Even more quackery at–where else?–The Huffington Post

Khhaaaaaannnn!

I mean, Arriiiaaaaannaaa!

Ever since its very inception, I’ve been–shall we say?–less than enthusiastic about the Huffington Post’s medical blogging. Indeed, the level of anti-vaccine rhetoric there from the very beginning, back in 2005, astounded me. If anything, HuffPo’s record has gotten even worse over the last four years, be it Deepak Chopra, or, in 2009, the addition of a variety of quacks to its roster, not to mention a brain-blisteringly stupid anti-vaccine rant by Fire Marshal Bill–I mean Jim Carrey–the promotion of “functional medicine” quackery by Mark Hyman, “detox” woo, or several different varieties of swine flu quackery. (Speaking of swine flu quackery, there’s been some more at HuffPo just the other day. Fortunately, PalMD’s on the case.) Heck, there’s even at least one post advocating “distant healing.”

In any case, it seems to me that the quackery quotient of HuffPo has been escalating ever since Patricia Fitzgerald, acupuncturist and homeopath, was hired as HuffPo’s “Wellness Editor.” The trend has continued since Dr. Dean Ornish was hired to become HuffPo’s medical editor. A more embarrassing title I’m hard pressed to come up with. HuffPo’s “medical editor”? Is that like being the biologist in charge of Ken Ham’s “Creation Museum“? Be that as it may what is the one thing that would nail down HuffPo’s title as the “mainstream” blog with the highest quackery quotient of all? Let’s see. Anti-vaccinationists? Check. Deepak Chopra. Check. Distant healing. Check. Beck protocol? Check. What else? Well, there’s been a little dabbling in discussing homeopathy (or, as I like to call it, The One Quackery to Rule Them All), but not that much, other than in passing. What HuffPo needed, apparently, to complete its transition into Whale.to was a real, honest-to-God homeopath, not someone like Fitzgerald, who’s a multifunctional woo-meister and apparently only dabbles in homeopathy.

HuffPo needed Dana Ullman. And HuffPo got Dana Ullman!

Dana Ullman, M.P.H. is widely recognized as the foremost spokesperson for homeopathic medicine in the U.S. He has authored nine books, including his newest book, The Homeopathic Revolution: Why Famous People and Cultural Heroes Choose Homeopathy (North Atlantic Books/Random House, 2007), which includes a Foreword by the Physician to Her Majesty Queen Elizabeth II. He has also written Homeopathic Medicines for Children and Infants (Jeremy Tarcher/Putnam, 1992) and the best-selling Everybody’s Guide to Homeopathic Medicines (Jeremy Tarcher/Putnam, revised 2004) that is America’s most popular guidebook to using homeopathic medicines at home.

Dana Ullman has written extensively on homeopathic research in an ebook entitled Homeopathic Family Medicine: Evidence Based Nanopharmacology, which describes and references 200+ clinical trials testing homeopathic medicines. Dana’s resource center, Homeopathic Educational Services (www.homeopathic.com) is a leading source for homeopathic books, medicines, home medicine kits, software, and courses.

Oh, goody. As Kimball Atwood so cleverly put it:

In any discussion involving science or medicine, being Dana Ullman loses you the argument immediately…and gets you laughed out of the room.

My corollary is: “For any blog that discusses, or has a section discussing, science and medicine, having Dana Ullman as one of your bloggers loses you any medical argument immediately–and gets you laughed off the blogosphere.”

Dana demonstrates the soundness of this corollary immediately for HuffPo with his inaugural post, The Wisdom of Symptoms: Respecting the Body’s Intelligence.

The stupid, it burns. Homeopathically. Oh, wait. Wouldn’t that mean that it doesn’t burn, or that the less you put into it the hotter it burns. Or perhaps it means that there is only a homeopathic amount of science and reason in Ullman’s post, you know, diluted so much that there is not even a trace left, leaving only stupidity behind. Yeah, that’s the ticket. He delves right into the homeopathic intelligence right from the first sentence:

Have you ever wondered what is that stuff coming out of your nose when you have a common cold? Such nasal discharges are composed of dead viruses that were killed by the body’s defenses, dead white blood cells that were killed as a result of the infection, and a liquid substance known as mucus which the body deploys as a vehicle to remove this dead matter.

