You may be wondering what possessed me to spend a day listening to a bunch of quacks talking piffle. Having done it, I’m wondering the same. The best I can say is that I went for the same reason I once consented to an examination by a chiropractor, wore a niqab and gave birth at home (not all at the same time) and why I might yet have a reiki massage and do the alpha course: I wanted to see what it was like. I saw it as part of the rich tapestry of out-of-the-ordinary experiences that life has to offer. What could be more bizarre than to sit listening to “top PhD research scientists” talk about one of the loopiest of all quack therapies as if there was a serious chance it could revolutionise health care systems in the developed world?

The conference, organised by the very scary Jayney Goddard of the Complementary Medical Association, was promoted thus:

Jayney Goddard ‘Homeopathy is nothing more than placebo! It doesn’t work and homeopaths are cynically ripping off vulnerable people!’ We’ve all seen these ridiculous headlines. So, if you are as fed up as we are of hearing this constant nonsense, do come along to the 2010 “Scientific Research in Homeopathy” Conference. This is a not-for-profit event that will give you the proof you need to effectively counter these arguments.

Jayney opened the conference with the declaration that, “Homeopathy is weird. We know it works but we don’t know how,” and promised us speakers “at the zenith of their profession.”

Are you ready?

Lionel Milgrom

Call me naive, but when I go to conferences I expect to hear professional presentations in keeping with the theme of the event.

I’d never seen or heard Dr Milgrom perform live before and I initially mistook him for some cocky little barrow boy from Billingsgate market who’d wandered in by mistake. But, according to the conference website, he’d had a “a long career as an academic research scientist”. Blimey, as Milgrom would probably say, he certainly kept his scientific credentials well-hidden during the hissy-fit he gave in lieu of a presentation.

The list of targets was predictable enough: Edzard Ernst, Richard Dawkins, David Colquhoun, Michael Baum, Simon Singh and Ben Goldacre all came in for a tongue-lashing as did the Sense about Science charity, with a special mention for the charity’s founder, Lord Taverne: “Dick by name, dick by nature,” spat Milgrom, to approving sniggers from the audience. But the main target for his venom was Evan Harris. “I’ve always voted Lib Dem before,” he snivelled, “but I never will again.” He announced that he’d written to Nick Clegg requesting that Evan be censured — “and I really hope he is!” See gimpyblog for a look at the letter.

It seemed a curious decision to kick off a purportedly serious conference about homeopathy and scientific research with a session that was little more than a rant about “the new fundamentalism”, as Milgrom describes the growing opposition to the unethical promotion and public funding of scientifically unsupported therapies. It also seemed curious that he should give a presentation that, as far as I can see,  was virtually identical to the one he gave at the first such conference two years ago (available here or, for anyone who’d prefer to read the same old guff in article form, try here). As an update on his last rant, we’d been promised a “critique” of the article by Michael Baum and Edzard Ernst on the truth about homeopathy, but nothing that could reasonably described as a critique took place.

It will come as no surprise that Milgrom gave the usual quackish misrepresentation of what was happening in the BCA v Simon Singh libel case (in spite of Jack of Kent’s hilarious post about him last year), sneered at the 10:23 event and at skeptic bloggers in general. And, of course, he called the meta-analysis by Shang et al (the one that reveals homeopathy to be the biggest cock and bull story since the virgin birth) the “best example of bad science worthy of Ben Goldacre”, which is what he said last time (see apgaylard), and which is, of course, nonsense. There were a few criticisms of the Shang paper but these have been more than adequately answered and, anyway, they had no effect on the truth of Shang’s conclusions. Milgrom is not the type of quack who would let the truth get in the way of good story, however.

If anyone’s interested in any of the…ahem…‘scientific’ content of Milgrom’s slot, I suggest you go and read Andy Lewis’s superb article about what he said at the previous conference and if that isn’t enough for you, I can recommend Shpalman’s collection of articles on Milgrom. As far as I’m concerned, he’s a waste of space and I’m not going to waste any more of my time on him.

19.4.2010: Edited to add link so you can read Milgrom’s rant now published on some quack website. Don’t all rush.

Alex Tournier

The demeanour of this charming Frenchman couldn’t have been more of a contrast to that of the horrendous Milgrom. Not only did he not slag anyone off but his was one of only two presentations at the conference that contained some science and it is rather sad that someone so well qualified is wasting their time on homeopathy. Dr Tournier is a biophysicist and a research fellow for Cancer Research UK. He is also chair of the Homeopathy Research Institute.

I don’t propose to say much about the content of his presentation because, although I took copious notes, I don’t have a copy of the slides he used. (Copies of all the presentations were promised to attendees; none have so far materialised.) Even with the slides, I found his argument difficult to follow and it was even more difficult to take him seriously after he’d introduced his session with probably the daftest remark made by any of the speakers during the entire day, which is that the principle of like treating like — the ‘Law of Similars’ — is “pretty uncontroversial”.

