Deconstructing a Fallen Star

On Wednesday December 19^th Rustum Roy sallied forth to defend the plausibility of a mechanism of action for homeopathic remedies; but not their clinical efficacy.  His apologia, published in the “Comment is Free” section of the UK’s Guardian newspaper focuses on the alleged structure of water.  This, he opines, leads to the memory of water.  In turn this makes homeopathy real: not to be “…labelled a fraud…”.

Then he stretches an already weak position to claim that criticism of homeopathy is a social disease that should not be tolerated: “homeophobia“.

Let’s review his contribution (in bold) and see what Roy has conveniently forgotten to mention and what his “social disease” actually is.

“Ben Goldacre excoriates the practice of homeopathy. For the record, I have never studied or held a position for, or against, the clinical effectiveness of homeopathy…

This is an odd start for a man who has been a long-time advocate of ‘alternative’ medical practises.  Roy may not have specifically advocated for homeopathy, but as the founder and chair of “Friends of Health“ he has, by his own admission, twenty years of involvement “…with whole person healing (WPH)-(complementary and alternative medicine)…”.  This organisation is a “…champion for all ancestral healing practices…” (emphasis not mine).

So this is a man who is prepared to champion “all ancestral healing practices.”  This necessitiates supporting healing practises in the absence of evidence; or even in the face of evidence to the contrary.  All that matters is that they are “ancestral”.

…However, I am a materials chemist who has written one of the most cited papers in materials science, on aqueous solutions…

This is true; but not relevant.  He does not have a good track record on water research or the physical analysis of homeopathic preparations.  In fact the Physicist Robert Park alleges that Roy was taken in by the ‘Polywater’ debacle.  The relevent fact is conveniently omitted.

…Having recently studied the extraordinary biological properties of ultradilute aquasols (water with one part per million of solid particles) and written a long review on the structure of water, I accidentally also discovered a new social disease, “homeophobia” – that is, a phobic reaction (mainly by scientists) to the word “homeopathy”, the virulence of which is exemplified by Goldacre…

Let’s get real, and scientific.  Experience with one part per million “aquasols” has no relevance to homeopathy.  One part-per-million is staggeringly more concentrated than most homeopathic treatments.  Assuming that the undiluted ‘mother tincture’ was a one molar solution, one part per million would represent a 3C homeopathic potency.  This is 10¹⁸ times (one followed by eighteen zeros) more concentrated than a 12C homeopathic preparation; 10⁵⁴ times (one followed by fifty-four zeros) more concentrated than a 30C preparation.  So Roy’s experience with aquasols, impressive as it is, is not at all relevant here.

Roy’s structure of water review paper was not puiblised in a reputable (peer reviewed) journal.  In fact it was published in Roy’s own journal, Materials Research Innovations.  This publication does not peer-review papers, it performs a kind of review of the author.  This is what Roy calls “super peer review“.  Because it does not focus on content, its publishers can make this claim:

“…Because of its super peer review procedures, the journal is especially suited for the publication of results which are so new, so unexpected, that they are likely to be rejected by tradition-bound journals…”

In other words it can, if it wishes, publish ill-conceived flights of fancy by established academics, like Roy!

The term adopted for this “new social disease” is just a silly near-homophone.  Calling people “homeophobes” is not a replacement for evidence and argument.  Neither, in Goldacre’s case, is it fair.  For all his alleged virulence, Goldacre concluded his article with these comments:

“…When I’m feeling generous, I think: homeopathy could have value as placebo, on the NHS even, although there are ethical considerations, and these serious cultural side-effects to be addressed. But when they’re suing people instead of arguing with them, telling people not to take their medical treatments, killing patients, running conferences on HIV fantasies, undermining the public’s understanding of evidence and, crucially, showing absolutely no sign of ever being able to engage in a sensible conversation about the perfectly simple ethical and cultural problems that their practice faces, I think: these people are just morons. I can’t help that: I’m human. The facts are sacred, but my view on them changes from day to day. And the only people who could fix me in one camp or the other, now, are the homeopaths themselves.”

This is neither virulent nor unreasonable.  If this is ‘homeophobia’, then it doesn’t sound like a “social disease” at all.  This is robust scientific debate; this is part of science.  Little wonder that this a reaction “mainly by scientists“.  An academic like Roy should be encouraging this sort of honest engagement with the evidence; not trying to make it sound disreputable.

…A major bugaboo for “homeophobes” is the concept that a solution where the solute is extremely diluted (beyond Avogadro’s number) absolutely cannot, they believe, be any different from the original solvent. Hence homeopathy must be a fraud. This has been the anti-homeopathy crowd’s trump card for more than 100 years…

Roy seems to forget that the problem of dilution past the point where any active ingredient is likely to be present (extremely dilute is something of an understatement) is not the only implausible feature of homeopathy.  It was recently pointed out to Roy, by Steven Novella, that there is a chain of implausibility.  Dr Novella’s points are paraphrased below.

