Wednesday, July 28, 2010

Credo quia absurdum? More bad science: Der Spiegel denounces the homeopathy hoax

From the sublime to the ridiculous, poetry to poison.  One of those topics one just loves to hate.

I've always been fascinated (in a horrified sort of way) by the European gullibility concerning "alternative medicine."  Such products, for both good and ill, are more readily available there, and are part of the accepted training of physicians and pharmacists.  Now, I know the issue should not be caricatured; let's make that clear.  Many "traditional" medicines and practices have proven to have value.  (As I've pointed out before, quoting Steven Novella, herbal drugs are "are, after all, just pharmaceuticals in unpurified plant form.") "Many of the more "scientific" ones have drawbacks ranging from side-effects to expense.  And in the US, the combined policies of the big pharmaceutical companies and the stringent testing requirements of the Food and Drug Administration often seem to stifle innovation or slow the adoption of new products.  No argument there.  But here's the thing:  any "alternative" medicine or medical practice that can demonstrate its efficacy and safety will in principle eventually win the seal of approval.  Most "alternative" medicines in fact cannot, and their adherents don't care—and that's the distinction defining the chasm between science and bullshit.

One of the ironies of this system (as I have likewise noted) is that medicines, and food products that have not yet been proven to cause any harm (such as irradiated meat and genetically modified foods), are strictly regulated, whereas the world of alternative medicines is totally unregulated:  so-called "health food" or "whole food" stores can sell practically any concoction—some of which are useless, and others of which are downright harmful—as "supplements" provided they make no definitive claims about health benefits. It is insane. Still, it's our way of life, and there is a method to this madness: that nostrums proliferate is regrettable, but this is not a totalitarian society, and the main thing is that the boundaries of medicine are strictly enforced.  As the blogger PalMD puts it:
There is no "alternative" to medicine. There is simply that which can be shown to work, and that which cannot. The humane application of what we know is the art of medicine. The humane application of alternative medicine is quackery with a smile.
Europe is insane, and in an illogical way.  The worst quackery of all is homeopathy. It's a plague on both sides of the Atlantic, but particularly over there.  I am always amazed when I talk to otherwise highly educated people who swear by it.  People who evince a healthy skepticism or scarcely concealed scorn for "traditional religion" show no such hesitation when it comes to this unsubstantiated doctrines that likewise rests on faith alone.  We know—because we can prove—that homeopathy is a fraud. We have no way of proving religion to be true or false.  Maybe that should be a new marketing slogan: "Homeopathy: it's more dangerous than organized religion!"  Oooh: Transgressive!

I noticed the cover story on the German edition of Der Spiegel right away, but it took a while before it appeared on the English-language web site, and then I got distracted. At any rate, as the title—Alternative Medicine or Witchcraft? Europeans Cast Critical Eye on Homeopathy—suggests, it's well worth the read.  The story begins by recounting a dramatic gesture of protest:
It was the kind of humor that the British love. In several cities across the country, mostly young crowds marched into their local branches of the drug store Boots. Each purchased a small bottle of the homeopathic remedy Arsenicum album, which is used in the treatment of anxiety and food poisoning.

At 10 a.m., they all opened their bottles, full of remedy globules. One man wearing a hat shouted out that he was sacrificing himself for the sake of science. On command, the entire crowd began swallowing the globules -- not two or three of the small pills, but the entire bottles. "Mmm, delicious," some said. Others just laughed.

But nothing happened. And that was exactly what the demonstrators had hoped to prove. Not a single member of the "Overdose" Campaign documented on the website, was poisoned or injured in any way.

The campaign had been organized by a network of British homeopathy skeptics. "We wanted to show that homeopathic globules contain absolutely nothing but sugar," said co-organizer Simon Singh, a former BBC journalist and author of the book "Trick or Treatment," which has become the standard of critical books on the use of alternative medicines.
Of course, the Spiegel gets it wrong here on two counts:

1) As I have noted before in these pages, Belgian skeptics actually did this years ago (life imitates art? maybe it's like the Agatha Christie mysteries in which the British police have to learn from Hercule Poirot). We have to cut the authors some slack, though. As an entirely foreign phenomenon, humor has never been the German strong suit, so they probably just think of it as "typically" British.

2) Also, the event took place at 10:23 a.m., not 10:00. This is not a quibble, or at the least, it is relevant. actually alludes to the superscripted 10 to the 23rd power, as in Avogadro's constant (remember your high school or college chemistry?), 6.022 x 1023, referring to "the number of "elementary entities" (usually atoms or molecules) in one mole, that is (from the definition of the mole), the number of atoms in exactly 12 grams of carbon-12" of a given substance. That is crucial here.

Homeopathy, as the Spiegel goes on skillfully to explain, is based on two nutty principles: the law of similars and the principle of dilution (even the names are stupid).  The first holds:
the cause of a symptom should also be treated with the cause. When treating someone, a homeopath considers which substance would cause the same symptoms in a healthy person. Arsenicum album, for example, which the activists in the campaign tried to overdose on, should in theory cause restlessness and nausea in a healthy person. But in an ill person, it is supposed to heal exactly these symptoms.
Dumb and baseless.  Still, the second is, if possible, even stupider:
The more a medical ingredient is diluted and shaken, the stronger its effect will be -- at least that's the assumption. But most homeopathic substances are so strongly diluted that molecules of the active ingredient can no longer be traced. Homeopaths still believe in the effects because they are convinced the water has a "memory."
Scientists shake their head in disbelief, for here's where Avogadro's constant comes in, as this graphic makes shockingly clear.

In other words, they're selling you very expensive water.

That's really all you need to know. 

The estimable Bob Park has been pointing this out for years (though nowadays he has to spend a lot of his time fighting the idiotic belief that cell phones cause brain cancer).

Still, read the rest. It's well worth it. There, you will see that sales of homeopathic remedies in Germany have risen from 148 to 267.8 million Euros (an increase of 81%) since 1993, and the number of German doctors with additional homeopathic training has reached 421,686: an increase of 203 percent over the same period.

Stupidity is tragic.  Duping people out of their money is tragic. Giving them false hope and perhaps shortening their lives by duping them out of their money is criminal.  And the larger tragedy, of course, is that, even as our modern welfare states are facing an unprecedented fiscal crisis driven in part by rising health care costs, societies are squandering precious resources on these frauds.

Bottom line: If you believe in homeopathy, you believe in a doctrine that violates the fundamental laws of chemistry and physics, and that's pretty scary. Do what you want to yourself, if you must, but I sure hope you are not preparing my food or designing my car.
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