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).


I trust you will find this useful.

Perhaps this is matter for another campaign by bloggers?

Follow-up to Homeopathy Awareness Week

[BPSDB] There was no follow-up to the letter published prominently in the Guardian on 13 June 2009, on which I have commented before. I have followed this up with a letter to the paper’s Readers’ Editor. I actually wrote on two different issues, so this is an extract from the letter.

On Saturday 13 June you published prominently a letter from three physicians (Dr Lewith et al). This consisted of an unfounded claim (see http://apgaylard.wordpress.com/2009/06/15/false-positives/) about evidence for the effectiveness of homeopathy, in which the signatories appear to have a direct financial interest.

I expect that there were many letters (including my own) in rebuttal of this claim, but none appeared in the paper. It appears to me that homeopaths and their supporters get an easy ride in the paper (outside of Dr Ben Goldacre’s columns) despite the fact that it is to medicine pretty much what astrology is to astronomy.

For information, this is the public information on the involvement of the three signatories with homeopathy:

Dr George Lewith

Dr Michael Dixon

Dr Peter Fisher

They all use the weasel word “integrative” or “integrated”, which has come  to be a warning sign for serious bullshit whenever it is associated with the word “medicine”. Homeopathy is fake medicine. It imitates the protocols and procedures of medicine (but not necessarily the ethics), while the theory behind it, and the remedies themselves, are as empty of real content as the magic in the Harry Potter books.

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.”


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.

Homeopathy Awareness Week: Spinning homeopathy, not arguing for it

[BPSDB] Some – what I consider outrageous – spinning of homeopathy in the Guardian,  by three committed homeopathy-friendly physicians (Professor George Lewith, Professor of health research at the University of Southampton, Dr Michael Dixon, Medical director at the Prince’s Foundation for Integrated Health and Dr Peter Fisher, the Clinical director, Royal London Homoeopathic Hospital).

They come about as close as they can to claiming evidence for homeopathy while actually admitting that is no real evidence for its effectiveness. The origins of homeopathy were in the days when medical science was just beginning. In those two centuries science has gone on to confirm the atomic nature of matter, has discovered the cellular and organic basis of life, the existence of bacteria and viruses, the mechanisms of heredity and the causes of inherited diseases. It has invented advanced methods of diagnosis and treatment, and intensive care. Yet homeopaths are still using weasel words like “cautiously positive”.

The second part of the letter is a non sequitur that sets a trap for the reader. It is of course morally wrong for patients to be denied clinically effective treatment or amelioration, where it exists. But that’s irrelevant to homeopathy if homeopathy has not been shown to be an effective treatment. What is probably true is that homeopathic treatments (rather than the pills) help patients feel better, but so does any treat.  In actual fact, homeopathic pills and potions are based on magic, so why should they be favoured over (say) giving patients tickets to the theatre, another kind of pleasing and voluntary suspension of disbelief that cheers people up? The difference is that homeopathic practice mimics the protocols and procedures of medicine without  the reality, so it is easy to confuse with medicine. It is cargo-cult science.

Lewith and co. also claim that Evan Harris and Edzard Ernst “assume that we have effective treatments for all conditions and all patients.” I doubt that that is the case, although Harris and Ernst can no doubt comment on that themselves. We know that effective treatments do not exist for all conditions and all patients. That’s why there is medical research. That still does not imply that homeopathy is useful though, in the absence of evidence that it is effective.

David Colquhoun considers that homeopathy is boring, and of course it is, like flying saucers and ghost pictures and astrology that depend on the repetition of memes without any depth of theory or reference to reality. The contrast between the intellectual richness of science and the shallow repetitions of pseudoscience is striking. But while there are shills rooting for homeopathy, it is still necessary to keep pointing out the truth. As Professor Colquoun points out, homeopathy is a business like the tobacco industry that, if frustrated at home, turns abroad and looks for more vulnerable victims to assist its expansion.

We are all patients of the medical profession at some time in our lives – I have been very lucky not to have needed the services of doctors and hospitals very much in my life, but I have had one of the potentially fatal diseases that some homeopaths claim to be able to cure. Some of my family, on the other hand, have received the full benefit of scientific medicine. As a taxpayer, I would like to see my money used in the NHS to best advantage – that means for effective treatment. (I have no problem with patients paying for homeopathy, snakes’ entrails or reiki if they choose). And I would be very concerned if I , or someone I knew, was referred to someone who holds the sort of views expressed by Dr Lewith and his colleagues. Not necessarily because they may consider homeopathy useful or even possibly effective, but because they are educated and accomplished doctors and yet they argue for their vested interest in this inept way.

Which brings me to what was originally going to be the intention of this post: to use the Guardian letter as an example of how spin is used to disguise a weak or non-existent argument. That will now have to wait for another post, as I have rambled on to other points.

