A “disinformation campaign” against homeopathy?

Oh goody.

Goody, goody, goody, goody, goody.

As I sat down to lay down a bit of the old ultrainsolence on a hapless bit of psuedoscience, I was near despair. For whatever reason, there didn’t appear to be anything new out there for me to sink my teeth into. True, when this has happened in the past, I’ve often delved deep into the Folder of Woo in search of tasty tidbits of quackery saved for just this eventuality, but I really hate to do that. After all, it might be good to apply science, critical thinking, and reason to a particularly nonsensical bit of pseudoscience (which is fun) or to a more challenging bit of poor scientific reasoning (which is educational), but it’s even more fun to take on pseudoscience that is topical, either as a result of its being in the news or as a result of a its being new excretion of burning stupid by a pseudoscience booster. Yesterday, I took on the pseudoscience that was topical because it was in the news. Last night, thanks to the wonder of Google Alerts, I became aware of a bit of tempting pseudoscience from a very old “friend” of the blog.

Who could it be? Take a guess. First, what’s 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? Yep, we’re talking homeopathy baby! That tells you the what. But what about the who? (And, no, I don’t mean The Who, as in the band, no matter how much I love The Who.) Regular readers of this blog probably know about whom I speak, or they will if I tell you that it isn’t John Benneth. It is, however, someone who calls himself an “evidence-based homeopath.” (It’s even right there under his name in the blog post.) He’s even occasionally “graced” this blog with his presence on occasion? Do you know who it is yet? OK, I’ll tell you.

Yes, it’s Dana Ullman. Once again, Dana’s decided to pontificate from his blogging home on that wretched hive of scum and quackery, The Huffington Post. As usual, Dana’s blogging about homeopathy. He’s also quite unhappy. The reason is that he sees a nefarious plot, an evil plot, a veritable disinformation campaign against homeopathy. As is typical for Dana, criticism by homeopathy by supporters of science-based medicine (like myself) is not due to the fact that homeopathy is based on vitalism and sympathetic magic; that homeopathic remedies are diluted into nonexistence; or even that for homeopathy to work, huge swaths of physics, chemistry, and biochemistry would have to be not just wrong, but spectacularly wrong. Oh, no. It’s not that at all. To Ullman, it’s all ideological; it’s all nothing more than a huge conspiracy to crush a competitor because, as Ullman puts it, homeopathy is an “ongoing threat to the scientific, philosophical and economics of conventional medical care.” In the process of trying to defend homeopathy, Ullman further lays down his usual panoply of logical fallacies, misinformation, and pseudoscience, beginning with the claim that only homeopathy treats the real cause of disease:

It is common, for instance, for homeopaths to question the alleged “scientific” studies that conventional drugs are “effective” as treatments because of concern that many of these treatments tend to suppress symptoms or disrupt the complex inner ecology of the body and create much more serious illness. Just as opiate drugs of the 19th century gave the guise of healing, homeopaths contend that many modern-day drugs provide blessed short-term relief but create immune dysfunction, mental illness and other chronic disease processes in its wake. Further, the fact that most people today are prescribed multiple drugs concurrently, despite the fact that clinical research is rarely conducted showing the safety or efficacy of such practices, forces us all to question how scientific modern medicine truly is.

Homeopaths contend that increased rates of cancer, heart disease, chronic fatigue and various chronic diseases for increasingly younger people may result from conventional medicine’s suppression of symptoms and disease processes. It is therefore no surprise that conventional physicians and Big Pharma have a long and dark history of working together to attack homeopathy and homeopaths.

Because to Ullman it is nothing more than big pharma keeping homeopathy down, rather than the fact that homeopathy is pure quackery. Ullman then engages in his favorite logical fallacy, argumentum ad populum. He points out how popular homeopathy as in the 19th century, as if that has any relevance today. After all, homeopathic remedies are diluted to nothing more than water, given that they are diluted far beyond the point where a single molecule is likely to remain; so they are the equivalent of doing nothing. Given that a lot of medicine practiced in the 19th century involved toxic purges and various other harmful practices, it’s not that surprising that homeopathy appeared to do better. But you know what? As medicine became more scientific, as the toxic therapies were replaced with more science- and evidence-based therapies, medicine became more effective than doing nothing for many conditions, which means it became more effective than homeopathy appeared to be.