Say what?

It isn’t the first time I’ve heard a quack from a scientific background mention vaccines in the same breath as homeopathy and, coming from people like that, I can’t see the comparison as anything other than dishonest. I know a lot of homeopaths say things like, ‘homeopathy works by stimulating the body’s own healing power’, but they’re just stupid. That’s not an explanation!

Surely the ‘treat like with like’ — sympathetic magic — idea is every bit as controversial as the ‘more dilute = more potent’ nonsense. (The latter is what Alex Tournier described as the ‘Achilles heel’ of any theory of homeopathy, when really it’s just the part that most easily lends itself to ridicule.) The ‘Law of Similars’ has always been a huge stumbling block to acceptance as far as I’m concerned and I still await answers to the questions about it I have posed several times already in previous posts.

Tournier soon made his second ludicrous and dishonest assertion of the day, which was that homeopathy’s detractors never pick up on the similarity of the high dilutions principle and hormesis. Oh, good grief! I may not have a PhD in biophysics but even I know the difference between something and nothing.

Another reason why I didn’t expect to be blown away by Tournier’s presentation is that I’d read Gimpy’s analysis of what he said last time. To quote Gimpy,

…he indulges in the familiar deceit, misinterpretations and hypocrisy of homeopaths when it comes to evaluating scientific approaches to homeopathy

Exactly.

Anyway, as I can’t bring Tournier’s presentation to you, I’ll just c & p what he said in the pre-conference information and move on. (I’d skip it if I were you.)

There is presently no accepted scientific theory of how the high-dilutions involved in homeopathy might carry any physical effect, let alone a therapeutic effect. Several lines of enquiry have been followed over the years with little success. There is currently a great need for a testable theory of high-dilutions, such a theory might be that of Quantum Coherence Domains (QCDs).

Giuliano Preparata (1942-2000), an Italian theoretical physicist at the university of Milan, hypothesised the presence of QCDs in room temperature condense matter. QCDs emerged out of Preparata’s extension of Quantum Electro-Dynamics to include interactions with external Electromagnetic (EM) fields. In the case of water these hypothesised QCDs would be small volumes of water each one acting as a single quantumly coherent entity.

These QCDs have interesting properties in terms of a potential explanation of the phenomena linked to high-dilutions. These QCDs are predicted to capture the EM fields present at the time of their creation. This process could, in principle, capture the specific EM signature of any given substance. The serial dilution/succussion process involved in homeopathy could then be seen as a way of propagating QCDs around a sample (through succussions or, equivalently, vortexing) and eventually removing all trace of the original substance (through dilutions).

QCDs are currently being investigated as a potential explanation of a number of anomalous behaviours reported in experiments investigating solvation effects. In the context of high-dilutions a number of experiments have already reported some effects, although not in a fully reproducible way.

I will present an overview of the theory of QCDs and how, when applied to homeopathy, it offers a framework through which many of the observed phenomena can be investigated and potentially explained.

Kate Chatfield

Chatfield’s name will be familiar to anyone who’s been following David Colquhoun’s campaign against quackademia (snigger). She still leads an MSc course at Uclan but it’s only in homeopathy by e-learning, which would explain why Chatfield, who described herself as a “philosopher not a scientist” is considered qualified to take it.

Obviously, as she’s not a scientist, her session wasn’t remotely connected to science. Instead she promised, in her session, to address the question of whether it is unethical to prescribe homeopathy. Chatfield, a homeopath, concluded that it isn’t. Fancy that.

Steven Cartwright

How lucky am I that Azneo has produced a very nice wee blog post on the same presentation — right down to the quote from Sir Arthur Conan Doyle — given by Cartwright at another venue! Before you click on the link, allow me to indulge in a bit of blatant well-poisoning.

I’m sorry but I just have to share with you some bits from an article by the same Dr Steven Cartwright that was published in The Homeopath magazine in 1996.

Cartwright had several years experience as a homeopath and four years involvement in shamanism, when he travelled to Peru to learn about the shamanic healing practices of a tribe of Amazon Indians. He “knew intuitively that there were important connections between shamanism and homeopathy”.

My favourite bit is his description of how a shaman deals with a sick person who comes to see him and how it may take several visits before the shaman ‘sees’ what is wrong with the person.

The shaman would say that the spirits have shown him. And in that moment of ‘seeing’ the cure takes place. The singing that follows, the plant infusions that are given, all help; but unless the shaman has ‘seen’, no cure can take place.

