Mercola sells the delusion of homeopathy

It’s a really tough competition, but if I had to choose the most ridiculous form of quackery out there, I’d have to choose homeopathy. Although it’s common for so-called “alternative” medicines to be so utterly implausible from a scientific standpoint that it is not unreasonable, barring very compelling positive evidence, to provisionally reject them as impossible, homeopathy goes one further than most forms of alt-med. In fact, it goes many further than nearly any form of alt-med. First, it combines the principle of “like cures like,” a principle based far more on ancient concepts of sympathetic magic than on any science, with the concept of “proving,” in which whatever a bunch of healthy people who imbibe a homeopathic remedy feel and visualize tells what the remedy supposedly does and then write it down for the homeopath to supposedly figure out for what this new remedy is good for. This was taken to a hilarious extreme by one homeopath who did a “proving” of homeopathic plutonium.

But even that’s not enough.

Homeopaths then claim that they make their remedies more potent through a combination of serial dilutions sufficient to guarantee that most homeopathic remedies are highly unlikely to contain a single molecule of the active substance, between each of which the remedy must be “succussed,” or vigorously shaken. Whenever it is pointed out that diluting a substance doesn’t make it stronger and that there is no biochemical or physiological mechanism to make a remedy stronger as it is diluted into nonexistence, homeopaths will condescendingly and piously tell you that it is the succussation that imbues the magical homeopathic remedy with its curative powers. Of course, even if that were true (which it’s not), there’s no biochemical or physiological mechanism to make a remedy even work if there is not a single molecule left. Not to be deterred, homeopaths postulate that water has a “memory” of the substance it has been in contact with and that that memory can somehow be transmitted through the remedy for a curative effect. Of course, no homeopath has ever been able to explain to me why vigorously succussed water like Niagra Falls doesn’t retain a memory of every little bit of poo that it’s ever been in contact with, thus rendering it hopelessly contaminated.

The reason I bring this up is because, just by what its adherents say alone, it’s clear that homeopathy is The One Quackery To Rule Them All, The One Quackery To Find Them, The One Quackery To Bring Them All And In The Darkness Bind Them. In the Land of Mordor where the shadows lie.

Sorry about that. I do so love J.R.R. Tolkien’s The Lord of the Rings.

In any case, in my book, any practitioner who takes believes that homeopathy is anything more than water and that any effects observed due to it are anything more than placebo has wandered so far from the realm of science-based medicine that it’s hard to imagine a way to bring them back–which brings us to Joe Mercola. Dr. Mercola maintains one of the largest repositories of woo on the web at Mercola.com. If there’s any doubt that, his attempts to look like a reasonable guy notwithstanding, that Mercola promotes quackery should be dispelled by an article that appeared on his website by Amy L. Lansky, PhD, entitled Could This ‘Forbidden Medicine’ Eliminate the Need for Drugs? The brief answer is no. The longer answer follows.

Lansky starts by whining that skeptics are so very, very mean to her favorite woo:

Perhaps the most derided of alternative medicines is my own favorite – homeopathy. Over the past few years, detractors have focused their efforts in the United Kingdom and have succeeded in crippling homeopathic hospitals and clinics funded by the National Health Service, as well as the practices of many homeopaths.

A few well-placed editorials in prominent newspapers have done the trick, despite the fact that Prince Charles and the rest of the royal family are ardent supporters of homeopathy.

Well whoop-de-doo! that’s one of the most pathetic appeals to authority I’ve ever heard. Prince Charles is a moron when it comes to medicine, and he’s supported all manner of quackery over the course of his life, including homeopathy. It never occurs to Lansky that the reason that homeopathy is “derided” might be due to some very good reasons, namely that it’s one of the most outrageously ridiculous forms of pseudoscience that there is.