If you take a conventional over-the-counter drug for the common cold, these drugs “work” by reducing the body’s ability to create mucus, which simply inhibits the body’s own efforts to eliminate the dead viruses from the body. Although these conventional drugs may stop the nasal discharge temporarily, the side effects of these drugs are that they lead to bronchial congestion, headache, and fatigue, which can be more problematic and discomforting symptoms than the original simple nasal discharge.

The lesson here is that just because a drug is effective in getting rid of a symptom does not necessarily mean that this treatment is truly curative (or even helpful).

Wow! Such brilliance! I never would have thought of that! Imagine! The body has defense mechanisms! Who’da thunk it? Apparently Dana is amazed, and he leaps to this conclusion:

The basic assumption behind the broad field of natural medicine is that the human body has an inherent wisdom within it that strives to defend itself and to survive. Symptoms of illness are not simply something “wrong” with the person, but instead, symptoms are actually responses and efforts of the organism to defend and heal itself against infection and/or stress. Hans Selye, MD, PhD, the father of stress theory, once asserted, “Disease is not mere surrender to attack but also the fight for health; unless there is a fight, there is no disease.”

Our human body has survived these thousands of years because of its incredible adaptive capabilities, and one of the ways that it adapts is through the creation of symptoms. Whether it be through fever and inflammation, cough and expectoration, nausea and vomiting, fainting and comatose states, and even the variety of emotional and mental states, each symptom represents the best efforts of the bodymind to fight infection and/or adapt to physical and psychological stresses.

The “bodymind”? What is this, some new form of woo-speak, a new term for “mind-body medicine”? Who knows? Personally, I don’t care. The two paragraphs above show exactly how a “little knowledge is a dangerous thing.” Nowhere is that more true than in the “bodymind” of someone like Dana Ullman. Sure, many of the symptoms we try to treat are indeed reactions of the body designed to fight off whatever disease or disorder is trying to attack it. But that doesn’t mean that the “bodymind” (or even just the body) is inherently “wise” and that its reactions always result in better survival. Symptoms may mean different things in different contexts. They indicated different physiology. Moreover, not every symptom resulting from the body’s physiologic response to disease or injury is always beneficial. All too often, the body’s defenses go a bit haywire or even end up being the cause of more damage than the pathogen or injury.

Take inflammation as a good example of the body’s “fight for health.” It’s a critical physiological mechanism, a manifestation of our immune system’s function if you will, for healing wounds, fighting off infection, and getting rid of irritants (as in all that mucus that Bill Maher is so fond of talking about). However, the inflammatory response, as useful as it is, is not always in the best interest of the body’s survival. Indeed, consider the body’s response to sepsis. The systemic inflammatory response that is sepsis is, all too often, what kills the patient more than the infection itself. Blood pressure plummets, the heart pumps beyond its capacity, the microcirculation is dysfunctional. All of this can lead to what we used to call multi-system organ failure, what is now often referred to as multiple organ dysfunction syndrome (MODS). As one author has described it:

Sepsis is described as an autodestructive process that permits extension of the normal pathophysiologic response to infection to involve otherwise normal tissues and results in MODS…

Organ dysfunction or organ failure may be the first clinical sign of sepsis, and no organ system is immune from the consequences of the inflammatory excesses of sepsis.

Note the word autodestructive.

But, no doubt Ullman would say, it’s all because of those pathogenic bacteria! Well, yes, indeed it is. But if the body is so “wise,” why does it overreact so to such infection? If the body is so wise, why can’t it prevent a localized infection from affecting the entire circulation and causing multiple organs to start to shut down? If the body is so wise, why can such a septic-like picture occur in patients who have been badly injured but do not have any evidence of a serious infection?

What?

That’s right. There’s a syndrome known as systemic inflammatory response syndrome (SIRS). This inflammatory syndrome can occur after traumatic injury, surgery, pancreatitis, hemorrhage, or all other manner of insults. The key feature of SIRS is that it looks for all the world like septic shock, except that no infection can be found. If the body’s so “wise,” if initial symptoms like fever, lightheadedness, and a racing heart are so “wise,” how on earth could such a syndrome result in the failure of multiple organs and a 40-50% death rate (at least)?