I want to do something really dangerous

[BPSDB]There is this piece of flimflam on the web site of Neal’s Yard (the unethical selling company):

In more severe, acute situations the 200th potency (200C) may be administered once – this should not be repeated. Unless you have some knowledge and experience of Homoeopathy it is best to leave administration of 200th potency remedies to a qualified practitioner and remedies of higher potency than 200C should never be taken without first seeking the advice of a qualified homoeopath.

Surely, though, homeopaths like to claim that homeopathy is absolutely safe if done properly – the one thing that homeopaths and the reality-based community agree on?

In the real world, we know perfectly well that a properly prepared 200C homeopathic remedy is exactly the same as a 30C or 400C remedy of the same remedy or any other remedy – it contains absolutely nothing of the original substance used to prepare it. (Even if it was prepared with the purest available water, however, it will still contain trace amounts of tens of thousands of other chemical substances that pass through our bodies every day.)

I’m sure this must have been done before, but I’d be happy to take any 200C or higher “potency” remedy under controlled conditions to find out why it is a risky business as Neals Yard claims. Presumably, I should start to experience symptoms related to the remedy (under the principle of “like cures like”).

“Under controlled conditions” would mean that I wouldn’t know what remedy I was taking, but someone would have to ensure that the homeopath didn’t cheat. Perhaps this could be made more of a scientific trial by having a sufficiently large number of us, none of whom knows which is having a homeopathic remedy and which is having an inert pill or water. And the samples would be blinded before administration – in other words, the person who prepared the samples would also not know who was getting what.

Perhaps homeopaths will object to this on the ground that it would be unethical to administer a strong remedy to someone who is not sick, but I’m a willing volunteer, and will endure great danger in the cause of science…

If anyone is willing to collaborate on this, please contact me.

Added 19 June: jdc325 pointed out that there is a 2004 video of a meeting of Australian sceptics taking an overdose of homeopathic sleeping pills.  The pharmacy assistants (around 3m40s into the video) gave dumb advice which was good for a laugh.

You ask, they don’t answer: Neal’s Yard Remedies

[BPSDB]The Guardian invited online readers to ask questions of Neal’s Yard, the self-described “ethical” skin and body care products firm. You can imagine the sort of questions people would want to ask. The comments thread is funny (and not at all insulting, unless you think that questioning someone’s assertions is in itself offensive). I expect Neal’s Yard thought they were going to get questions like “What homeopathic remedy should I take for my psoriasis?”

(I originally posted that the comment thread appeared to be taken down – whether there was a problem or not, it seems to be back. My own archive is now removed.)

Added later: it’s now been reported in the thread that Neal’s Yard have now backed out of answering questions.

Neal’s Yard have corrupted the word “ethical” to mean selling quack remedies and misleading information on health. They are as ethical as an untrained plumber doing defective work for an unwitting vulnerable person. (No intentionality necessarily intended here, of course: the untrained plumber may genuinely believe he is doing his victim a favour.) But in this case, Neal’s Yard seem to be dodging the questions the same way cowboy plumbers do when confronted by TV investigators.

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.

Word: Quantum

The word ‘quantum’ appears commonly in two kinds of writing. The first is in physics, where the word simply means a very small amount of energy, or a small change in energy, such as when a molecule absorbs light and changes to a different form.

The second use occurs in all kinds of writings on ‘complementary’, ‘alternative’, ‘holistic’ or ‘integrated’ medicine (CAM), where it means nothing at all. In fact, if in a CAM poster, leaflet, website or consultation the word ‘quantum’ appears, you can be 100% certain it is bullshit. You can also be certain that either the writer does not know what she or he is talking about, or that you are being targetted to pay good money for something of little or no value. In this article, I shall attempt to explain why.

Quantum theory is the most important theory in physics. It was developed through the 20th century to bring understanding to a lot of confusing phenomena, and it has been very successful. it has been well tested in countless numbers of experiments, and it has been used to develop a vast range of technology that we enjoy in our lives today.

Sometimes, the theory is referred to as ‘quantum mechanics’, which describes quite well what the theory is about. ‘Newtonian mechanics’ is the theory that describes how large objects like balls and motor cars move in the world that we see around us, and how they interact by exchanging energy with each other. ‘Quantum mechanics’ is the corresponding theory applied to very small objects such as atoms and molecules. What was surprising to physicists in the early 20th century is that these very small objects (an atom is about .00000002 centimetres in diameter) do not behave like small versions of the objects and waves that we can see, but obey different laws. Nevertheless, those laws can be described using mathematics, just as you can do the maths for colliding and falling bodies in the big world.

So why is the word ‘quantum’ so popular with CAM merchants? I think there may be several reasons.

Firstly, ‘quantum’ sounds modern and cutting edge. (Actually, the basic theory was worked out in the 1920s.)