What really appears to get Lansky’s goat is this, however:

It now seems that some of these folks are taking their show on the road. Two key UK players, Michael Baum and Edzard Ernst have published a commentary in the November 2009 issue of the American Journal of Medicine [1] in which they state, “a belief in homeopathy exceeds the tolerance of an open mind. We should start from the premise that homeopathy cannot work and that positive evidence reflects publication bias or design flaws until proved otherwise.”

Not surprisingly, their commentary also reflects a complete ignorance of homeopathy and the range of studies that support its effectiveness. For example, their article incorrectly uses the term “potentation” instead of “potentization” for the method used to create homeopathic remedies (more on this later). The authors also insist on citing a single negative meta-analysis study that has already been shown to be methodologically flawed [2], while ignoring many positive studies in respected publications, including two other meta-analyses that showed positive results [3–8].

Actually, I think that Ernst and Baum make some excellent points in their editorial. I’ve said it many times. It’s good to be open-minded, but not so open-minded that your brains fall out. To accept homeopathy, your mind would have to be so open that your brains not only oozes out of your skull, but reconstitutes itself and runs away screaming at the assault on its neurons by the sheer stupidity of the concepts of homeopathy, leaving nothing but the brainstem to keep the body still breathing and to maintain autonomic function. Or, as Baum and Ernst put it, “Should we keep an open mind about astrology, perpetual motion, alchemy, alien abduction, and sightings of Elvis Presley? No, and we are happy to confess that our minds have closed down on homeopathy in the same way.”

I also happen to know what meta-analysis to which Lansky is referring. Shang et al has been a thorn in the side of homeopaths, who are still whining about it nearly five years later. Indeed, that evidence- and science-challenged homeopath, Dana Ullman, has shown up on this blog multiple times trying to blast this study on multiple occasions. Basically, Shang et al showed that the larger and higher the quality of study of homeopathy, the more likely the study was to show that the effects of homeopathy are not distinguishable from that of a placebo. It’s not a perfect study, but it’s basically solid and is entirely consistent with the effects of homeopathy being consistent with placebo effects. This result is very much like what is found for acupuncture, where better blinding, larger studies, and more vigorous trial design lead to results in which acupuncture is indistinguishable from sham, or placebo, acupuncture. Moreover, Ernst and Baum didn’t just cite one meta-analysis or systemic review of homeopathy; they cited three such reviews, among them one written by Ernst himself.

Lansky then goes on to repeat some of the hoary old “explanations” for how homeopathy works. True, she doesn’t go as hilariously far into the woo of homeopathy as, for example, Lionel Milgrom, Charlene Werner, or John Benneth. In fact, she just regurgitates praise for Samuel Hahnemann, the founder of Homeopathy, following up with the Law of Similars (sympathetic magic again), and fallacious examples, such as Ritalin, which does not support the principles of homeopathy any more than the analogy to vaccines of which homeopaths are so fond does. Ritalin works through a biochemical mechanism that we can understand. No appeal to magic or “memory of water” is needed. She then cites “studies” by cranks like Rustum Roy, who published one of the most incompetent scientific studies ever in support of homeopathy, with the ethanol used in the study being clearly and obviously contaminated on the basis of its UV spectrum alone, and Jacques Benveniste, whose studies were similarly flawed and had been revealed to be nonsense by James Randi himself, who with the other two observers who examined Benveniste’s work, published an editorial in Nature about the affair.

What made me laugh the most when I read this article, though, was Lansky’s claim that big pharma is afraid of homeopathy. Actually, it was the reason that big pharma is allegedly afraid of homeopathy that made me laugh:

What if an expensive drug could be potentized to create billions of effective doses at essentially no cost? It would destroy big pharma entirely. Medicines that cost essentially nothing? Nontoxic ultradiluted medicines that cause fewer side effects? How could the coffers of big pharma be sustained? Forget about the Law of Similars. It’s potentization – the process of creating effective ultradilutions – that big pharma is scared of! No wonder Baum and Ernst got the word “potentization” wrong. This one word is the small stone that could take Goliath down.