I must admit, though. Ullman is pretty funny. Let’s take a look at how he tries to paint skepticism of homeopathy as being in reality pseudoskepticism. It’s a textbook example of not understanding what skepticism really is. Ullman first complains that “homeopathy deniers” (a label that I wear proudly as a practitioner and defender of science-based medicine, by the way) “make a simple false accusation, a lie, and repeat it constantly and consistently in an attempt to make it a new ‘truth.'” In reality these are not false accusations at all; they are the truth. Rather, it’s Ullman and homeopathy apologists who take a lie and repeat it constantly. Next, Ullman tries to accuse us evil skeptics of finding excuses to downplay positive evidence for homeopathy. Never mind that that “positive” evidence is invariably easily explained by the random noise that occurs in clinical trial results, in which at least 5% of clinical trials produce false positive results based on the definition of statistical significance (and, given the imperfections, biases, and flaws in clinical trial methodology, it’s usually much more than 5%). Combine that with the utter implausibility of homeopathy based on physics, and those equivocal results are even more obviously false positives.

Let’s just put it this way. It’s possible that everything we know about physics is wrong in such a way that homeopathy works. Incredibly unlikely but probably not absolutely impossible. However, if homeopaths are going to disprove well established laws of physics supported by mountains of evidence, they need to bring mountains of unequivocal evidence of their own that are equal to or greater than the scientific evidence that concludes that homeopathy can’t work. Equivocal clinical trials that appear to show results just barely better than placebo just won’t cut it. Heck, I’d even settle for a quantity and quality of evidence that are even in the same order of magnitude as the quantity and quality of evidence showing that homeopathy can’t work.

Homeopaths have never come close to that.

Next, Ullman tries to appropriate the concept of skepticism for himself, while at the same time erroneously trying to appropriate a simple principle of how new theories expand upon old theories:

The third component of the technique is to sell the lie to a vulnerable population in an attempt to have repetition from that group. In the case of the homeopathy deniers, the vulnerable groups are often young students of science who are enamored with the language and elitism of their newly-learned craft, but who lack the deep understanding and experience to realize that they are being “used” by the deniers. The homeopathy deniers also play on the fears of those older and established scientists and physicians and who are led to believe that “if homeopathy is true, then everything about modern medicine and science is false.” This over-simplification of reality is commonly repeated.

However, just as quantum physics does not “disprove” all of physics — but, rather,extends our capability to understand and predict events on extremely small and extremely large systems — likewise, homeopathy does not disprove all of modern pharmacology but extends our understanding of the use of extremely small doses of medicinal agents to elicit healing responses.

Apparently Ullman’s been reading about physics. He’s even correct that new theories don’t usually completely refute old theories, although he used the wrong example. The most common example used here is relativity. Relativity didn’t disprove Newtonian physics. Relativistic equations simplify to Newtonian equations under the condition of velocities that are such a small fraction of the speed of light that they are negligible in comparison. Of course, most velocities that humans ever see in common everyday life fall into this category, which is why Newtonian physics was so useful for so long and remains so for many applications. The problem, of course, is that homeopathy “extends” our understanding of…nothing. Certainly homeopathy provides no understanding of the use of extremely small doses of medicinal agents unless you mean no doses of medicinal agents. Again, most homeopathic remedies have been diluted to the point where nothing but water remains. Does this really need to be repeated? Apparently it does to Dana Ullman.

Let’s take a look at Ullman’s “myths.” First up on the list:

Myth #1: “There is no research that shows that homeopathic medicines work.”

Such statements are a creative use of statistics, or what might be called “lies, damn lies and statistics.” Actually, most clinical research studies conducted with homeopathic medicines show a positive outcome. However, if “creative statisticians” evaluate only the smaller number of large studies, a positive result is less likely, not because homeopathy doesn’t work, but because these larger studies tend to dispense only one homeopathic medicine for everyone in the study, without any degree of individualized treatment that is typical of the homeopathic method (1). To claim that homeopathic medicines do not work using only these studies is as illogical as to say that antibiotics are ineffective just because they do not cure for every viral, fungal or bacterial infection.

So many typical fallacies, so little time. First, I would dispute that “most” studies of homeopathic remedies show a positive outcome, although, if that were true, it would be excellent evidence of publication bias more than anything else. Typically, Ullman falls back upon the claim that, when clinical trials show homeopathy doesn’t work, it must be the fault of the clinical trial because the remedies aren’t “individualized.”

Onward to myth 2:

Myth #2: “The research studies showing that homeopathic medicines work are ‘poorly conducted studies.'”

Which is, for the most part true, no matter how assiduously Ullman tries to deny it. True, he tries to argue that because these studies have been published in prestigious journals then they must be good. However, any regular reader of this blog will realize that publication in a respectable journal does not guarantee that a study is any good. At least once a month, if not more often, I lament how badly designed trials of blatant pseudoscience somehow slip past reviewers of prestigious journals, yes, even journals like the New England Journal of Medicine.

Now here’s a silly one:

Myth #3: “12C is like one drop in the entire Atlantic Ocean.”

