h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

Thanks for your considered replies.

>> but the seeming need for a whole set of explanations which seem scientifically implausible to many does explain why many people are deeply and honestly skeptical, even if many would be extremely interested in seeing proof that homeopathy *did* work, regardless of the supoposed mechanisms.<<

I think there are two ways this can be approached.

One is to acknowledge that many practitioners and clients experience homeopathy as effective (this includes people with formal science training like medical doctors), and to work from that starting point. So it is possible to design trials based on the *practice of homeopathy to see how efficacious it is without having to have a science understanding of how it works, but people have to put aside their bias against homeopathy based on lack of a scientific how. The main problem so far with research is that it's not being done by people who actually understand what homeopathy is.

The other is to look at the *how. I don't have enough science to contribute much to the discussion here, although I am interested. However I think it would be important for scientists to have an open dialogue with homeopathic practitioners and theorists to make sure that there is a shared understanding of concepts. This is what I was referring to earlier in the thread. Terms like 'energy', 'physical' etc have different meanings to alternative health practitioners and there needs to be good communication to make sure that people are talking about the same things.

For instance:

>>That was my reaction to the idea of supermolecular structures surviving as well. Take this structure and churn it around with hydrochloric acid for a couple of hours, and it's still able to reconstitute itself after passing successively through a number of membrane barriers... <<

Azara, there is an inherent assumption there that the homeopathic substance needs to transit the digestive tract and be absorped into the blood stream and then transported to a specific site or sites (Potholer was suggesting the same). However while this is how drugs work , I doubt that it's how homeopathics work. There are homeopathic remedies administered via the skin (eg arnica cream), and there is also the possibility that the remedy is assimilated at least in part in the mouth directly into the bloodstream.

And to get passed the membrane issue, it's also possible (likely IMO) that they work in a way that is beyond the understanding of science's current mechanistic view of the world. I haven't read alot of homeopathic theory, but there are many other modalities that work with a view of the body having some kind of subtle energy system that is affected by certain interventions (homeopathy, acupuncture, meditation etc). In this view you could presumably put the remedy anywhere on the body for it to work (I'm guessing about that , I don't know if that is how homeopaths actually see it).

I'm not saying this *is how they work, but just wanting to point out the tendancy to view homeopathics as a drug and make assumptions based on this (this is why the trials are usually inadequate).

There is also this issue of what homeopaths might call energy. And before anyone jumps on me again, let me just say I personally don't think this is any woowoo thing, just that there are people who work directly with phenomena that they call energy that is quite conceptually different from what a scientist called energy and until scientists learn to understand that they're not going to get very far.


What I'm trying to suggest is that the kind of science approach needed is a more lateral one, kind of the difference between thinking newtonian physics and quantum physics. Isn't it true that alot of quantum physicists say that their work is really weird. Why is it so hard to accept the weirdness of homeopathy then?


Potholer, to address some of your specific points one would first have to agree that any homeopathic effect is chemical. But that hasn't actualy been established.

I do know that homeopathic remedies are prepared very carefully, and that when taken one is not meant to let the remedy touch anything else (you put them straight from the container into the body).

>>>
e) Whether the effect of homeopathic solutions on the human body is somehow biased towards the positive. Such supposedly effective treatments would seem to have at least the potential for harm if applied wrongly. It is hard to have anything which is both effective and 100% safe.
<<<

In practice, higher potency remedies are considered to be potentially harmful if taken incorrectly. That is why you usually only see low potency remedies (eg 30C) for sale to the general public.

There are also practice issues around incorrect prescribing where the pattern of the illness is pushed further into the body. That is quite a complex phenomena to explain, but suffice to say that there are people who are experienced with homeopathy who would say that it's not inherently benign.

Of course if one accepts that it's not benign one has to accept that there is some kind of effect beyond placebo.


>>>
(As an aside, I wonder how many studies have been done with 'pretend patients' to see how much (or how little) variation there is in precise diagnosis and prescribed treatment across various kinds of regular or alternative medical practicioners?)
<<<

Not sure exactly what you are getting at there. There is a large variation in both diagnosis and prescription mainly because alternative practitioners usually treat individuals not diseases, whereas allopathic medicine treats the disease. Although there is still quite a bit of variation in diagnosis and treatment amongst western medical doctors too.