The problem is, as PalMD put it, symptoms are neither inherently good nor bad. They just are. The same symptoms can also signal different things. A good example is chest pain, which can be due to muscle strain, gastroesophageal reflux, esophageal cancer, pericarditis, or ischemia to the heart muscle due to coronary artery disease, which, if left untreated, can result in a myocardial infarction and even death. And that’s only a partial list. The diagnostic possibilities for abdominal pain can range from benign, self-limited conditions to pancreatic cancer. There are literally dozens of possible diagnoses. Heck, if we even limit the abdominal pain to right lower quadrant pain, certainly appendicitis is often a diagnosis, but it can also be several other things, such as Crohn’s disease. In a female, add to that all the possible problems in the female reproductive organs that can cause lower abdominal pain, from a ruptured ovarian cyst, to pelvic inflammatory disease, to ectopic pregnancy, and many others. It takes skills and knowledge to differentiate between them.

Of course, Ullman is completely clueless regarding even these simple facts. Instead, he says:

The implications of recognizing that symptoms are efforts of the body to defend itself are significant. Because some conventional drugs work by suppressing symptoms, these drugs tend to provide helpful temporarily relief but tend to lead other new and more serious problems by inhibiting the body’s defense and immune processes. Such drugs should be avoided except in dire situations or in extreme pain or discomfort when safer treatments are not working fast or adequately enough.

Because symptoms are adaptations of the body in its efforts to defend and heal itself, it makes sense to use treatments that mimic this wisdom of the body. Ultimately, homeopathic medicine is a well-known therapeutic modality that honors this wisdom of the body. Homeopathy is a type of “medical biomimicry” that uses various plant, mineral, and animal substances based upon their ability to cause in overdose the similar symptoms that the sick person is experiencing.

Here we go again with the claim that conventional drugs “work by suppressing symptoms.” If he honestly believes that, I’ll give him one point. Homeopathic remedies certainly don’t relieve anything, other than perhaps symptoms relievable by the placebo effect. So, right off the bat, Ullman is making a contrast that is correct in one small way, just not in the way he thinks it is. He’s contrasting actual, effective medicine that can relieve symptoms to the make-believe, fairy dust medicine that is homeopathy, that can’t relieve or fix anything.

It is pretty hilarious, though to see Ullman calling homeopathy “medical biomimickry.” For anyone to come to that conclusion requires that that person accept the homeopathic principle of “like cures like,” a principle for which there really is no good evidence. At least, there’s no evidence that there is any sort of general principle that “like cures like.” More importantly, homeopathy is ridiculous at its very core in postulating that taking this “like” to heal “like,” serially diluting it far beyond Avogadro’s number, with magical shaking at each dilution step that somehow imbues this remedy with its mystical magical power to heal. It’s nothing more than sympathetic magic. As I’ve said before, homeopathy combines the magical Law of Similarity with the magical Law of Contagion, given that it postulates that water somehow remains influenced by substances that it’s been in contact with even after that substance has been diluted away to not a single molecule. It just reverses the concept from “like produces like” (the Law of Similars”) to “like heals like” (or “like reverses like”).

That doesn’t stop Ullman from making an equally clueless analogy:

It may be no coincidence that two of the very few conventional medical treatments that augment the body’s own immune system are immunizations and allergy treatments, and these drug treatment modalities “coincidentally” derive from the homeopathic principle of similar (treating “like with like”).

Ugh. This has to be one of the oldest canards about homeopathy there is. The reason, of course, is that vaccinations actually have some active substance in them. Actually, the amount of active substance in vaccinations is enormous compared to the amount of substance in a typical homeopathic remedy. A vaccine contains billions of viruses or protein molecules used as antigens; a homeopathic remedy is nothing other than water. Vaccines do not require serial dilutions to work. In fact, they tend to work better if there is more antigen, not less. The same is true of treating allergies. This involves treating a patient with a gradually increasing amount of the allergen that provokes the patient’s allergic response in order to desensitize the patient. If there were any resemblance to homeopathy at all, it would probably involve treating a patient with gradually increasing dilutions of the same substance, given that one of the principles of homeopathy is that its remedies are “potentized,” or made stronger, with dilution. For both vaccines and allergy treatments, no appeal to the “memory of water” is required.

Unfortunately for rational readers but fortunately for me, Ullman states near the end of his post:

Note: A future blog will feature descriptions of and references to clinical and basic sciences research that verify the efficacy and biological activity of homeopathic medicines.

Oh, well. This may mean the burning stupid will continue to pour forth from HuffPo, but at least I’ll never lack for blogging material, particularly when I’m in a particularly foul mood.