There needs to be a SCAM index, some quantitative tool, a formula for ranking the SCAMs, so one SCAM could reign supreme, to be definitely declared the the goofiest of all SCAMs. Perhaps (number of adherents)x(number of Pubmed publications)x(age of SCAM) all divided by a plausibility factor.
Homeopathy would win and any SCAM index that did not rank homeopathy at number one would have to put up a very convincing argument indeed that their formula was not somehow fundamentally flawed.1
For first time readers, homeopathy is based on several fictions, totally divorced from reality, made up in the 1800’s.
The first law,2 with less reality than Joe Abercrombie’s, is, “similia similibus curentur,” or “let like be cured by like”. Substances which cause specific symptoms can be used to cure diseases which cause the same symptoms. If like cures like, I am uncertain what moonlight, one of many fanciful homeopathic nostrums, would cure. Lycanthropy?
Say you have a headache. What causes a headache? Being smacked on the head by a hammer. So in homeopathic thinking, being hit on the head with a hammer would cure your headache.
But you would not want to give known poisons like arsenic or belladonna to people in attempt for like to cure like, unless one would classify death as cure. Even the otherwise chemistry-challenged homeopaths know that would be a bad idea.
So there is the second law, that of infinitesimal dilutions, where the substances are sequentially diluted in either water or alcohol, and the potency increases with each dilution. And dilute it they do.
Take the hammer for the migraine. Take 100th of it. Thump the remainder against a Bible to activate it, the succussion of homeopathy. Then take 100th of that. Thump it against a Bible. Then 100th of that. Thump it against a Bible. And so on. Do that 6, or 15, or 30 or even 200 times. When finished you will have the an extremely small, perhaps nonexistent, but potentized hammer with power exceeding Mjölnir. Use that to hit the skull to relieve the headache.
It doesn’t get goofier than that. Homeopathy is one of those topics which demonstrates that I am not a true skeptic. A true skeptic would say that homeopathy is highly implausible. I tend to say it is wackaloon impossible on basic principles. Zero plausibility would make homeopathy infinite on the SCAM index.
Homeopathy and adverse effects
Given that homeopathy is nothing that does nothing, not only would I expect any homeopathic preparation to have no efficacy but also no toxicity. With the caveat that it is the dose that makes the poison. Any product with less than 12 serial dilutions could have an active ingredient, so depending on what was being diluted a homeopathic nostrum could have effects, both good and bad.
I spend most of professional life in the hospital taking care of very ill people with multiple diseases and interventions. Trying to decide what is an adverse event is not always as straight forward as one would like. It is easier if the intervention is physical: a dropped lung from an acupuncture needle or a stroke after a chiropractic neck whack.
Determining what is an adverse reaction from medications is more difficult. Is it an allergic reaction? A toxic reaction? A drug-drug interaction? An unexpected complication of the medication altering the patient’s physiology in known or unknown ways? Adverse reactions have different mechanisms and it is often not clear-cut what is causing the reaction. If you stop the medication and the adverse reaction fades, it is nice but not diagnostic. It would be optimal to rechallange the patient to prove the adverse effect, but given the potential morbidity it is very rarely done.
Imagine my surprise when I stumbled across “Adverse effects of homeopathy: a systematic review of published case reports and case series.” My first thought was – no way! Nothing can’t cause an adverse reaction and I would be skeptical that a homeopath would recognize, much less report, an adverse reaction.
The article was one of the usual complete evaluations by E. Ernst and colleagues. As always he scoured the published literature, finding the most obscure of articles pertaining to the topic at hand, and summarized them nicely.
The abstract flabbered my gaster:
In total, 38 primary reports met our inclusion criteria. Of those, 30 pertained to direct AEs of homeopathic remedies; and eight were related to AEs caused by the substitution of conventional medicine with homeopathy. The total number of patients who experienced AEs of homeopathy amounted to 1159. Overall, AEs ranged from mild-to-severe and included four fatalities. The most common AEs were allergic reactions and intoxications. Rhus toxidendron was the most frequently implicated homeopathic remedy.
Four fatalities from giving nothing? It turns out that most of the adverse reactions were intoxications or allergic reactions and were not from giving nothing after all:
In 94.7% of cases, the potencies were described as below 12 C, the point beyond which the likelihood of a single molecule being present in the remedy approaches zero. It is plausible that low dilutions of homeopathic preparations cause direct AEs, particularly allergic reactions.
People were being given cesium, bromide, petroleum, mercury (at higher doses found in vaccines) and arsenic and getting toxicities. Patients were being poisoned.
Allergic reactions were most common to Rhus toxicodendron given at dilutions where there was a measurable level of the plant. But what is Rhus toxicodendron? Poison ivy. Really? People taking poison ivy and getting an allergic reaction as a result? Who da thunk it?
I wonder if the patients were told they were being given poison ivy, or just given the Latin name. Latin can obscure so well. Who would take duck heart and liver for influenza? Not me. But Anas Barbariae Hepatis et Cordis Extractum sounds like it could be legit. Latin is the Confundus Charm of homeopathy.
