Lesley Regan’s Medicine Cabinet
Given the mountains of crap spewed at us everywhere we look by homeopushing gobshites, it was a refreshing change last week to see Professor Lesley Regan front this BBC TV programme exposing homeopathy for the poppycock it is.
Obviously, her task was not difficult. First, she allows a genuine homeopath, one Tony Pinkus, to demonstrate how the remedies are made. We see him add a drop of arnica to a test tube containing 99 drops of alcohol and then strike the test tube against a book 20 times. The solution is subsequently diluted one part in a hundred in several more test tubes (I think 12 in total). Pinkus, looking every inch the scientist in his white coat, explains earnestly,
As we progressively dilute and shake you can improve the effectiveness of the remedy and also take away the side effects so it’s a win-win situation
The more dilute the remedy, the potent it is of course. This will come as no surprise to anyone who read my earlier comprehensive post about homeopathy. What may be surprising is that Tony Pinkus is registered with the Royal Pharmaceutical Society of Great Britain, as is his coven, the Ainsworths Homoeopathic Pharmacy.
Pinkus comes up with the usual guff about like treating like and how he would give an onion-based remedy to someone with streaming eyes. Professor Regan, commendably, keeps a straight face all through this explanation, even when he asserts that the reason why homeopathy hasn’t been scientifically proven to work is that “we don’t have the werewithal in science as it is today to actually be able to do that but one day we will.” How do we know it works? “From experience,” is the predictable response. How dare this man presume to wear a white coat!
In fact, as the programme’s narrator tells us, loads of studies have been conducted into homeopathy and, courtesy of the programme, a “decade’s-worth” of these landed on the desk of poor David Spiegelhalter, Winton Professor of the Public Understanding of Risk at Cambridge University, who proclaimed what those of us who take an interest in the subject already know. This is what he says about the studies:
A number of them have been very well done by good teams and published in reputable journals and they come up with some positive findings. But they tend not to be big enough. Even the good ones are just not big enough. When you start looking at the larger studies, the ones that have been properly randomised and blinded, then the evidence for homeopathy gets smaller and smaller and that means that if you did a really big study you might find there’s almost no evidence for homeopathy at all. For me, the evidence for homeopathy is not convincing.
Many of us already know why homeopathy appears to work for some people. Nevertheless, it’s worth quoting Dr Dylan Evans, author of Placebo: The Belief Effect who appears on the programme and puts it concisely:
The placebo effect is the power of a treatment to work just because we believe it works. All placebos can do is boost our own natural healing mechanisms. If something is beyond the capacity of the body to heal altogether then no amount of believing is going to change that. Homeopathy works very well for pain, for swelling, for nausea and for all the conditions we know to be placebo-responsive. That in itself suggests that homeopathy may be a pure placebo.
Homeopathic practitioners are experts in the placebo effect even maybe without realising it. They’ll use scientific looking procedures to prepare their remedies, they’ll wear similar looking scientific clothing, they will surround their whole practice with a sort of aura of science precisely to give it that sense of importance that will encourage the belief in the treatment and therefore the placebo effect.
Finally, on the premise that “if homepathy really is down to the placebo effect, Professor Regan ought to be able to create an equally successful remedy”, we see Lesley Regan set up a couple of wee experiments of her own. In the first one, she finds a few chronic insomniacs and gives each of them a bottle of sugar pills, tells them it’s a sleep remedy and sends them off to test it. It works.
In a nutshell, what the programme does is, firstly, reveal the sheer lunacy involved in the manufacture of homeopathy; secondly, it reveals that there have been many scientific trials of homeopathy and the weight of evidence suggests that any positive benefit is due to placebo; finally, to lend weight to the hypothesis that homeopathy only works because of placebo, Lesley Regan demonstrates the power of placebo on a small group of people, leaving the viewer with a choice between believing that homeopathy works because the ridiculous claims made for it (that dilution increases potency, that ‘like treats like’, etc) or it works because of placebo. Not perfect, but on the whole it’s nicely done.
There’s quite a bit more to see in the programme, which also looks at whether branded painkillers are better than generic ones, self-testing kits for disease prevention and herbal remedies, where we hear the usual idiotic comments from users about herbs being “natural” and therefore better. The progamme isn’t on youtube yet but UK viewers can watch it on the BBC website here.