This all sounds fair enough, doesn’t it? We are talking about a primitive people living in the Amazon rainforest, after all. I don’t suppose too many of them get the chance to go to university, unlike Steven Cartwright who, according to his conference profile, gained his PhD from Edinburgh University and spent many years as a research biochemist at Oxford University before discovering homeopathy. He continues:

The parallels with homeopathy were unmistakable. A patient can come several times to the homeopath, but only when we ‘see’ the nature of the patient’s sickness, only when we understand, can and does, cure take place…For the shaman it is the spirits who help him to ‘see’. The homeopath has only symptoms to help him or her to ‘see’. And intuition.

Now here’s the bit that made my jaw drop:

For those of us who do not follow the way of the shaman, there is a symbolic system above all others which is so versatile and which tells us so much about a patient and their state of being, including their heredity, even before they tell us their story, that it is invaluable as an aid to coming to the meaning of sickness; and that symbolic system is astrology. Astrology gives us access directly at the level of meaning, rather than manifestation, and that, to my mind, is its great value.

I’ve since learned that astrology — sorry, I mean medical astrology — is considered quite appropriate for incorporation into the homeoquack’s armoury. I am so tempted to book a consultation with Steven Cartwright just to hear him talk about ‘Mars in Scorpio rising’ or some such twaddle.

You may be wondering why somebody like this was speaking at a conference that has the word ‘science’ in the title. The answer is that he’s been involved in “experimental work at the Cherwell Innovation Centre in Oxford aimed at developing assay systems for homeopathic potencies as well as demonstrating changes in solution on succession, which it is hoped will eventually lead to an explanation of the mechanism of action of homeopathy”.

Steven Cartwright, bless him, comes over as a really sweet and personable man but he doesn’t half talk some hogwash. Here’s a sample taken down verbatim from his session:

Has anyone here given a remedy and it hasn’t worked, then given the same remedy further down the line and it has worked? (Murmers of assent.)

What’s happening?

The indications are that potencies oscillate in their effectiveness over time…What if James Maddox and James Randi had come to Benveniste’s lab on a day when the strength of the potency was at its lowest? And if they’d come when the strength of a remedy was at a peak, I wouldn’t be standing here now because Benveniste would have won the Nobel prize and it would all have been sorted.

OK, go away and read that other blog now, if you’re interested enough in what Dr Cartwright has to say. (As an alternative, I’d recommend yesterday’s interesting post by Prof Stephen Curry: Homeopathy and the Structure of Memory.)

By the way, if anyone doesn’t know the story of Benveniste, you could do worse than watch the 2002 Horizon documentary on homeopathy, which is now on youtube. The advantage of this is you get to see and hear Benveniste himself talk and he’s dead sexy. Well, just dead now, of course. Milgrom’s in it too.

Edited to add: Or see the Bienveniste story told in cartoon strip here — superb!

Oliver Dowding

We have huge “constituencies” of satisfied users consistently proving beneficial outcomes. These are satisfied users who generally have four legs, but in some cases, only two, and all come from the animal kingdom. Whilst not widely practised in this country, there are a great many more animal users of homoeopathy than sceptics are prepared to accept.

Yes, I know. This extract from Dowding’s conference profile is just begging for ridicule. You’re right, Oliver, I do not accept. Just put me in touch with some of these four-legged “users” and let them tell me themselves how satisfied they really are.

There is more of the same on this website, which he directed us to.

This article is written from the experiences I had in keeping 500 head of dairy livestock for 14 years, whilst managing the farm under organic principles.  I was meeting many health challenges that they faced, which we primarily resolved with homoeopathic remedies.  The overriding outcome and opinion formed was that cows are not inherent liars or fraudulent creatures!  They have no axe to grind, nor a commercial position to maintain or enhance.

There’s not more much I can say about this former dairy farmer, who was yet another speaker at this so-called science conference who began his session by declaring he wasn’t a scientist, had no degree of any sort in fact but he had “spent a lifetime doing things”. Well, that’s nice to know.

Dowding was as sour as Cartwright was sweet. Allopathic medicine is failing on a big scale, he told us, and we need alternatives. I’m sure he knew he was singing (or, rather, reading his speech word for word) to the choir but that didn’t stop him.

Like Lionel Milgrom, he felt the need to have a cathartic rant at the usual suspects — mainly Ben Goldacre — but also at the more humble everyday folk who like to challenge the promotion of dangerous nonsense on the web under “ridiculous pseudonyms”. I can’t think who he means. Strangely, the one he chose to focus on was my friend, Margaret Nelson, who makes no attempt to hide her identity in making her brief comment on libdemvoice.org, which Dowding read out because it ends with this throwaway line:

Oh, and if Oliver’s use of homeopathic “treatments” for his livestock causes them any suffering, he’s liable to be prosecuted on animal welfare grounds because it’s not treatment at all.

Dowding, to my astonishment, then read out his entire response, which is nearly a thousand words long! How surreal was it to be at a conference supposedly about scientific research listening to Worzel Gummidge read out some squabble he’d had on the internet? Honestly, it felt utterly bizarre. I will add that I go to quite a few meetings and conferences and if the humanists and skeptics I hear at them behaved like some of these people did, I’d have nothing to do with them.

