Wednesday, August 31, 2005

Stick Your Arnica Up Your Paradigm

One of my most shocking experiences in a doctor's surgery was when the doctor took a homeopathy manual from his bookshelf. I reflected on the amount of taxpayers' money it had taken to train him in medical science.
Now another study has found that whilst homeopathy may work as a placebo for some people it has no real curative powers. And if the NHS is going to dish out placebos then coloured water would be a great deal cheaper. Of course, that doesn't work if you tell the patient it's only coloured water. But lying to patients would be considered unacceptable - unless apparently you're giving them homeopathic coloured water.

The principle of homeopathy is that the more you dilute a substance the more effective it becomes, so homeopathic tinctures are diluted until they disappear up their own arse.
Here's a thought: mainstream science tells us that, since there are a finite number of atoms on the planet that are endlessly recycled, most of us have some of Shakespeare's atoms in our bodies. Does this mean that most of us, if we made the effort, could write Hamlet or King Lear? With maybe one of Will's atoms to 50,000,000,000,000,000,000,000.......[add a few more trillion noughts] other atoms, the homeopathic principle would suggest we could.
Hang on a minute, I feel a sonnet coming on.

It was fun to see several agitated homeopaths crawling out of the woodwork to defend themselves in the Guardian letters column. One of them deployed a common argument: the new research "may well be correct, within the materialistic paradigm of conventional science, but the paradigm is inadequate for a full critique of homeopathy."

Don't you just hate those inadequate paradigms?
The same inadequate paradigms that in the course of thousands of years of deploying human reason and using evidence-based research methods have given us a much greater understanding of our planet and universe and given millions of people a quality of life far greater than that of our ancestors even 200 years ago. Yes, science sometimes has disastrous side-effects and is put to terrible uses. But next time your dentist needs to drill your teeth are you going to decline the anaesthetic and ask for an arnica tablet instead?

Let's try shifting the paradigm argument to another area.
"Executing people who fail to vote for the governing party without trial and on the orders of the Prime Minister may be unacceptable within the paradigm of liberal democracy but the paradigm is inadequate for a proper critique of alternative forms of governance."
Would we swallow that one?

Homeopathy may, in most cases, be harmless nonsense. But the flight from reason is a dangerous thing. It leads to body parts scattered round Russell Square and teenagers hanged in Middle Eastern squares.

One final linguistic reflection: most other words ending in 'path', meaning disease, like 'psychopath' and 'sociopath' refer to someone who is mentally disturbed or who has lost the power of reason. Is 'homeopath' the exception? It denotes nothing more threatening than a purveyor of remedies that have no scientific basis.
But personally, as with people who have fairies at the bottom of the garden or who insist that Elvis is working in their local Kentucky Fried Chicken, I prefer to give them a wide berth.


A letter in today's Guardian refers to an experiment at the University of Leipzig which "gave concentrations of belladonna which were literally less than a drop in the ocean" to rats.
Is that a concentration? And what does 'literally' mean in that sentence? What size of 'drop' and which 'ocean'?
But I'm being picky.

Anyway, "statistically significant changes in the contraction of the gut of rats were measured consistently and repeatedly. The study used double-blind techniques designed to detect the placebo effect."
How the hell could a rat experience a placebo effect anyway?
But the real point is this. The previous letters from homeopaths [the Guardian uses one 'e'] argued:
a) that normal scientific trials could not be applied to homeopathy
b) that the effectiveness of homeopathy stems from its uniquely holistic approach to the patient.

"Homeopathy is a therapy that relies on the practitioner finding the remedy to suit the patient's condition based on successfully matching the patient's symptoms with the picture of our known medicines" wrote one.
"....the medicine is tailored to the patient and not to their medical diagnosis", wrote another, the head of The Society of Homeopaths, no less.