Just rereading the earlier discussion:

>>
2)"Homeopathists claim that water retains a 'memory' from the homeopathic solute - whether any remains in solution or not. I am going to stick my neck out here and state that this is not unrealistic. Metallurgists are now producing 'memory-metals': they regain their crystalline structure (the metals, not the metallurgists) when treated after deformation." Master B

The metal is a solid the entire time. This is a critical difference. Also, phase changes happen all the time, where a solid changes from one crystal structure to another, and possibly back. This is a result of external parameters (temperature, pressure, etc.). Homeopathic memory affects are *not* dependent on external parameters. Big difference.
<< Dealer

Not sure if I followed that correctly but ... homeopathics are prepared by making an alcohol extract of a substance that produces a certain reaction in the human body.

eg chichona (from which quinine is derived) treats malaria in the ill human, and produces malarial like symptoms when taken by a healthy human. The first homeopathic experiments involved giving smaller and smaller, but still chemically active, doses of chichona, to effect a cure.

"Hahnemann did not stop there. Dissatisfied with the side effects of his diluted medicines, he experiemented with smaller and smaller doses of these single remedies in order to minimise side effects. He found, however, that when he diluted a medicine sufficiently to eradicate side effects, it no longer effected a cure. He therefore developped a new method of dilution: instead of simply stirring the substance after each dilution he shook it vigourously. This shaking he called 'succussion' and the resultant remedy a 'potentised remedy'.

He found that not only did he obtain a remedy that had no side effects but that the more he diluted using succussion, the more effective his remedy cured. He believed that the shaking released the strength or energy of the substance (involving some sort of imprinting on the water/alcohol solvent) with none of it's toxic side effects"

The Complete Homeopathy Handbook, Miranda Castro

Does this not mean that homeopathics are dependant on external parameters i.e. the succussion?
*

>>>
Is *any* explanation offered for how/why the presence of more molecules of solute earlier on in the dilution process prevents the water taking up its optimal state of highest enery/strongest memory, or indeed why a tube of ultrapure water wouldn't be incredibly susceptible to memorising any stray molecule that happened to fall into it, which would appear to be a logical conclusion.
<<< Potholer

I'm not sure if I can answer that, but there are several processes involved. The first one is to make an alcohol extract of the substance. This is very concentrated. The dilution process doesn't just go from adding say 1ml of extract to 1,000,000mls of water (or whatever it is that leaves no chemical trace). It is done by a number of dilutions accompanied by succussion each time (by tenths or hundredths each time I think eg 1 ml extract to 9 mls water, succussed, then 1ml of the succussed mix to 9mls water etc).

Is it possible that whatever is transferred (memory, energy?) is dominantly strong because of the relative concentration of the original extract compared to any contaminants?

Well, what I am interested in knowing, kea, is if homeopathic remedies work in themselves or if it is the extra time and caring most homeopath practitioners give to their patients that helps them feel better.

It seems that science is debunking homeopathy as something that works strictly based on the remedies provided.

And I'm also in that camp. I'm very sceptical.

But I do know how extra care and attention can help someone heal themselves better.

More than once I've been 'healed' by a caring doctor who took time to talk to me and treat me like someone who also had a say in their treatment. This empowered me. I was allowed to make choices. And to question my doctor. It was a very 'healing' sort of relationship, if you know what I mean.


az

Regarding 'pretend patients', it'd be interesting to see the various diagnoses and prescribed treatments obtained by having some good actors visit multiple practitioners from each of many kinds of alternative medical fields, as well as conventional doctors, and see how consistent the diagnoses and treatments are.

For example, if someone told exactly the same information to 20 homeopaths (or acupuncturists, or GPs, or crystal healers), how wide would the variation be in opinions about their problems and treatments prescribed within a particular field.

I absolutely agree that the relationship between a practioner (of any kind) and patient can be healing in and of itself

I guess to test whether that was the only effective factor in homeopathy one would have to design a trial where one group were given a consult with remedy, and another were give a consult without a remedy. Hard to do though because people are so individual you can't control for the healing interaction.

Homeopathics do work on animals, and the homeopath doesn't have to be present (all the information can be gathered from the owner separately).

>>
It seems that science is debunking homeopathy as something that works strictly based on the remedies provided.
<<

Well I don't see science as debunking homeopathy at all mainly because it's trials have been so poorly designed. However, most good practitioners understand the healing power of the consultation (I'm lucky to have a GP who does too). If I were a practitioner I doubt that I would would be worried too much about quantifying what was the interaction and what was the remedy. The important bit is the wellbeing of the client and what happens to them. But then I already experience homeopathy as effective so the proof stuff is quite secondary.

<>

Yeah okay, but does it 'work'?