Anyway, Worzel said nothing that was worth reproducing here so I’ll move swiftly on.

Clare Relton

During the conference, two conflicting views were expressed on the state of scientific evidence for homeopathy. One view is that there is loads of good quality scientific evidence that homeopathy works (Milgrom) and the other view was that there isn’t (Relton — though, in fairness, she implied this rather than said it in as many words).

Milgrom repeated the lie that “there are many good quality scientific trials and meta-analyses showing that homeopathy can demonstrate clinically observable effects over and above placebo”. Relton, on the other hand, while stating that since 1945 there have been some 200 RCTs published on homeopathy and that a new one lands on her desk every couple of weeks, repeated the argument so beloved of altmed devotees, which is that “lack of evidence of effectiveness is not the same as evidence of lack of effectiveness”.

Indeed it isn’t and it’s a perfectly reasonable thing to say in relation to a therapy that — unlike homeopathy — is scientifically plausible but hasn’t been trialled extensively. When a treatment that — unlike homeopathy —  doesn’t flout any fundamental laws of physics but — unlike homeopathy — hasn’t been subjected to rigorous scientific testing, then of course we can’t know for certain whether it works or not.

Take, for example, the extract from the foxglove plant, digitalis, which was originally part of an old folk remedy for heart disease and which is still used by homeopaths “for people who are prone to heart and circulatory disorders. The remedy is considered particularly appropriate if symptoms are accompanied by a fear of death, or a fear that moving — especially walking — may cause the heart to stop beating”.

For more than two centuries digitalis (digoxin) was considered a life-saver by physicians practising orthodox medicine as well.

…doctors based their ideas on their clinical experience and intuition, and knew that digoxin saved lives. They could see it working. The 1997 trial showed that doctors had been wrong on this point for two centuries. People who took digoxin lived no longer than those who swallowed a placebo. That was not because it was less ‘natural’ than chewing on a foxglove, simply because the effect of the active compound on the human body was not as miraculous as intuition suggested.”

Druin Burch,Taking the Medicine p. 237

When it comes to a therapy that has been tested in a couple of hundred RCTs and when the better quality trials demonstrate an effect no better than placebo….well, if that isn’t evidence of lack of effectiveness, I don’t know what is.

But for homeopaths — or any other breed of quack for that matter — if the science tells us something we don’t like, then there is something wrong with the science. Clare Relton used her slot to talk about clinical trials — the subject of her recently completed PhD. She was the most engaging speaker at the conference and her presentation was the only one I found vaguely interesting, though not as interesting as her story of how she flunked science at age 13, got a “motley collection of GCSEs” yet ended up being employed by the NHS to provide homeopathic treatment and is now a research fellow at Sheffield. She said she found the fact that she now earns her living from science “intriguing” and, having heard her presentation, so do I.

She mentioned her extensive experience of treating menopausal women with homeopathy. As someone who’s spent the best part of a year finding out just how bad the menopause sucks and how it can ruin one’s social life, I had no trouble imagining how nice it would be to spend an hour in the company of this charismatic woman. I could envisage her listening intently, maybe even holding my hand as she nodded sympathetically. Then she would prescribe an individualised remedy — a remedy just for me — devised after careful consideration of everything from my food preferences to my phobias (for a list of questions used in homeopathic consultations, see here). I have not the slightest doubt that if anyone can cure my menopause, Clare Relton can. A series of appointments with her and I’m sure the hot flushes would lessen in frequency and eventually disappear altogether. Yep, I’m convinced of it.

Anyway. Dr Relton talked about perceived shortcomings of RCTs and about her pioneering work on a new trial design: Relton et al BMJ. 2010 Mar 19;340:c1066. doi: 10.1136/bmj.c1066. Rethinking pragmatic randomised controlled trials: introducing the “cohort multiple randomised controlled trial” design.

Here’s an extract from the article:

We have obtained ethical approval for and have conducted a pilot study of the cmRCT design. (Relton C. A new design for pragmatic RCTs: a “patient cohort” RCT of treatment by a homeopath for menopausal hot flushes. [PhD thesis] ISRCTN 0287542. University of Sheffield, 2009.)

In this pilot, a large observational cohort of 856 women aged 45-64 was recruited and their outcomes measured. A total of 72 women reported frequent or severe menopausal hot flushes, or both. Of these 72 women, 48 were eligible for the trial treatment (NA) and 24 were randomly selected to be offered the treatment (nA). The outcomes of the randomly selected patients were then compared with the outcomes of those eligible patients not randomly selected (NA – nA) using both intention to treat analysis and CACE analysis.20 Patients were not told about the treatments that they were not randomly selected to be offered.