1) The “Law of Similars“; the notion that what causes a symptom in large doses will, in small doses, cure it.

2) Hahneman’s theory of disease, the miasma theory (the notion that all chronic illness is caused by external poisons or miasmas)

3) Homeopaths claim to be “holistic“contradicts the law of similars, where the cure is based on the symptoms.

4) The idea of “principles of cure“, including the bizarre idea that homeopathic treatments work from top down, the inside out; and start with the most recent symptom.

5) The “law of infinitessimals” (the dilution problem).

6) Succussion, the principle that by shaking the homeopathic preparation at each dilution the “energy” or “essence” of the solute will be transferred to the solvent.

7) The appeal to the “Memory of Water” introduces yet more levels of implausibility: this effect has not been established; there is no known mechanism by which liquid water can hold onto a clinically significant complex three-dimensional structure for any significant time; equally a mechanism is required by which water forgets everything that has been in solution previously; finally small levels of contaminants that are bound to be present in the water used by homeopaths would need a mechanism that prevented their effect being amplified via dilution and succussion.

8)  Any information that could be held in a water structure would need to be transferred to the pills that homeopaths commonly use. Thus the structure, or the information encoded in it, would need to be copied from the drop of homeopathic preparation placed on the pill “blank” to that pill.

9) Water memory would have to survive ingestion and absorption into the body and transportation through the blood and to the tissues.

10) No receptors for any “water memory” or homeopathic signals have ever been discovered.

Given the numerous well-known links in Novella’s chain of implausibility, Roy would appear to have had a convenient memory lapse.

…But let us turn to scientists who specialise in water’s properties. Prof Martin Chaplin of London’s South Bank University, a leading expert on the (molecular) structure of water, says: “Too often the final argument used against the memory of water concept is simply ‘I don’t believe it’ … Such unscientific rhetoric is heard from the otherwise sensible scientists, with a narrow view of the subject and without any examination or appreciation of the full body of evidence, and reflects badly on them.”…

It would be nice if this quote were sourced.  Chaplin may have had this experience; but I would hope that this is uncommon.  My experience with a journal club examining the special issue of Homeopathy on this topic was that many people were prepared to wade through the “intellectual shambles” contained in that issue and honestly engage with the science.  We were not impressed.  A number of critical letters are due to appear in the January 2008 issue.

Here are some examples of people engaging with the evidence :

• Paul Wilson on Chaplin’s paper (this is to be published in the January 2008 issue)
• shpalman’s very detailed examination of Lionel Milgrom’s quantum flap doodle oeuvre, including a paper in Homeopathy.
• Philip Ball’s “A bad memory“
• Philip Ball’s “Here lies one whose name was writ in water...”
• Philip Ball’s “Yet more memory of water“
• Timmer, et al “Diluting the scientific method: Ars looks at homeopathy“
• Philippe Leick on the invocation of “Weak Quantum Theory” by two papers in the issue.
• The flaws in “Rao, M. L., Roy, R., Bell, I. R. & Hoover, R. (2007) The defining role of structure (including epitaxy) in the plausibility of homeopathy. Homeopathy 96, 175-182“
• Homeopathy and the memory of water: Milgrom and the philosophy of science (comment on the abuse of philosophy; to be published in the January 2008 issue)
• Homeopathy and the memory of water: memory or invention? (to be published in the January 2008 issue)
• Homeopathy and the memory of water: going round in circles

I am sure that there have been other similar serious, scientific comments.  This is not to say that all these criticisms are necessarily correct; science relies on a robust debate.

However, even if Chaplin or Roy disagree with what they say it is not right to pretend, as Roy is doing, that this sort of seriuous engagement has not happened.

The ultimate arguments are (a) there is no evidence that water can remember anything, let alone clinically significant information and (b) there is no plausible mechanism for such a memory.  If it did anything the “Memory of Water” issue of Homeopathy proved this.

…As it happens, there is agreement among all those who have studied liquid water that it is, in fact, the critics, who are totally wrong. Proof? Diamond is the planet’s hardest material; graphite one of the softest. They are absolutely identical in composition, and they can be interconverted in a millisecond with zero change of composition…

First, I’m no materials chemist, but I know that carbon isn’t water.  The graphite/diamond argument is irrelevant.

Next, there is not agreement among all those who have studied liquid water.  Roy seems to be forgetting that he criticised Chaplin’s view of water structure recently (see slide 36).  If he read the “Memory of Water” issue of Homeopathy he is also forgetting that Teixeira, a real expert on water, concluded:

 “…There are no water clusters in pure liquid water, but only density fluctuations…The longest life of any structure observed in liquid water is of the order of 1 ps …This is why any interpretation calling for ‘memory’ effects in pure water must be totally excluded.”

It’s hard to imagine how a distinguished academic like Roy could get this point so badly wrong.