I have to admit when I think of homeopathy I think of water and sugar pills. I do not think of homeopaths as giving measurable amounts of chemicals and poison ivy to people.
But that gets to one of the issues with many SCAMs: poorly educated practitioners providing useless therapies for processes that do not exist when there are real diseases and toxicities they do not understand. I am surprised they found so few adverse reactions, although I suspect it is less an issue of under-reporting and more likely that most homeopaths would not recognize an adverse event.
The authors do indulge in a little classic understated humor:
Evidence of indirect AEs highlight the need for all homeopaths to be adequately trained such that harm of this nature can be avoided in future.
The preference of homeopathy over conventional medicine when dealing with serious, life-threatening conditions may cause serious harm, and this issue relates to the question of practitioner training…Again, we would therefore stress the need for making sure all homeopaths are medically competent.
Then they would be, I don’t know, doctors? If homeopaths were adequately trained they would not be homeopaths, n’est pas? Can’t make a silk purse out of a sows ear.
35 years ago I graduated University of Oregon (Go Ducks) with a degree in physics. There was a time when I really understood modern physics (quantum mechanics and relativity), at least as it was 35 years ago and at the level of the undergraduate. I do not pretend to be a physicist, or even to play one television, although I like to read on the topics to maintain a general understanding. I may not be able to do the math anymore, but I remember the concepts and their limitations.
It is why I grimace whenever I see a SCAM article that attempts to explain its nonexistent efficacy in terms of quantum mechanics. The homeopaths seem to have a special affinity for this approach, starting with LR Milgrom, whose articles are gibberish to me. Yes, I know. If only I were a box of flashing lights I would be able to comprehend the deeper understanding of quantum homeopathy more fully.
Now there is more quantum understanding of homeopathy, A quantum-like model of homeopathy clinical trials: importance of in situ randomization and unblinding. Sorry. It was gibberish to me, and disappointing gibberish as well. The author states:
In order to make the notions of quantum physics more easily understandable, I will draw a formal comparison between homeopathy trials and single-particle interference in quantum physics.
And here I was so hoping they were going fire a series of homeopaths at a double slit to get the smearing effect of an interference pattern. No such luck. So disappointing. Somehow, and I am not certain how, the double slit is similar to homeopathic efficacy trials and their failure to demonstrate efficacy in randomized clinical trials (RCT):
I draw an analogy between the one-particle interference experiment and homeopathic trials, which appear to have comparable mathematical structures. Indeed, according to the context of the clinical trial (both observables e labels and pair concordance e measured by patient/practitioner vs. ‘external’ measure of labels), either only concordant pairs (CP) (equivalent to detection in D1) or both CP/ discordant pairs (DP) (i.e., equivalent to random detection by D1 and D2) are obtained (Figure 1 and Table 1). This suggested that a quantum (or more precisely quantum- like) model could be built to describe homeopathy trials, including the ‘paradoxical’ failure of homeopathy blind RCT.
And here I thought the failure of homeopathy to be effective in RCT’s was not paradoxical but was due to the fact homeopathy is based on fantasy and that its minimal (homeopathic?) effects were entirely due to bias. Homeopathy is the archetypal alternative medical beer goggles; it doesn’t alter the reality of disease, just the perception of it.
Our quantum-like model suggests that the correlations between positive outcomes and homeopathy treatment observed in open-label conditions vanish in conditions comparable to blind RCT.
Ioannidis got it wrong. The reason well-done studies show homeopathy does nothing is not because they minimize the confounding factors of
… study power and bias, the number of other studies on the same question, and, importantly, the ratio of true to no relationships among the relationships probed in each scientific field. In this framework, a research finding is less likely to be true when the studies conducted in a field are smaller; when effect sizes are smaller; when there is a greater number and lesser preselection of tested relationships; where there is greater flexibility in designs, definitions, outcomes, and analytical modes; when there is greater financial and other interest and prejudice; and when more teams are involved in a scientific field in chase of statistical significance.
Homeopathy failure in RCT’s is the result of quantum mechanics, not bias in poorly done studies on a fantastical intervention. The cat isn’t dead after all.
I thought it would be fun to finish this entry by explaining, as a joke, that the mechanism of homeopathy is not in quantum mechanics but is the result of dark energy and dark matter. Someone beat me to it, although not as humor:
What is required is just to understand Homeopathy medicines (alcohol) actually extracts this Dark Energy from substances when prepared and thus it’s energy that is in them and not any electrostatic potential, memory, magnetic field etc in them those have been proposed earlier and even then have not given any plausible explanation to Homeopathy. More so it must be clear from now onwards it is Energy in Homeopathic medicines than anything else.
Maybe that is why beer makes me feel good. Nothing like getting your Dark Energy extracted.
As I learned the day before this post went up, homeopathy is not quantum in its mechanism, but magnetism.
Or maybe it is dark quantum magnetism. Three for the price of one. Yeah, that’s the ticket.
- Get to work guys and gals. Time’s a wasting.
- Law here is like a legal law, like “any written or positive rule or collection of rules prescribed under the authority.” Essentially made up. Not like a law in physics, proven by experiment.