Now, here’s how she described to the conference audience, what she’d told the women selected to be offered the treatment:

There is a treatment that we think might benefit you but we are not sure. There doesn’t appear to be any risks because it is homeopathic, although there is not much evidence about it.

I don’t pretend to be any kind of expert in these matters but even I managed to spot a teensy-weensy problem with that scenario. We know by now (and, indeed, have known for more than 200 years) that the mere belief that a medical intervention is taking place can result in an improvement (or worsening) in some medical conditions. That’s why trials have control groups and why both groups are blinded. Isn’t comparing a group who know they are being treated to a group who know they aren’t, asking for bias? What am I missing here? I hope someone will be able to explain it to me — preferably someone who knows what they are talking about.

If you’re wondering why I didn’t pose this question to Dr Relton at the time, it’s because we were forbidden by Janey Goddard from asking questions in the sessions. The conference wasn’t an occasion at which conferring was encouraged until a brief all-speaker panel session at the end. Goddard said it was more “holistic” (yes, she really said that!) to save questions until the end of the day when, inevitably, there were too many — mostly daft — questions for the time allotted.

During her slot Relton also highlighted, with the help of the BMJ pie chart, “how little we know about the effectiveness of NHS-funded healthcare”. To her credit, she didn’t do what I’ve mostly seen quacks do with that pie-chart and claim that it refers only to conventional medicine when it fact it refers to all commonly used treatments including the one Dr Relton has spent years practising. She focussed very much on the 51% of treatments of unknown effectiveness (treatments “for which there are currently insufficient data or data of inadequate quality”) without mentioning the criteria on which treatments were included or left out so I’m not sure what point she was making. Funnily enough, she made no mention at all of the 13% of treatments of proven effectiveness and of the fact that homeopathy was not included amongst them.

Dr Rob Verkerk

Verkerk is a “compelling speaker who is also extremely personable,” said the pre-conference publicity. In fact, Verkerk, who has a PhD in something to do with agriculture comes across a dreary, whingeing and obnoxious gobshite, very much in the Milgrom mould. He is the Executive Director of the Alliance for Natural Health — whatever that is — and, like many of the presentations at this ‘Scientific Research in Homeopathy’ conference, his had nothing much to do with scientific research but, like Clare Relton’s session, focussed much more on dissing the methodology employed by scientific researchers because it doesn’t suit quack remedies.

He quickly endeared himself to the audience with a hilarious joke that went something like this: “It’s important to declare one’s biases and my bias is that I don’t like pharmaceuticals a lot”. His second bias is that he doesn’t like “corporate imperialism”. I’m sure you can work out one of his favourite themes from those two biases and his argument was so tired, I’m not even going to go there.

My interest was piqued when he informed us that “energy-based medicine” is central to some ancient tradition or other and that the only people who don’t understand it are orthodox physicians. But my hope that he was going to give some sort of explanation of this energy-based medicine was not realised, alas. Instead he told us his third bias is Ben Goldacre, whom he doesn’t think is a very good doctor or scientist. But then Dr Verkerk evidently doesn’t think that any doctor or scientist who considers the totality of available evidence for quack remedies and concludes that they are basically crap, is a very good doctor or scientist.

Verkerk talked about the difference between efficacy in the “ideal experimental world” and effectiveness in the “real world”. As every quack knows, the methods of research favoured by scientists tend to demonstrate a lack of efficacy in quack therapies and this, he whined, is mainly because scientific researchers ignore clinical experience, which isn’t what David Sackett intended at all. No, indeed! Then again, I don’t think he intended that clinical trials should be cherry-picked and the larger, better quality ones ignored. In his 1996 article in the BMJ, (which Verkerk mendaciously referred to as a “complaint” that clinical experience is being disregarded), Sackett said,

Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.

It follows that, as the best clinical evidence from systematic research of homeopathy shows it’s a crock, NHS funding for it should be withdrawn immediately.

Of course, Verkerk also had a go at Edzard Ernst. He went on about Edzard rather a lot, in fact. To give a flavour of what he said and the tone in which he said it, this is Verkerk reading from a systematic review of RCTs of individualised herbal medicine conducted by “Ernst and his chums”, in 2007.

“There is a sparsity of evidence regarding the effectiveness of individualised herbal medicine and no convincing evidence to support the use of individualised herbal medicine in any indication”…so says God! And it is utter rubbish! If only he was to look at what’s happening in a clinical environment…

If this conjures up a picture of a surly adolescent having a tantrum, I’ve succeeded in conveying my own impression of Verkerk’s session. If not, you might like to look at Verkerk’s written response to the same systematic review, in which he says pretty much the same thing and in the same way as he did at the conference.

Scientists like Prof Ernst have become so introspective over their worship of their reductionist methods that they fail to see how they do or don’t relate to the much, much bigger picture of how extremely complex and diverse natural substances interplay with even more complex and diverse genomes. This truly is an abuse of science.