Now, what I want to know is this:
1) What were the Leipzig rats able to tell the scientists about their guts?
2) Was there anything wrong with the rats' guts to start with?
3) How exactly do you practise a rodent-orientated holistic approach?
4) Were the rats questioned about their lifestyle, musical tastes, star signs, etc?
5) If homeopathy is individually tailored, why were all the rats given belladonna rather than some being given arnica or something else?

I'm sure there are more questions, but now my own gut is contracting.
From laughter in my case.


At 10:06 AM, Blogger Urban Chick said...

i hear what you are saying about paradigms and it sounds like a cop-out, i agree

however, i have to put in my ha'penny's worth for another realm of 'complementary' medicine: chinese medicine

western scientific thought cannot get its head round why it is that acupuncture works both to relieve pain and to treat and cure other conditions and yet it does (and studies carried out in western countries by western doctors have proven it to be effective in a number of areas)

and western medics find it hard to get their head round the idea of a compound approach in herbal medicine: where a concoction is individually tailored (so your asthma concoction may not be the same as mine)

again, some 'western' doctors have researched the treatment of many diseases (ezcema, hepatitis C etc.) with chinese herbal medicine and found its to be very effective but cannot explain why a mele of herbs do the trick (in their minds, they are always hunting out a single 'active ingredient')

so i have some sympathy for the idea that medical traditions have grown up based on different assumptions and experiences - if i'm describing a paradigm, then i hold my hands up!

i cannot offer a defence for homeopathy (and i have my doubts more so since hearing of this research), but we need to be careful not to translate scepticism about some types of 'complementary' medicine into full-blown, blinkered arrogance about the capabilities of western medicine, because it too has some glaring weaknesses

[can you tell this is what i used to do for a living?!]

At 10:19 AM, Blogger Merkin said...

My favourite "Dilbert" cartoon is when he tells his pointy-haired boss some technical mumbo-jumbo and the boss lets out an anguished groan and collapses.

"What was that?", asks Wally
"The sound of a paradigm shifting without a clutch.", replies Dilbert.


At 10:51 AM, Blogger patroclus said...

Oh, you've got me on to my favourite subject: etymology. In fact yer suffix -path (from pathos, suffering) denotes sensitivity or suffering, rather than disease. Such that an empath (a word which may only have been used in Star Trek, but that's good enough for me) is someone who can feel what another person is feeling. And homeopathy, therefore, means the treatment of an ailment with a diluted form of the same (homeo-) thing that caused the suffering in the first place (a bit like hair of the dog).

So, erm, I think my point is that the suffix -path isn't quite as negative as you suggest. Or am I talking bollocks again?

At 11:57 AM, Blogger zaphod said...

I do hope that you are not unwell Mr Lupin, what with going to the doctors and such.

Mrs Zaphod sends her regards..

At 12:47 PM, Blogger Merkin said...

Patroclus -
Armed with my Ancient Greek GCSE but with no textbooks remaining to check this out - shouldn't that be "homo" meaning same, as in homogenous, or homosexual? So if that's what was meant, those quacks would call themselves homopaths, wouldn't they? Where did the extra "e" come from?

They're still snakeoil salesmen!

At 1:26 PM, Blogger patroclus said...

Erm (getting into very shaky territory now), isn't it actually supposed to be spelled homoeopathy? Which doesn't actually help matters, because now there's two extraneous vowels.

At 1:30 PM, Blogger Urban Chick said...

in jumped the pedant:

actually, homo- and homeo- both mean 'same'


*big cheesy parents-would-be-proud-of-me grin*

At 3:18 PM, Blogger Willie Lupin said...

uc: firstly, when I write about serious subjects like this I write a tendentious, polemical and, I hope, entertaining piece which makes no attempt to explore the full complexity of the issue. I identify what journalists call an 'angle' and then flog it to within an inch of its life. That's not to say that the views aren't ones I genuinely hold.

