Map of life expectancy at birth from Global Education Project.

Monday, July 12, 2010

The Way of Wu

Wu is the very widespread east Asian system of shamanistic healing, which involves shaking bells and chanting and burning slips of paper and what not. Usually spelled woo, it has been adopted by defenders of rational, scientific medicine as a generic label for the mystic arts promoted in late night infomercials and the Huffington Post. Probably the most popular form of woo around is homeopathy. I won't bore you, or reinvent the wheel, by describing and debunking this utterly ridiculous belief system, but check out the thorough historical treatment at the Skeptic's Dictionary.

I recently got into an e-mail pissing match with a proponent of homeopathy and it has provoked me once again to contemplate the allure of the irrational. After I avowed that there is no such thing as "legitimate homeopathy," her first response was to insinuate that I denounce homeopathy because I have some sort of financial stake in my opinion. You can imagine what happened when she pushed that button. At that point further conversation was undoubtedly useless, but let me carry on here.

It is well known that the first recourse of the wumeisters is to claim that medical science is all a conspiracy by Big Pharma to defraud us, that "They" don't want you to know about the miracle cure because it would hurt "Their" profits, and that the critics of wu are all shills for Big Pharma who are lining their pockets with consulting fees, kickbacks, and stock dividends.* Unfortunately, they can't claim this about their bete noir, Dr. Stephen Barrett, who is a retired psychiatrist, so they just accuse him of having a closed mind and continually sue him. When I pointed out to my correspondent that Barrett has never been successfully sued for libel or defamation -- or anything else -- she responded that he has too lost a lawsuit. Well, yeah, except he was the plaintiff. Here's the truth about this case, from Barrett:

In November 2000, Attorney Grell, Dr. Polevoy and I filed suit in Oakland, California against Hulda Clark, the Bolens, JuriMed, David Amrein, the Dr. Clark Association, Ilena Rosenthal, and others who have spread or conspired to spread the defamatory messages [11]. New Century Press was subsequently added as a defendant. In July 2001, the judge ruled that defendant Rosenthal, who had republished messages from Bolen to several news groups, was shielded from liability by the Internet Decency Act, which the judge believed was intended to protect anyone posting messages to newsgroups. The judge also ordered us to pay $33,000 in attorney's fees. We believe this ruling was incorrect and extremely unfair. In March 2002, we filed an appeal which noted that the judge's ruling, if upheld, would abolish all protection against Internet libel because a "clever libeler" could easily escape liability by having an anonymous or remote "Internet user" publish libelous statements that any other Internet user" would be free to republish [12]. We also appealed the judge's order for attorney's fees. In October 2003, the appeals court agreed with our view of the Internet Decency Act and ruled that Rosenthal could be sued for posting a defamatory message about Dr. Polevoy. However, the California Supreme Court reversed the Appeals Court, so Rosenthal was dismissed as a defendant. The other defendants remained, but in 2009, the local judge concluded that we had not pursued the case quickly enough and dismissed it.


Hardly evidence against Barrett's integrity, but this is the sort of tendentious, facts-be-damned argumentation style that the wumeisters generally adopt.

A scientist named Edward Calabrese is interested in the phenomenon of hormesis, which is a label for a perfectly well-known phenomenon. Essentially, the biological response to low doses of some substances can be dissimilar to the response to higher doses, in other words the response to more is not just more of the same. Obviously, low doses of any medication may be beneficial whereas doses that are too high are toxic, but this idea goes a little bit further. A mild irritant can recruit a reparative response, such as inflammation, which may also repair some pre-existing lesion or disease process. Peppermint oil, for example, is a mild irritant which may actually be helpful in some gastrointestinal and other conditions.

However, this has nothing to do with homeopathy. Homeopathic remedies are water; they are biologically inactive except for the prevention and treatment of dehydration. Nor is it in any way a promising organizing principle for a broad program of research. There might be a useful remedy or two based on the idea. However, there is no single, secret key to all disease and healing. Organisms are extremely complicated; they are systems of systems, with all sorts of feedback systems to maintain homeostasis and competing positive feedback systems to respond to challenges; beset by pathogens; and disturbed by sub-optimal inputs such as malnutrition and environmental toxins.

Accordingly, medicine is eclectic. There isn't any single principle, or even just a few principles, on which scientific medicine is based. Rather, biomedical scientists try to understand each situation as it is, and evaluate treatments based on their specific merits and risks. Antibiotics kill pathogens; antivirals restrict viral replication; antihypertensives target various signaling systems; insulin replaces a hormone the body fails to produce; surgery repairs physical lesions; some treatments, such as analgesics, are largely palliative; etc.

Some people apparently find it tempting to believe that a single magic principle will banish all disease and suffering but it just doesn't work that way. Homeopathy grows out of a sort of mantra: Like Cures Like. Well, generally, it doesn't. Just believing in a slogan doesn't constitute evidence. There is plenty of evidence regarding homeopathy and it all points, inescapably, to a single conclusion: homeopathy is useless.

There isn't any evil conspiracy against homeopathy, and we don't denounce homeopathy because we have closed minds. Homeopathy is nonsensical. And no, it isn't harmless. When people's belief in nonsense causes them to refuse potentially beneficial therapies, they can be seriously harmed, or die. Now, that's an evil conspiracy.



*For the record, I am a medical sociologist, who earns a modest academic salary mostly based on funding from the National Institutes of Health to study physician-patient communication. NIMH does not know, or care, what I think about homeopathy, nor does my employer.

8 comments:

Anonymous said...