Worship of reductionist methods? Enough already! I really can’t be bothered to transcribe the rest of what this guy said. Let’s just consider that the pre-conference publicity said the main purpose of Verkerk’s session was to “outline a potential way forward aimed at facilitating greater acceptance and uptake of homeopathy by mainstream medicine”.

This is what he said in conclusion:

It is time to park some of the thinking on efficacy. It ties up a huge amount of resources. If they want to do it, that’s fine, but the work is done so consistently badly and inappropriately that, most of the time, it’s not worth it…We need to be thinking about mechanisms but it’s not not the end of the line if we don’t have one. We need to focus on finding better tools to measure what is going in a clinical environment. We have to translate that patient experience and find better ways of translating what’s happening at a clinical level into a so-called scientific approach.

In other words, stop worrying about how it works; the way scientists do science sucks and we just need to find ways of making all our anecdotes look like convincing evidence. Clare Relton said pretty much the same thing — she just said it in a nicer way.

Conclusion

The conference has been described as a “huge success” but only, so far as I know, by the person who organised it. It’s not clear what criteria she is basing her judgment on but probably that people enjoyed it as a social occasion. One thing I can be sure of: not a single person left that conference equipped to “effectively counter” the arguments against homeopathy as a therapy or against its provision on the NHS.

Something I hoped to gain from the day was a better understanding of why people so passionately believed in such an implausible idea. Is there something more going on here (I mean psychologically, not with homeopathy) than the naive post hoc ergo propter hoc assumption?

I don’t think so.

I think we already know the factors that come into play: perhaps the most important one is that bad experiences with proper medicine make one more disposed to wanting any alternative to work, however batty it sounds. The apparently miraculous recovery of a loved one (or oneself) when nothing else had worked — as was the case with Relton’s son’s chronic ear infections, which hadn’t responded to antibiotics but got better after getting homeopathic treatment — can provoke an ephiphany and I use that word deliberately. The conversion to homeopathy is closer to a religious experience than it is to anything else, just as homeopathy is more like a religion or cult than it is like a proper health discipline. I don’t think faith in homeopathy can be explained by any new insight into the human condition that has thus far eluded us.

And, of course, once someone has invested days, months or years and a considerable amount of money to becoming a homeopath and especially once they’ve found they can make some sort of living out of it, their minds become resolutely closed to the possibility that they can be wrong about it. (By the way, in my usual spirit of open-minded enquiry, I wouldn’t mind doing this two-day beginners’ course at the Centre for Homeopathic Education, if only it didn’t cost £250. Any offers to fund me?)

Talking of money, I will say that if the conference had really lived up to the title and the promises, i.e. if it had really been about scientific research, if the speakers had really been top PhD scientists and at the zenith of their profession and if it had really equipped people to effectively counter what are really very simple arguments, then it would have been a fantastic bargain at £58.

As it is, the best thing I got out of it was a rather nice goody bag which, once I’d binned the contents, proved quite useful on my next trip to Sainsbury’s.

Ernst is vociferously campaigning against the very libel laws he has just invoked to threaten not me, but my 21 year old website designer who isn’t remotely connected to complementary therapy and had never even heard of Edzard Ernst until yesterday.

So says the diabolical blogger whose nasty, vicious and unsubstantiated attack on Edzard Ernst, I blogged about yesterday. Chris Holmes had posted three articles entitled ‘Edzard Ernst is a fake’ on a blog called Truth Will Out. Less than 24 hours later, I’m pleased to report that all three of these articles have been removed.

In their place Chris has posted another unbelievably silly attack on Edzard, whining that Edzard has threatened to sue his “web designer”, Nathan Beck. Here’s Chris in full fantasist mode:

I wonder why he didn’t contact me? Perhaps he’s not talking to me. Or maybe he read some of the things I’ve written and thought: “This guy calls powerful drug companies all the names under the sun, calls the Department of Health and the BMA corrupt liars with blood on their hands, and ASH, and the Royal College of Physicians… maybe he won’t be intimidated by an email from an academic…

Or maybe Edzard knows young Nathan isn’t just the web designer but is also the registrant for the Truth Will Out domain? It’s not exactly a secret, after all. The information is in the public domain and obtainable in a couple of clicks of the mouse.

Predictably, Chris can’t just graciously admit that his articles were indeed defamatory and remove them but has instead made a pathetic attempt to paint Edzard as some kind of hypocrite:

Can’t help feeling though, ‘Professor’, that in invoking the very laws your campaign says are outrageous when used on Simon Singh (and I agree), you just undermined your own credibility more effectively than The Mole from Thunderbirds.

Oh please! Nobody — not Edzard Ernst, not Simon Singh, not a single one of the thousands of us who are campaigning for libel reform — is arguing that we should do away with the libel laws altogether. That’s why it’s called the Libel Reform Campaign and not the Libel Abolition Campaign.