I'm all for alternative curing methods myself, within reason. And all doctors who have had the misfortune to meet me get the message straight away that I'm just never - ever - going to walk away happy with a prescription in my little hand.

It's so very normal here in Spain to prescribe antibiotics for all sorts of things - I was taught by my ex-GP in Toronto that I should only *ever* take antibiotics when there was no other recourse - otherwise I was f**king up my own natural defense system (and it would probably give me thrush! ick).

Homeopathy treatments seem to be working for you, and I certainly wouldn't be the one to say you're wrong at all.

But frankly, if say, I got a cancer I would use both natural and standard medical information to treat myself. And probably the last thing I'd submit myself to would be chemo. I'd change my diet drastically, do some radiology treatment, surgery if necessary . . . but a whole mix of it all.

What I would *never* do would be to believe that if I drank some homeopathic liquid with stuff in it, or not in it, that this would cure my cancer. And any homeopathic practitioner who professes they can cure cancer should be locked up so as not to kill the 'wanting to believe' types.

Hmmm, finding I actually feel quite strongly about that. Didn't know that before.


az

I'm quite critical of alternative practitioners who claim they cure cancer too. I think the exceptions would be ones who specialise and who don't make grandiose claims.

However there is a significant distinction between western medicine and most 'alternative' therapies. Medical science usually intervenes directly against the pathogen or diseased part eg antibiotics kill the offending bacteria (along the good ones), or chemotherapy kills cancerous cells.

Alternative therapies (and this a big generalisation) tend more to offer support or stimulation to the body's natural healing resources eg echinacea (a herb) stimulates parts of the immune system (although it does have antibacterial properties as well) that enables the body to deal with the pathogen itself.

Often it's about prompting the body into an organ/tissue/cellular state of rebalance, or of physiological rebalance. This is why it's so hard to compare drugs and say herbs or homeopathics. One treats a relatively distinct phenomena (eg bacterial infection), the other is addressing the whole package (the underlying reasons why the bacteria were able to infect at that time).


>>
And any homeopathic practitioner who professes they can cure cancer should be locked up so as not to kill the 'wanting to believe' types.
<<

The problem is also with oncologists who haven't been particularly honest about the fact that most people with cancer who receive treatment and die, in fact die from the treatment not the cancer.

One thing that irks me as much as alternative cancer cure claims is medical doctors expressing opinions about alternative medicine without actually knowing anything about it. If a medical doctor has received training or has educated themself in an alternative modality fair enough. But many 'medical' opinions about alternative medicine are incredibly ignorant and dishonest about their ignorance to boot.

I tend to view practitioners all on a par now - there are competent ones, incompetent ones etc in all the healing professions.

hi kea,

Two of my English students are oncologists - one is the head of the nuclear medicine department at the general hospital here, the other is his second in command. They work a lot with PET scans as Seville has one of the few machines available for this in Spain. This particular scan can identify tumours better than any other scans available, which gives them better early diagnosis treatment options.

My mother had a breast removed a couple of years ago - she totally refused chemo (said she was sure it would make her sicker than she actually was and besides, she didn't want to lose her hair). All the doctors that saw her recommended chemo. Instead she did radiotherapy and, so far, she's just fine and has all her hair.

And stupidly or otherwise, I think my mother's stubborn determination to *not die* is a huge element in how well she has come through this treatment. She's now 75, stubborn as a stubborn thing, just fighting her cancer with all her will - and this is why I say that 'alternative' options can help a lot.

Because a part of me *does* believe that we can make ourselves well again. Can help ourselves heal. When we get all the information we need in order to make decisions.

Don't you think that it is maybe people stuck in hospital beds being told 'the best is being done for them' that maybe give up hope and stop believing in their own power to make themselves better? Yeah okay, might be only for a short time longer, but that 'giving up' thing is, I think, something that ensures they will die sooner than later.

Oh, maybe rambling a bit.


az

At the conference I attended last week, a scientist gave a talk on the effect of solutes on the structure of the surrounding water. Someone asked him how long the homeopathic memory effect would last - if you were to remove the solute, what happens to the water structure. He estimated the structure would last on the order of picoseconds.

A picosecond is a trillionth of a second.

Homeopathic medicine hypothesizes that there is a memory/strucutre effect in the water. Every test of that hypothesis has yielded negative results. The scientific method indicates a new hypthesis should be proposed (eg. Az's theory).

So how about some physical, direct evidence for the water memory effect (spectroscopic or thermodynamic data), or a change of hypothesis for how homeopathy works?

