judge. Dr Singh has indicated, however, that he proposes to challenge that decision at the Court of Appeal and he now has three weeks to lodge that challenge.

Mr Justice Eady ordered Dr Singh to pay the BCA’s costs of the hearing within 28 days.

After the hearing BCA President Dr Tony Metcalfe said, “The BCA brought this claim to preserve its integrity and reputation. I’m delighted that the Judge has vindicated the BCA’s position.”

The trial will conclude later this year.

In actual fact, the trial has not taken place, so the BCA has not been in the slightest degree “vindicated”. All the judge has done is issued a perverse ruling on the meaning to be placed on Dr Singh’s words, so that in order to win the case he has to prove something that he apparently did not mean in the first place. It also means that the case no longer has any bearing on the real scientific issue, which is whether the evidence that these treatments are effective exists.

However, the BCA seems to have quietly and implicitly conceded that what Dr Singh wrote is true, as they have removed the offending document (checked on 19 May 2009), with the claims that Dr Singh complained of,  from their web site. It remains true so far that the BCA has not produced “a jot of evidence” for this claim, and from the fact that they went to law rather than produce the evidence leads me to conclude that the evidence does not exist. I think it is also a reasonable inference that if the BCA makes the claims in future without producing the evidence, then it is doing so in the knowledge that the evidence does not exist.

I have looked through the publicly-accessible part of the BCA web site, to the greatest extent I could, and it does not appear to repeat the claims elsewhere. As regards children, the material on the web site consists of claims so vague that they would be difficult to challenge (as in a video on pregnancy and children), general good advice on posture and activity, and scare statistics on back pain. In fact, if you looked through those specific materials, you would find it difficult, if not impossible, to know exactly what a chiropractor does, except that they claim to have some sort of knowledge of the causes of back pain.

As it’s hidden behind a log-in, I have no way of knowing what information the BCA has passed on to its members. If it has told them the same as in the press statement, then it is misleading its members. It should at least make it clear to them that it cannot support the claim that it originally made about treating childhood ailments.

I have been looking at a few chiropractors, selected because they are local to me. One of them makes very serious claims on her web site about the effectiveness of chiropractic in the treatment of specific conditions, including some referred to by Dr Singh. I have contacted the practice, and am waiting for someone to get back to me. Otherwise, the general impression that I get of the public front of chiropractic is vagueness. I hope to post more on this later.

What will an MP swallow?

This is a follow-up to my MP in in answer to his letter to me supporting homeopathy on the NHS.

Dear Mr Kawczynski,

Thank you for your reply of 31 August to my letter to you about the Early Day Motion on homeopathy. I would like to comment on your reply.

I wrote specifically about homeopathy. Other forms of ‘complementary medicine’ raise their own specific issues, but homeopathy is something that the NHS should certainly not support.

Studies show that homeopathy is no more effective than a placebo (an inert pill or water disguised as a treatment). This is not surprising, as homeopathic remedies contain absolutely no active ingredient – they are placebos. It is certainly untrue that homeopathy can treat conditions that science-based medicine cannot.

Most homeopaths treat only conditions that get better by themselves. In that sense they do no harm. But money spent on homeopathy is money that would be better spent on treating people with serious conditions using the best known treatments. And homeopaths become dangerous when (as some do) they make the false claim that they can treat or offer protection from serious diseases such as malaria or AIDS.

Homeopaths like to try to imply that their remedies are ‘natural’ or ‘herbal’ remedies, but they are not. They are inert tablets or solutions created with a ritual that is based on late 18th century magical thinking, long before science discovered bacteria and viruses and identified the organic and molecular bases of disease.

Homeopaths also like to try to suggest that their ‘treatments’ are somehow outside the scope of testing. This ignores the fact that techniques such as randomised double-blind trials were invented precisely because there is no other reliable way of knowing whether a treatment is effective or not.

If you would like to get an idea of the extent to which homeopaths are mocking reason and deluding the public, please have a look at the catalogue of Helios, a major supplier of homeopathic ‘remedies’. There you will find about 12 pages of supposed remedies supposedly based on just about everything including Excrementum caninum (dog excrement). This is reminiscent of the witches in Macbeth, except that there is no way you could in reality distinguish between any of the remedies on the list. The catalogue is at: https://www.helios.co.uk/download/Remedy_File.pdf.

If you would like to see a more detailed criticism of the assertions in the Early Day Motion, I strongly recommend the full explanation with references at: http://apgaylard.wordpress.com/2007/09/27/homeopathic-motions/

I hope that this explains my concern. I am sorry to see that so many of our elected representatives are so badly informed about the matter. There seems to be a serious lack of understanding of science and medicine in the House of Commons. This is dangerous when so much of our society and economy depends on science and technology.

Yours sincerely,