We all agree that we need libel laws designed to protect individuals from being hurt by malicious falsehoods being promoted by desperately nasty people like Chris Holmes. What we don’t need are libel laws that intimidate the scientific community from publicly challenging dangerous nonsense promoted by zealous quacks like the BCA.

The object, as it states quite clearly on the LRC website is

to simplify the existing law, restore the balance between free speech and the protection of reputation,

Got it now?

Chris Holmes has already made a big show of having signed the petition yesterday so he could write his latest sanctimonious post. But to anyone who hasn’t signed, please do so now and write to your MP if they haven’t signed Early Day Motion 423.

The writer is one Chris Holmes, a hypnotherapist and author of a self-published book about nicotine. Edzard evidently winds Chris up so much that he spent some 2,000 words (and that just on part 3) huffing with resentment and pushing a monstrously fallacious argument, which amounts to this:

P1. To be a professor, you must be a “qualified expert”;
P2. To be a qualified expert you must have professional experience as a practitioner;
P3. There is nothing that says Edzard has ever been a professional CAM practitioner;
C1. Therefore Edzard shouldn’t be a Professor of Complementary Medicine.

I’m sure anyone who can get all the parts of their brain working together as a team, can agree with P1 and can see that P2 is arrant nonsense; it follows that P3 – whether true or not – is irrelevant and that the conclusion and all the bluster that accompanies it is false. (In fact, in his book Edzard mentions that he is “an insider who practised medicine for many years, including some alternative therapies,” but this doesn’t suit Chris Holmes’s purpose so he disregards it. If he can’t find the hard evidence with Google, then it can’t be true.)

To anyone who can’t see that P2 is nonsense, I guess with a big weary sigh that I’ll have to spell it out for you. First, here’s a question: do you think that a Professor of Theology or of Comparative Religion isn’t properly qualified unless he’s done a stint as a bloody vicar?

Here’s Chris Holmes’ killer argument:

The least they would require, if they were looking to find the ideal candidate for a Professor of History – for example – was that the person was at least an historian. Any Chair in the field of Mathematics, naturally you are looking for a mathematician.

The fundamental flaw in Chris’s argument lies with his unstated premise that CAM is an academic discipline. History, mathematics, philosophy, and all the various branches of the biomedical sciences are established academic disciplines. Complementary medicine – like religion – is not. Complementary medicines – like other quasi-religious beliefs and practices – are phenomena to be investigated academically. This is why the Chair was created in the first place and why the Peninsula Medical School’s Department of Complementary Medicine’s stated objectives are:

• To conduct rigorous, inter-disciplinary and international collaborative research into the efficacy, safety and costs of complementary medicine.
• To be neither promotional nor derogatory but to struggle for objectivity.
• To promote analytical thinking in this area.

Now, given that the stated objectives are neither to teach the practice of nor to deliver any CAM therapy but, rather, to investigate scientifically whether they are of any benefit, what real advantage would clinical experience of delivering, say, acupuncture, bring to the role? Is the idea that an acupuncturist would be better able to design clinical trials or survey systematic reviews better than somebody who only held a Chair in a biomedical science? Given their penchant for cherry-picking poor quality trials, I’d say the idea that your typical quack can meet the all-important requirement of objectivity, is a pretty much a non-starter. As for the notion that a CAM qualification equips one to conduct scientific research into any CAM therapy…anyone who’s read any of David Colqhoun’s posts exposing the content of these courses, will find that suggestion screamingly funny.

As Edzard himself says, good quality evidence can only be obtained if

well-trained scientists (rather than CAM enthusiasts with a mere veneer of science to hide their biases) conduct the research.

The suggestion that, just as CAM therapies should be delivered by professional CAM therapists, so scientific research should be left to professional scientists, might not seem particularly controversial but it sent Chris Holmes scurrying for the stupid pills. Here’s his response:

Oh, really? That’s assuming that even well-trained scientists might lose their scientific objectivity if they have any enthusiasm for what they are studying, is it? Tell that to NASA. Or is it just a swipe at CAM enthusiasts particularly, a sort of Catch 22 that if you are a CAM enthusiast you cannot possibly be a well-trained scientist?

(I know – the stupid, it burns!)

No, Chris, it isn’t assuming that “well-trained scientists might lose their scientific objectivity”. The assumption is that well-trained scientists will retain their objectivity, whatever their enthusiasms. Edzard neither states nor implies that a CAM enthusiast can’t be a well-trained scientist; he will have read studies lead by such people and perhaps marvelled at how even well-trained scientists can conduct trials that are badly methodologically flawed. (Fortunately, most well-trained scientists understand the need for replication and peer review and some are even prepared to admit sometimes that they get things wrong, as did Klaus Linde, whose 1997 homeopathy meta-analysis contains the most cherry-picked sentence in the history of homeoquackery, much to Linde’s dismay.)

