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.

‘How can you deny my experience?’

[BPSDB] A few months ago someone commenting on a blog post (I think it was on Gimpy’s blog) described how some of his family were allegedly cured of illness by homeopathy, and asked ‘How can people deny my experience of this’?

I did not have time to reply on that occasion, but I thought that the question deserved a serious reply, and I considered how I would have replied to it.

To deny or belittle someone’s experience is a serious matter, especially when that experience has been a tragic one (which fortunately it hadn’t been in this case). For example, people who have pointed out the strong evidence that autism cannot have been caused by the MMR vaccine have found themselves accused of being sceptical or uncaring about the experience of the autistic children or their parents, even though that is clearly not the case.

So, if I respond to the homeopathy questioner, ‘no, I don’t think your family were cured by homeopathy’, am I denying his experience? The answer is ‘no’, but the reason is not an obvious one.

I would not deny the experience that the members of his family had the experience of being ill and getting better. As I do not know him personally, I cannot be in any position to deny or affirm it, but I tend to assume that people are telling the truth unless I have evidence otherwise, or unless the stakes are very high. In the interest of discussion, I accept that he had that experience.

Similarly I would not deny that the questioner’s family members had homeopathic treatment for their illness. Again, this is something I am happy to take his word on.

But that is not all there is to the claimed ‘experience’. There is an additional claim that they got better because of their homeopathic treatment. This is not an experience. It is an explanation. Even if the family members were made better by the homeopathic treatment, this explanation cannot be experienced directly.

An explanation is a story we create describing the supposed causes of events or phenomena. An explanation may be true or false, and we may sometimes be able to use our experience directly to confirm an explanation, for example, if we see someone knocked down by a car or shot with a bullet, we may be able to say that the cause of death was the accident or the shooting, and ignore the fact that the dead person had (say) serious heart disease or a brain tumour. But causes are rarely that obvious, which is why in cases of death we expect a doctor to certify the cause of death, with in some cases the need for an autopsy or an inquest.

In science, explanations are called theories. (I am simplifying here, but a scientific theory is basically an explanation for a whole lot of observations). The reason why science exists is that explanations are not obvious, and the most seemingly obvious explanation is often the wrong one. Scientists have to consider all the possible explanations for the phenomena they are studying, and try to weed out the wrong ones by looking for the evidence that contradicts them and shows that those explanations are wrong.

We are often led to the wrong explanations by the fact that we do not have all the evidence. We tend to jump to the conclusion that most pleases us and fits the evidence that we have (or that we are prepared to consider, because very often people ignore evidence that does not fit their preferred explanation).

As an example, watch the TV programme The System by Derren Brown if you get the chance. In this programme, Derren supplies a young woman with correct forecasts on the outcome of a series of races. By the fifth race, she has overcome her scepticism and is willing to believe that Derren has a ‘system’ that enables him to predict the results correctly, and she borrows a lot of money to place on Derren’s prediction for the sixth race…

What she doesn’t know (and apparently does not consider as a possibility) is that she is part of an elaborate version of a scam that is commonly used by share tipsters.The true explanation is simply that the programme team has sent out different predictions to a large number of people, and she just happens, by chance, to be the one who received all the correct predictions for the first five races. There is really no reason to suppose she has better odds than pure chance of winning on that sixth race. The evidence was not available to her (or she did not consider it) to determine the real reason for her winning streak.

Of course, there is a lot more to the programme than that, and Derren is too much of a showman to give all his secrets away. We know in all his programmes that he is keeping information from us. We understand that stage magicians do not really do ‘magic’ (the apparent explanation for what they do) but that if we had more information we would know the real explanation for the tricks that amaze and amuse us.

And yet… so many of us fall for the same ‘trick’ when it is done by nature rather than a magician. We jump to an explanation that does not take account of the knowledge  we do not have (or that we ignore). The questioner in the blog was in the same position as Derren’s ‘victim’ in the programme. She assumed that there was a ‘system’, even though she did not know the full facts and more knowledge tells us that this could not be the case. The homeopathy questioner assumed the ‘most obvious’ explanation, that the homeopathic remedies were responsible for the getting better. But that is not ‘experience’. There are other possible explanations, that the questioner’s experience cannot rule out. Most of these are impossible to discuss without knowing the details of the cases. But the  most obvious explanation is that the patients would have got better anyway without assistance. This is the explanation that homeopathy ignores, but science cannot. It is why science advances all the time, while homeopathy is stuck in a time-warp of ignorance.

To summarise: I do not deny the questioner’s experience that the patients got better, and that they took homeopathic remedies. But that the homeopathic remedies caused the improvement is not part of his experience. It is an explanation. The difference between science and homeopathy is that science is obliged to question this explanation and test it against evidence. Homeopathy does not do this.