From: BLANTON@VAX2.DSEG.TI.COM
Subject:      Healthy skepticism
Message-ID: <9212191338.AA29663@lll-winken.llnl.gov>
Date:         Sat, 19 Dec 1992 07:28:34 -0600

The following article by Tim Gorski appeared in the latest issue
of "The Skeptic", the newsletter of the North Texas Skeptics.  As
always, free distribution for non-commercial purposes is allowed
(and encouraged).

----------------
Healthy Skepticism
Medical "Pathies"
By Tim Gorski, M.D.
First in a Series

Anyone looking into the mushrooming "alternative medicine"
literature   is  apt  to  encounter  a  number  of
"-pathies" that generally obscure, rather than explain.
Homeopathy, thanks to the tireless efforts of its promoters, is
one of these that has been gaining new popularity in recent
years.  In the Christmas 1992 The Sharper Image catalog, for
example, right there on page 56, are "Longevity" products.  The
ad copy goes so far as to say that it's "medical science" and
"clinically proven," both of which claims are simply and utterly
false.

Many women have also bought the worthless homeopathic remedy
intended to cure vaginal yeast infections, "Yeastgard."  And
there's a whole line of homeopathic quack products sold under the
names "Bioforce," "Hyland's," and "NuAge."  Just as effective,
though, and lots cheaper, are the doctor kits sold in toy
departments that include jelly beans of different colors labeled
"heart pills," "kidney pills," and so on.

Invented by Samuel Hahnemann (1755-1843) in the prescientific era
of medicine, homeopathy is a self-contained system of theory and
practice, which is to say, a pseudoscience. It's based on several
fantastic notions which modern quacks, nevertheless, manage to
sell to their victims. The first of these ideas is that diseases
should be recognized primarily as combinations of symptoms caused
by psora, which is to say, an itch. Hahnemann went so far as to
argue that in olden times maladies including epilepsy, asthma,
and cancer were actually simple skin disorders which, because of
their suppression by habits of hygiene, have been driven inside
the body, so to speak.

The second is the principle that like cures like, for which
homeopathy is named. And the third is that substances which can
cause given symptoms can be used to treat those same symptoms by
administering them as extreme dilutions. Ipecac, for instance, is
an emetic used to induce vomiting in cases of poisoning. A small
dose of ipecac, according to the doctrine of homeopathy, can
therefore be used to cure nausea and vomiting. Not just a small
dose of ipecac can be used, though, and not even a very, very,
very small dose.

Rather, according to Hahnemann and the homeopaths, the effective
dose is a dilution so extreme that not even one molecule of the
substance is likely to be still present! And Hahnemann taught
that the more diluted a preparation was, the more effective it
was, and that a single dose of a homeopathic remedy could exert
therapeutic effects a month or more after being given!
No Scientific Basis

Now in a prescientific era during which effective medical
measures were few, using smaller doses instead of larger and
waiting patiently to see what would happen probably did give
better results. But today the grave logical and scientific
problems of homeopathy are obvious. The chief difficulty, of
course, is how a substance could exert any effect when it isn't
even present in what's given to the patient. The presumably
inactive material in which the active agent is diluted (the
diluent) would itself become the "medicine." But it would have to
somehow transmit the effects of the active agent ... Homeopaths
claim that this happens by the diluent being imbued through the
process of dilution, which involves a ritual of vigorous shaking
which they call "succussion," with "energies" or "vibrations" of
the active substance. Never mind that these "energies" and
"vibrations" can't be measured and are otherwise scientifically
unknown and unnecessary. And never mind that the diluents used
can't be shown to be absolutely 100% free of all contaminants
whatsoever, even including dissolved atmospheric gases. And
especially never mind that whatever diluent is used is
unquestionably swarming with the "energies" and "vibrations" of
everything that its molecules ever came into contact with.
More importantly, no body of reliable evidence supports the
doctrines of homeopathy. One study showed a very small, but
statistically significant, effect of homeopathic remedies used to
treat arthritis pain. But of course at a statistical significance
of P <= .05 (meaning that the results could have arisen by
chance with a probability of 1 in 20), one in twenty clinical
trials, on average, can be expected to show a variance with the
null hypothesis. One study does not a science make. And, in fact,
other clinical trials of homeopathic remedies have shown no
benefits compared to placebo.

The "Remembering Water" Caper
In 1988 a French homeopath, Jacques Benveniste, and collaborators
at his lab claimed to show that extreme dilutions of an antibody
could still cause effects on target cells. A paper appeared in
the British journal Nature which was pounced on by homeopathy
promoters as the long awaited "proof" that "It works!" and the
study is still so cited. But, miraculously, investigators from
Nature and the National Institutes of Health joined by James
Randi and others caused replications of the experiment to show
the expected negative results.

Another investigator using a similar system published negative
results soon after and the whole affair died down except in the
minds of homeopathy apologists. But an important feature of these
events went completely unnoticed. And that is that the effect of
an extreme - homeopathic - dilution of an antibody should have
been the opposite of the usual antibody effect on target cells.
So, even if the Benveniste claims had panned out, they could not
have provided the objective support that homeopathy remains so
utterly without. (See the Winter 1989 issue of The Skeptical
Inquirer for a report on the Benveniste "remembering water"
affair - Ed.)

Unfortunately, homeopathic quackery has enjoyed something of an
advantage over other forms of health fraud in that the 1938
legislation which created the U.S. Food and Drug Administration
recognized the Homeopathic Pharmacopoeia. Homeopathic "drugs" are
not thereby exempted from having to be shown to be safe and
effective but the FDA indicated that it wouldn't challenge
homeopathic remedies being sold to practitioners to treat "minor"
ailments. Presumably someone at the FDA thought that homeopaths
would satisfy themselves with using their placebos to treat
hypochondriasis. Instead, the promotion of homeopathic remedies
has exploded and the FDA has failed to enforce the law.

If homeopathic remedies are nothing but worthless placebos, of
course, they might be assumed to be as safe as their diluents,
which are often water or grain alcohol. But if, as homeopaths
insist, their treatments actually have pharmacologic effects,
they should be held to the same standards of safety and efficacy
as other drugs. This same stumbling block has been encountered in
the European efforts to unite their separate economies since
homeopathy is very popular, for example, in France.

Simply put, homeopathy is medical quackery. Now you know why.

Next month: Naturopathy, Osteopathy, and Allopathy.

Update: Pro-Quackery Bill Now Law
The marginal political/legal advantage of homeopathic products is
passing. Utah Senator Orrin Hatch's Health Freedom Act of 1992
discussed here last month passed both houses of Congress as a
rider to an appropriations bill and was signed into law by
President Bush. Drafted with the help of a health food industry
group, the legislation puts an effective end to the FDA's efforts
to protect consumers in the burgeoning marketplace of vitamins,
supplements and health foods.

Henceforth, as long as quacks continue to follow their
established practices of claiming to have "scientific evidence"
to support the wondrous benefits of their "natural and
nutritional" products, regulatory authorities will be powerless
to stop their deceptive schemes. Those engaged in these scams
have indeed gained new freedom. Consumers, on the other hand, are
as yet unaware that open season has been declared on them by the
nutritional profiteers. Caveat emptor!

This information is provided by the D/FW Council Against Health
Fraud. For more information, or to report suspected health fraud,
please contact the Council at Box 202577, Arlington, TX, 76006,
or call metro 214-263-8989.

Dr. Gorski is a practicing physician, chairman of the D/FW
Council Against Health Fraud and an NTS Technical Advisor.


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| John Blanton                                                    |
| Secretary, North Texas Skeptics                                 |
| blanton@lobby.ti.com                                            |
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