Yup! As I pointed out early on, homeopaths always point to the succussion and potentization of their remedies as being absolutely essential for their magical woo to work. She then goes on to proclaim benefits of homeopathy for poor countries. I’ve written about this before, for instance when homeopaths have done some questionable things while studying homeopathic remedies in Nicaragua or claimed to be able to treat AIDS in Africa, as well as other infectious diseases. If anything, homeopathy doesn’t benefit poor nations. It treats the poor with quackery and allows homeopaths from rich, white nations to exploit residents of poor, darker-skinned nations.

Clearly, Lansky is a true believer. Indeed, she has even written a book called Impossible Cure: The Promise of Homeopaths. Apparently this is a big deal among homeopaths. The book is a commonly used textbook to teach homeopathy in homeopathic schools and has been translated into several languages. She’s also into many other forms of woo, including chiropractic, network chiropractic, tai chi, qi gong, hands-on healing (e.g. Reiki), acupuncture. Truly, this is crank magnetism in action.

It’s also interesting how she “discovered” homeopathy:

Back in the early 1990s, my husband Steve Rubin and I were both computer researchers in Silicon Valley and followed our doctors’ instructions obediently, loading our kids up with every recommended vaccine on schedule. Our allopathic trance began to break in 1994 when our 3-year-old son Max began to show signs of autism.

I first read about homeopathy in the January 1995 issue of Mothering Magazine, which contained an article about the successful homeopathic treatment of ADD and other children’s behavioral problems [16]. Steve and I decided to give it a try and found a practitioner in our area. Within a week we began to see small and subtle improvement in Max – improvement that became a slow and steady trend. After two years of treatment, he was testing normally and was released from eligibility for special education benefits.

Of course. It’s autism. It always seems to come back to autism. The condition attracts more woo, from anti-vaccine nonsense to biomedical quackery, than just about any condition I can think of. Once more, we need to remember that autism is a condition of developmental delay, not developmental stasis, and that as many as 19% of children can lose their diagnosis by age 7. Given that homeopathy is water, it’s almost a sure thing that Lansky’s son was one of those children.

Lansky complains ad nauseam about us mean and nasty skeptics who, according to her, are “out to get” homeopathy because it supposedly poses a threat to “allopathic medicine.” While it’s true that we are very skeptical of homeopathy, the reasons are purely based on science, namely the lack of science behind homepathy and the lack of scientific evidence that it works. In addition, homepathy is about as pure a pseudoscience as there is. For it to be true, huge swaths of well-established physics, chemistry, and biochemistry would have to be wrong–not just wrong, but grossly wrong. I’d even be willing to believe that’s a possibility if anyone could produce very clear and compelling evidence that (1) homepathic remedies are distinguishable from the water used to dilute them and (Rustum Roy’s studies don’t count, given how crappy they are) and (2) they produce an effect that is easily distinguishable from a placebo. Time and time again, studies have failed to find such an effect. Lansky can cherry pick all the studies she wants, but the weight of the evidence comes to a clear result: Homeopathic effects are placebo effects.

200 years ago, homeopathy was not as ridiculously unreasonable as it is today. Back then, the germ theory of disease had not been postulated, and the dominant ideas regarding disease involved imbalances of the four humors. Back then, it was also not uncommon for “allopathic medicine” to involve bleeding, purging using toxic metals like antimony, and a variety of other nasty, toxic interventions. Homeopathy appeared to do better because doing nothing was actually better than the “allopathic medicine” of the time. Unfortunately for homeopaths like Lansky, in the 200 years since Samuel Hahnemann postulated his Law of Similars, medicine advanced, thanks to science. it now has highly effective therapies for a wide variety of diseases. Homeopathy, on the other hand, remains stuck in the 19th century clinging to a prescientific concept of how the human body works and how disease develops. Oliver Wendell Holmes was right to refer to homeopathy as a delusion back in 1842. Sadly, the delusion lives on nearly 160 years later, and Joe Mercola is trying his best to spread it.