I don't dispute that some complementary medicines are more effective and less nonsensical than others but as yet unexplained. Nor do I dispute that some of the nonsensical ones work as 'placebos' on some people. That's fine and it would be absurd to deny people that kind of 'cure'. But it's funny how people still rely on mainstream medicine if they're injured in a car crash or they get cancer or anything else life-threatening.
Does non-western scientific thought have a different version of the nature of matter or the laws of physics? Surely not, because some of these countries have developed nuclear programmes and put people into space.
Some African peoples, working to a different medical tradition, have some novel theories on the causes and prevention of AIDS. Most of them are six feet under.
The problem we have here is that the Government and the medical profession are under pressure from people like the Prince of Wales, with his coffee enema cures for cancer, to introduce to the NHS remedies that are as potentially dangerous to some people as witchcraft in African tribes.
One man's paradigm is another man's death sentence.

btw, I may update this post shortly.

merkin, thanks, I'm not too familiar with Dilbert. I never have any trouble silently shifting paradigms because I've always driven automatic cars.

zaphod, thanks for your concern, but that experience was many years ago. I'm as well as can be expected in a man of my age who spends too much time at the keyboard.

patroclus: you're right, it means 'suffering' rather than disease. But did the Greeks have another word for 'disease' or did they use that one?
I can understand why they'd rather be called 'homeopaths' than 'homopaths' in a society that confuses paediatricians with paedophiles.
And yes, I left an 'e' out of the word.
According to the OED, the Greek word has a double 'o': homoöpathie.
Oh dear, more extraneous vowels.
But what clever clogs you all are.
I didn't know you could do GCSE in Ancient Greek. They'll be doing it in Polari next.

At 3:46 PM, Blogger portuguesa nova said...

"Don't you just hate those inadequate paradigms?"


In a perfect world, everything would be treated and cured by bleach...diluted or not as necessary.

(I think this may be the second time I have expressed my love of bleach in the comment section of your blog.)

At 3:49 PM, Blogger portuguesa nova said...

PS. Totally unrelated. The other day my non-native English speaker husband was babbling on about something and ended his monologue with: "Eet does not matter 'ow strong zat I feel about zee subject. Zees (pausepausepause) eez a paradigma I will never understand."

I think paradigma would be a great name for either a lite rock band or a Star Trek fan club.

At 4:09 PM, Blogger Willie Lupin said...

pn: your passion for bleach is beginning to seriously worry me.
You will know, of course, that homeopathically speaking, if you use just one miniscule drop of bleach it will shift those stubborn stains that higher concentrations don't touch.
No, actually homeopathy involves treating like with like. So try this. Instead of washing powder, put a minute speck of dirt in your washing machine and see those soiled clothes come out whiter than white!

We can't get enough of your quotes from Mr PN.
Laughing at foreign accents is a national pastime here. We even laugh at Americans sometimes. And northern British, Scottish, Welsh.....
But can Mr PN's accent really be as sexy as you make it sound?
And has he ever said anything about your love of bleach?

At 6:31 PM, Blogger Urban Chick said...

fear not, i hear your polemical approach!

i s'pose i just sense a growing trend of lumping together and outright dismissal of what passes for 'complementary/alternative' medicine (i'm thinking of john diamond's snake oil book and francis wheen's mumbo-jumbo) when actually, we need to strip out the truly cranky stuff (and there is a helluva lot of of it for sure) and then take the rest and check it out properly

the men and women i worked alongside (five year undergraduate degree in both western and chinese medicine) often found themselves at complementary medicine 'health fairs' sitting next to tarot card readers and aromatherapists which they found deeply insulting

many chinese doctors would welcome scrutiny from western researchers but most research is carried out by drug companies and they are for the most part not interested unless there is an end product they can patent and market (doesn't compute when you talk about individually prescribed compounds)

yes, in china, if the medical issue is acute it's western medicine for the most part, if it's chronic then chinese medicine (sorry, but western medicine is very poor at management of many chronic ailments) - in many ways they take a more progressive view than we do

but when it comes to taxpayers' money in this country, it must not be spent on utter bunkum - i totally agree

ok, i'll put a lid on it now - promise!