More importantly, ‘quantum’ sounds mysterious. This is very useful if you are trying to give a feeling of mystery as well as cutting-edge research to a load of mumbo-jumbo. Because it takes skill that must be learned in order to understand quantum theory well (especially the mathematics), it is easy to suggest falsely that no-one really understands anything about it. Also, because the laws of motion for quantum particles are different from those of our familiar objects, it suggests (again falsely) knowledge beyond our understanding.

Unfortunately, some physicists who ought to know better have contributed to this by publishing ‘popular’ works of vague speculation about life, consciousness, the universe and everything that they would not dare submit to a serious scientific journal. But these ramblings are vastly outweighed by huge numbers of scientific papers over the last century applying quantum theory to understanding real problems, in fields as diverse as basic physics, chemical structure, electronics and biochemistry.

The third and most important reason, I think, why the word is used so much in woo-woo is that ‘quantum’ sounds vague. Again, because it is not obvious that the theory can be applied in very precise ways, woo-woo practitioners use the word to suggest that physicists are talking vaguely, and therefore that it is legitimate to engage in woolly talk and meaningless verbiage. This is enhanced by taking technical terms from quantum theory that the writers do not understand and using the concepts wrongly, for example, ‘uncertainty’ or ‘indeterminacy’, and ‘entanglement’.

It is true that the quantum theory tells us that it is impossible to know some information about the motions of very small particles and that often we have to settle for statistical information at this level. However, the information obtained using quantum-theoretical effects is often highly precise. Here are a few things that have been developed from quantum theory:

Atomic clocks accurate to one thousand millionth of a second per day
– Accurately determining the structures of molecules and crystals, including the structure of the genetic material DNA which led to our modern knowledge of genetics
– Scanning the tissues of the body using Magnetic Resonance Imaging (MRI)
– The electronic materials used in your computer and all the other electronics in your home and work

The list is potentially endless.

If someone tries to sell you a CAM treatment or diagnosis method supposedly based on ‘quantum effects’, ask them to show you precisely how it works. Try to get them to give you references to the basic theory. There are many people (including myself) who visit the blogs that discuss quackery and pseudoscience, and I am sure they will try to help get these sources validated by experts. (In most cases these sources will simply not exist.)

In contrast, for a legitimate technique like MRI there is no end of explanation available to show how the use of the technique depends on the real quantum effect involved. See, for example, Wikipedia.

If you have the interest and stamina to take this a bit further, I’d like to mention a couple of other uses of quantum mumbo-jumbo that you will find in CAM websites and publications. Both are used by homeopaths and their hangers-on.

One is ‘quantum entanglement’. This is a quantum phenomenon that occurs when two particles have interacted, and it is possible at a later time, when the particles are separated, for the state of one particle still to influence the state of the other. Using this idea, weird explanations have been put forward for supposed CAM treatments, involving the practitioner, the patient and the remedy.

But remember, quantum effects apply to very small entities. There is a principle in quantum theory called the ‘correspondence principle’, that says that when you scale up to the big world, quantum effects become the same as the laws that we observe in our world. So, when these claims are made, ask the one making them to show the research that purports to extrapolate this strange behaviour from the quantum world to the big one. I am sure you won’t get it.

The other quantum bamboozlement is called ‘memory of water’. Homeopathy was invented around 200 years ago before the modern atomic theory was established. The supposed principle of homeopathic remedies is incompatible with the most elementary ideas of chemistry, so, to try to get round this, homeopaths have invented this ‘memory’ idea. There was even a whole issue of a homeopathic journal devoted to the ‘memory of water’, but the actual discussion of the ‘memory’ was a bit thin, since there is not the slightest evidence for this ‘memory’, either experimental or theoretical.

However, if the ‘memory of water’ does exist, then it must be a quantum-mechanical effect. So again, there must be plenty of theoretical research to explain it. Right? Wrong.

There is a genuine structural effect in water, called the ‘hydrogen bond’. It is weak, but it is well understood through quantum theory. It also plays a vital and fascinating role in the processes of life. There is a beautiful video here (click on the image labelled ‘F1-F0ATPase’) of one of the vital chemical reactions in the cell, the one that converts a molecule called ADP into another molecule called ATP. The video shows the small but crucial step where the ADP molecule is held in place with hydrogen bonds. (To me, learning about this sort of thing brings home the richness of science compared with the dire intellectual poverty of CAM.)

So, I hope you can see how much information quantum theory has given us about a real phenomenon that sustains us all, in every cell. And if a CAM practitioner gives you guff about ‘quantum’ effects, ask them: Where’s your theory? Where’s your evidence?

To sum up: Quantum theory gives us precise and well-tested explanations of the physical universe, and enables us to build useful and accurate technology. ‘CAM’ practitioners borrow the word ‘quantum’, with its suggestion of cutting-edge science, and use it to mystify and waffle.