Bart, I believe disclosure is required on your part to clarify the following:

"I recently got into an e-mail pissing match with a proponent of homeopathy and it has provoked me once again to contemplate the allure of the irrational. After I avowed that there is no such thing as "legitimate homeopathy," her first response was to insinuate that I denounce homeopathy because I have some sort of financial stake in my opinion. You can imagine what happened when she pushed that button. At that point further conversation was undoubtedly useless, but let me carry on here."

1. The question was asked of you:
"Bart, May I ask if you have any financial pony in the race of having homeopathic medicine deemed utter rubbish?"

2. To which you replied: "You are an idiot. I am paid a salary to be a medical sociologist. I study physician patient communication. My funding comes from the National Institute of Mental Health, mostly.

3. To which I replied: "Bart, you wrote, 'You are an idiot. I am paid a salary to be a medical sociologist. I study physician patient communication. My funding comes from the National Institute of Mental Health, mostly.' The oxymoron in this one made me giggle. So do you encourage that physicians tell patients they are "idiots" while communicating matters as established with funding from the National Institute of Mental Health?..Perhaps a good homeopath could assist you in overcoming your anger. In all seriousness, Bart. Your direct, personal attack while discussing a matter that impacts US health policy and thus impacts us all, is indicative of an emotional attachment to your position, detrimental to the spirit of learning."

And I am NOT a proponent of homeopathic medicine anymore than I am Western. Just like Western medicine, some homeopathy is good, some of it is not so good. You never even bothered to ask what I do or what is my educational background. What I am, is a proponet of integrity in health marketing - which is the study of how policies are established when directing clinical practices that impact us all.


Sharon Kramer

Cervantes said...

To conclude that I recommend that physicians call their patients idiots because I called you an idiot is, well, idiotic. It is also idiotic to maintain that there is such as thing as "good homeopathy." Accusing me of being financially corrupt is a direct personal attack, which you made on me. I responded in kind, which you deserved.

Your credentials or profession are irrelevant. You are an idiot.

Mark B. said...

Haha, nice back & forth here. Homeopathy may at least have some placebo effect-related advantages

Dr. Rick Lippin said...

Bart says "Accordingly, medicine is eclectic. There isn't any single principle, or even just a few principles, on which scientific medicine is based."

I like that.

But ask Ed Calabrese how many decades it took him to have mainstream science or mainstream medicine to accept what you call a commonly known phenom. It may be commonly known, Bart, but there sure has been a history of resistance to Calabrese's work.

I have known Calabrese for over 20 years.

Thanks

Dr. Rick Lippin
Southampton,Pa

Anonymous said...

Now tell me again? Where is the professionalism as an educated socialogist that would deem it appropriate to call those with differing opinions "idiots"?

The oxymoron and irony indicative of a greater societal problem of your statement, still makes me chuckle upon rereading,

"You are an idiot. I am paid a salary to be a medical sociologist. I study physician patient communication. My funding comes from the National Institute of Mental Health, mostly."

Mrs. Kramer

roger said...

wu certainly stirs the chi.

Anonymous said...

Botox will now be allowed as treatment in the UK for chronic migraine. Typically (for this kind of malady) 35% sufferers who got a placebo reported reduction of 50% or more of days of pain - day of bad pain wise, their pain was cut in half. In the Botox group, almost half the patients (47%) reported the same reduction. Now of course that is a consequent - and of course wildly statistically significant - difference and the reason why Botox is being ‘legalised for medical use.’ 1.

In my head I have the number of ‘70% patients experience consequent reduction’ - produced with a placebo for ‘feeling nauseous when pregnant’. Meaning, any medication for ‘nausea during pregnancy’ has to beat that 70 % number. (No links sorry C might know.)

Obviously this complaint is easily diminished or eliminated by all kinds of things: loving husbands, servings of pickles with ice-cream, high self-esteem, a job with a an open schedule, as well as a caring doctor with a ‘new’ pink pill. And perhaps it is created by fear, anxiety, loneliness, therefore not, strictly speaking, a ‘medical’ complaint, though that’s another discussion.

Therefore, no meds for this complaint can be bought on prescription and no over the counter meds are allowed to advertise/state/: helps nausea. during p. (Where I live.)


Homeopathy and other ‘woo’ works, because of the placebo effect, and additionally because some minor ills just don’t last. It is not surprising that many turn to it, in view of the expense and danger of ‘official’ medics. Seen under that light, it would seem hard to imagine it could ever disappear, as after all instituted medecine counts on the same effects to some no doubt large degree. IMH experience, practically everyone is cured of a whole host of ‘ills’ with *prescription* medecine that can’t possibly have had any real effect.

Anyway placebo is an issue I haven’t sorted out in my own mind. 2. Here some patients are treated both by accredited Docs AND by some local witch doctor who pitches in. Works a treat I am told (anecdotal.) Homeopaths, conversely, lobby and work hard to become ‘respectable’... In Geneva, they managed to institute a lectureship in Homeopathy in the medical Faculty - under pol pressure - had to be cancelled finally as no students showed up.

1. I read this here (in french) no doubt goog will provide.

http://www.letemps.ch/Page/Uuid/d3182432-8ba1-11df-a7c3-d97c1092a604/Du_Botox_pour_soigner_la_migraine

2. Not on how it works, but the statistics of it, interaction with diff. kinds of illness, medical treatment, etc.

Ana

C. Corax said...

Ed Calabrese?! I knew him well back in the early 80s! Well, I knew him through his wife. In fact, when our hot water heater died and took three days to be repaired, I walked up the road to take a shower at their house. They had a truly mellow and wonderful Irish setter at the time. I lost touch when they moved one town west.

He was subjecting sheep's blood to exhaust pollution to study the effects of auto exhaust way back then.

I love how some woo-believers get their knickers in a twist over this, that or the other thing in vaccines, but merrily swallow toxins in their homeopathic swill.