What’s been the response from the quacks? Silence mostly, though I did come across one from someone who modestly describes herself as a leading nutritionist, by which she means she has a diploma from the notorious quack Patrick Holford‘s Institute for Optimum Nutrition, and who somehow managed to miss the point entirely.
On her blog she writes of the programme,
The homeopathy study she did was on four people, all who had chronic insomnia. Instead of giving homeopathic remedies she used sugar pills. I’m wondering why she didnt just try the homeopathic remedies anyway. Perhaps she was worried that they might actually work! The placebo pill worked well on the insomniacs and homeopathy was branded as nonsense.
What homeopathy study? It is stated clearly that the experiment was set up to demonstrate the power of placebo. And no, having heard from the country’s leading statistician that the evidence for homeopathy is not convincing, I very much doubt that she was worried they would work. The reason she “didn’t just try the homeopathic remedies anyway” is that if the subjects had got a good night’s sleep after taking a homeopathic remedy, it wouldn’t prove anything. That is precisely the point made repeatedly in the programme about the need for homeopathy trials to involve a large enough group of people that any positive results are statistically significant. Got it now?
A further comment from this blogger:
What would have made far more interesting viewing would have been giving the homeopathy to young children or babies where placebo becomes a non factor.
It may have made interesting viewing but, again, what would be the point? Let me spell out the bleeding obvious one more time:
A scientific trial needs to be large if the results are to be statistically significant. It needs to be placebo-controlled to demonstrate that the remedy works better than placebo. It also needs to be randomised and double-blinded so that neither the practitioner nor the subject — or, in the case of babies, the subject’s carers — know whether they are getting the remedy or the placebo. Giving a few babies a homeopathic remedy — whether it appears to work or not — would prove absolutely nothing.
Why do animals and babies respond so well to homepathy if it is all in the mind?
They don’t. Actually there is evidence that the placebo effect works on animals but this question is a classic example of the post hoc ergo propter hoc fallacy, which I frankly can’t be bothered to explain again. It’s a shame Patrick Holford doesn’t include a course in logic and critical thinking in his nutrition school but I guess that if he did any student who completed it would refuse to buy into everything else he offers.
If a trial is backed by a pharmaceuctical company how can the trial be unbiased? We have no idea who paid for these research trials and that is key to how to interpret the results or any trial done on any medicine.
This is an important point, for it is true that trials tend to be biased in favour of whoever funds them and trials that suggest any kind of positive benefit for homeopathy tend to be funded by the homeopathy industry. However, it is not “key to how to interpret the results or any trial” — it is one factor to be considered together with all the other factors, such as the number in the trial, the blinding, the randomisation etc. The argument, promoted ad nauseum by scientifically illiterate quacks, that if a trial is funded by a drug company then the results can’t be trusted, is fallacious. Let me try to make this as simple as possible:
Not all conventional drugs work but many do. I’m certainly not claiming that every drug ever produced has been safe; of course not, some have had catastrophic effects. But, in general, they work and, in general, as long as they are taken according to instructions, they are safe. To ensure that they are effective and safe, billions of pounds needs to be spend on research, development and testing. Who the hell is going to fund all this development, research and testing, if not the pharmaceutical companies? Would the detractors prefer that Big Pharma didn’t fund any trials at all?
The only other blog response to the programme I found was from the Yorkshire Centre for Classical Homeopathy, which is the rather grand name chosen by a couple of homeopaths with delusions of grandeur. At least they didn’t misunderstand the placebo experiment in the programme but their response was dishonest in a way that I find is typical of homeopushers:
She inferred that homeopathy does not undergo rigorous testing, for her information homeopaths were conducting double blind trials fifty years before conventional medicine and we continue to conduct rigorous trials (provings) on all our remedies ensuring that they are effective and above all safe to use…
I’ve lost count of the number of times I’ve heard homeopushers claim that double-blinded trials are no use for homeopathy because the remedies have to be “individualised” etc but this is the first time I’ve heard homeopushers claim their particular brand of quackery pioneered them! In the absence of any further explanation, it’s safe to assume that this claim is as untrue as the second claim about homeopathic provings being in any way useful, let alone “rigorous”. I give an explanation of what is involved in provings in my previous post on homeopathy. Just make sure you’re not eating or drinking when you read it.
The final comment from this pair:
Science really needs to catch up!
I was going to respond to this utterly moronic comment but on second thoughts, as it’s pretty obvious that what any of these bloggers know about science could fit onto an echinacea leaf, I don’t think I’ll bother.
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