Pure fantasy (and fuzzy math)! In fact, the 12C dose requires 12 test tubes, and 1 percent of the solution is drawn from each of the 12 test tubes. It is also very typical for the “deniers” of homeopathy to assert with a straight face that the making of a single homeopathic medicine requires more water than exists on the planet. It seems that the skeptics are so fundamentalist in their point of view that they consciously or unconsciously mis-assume that the dilutions used in homeopathy grow proportionately with each dilution; they assume that each dilution requires 10 or 100 times more water with each dilution — which they don’t, and even the most elementary articles and books on homeopathy affirm this fact.

Oh, Dana! Dana! The organizers of the Burning Man festival called. They want their giant strawman back. No, skeptics don’t claim that it requires a volume of water the equivalent of that of the Atlantic Ocean. It’s a metaphor to demonstrate the degree of dilution. No skeptic claims that the making of a single homeopathic remedy requires more water than exists on the planet. That would obviously be ridiculous. However, it is not ridiculous to point out that, through the power of serial dilution, homeoapths can achieve dilutions equivalent to diluting a remedy in all the water on earth or even in all the particles in the universe. For example, there are homeopathic remedies that are diluted to 200C. That’s 200 hundred-fold dilutions, or 10400. I note that the number of particles in the known universe is on the order of 1078 to 1082.

You get the idea. Unfortunately, as usual, Ullman does not. After all, he says with a straight face:

Myth #4: “There is nothing in a homeopathic medicine. It is just water.”

This is, of course, true for most homeopathic remedies greater than 12C or so, which, being a dilution of 1024, is greater than Avagadro’s number. Certainly it’s true for homeopathic dilutions greater than 15C or so. So what’s Ullman’s retort? First, he points out “low potency” homeopathic remedies. This is, of course, true; there are homeopathic remedies less than 12C in which there is detectable starting compound. None of this validates homeopathy, which claims that diluting a remedy with succussion makes it stronger, that “like cures like,” and that homeopathic “provings” are the way to figure out how a remedy “works.” Ullman also cites a couple of very dubious studies that claim to find differences between homeopathic remedies and water, one of which I myself deconstructed in depth.

Finally:

Myth #5: “If we do not presently understand how homeopathic medicines work, then, they cannot work. It’s witchcraft.”

Well…not exactly. Homeopathy is indeed witchcraft, but not because we don’t understand how they work. Certainly that’s not the reason why we conclude that they cannot work. We conclude they cannot work because they violate the laws of physics and homeopaths can’t produce evidencethat they do work of sufficient power, quality, and quantity to lead scientists to seriously question current laws of physics and chemistry. Ullman even tries the tired old ploy of labeling skeptics as “close-minded”:

One other critical piece of evidence to show and even prove the unscientific attitude of the homeopathy deniers is that they now wish to close off all discussion of the efficacy of homeopathic medicines (Baum and Ernst, 2009). These medical fundamentalists actually discourage keeping an open mind about homeopathy. One must question this unscientific attitude that select antagonists to homeopathy embody, and one must even wonder why they maintain such a position.

Uh, Mr. Ullman. Burning Man festival organizers again. We still want our giant straw man back. You haven’t returned it yet. In fact, we may have to charge you for wear and tear, given how much you appear to be using it.

In reality, the argument is more subtle than what Ullman represents. Basically, the argument is quite reasonable, pointing out that the evidence against homeopathy based on physics and the overwhelming lack of clinical evidence, is so compelling that it is unreasonable to keep doing clinical trials using homeopathy until such a time as there is compelling evidence that it might be effective. Although the end result would be the same (no more clinical trials of homeopathy) this is a very different argument than how Ullman represents it. Nor is it unscientific to suggest that it is unethical and a waste of resources to test pseudoscientific remedies based on sympathetic magic more than science on human subjects unless and until there is compelling basic science evidence supporting homeopathy.

So much for the “evidence-based” part of “evidence-based homeopath.”

Although this little paranoid screed is typical Dana Ullman, it does end on an intriguing note. Ullman finishes by promising to “provide further specific evidence of the unscientific attitude and actions from those individuals and organizations who are leading the campaign against homeopathy.” He even promises to name the names of a “leading antagonist” to homeopathy from the U.S. and another from the U.K. Obviously, the U.K. “antagonist” will almost certainly be Edzard Ernst, but who will the U.S. “antagonist” be? I wonder.

Oh! Oh! Dana! Pick me! I want to be the U.S. homeopathy antagonist! Don’t be boring and pick someone like Steve Novella (a likely choice) or James Randi (another likely choice)! Pick the wild card. Pick Orac. I deserve it. Whatever the identity of the U.S. homeopathy antagonist is, I bet Ullman’s followup article will be as unintentionally hilarious as this one was.