How about a test of the Az theory? Have two groups, both taking placebos. Just change the amount of time the physician spends talking/empathizing with the patient between the groups.

I think there is some research that shows that people who are 'difficult' patients have better outcomes - presumably they're the ones that get what they need, but I agree the fighting spirit is also important. I think good clinical doctors recognise these more subtle aspects in people's recovery.

There might also be some research that shows that telling people their bad prognosis shortens their life.

>>
Because a part of me *does* believe that we can make ourselves well again. Can help ourselves heal. When we get all the information we need in order to make decisions.
<<

Totally with you on that

What's this 'az theory' stuff, Dealer?

Just because I said that people respond better to treatment when they feel their doctor is spending time talking to them?

I don't think I said anything new or unknown there. Common sense.

Are you making fun of me?

In any case, I do think that if a physician takes time to speak with their patient (which is sadly not an option with most social security health services patients who get 3-5 minutes) that the caring they receive goes a long way with helping them get better.


az

<>
My own impression is that western medicine went through a period of "scientisation" (for want of a better word), when this was forgotten in the process of developing drug and surgery based treatments, but things like the Placebo Effect, and the role of the patient's psychology in outcomes are now well recognised in mainstream medicine.

Noggin

Quite likely I misunderstood you, Dealer.



az

Surely if homeopathy was invented by a German then it is a western medicine?

"Hahnemann did not stop there........ He therefore developped a new method of dilution: instead of simply stirring the substance after each dilution he shook it vigourously. This shaking he called 'succussion' and the resultant remedy a 'potentised remedy'."

This is exactly the kind of thing that says "pseudoscience" to me: in the 200 years since Hahnemann proposed his theories, the ways in which homeopathy is claimed to work are as mysterious as ever. "Scientific" medicine was pretty dreadful in Hahnemann's day, but look at what has been developed since. Compare it to astrology versus astronomy: in Newton's day, people often believed in both, but in the years since then astronomy has developed enormously, while astrology is still the same dead end. I can understand why Hahnemann in 1800 felt his methods were as good as conventional medicine, but neither the treatment nor the explanations seem to have advanced much since then.

Azara

I called it the Az theory just so I'd have a shorthand. Seriously though, I think Noggin's right about psychology being incorporated into treatment, but I still think we haven't come across an actual study which scientifically demonstrated that homeopathic "results" come from this.

Noggin said: "My own impression is that western medicine went through a period of "scientisation" (for want of a better word), when this was forgotten in the process of developing drug and surgery based treatments, but things like the Placebo Effect, and the role of the patient's psychology in outcomes are now well recognised in mainstream medicine."

I couldn't agree with that more, well said. A suggestion for a better word there would be, "technologization" or something - no wait, that's an awful word, forget I typed it.

What I mean to say is that I think it's crucial to make the point that what most seem to fear and distrust about modern medicine is not the fact that it has a scientific basis per se, but its extreme reliance on technology which has a scientific basis they may not understand or otherwise object to for another reason. Maybe some would consider that saying the same thing, but I don't. If people understood the scientific basis for modern medicines' techniques that are being proposed as part of some treatment, they might fear the treatment less - sadly, this was all too frequently in the past considered "beneath" doctors or "too difficult to explain to the layman." I've noticed, just in my lifetime, that this has greatly changed for the better.

It's encouraging to find that most people don't object to science once they truly understand the scientific method; mostly, they just don't understand the method, or worse misunderstand portions of it and end up sort of badly imitating science or inventing their own. I think what's worse are those few who *willfully* ignore science in favor of something they'd rather believe in, and I think what's behind that is an underlying fear/doubt/mistrust of technology as opposed to science itself. I think this is symptomatic of our society as a whole, reacting negatively to (perceived) too much technology, but that's another can o' worms. Asmiov may have really been onto something when he wrote the Foundation series.


- JD

I was rather put off homeopathy by a lecturer in medicinal chemistry who believed in it himself. One of the things he said is that the illness 'drips off' the body: so the head is cured first, then the torso, and lastly the legs and feet. I have no evidence against this idea, but I'd like to see some evidence for it before I start believing it!

TRiG.

TRiG, homeopathic principles like that illness clears from the head down are based on empiricial evidence. Homeopaths have been observing that effect for 200 years. However I wouldn't take it as an absolute, it's more part of the homeopathic paradigm of understanding symptomology. If you apply a strict science paradigm to it it probably doesn't make sense.

So you're saying my ingrown toenail is ultimately due to the head cold I had last winter?

- JD