At 11:01 PM, Blogger portuguesa nova said...

:)) I must be honest, I take a lot of flack from friends and family and my husband himself for my slight, miniscule, teeny exaggeration of Antonio's accent. Some have even accused me of making him sound like a Bulgarian prison warden...Nonetheless, everyone loves that man's accent. I fear the day when we live in Portugal and it'll be payback time for me.

This post really strikes a chord in my heart because I am such a massive lover of prescription medication. I love it. I love that someone has been trained to recommend I buy some, I love that someone has been trained to put it into a bottle and sell it to me. I especially love it when they prescribe more than is necessary so that you can take double the dosage.

I'm not talking about Prozac or Lithium or anything like that. Penicilan, amoxicilan, hydrocortisone...that, along with my love of bleach as a universal cleaning product is a guarantee that I will one day die at the hands of bacteria that are resistant to every drug known to man.

At 10:33 AM, Blogger Merkin said...

I think UC does herself a disservice by equating the fraudulent quackery of homeoeoeopathy with the unknown (and rarely dismissed-out-of-hand) that is Chinese medicine. I'm always intrigued why (for example) 1 in 10 British women get breast cancer, but only 1 in 10000 Chinese women do. They must know something that we don't.

As for a GCSE in Polari, Willie, these days it wouldn't surprise me in the slightest. What would Julian and Sandy get? Silly question - everyone gets A*s these days....

And that's a very valid point about rats being given placebos. I thought the effectiveness of a placebo as a control experiment relied on the psychological effect of the subject thinking they were getting a real pill. Perhaps these homeoeoeoeoeoeoeoeoeopaths speak Rat, as well as Duck?

At 3:07 PM, Blogger Willie Lupin said...

merkin, the more I think about it, the more I wonder if that recent Guardian letter was a spoof.

pn: I wonder if Ronaldo the footballer has an accent like Antonio? I've never heard Ronaldo speak but he cries sometimes when his team loses. So emotional, those Latin races.
Despite my criticism of 'alternative' medicine, I'm also very wary of prescription drugs. I annoy doctors by scouring the internet for all their side-effects. Maybe that's why one doctor reached for the homeopathy manual.

uc: write at as much length as you wish.
On two aspects you mention I totally agree with you.
Prescription drugs rely on a 'one size fits all' approach which sometimes has tragic consequences, as with the Seroxat suicides.
And research and trials are carried out by powerful drug companies motivated by profit.
I don't think we should lay these failings at the door of western science itself. It's more the fault of the social and political context in which it operates. Capitalism should have no place in any aspect of healthcare. Unfortunately, this Government believes the exact opposite.

At 5:51 PM, Blogger cello said...

Oo,oo,oo. I wish I had time to construct the opposite polemic and caress it lovingly to within a foot of its life.

I appreciate current science can't explain why homeopathy can work when conventional medecine can't. Methods of testing also conspire against the way homeopathy works (viz there isn't 'one' cure for any disease. It's about the patient) This is similar to the way IQ tests conspire against certain cultures.

But, speaking purely from personal experience, I have seen it work spectacularly well on both babies and animals, neither of whom could have been susceptible to placebo effects. As you know Willie, I am ruthlessly rational and despise superstition and mumbo-jumbo. The principle of treating like with like to stimulate the immune response is behind all vaccination. The bit people have trouble with is the diluion and shaking. I don't understand it either but I am trying to keep an open mind.

And the clincher is, if it's good enough for the bloody Queen...

At 1:35 PM, Blogger Willie Lupin said...

cello, if the Queen has a serious illness they won't be sending for the Royal Homeopath.
And if she suffers sudden brain death halfway through the Royal Variety Performance they won't cry 'Is there a homeopath in the house?'

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