…Prof Eugene Stanley of Boston University, the leading expert on the physics of water, has catalogued 64 highly anomalous property changes in pure water. According to the first law of materials science, that means that there must be the same large number of different structures in liquid water – what he called “polymorphism” of water. This year Prof Chaplin, in the journal Homeopathy, discussed in detail how water could retain a “memory”…

Ah, he did read that issue of Homeopathy.  One thing that issue didn’t do was discuss in detail how water could retain a memory.  It contained poorly conducted experiments, wild speculation and circular reasoning.

Among the critical letters that will appear in the January issue of Homeopathy are a damming indictment of a paper co-authored by Roy and a sharp critique of Chaplin‘s contribution.

Anomalies generally don’t require wild speculation.  They require careful investigation.  As the philosopher of science Thomas Kuhn pointed out, generally they are resolved within the scope of normal scientific practise.  As a scientist, Roy should know that.

…But the main thrust of Goldacre’s argument is the role of the “placebo effect”. Yes, this works. And, yes, it is without doubt present in every homeopathic intervention; but it is far more powerfully present in orthodox medical pills because they are advertised so widely in billion-dollar campaigns…

So homeopathy isn’t even very good at being a placebo. I’m glad he cleared that one up.  “Orthodox medical pills” have the pharmacological effects and a superior placebo effect.  Great.  What’s homeopathy for then?

Furthermore, as has been pointed out this comment has no relevance to the UK where such advertising is banned.  Therefore Roy would have us believe that the same drug will be more effective in the US than the UK, due to the powerful augmentation of the placebo effect due to advertising.

If this is the case then it is also a good argument for more pharmaceutical advertising.  If it is truthful and makes the drug more effective, why not?

In truth, the evidence shows that homeopathy is all placebo.

…Goldacre is accurate in pointing out the high rates of positive v negative outcomes in many of the homeopathy studies. But there are enormous discrepancies in any set of randomised controlled trials on the same orthodox pills…

Let’s just take a quick look at what Goldacre said:

“…How big is the problem of publication bias in alternative medicine? Well now, in 1995, only 1% of all articles published in alternative medicine journals gave a negative result. The most recent figure is 5% negative. This is very, very low…”

So we have more mangled reasoning by Roy.  His second point does not relate to the first.  The first sentence is about publication bias in the ‘alternative’ medical literature (This is very much greater than that in the orthodox literature).  This point is conceded by Roy.

Alleged “discrepancies” between trials of the same drug are different to publication bias, which is about not reporting negative outcomes.  Discrepancies between trials can only come to light if they are reported; or how would anyone know about them? Further, Roy’s meaning is unclear here:  What does he count as discrepancies?  He doesn’t say.  So I’ll not waste any more effort on this point.

…Does Goldacre seriously suggest that a homeopathy paper with a positive outcome would be treated fairly in any mainstream journal?…

How come homeopaths and their apologists are always making cherry-picked lists of positive trials that have been published? They can’t have it both ways.  On the point of fairness: Roy has already conceded that a negative trial of a conventional intervention is more likely to be published than a similar result for a homeopathic treatment.

…Rustum Roy is Evan Pugh professor of the solid state, and research professor of materials at Arizona State University rroy@psu.edu”

But he’s so much more.  On his website he has a CV for health groups.  Given its relevance it’s poor form that it wasn’t at least summarised.

“Rustum Roy

Founder & Chair of Friends of Health…

… is one of the nation’s and world’s leading materials scientists, honored by election to the U.S. National Academy in 1973, and subsequently to the National Academies of Japan, Sweden, India and Russia. In the Emperor of Japan’s 2002 Honors List, Prof. Roy was inducted into the Order of the Rising Sun with Gold Rays.

Rustum Roy has been an active churchman all his life. He has been associated but not only with the National Council of Churches, but with pioneering institutions such as the Kirkridge Retreat Center in Bangor, Pennsylvania; the Church of the Savior in Washington D.C.; and the Sycamore Community, one of the nation’s oldest house churches.

For twenty years Rustum has been involved with whole person healing (WPH)-(complementary and alternative medicine). It started with his friendship with many of the field’s world leaders-Linus Pauling, Norman Cousins, Andrew Weil, Deepak Chopra, Larry Dossey, etc. He dedicates half his time to this work.

Friends of Health, champion for all ancestral healing practices, is partnering with other groups in four unique projects:

Helping bring the varied institutions of WPH together;

Bridging the WPH community to that of large numbers of mainstream high-level science;

Educating the mainstream citizen community through regular undergraduate courses;

Creating local Circles for Health as a national preventative analogue of AA. “

Perhaps he forgot about these as well?  I hope that his water has a better memory than he seems to.

Finally, it’s very sad to see a distinguished academic label robust scientific discourse as a “social disease“.  Reasonable people will see this for what it is: a fig leaf covering the embarassment of no real clinical evidence of effectiveness and extreme implausibility. 

What Roy is really arguing for is a suspension of scientific standards when discussing homeopathy.  We should have been able to expect better.