Actually Chris Holmes goes further than decrying Edzard’s supposed lack of qualification. On Planet Holmes, Edzard is dismissed as “a pathological skeptic with a mere veneer of scientific objectivity,” and bewails his “17 years of over-zealous CAM-bashing posing as objective scientific enquiry using the badge of the university to give it credibility”.

It’s amazing how many people there are shrieking with indignation at what must be the most transparently stupid canard their tiny minds can come up with: ‘Altmed works and if the science doesn’t show that it’s work, the science is wrong and the scientist biased.’ As there is no danger of Chris Holmes letting us in on which of Edzard’s hundreds of papers he thinks isn’t objective and how it fails to be so, his unflattering description of Edzard can be disregarded as the mindless rant of an embittered ignoramus who wouldn’t recognise scientific objectivity if it sat on his face and sang Hello Dolly.

What I find fascinating are the more inventive canards people come up with in order to smear the character and impugn the motives of Edzard and of skeptics in general. First Chris gives us the usual one that

he doesn’t give a toss about the public, that is just a pose. He is, and always has been attacking Complementary Medicine with all the relentless determination of the self-righteous zealot, whilst turning a blind eye to all the sufferings and damage caused by so-called “evidence-based” medicines.

To this Chris adds his own eccentric twist

if Ernst really did have public interest at heart, and simply didn’t want valuable resources spent on things that (he says) don’t work, then he would happily agree with the Truth Will Out call for Nicotine Replacement Therapy (NRT) to be dropped by the NHS on the grounds that the long-term results are clearly no better than placebo (see Evidence section of this site).

Chris Holmes doesn’t have a clue what Edzard thinks or knows about NRT yet he proclaims that Edzard

seems quite happy for valuable resources to be squandered on drug-company products that don’t work, kill people or half-kill them..(which) seriously undermines Ernst’s credibility”.

I’ve lost count of the number of times the ‘no credibility’ ad hominem has been flung at just about every high profile skeptic by just about every no-profile quack. Undermines his credibility in the eyes of whom? Some jumped up quack of a nicotine-denialist?  I’m sure we’ll all lose loads of sleep over that.

The argument that ‘if you don’t speak out about the evils of orthodox medicine, you don’t care about the public good’, is as common as crabgrass even though it’s a red herring repeated by those who really don’t care about the public good. Let’s face it, if they cared about the public’s well-being, they wouldn’t be attacking people who expose worthless therapies and the charlatans who promote them and they wouldn’t be defending therapies that that are biologically implausible and scientifically unsupported.

I’m reminded of the bunch of desperado chirotrolls who hang around Zeno’s blog whining that if Zeno was really motivated by concern for the public, he would be attacking osteopaths as well! Here’s my favourite:

The “osteopathic lesion”sounds much like subluxation to me…This goes to show how vexatious this attack on the chiropractors really is and begs the question why was osteopathy never mentioned in Singh’s article in the guardian,why did he choose to single out the chiropractors?

Is there a link between Singh, Ernst and the osteopaths (or is too much of a conspiracy theory idea)?

The answer, of course, is that that Simon’s article was written for the ‘chiropractic awareness week’, which was an initiative of the British Chiropractic Association. But don’t you just love the idea of Simon and Edzard being in cahoots with osteopaths to discredit chiros? LMAO! Equally revealing are the nasty comments directed at Zeno by several chiros who repeatedly accuse him of sycophancy, bigotry and discrimination because he’s currently focussing on the quacks whose representative body decided to make a lot of noise and draw attention to themselves, rather than having a go at some other bunch that were content to fly under the radar. In order not to be accused of bigotry and discrimination, Zeno should be a broad-minded democrat and attack everyone equally, it seems.

Which brings me back to Chris Holme’s blog post and his motives in writing it. The post is a load of cobblers and I suspect Chris Holmes knows it is and that’s why he resorts to hyperbole and falsehood: puff out a thick enough smokescreen and you’ll divert attention from the painful fact that 17 years of academic research funded by someone who was keenly interested in CAM has unearthed negligible benefits. And from the equally painful facts that Edzard co-authored a fascinating and accessible book about it and that his co-author, Simon Singh, has had the temerity to stand up to a bunch of quacks aka the British Chiropractic Association, who thought they could bully him into shutting up, but who have instead succeeded far better than Simon did in attracting public attention to the bogus claims made by their members.

It must be so, so scary for those quacks who have for years been happily promoting bogus therapies for which there isn’t a jot of evidence to see what is happening to chiropractic and homeopathy in this country – the phrase “loss of credibility” springs to mind, funnily enough. But what quacks like these are too stupid to see is that ignoring the totality of available evidence while attacking the character and motives of their critics, doesn’t do much for their credibility either.