Much ado about nothing

So, the much-trailed^* paper on the homeopathic intervention in an outbreak of Leptospirosis in Cuba during 2007 has finally been published (Bracho et al, 2010) along with a very useful companion editorial (Roniger and Jacobs, 2010).

The editorial claims that, “the size of the population treated and the dramatic decrease in disease incidence compared to previous years make it difficult to dismiss these results as spurious or occurring by chance.”

Before finding it quite easy to dismiss these results, some background information on Leptospirosis is in order.

Keen on neem?

Neem [Azadirachta indica A. Juss] is a tree of the mahogany family.  Various claims have been made for its health-giving properties.  As the Abha Light organisation seems keen on neem as an anti-malarial, I decided to do a brief review of the literature.  What follows is a commentary based on searching PubMed for ‘neem and malaria’, and doing some additional searches.

I don’t claim that this is exhaustive and I have not been able to locate any information on some of the papers cited^*.  For articles behind paywalls, I have only been able to consult the abstract.

A Review

One of the first things that I look for, when I’m researching a new topic, is a review article.  A recent publication by Anyaehie (2009) seemed to provide a good starting point.

Deluded and Dangerous

I recently stumbled across a paper describing the work of the Abha Light organisation – a group of particularly dangerous homeopaths treating malaria in Kenya with homeopathy, and disparaging proper medicine for good measure.

It should go without saying that malaria is a serious, potentially fatal, disease that should not be treated with untested remedies – especially the sugar pills and magic water of homeopathy.  So committed are the homeopaths of Abha Light that they believe that their magic works and that it is superior to proven medicines.

These themes shine through the paper presented by Didi Ananda Ruchira at the Cuban Nosodes 2008 International Conference, entitled, “The Use of Homeopathic Prophylaxis and Treatment For Malaria in Endemic Areas Of Kenya: Part 2“.  It provides some alarming insights into the surreal world of Abha Light.

Reflexology and sub-fertility

I had never come across the baffling concept of “reproductive reflexology” until a local practitioner had a leaflet popped through my letterbox.  They rather fetchingly style themselves “foothold reflexology”.  The leaflet’s major theme is to suggest that reflexology can help with pregnancy and sub-fertility.

Given that a glorified foot massage is massively unlikely to offer help beyond relaxing someone and generally making them feel nice, I thought that this was worth a bit of investigation.  My main concern with this pitch is that issues around fertility can be profoundly distressing.  Though I am sure that this reflexologist is sincere and well-meaning, peddling false hope is cruel.

The emperor’s new gym

I have recently returned from an excellent holiday in sunny Spain.  Predictably, my first Monday back at work was a bit of a trial.  It was a training day to support the implementation of a new performance management system.  Not the most enjoyable part of my working life, but fair enough.

However, after an excellent introduction from our CEO, the trial began in earnest when the following two words were projected onto a screen at the front of the auditorium:

“BRAIN GYM”

A homeopathic refutation – part three

In the third part of my series examining an attempted refutation of the critics of homeopathy (Milgrom, 2009) I look at the claim that homeopathy has a serious scientific foundation.

Dilute Science

This part of the essay starts by outlining a common criticism levelled at the most common form of homeopathy practised in the US and UK.  This calls homeopathy unscientific because:

“[…] in many homeopathic remedies, the original substance has been diluted out of molecular existence, detractors claim belief in homeopathy has no basis in science as ‘nothing cannot do something’.”

So, can apologists for homeopathy point to serious scientific work which shows that nothing can do something? 

A homeopathic refutation – part two

This post is the second in a series examining the claims made in a recent essay that seeks, in part, to refute common criticisms of homeopathy (Milgrom, 2009).  I have already examined the empty assertions about evidence for clinically useful specific effects.  Now, I would like to move on to examine an attempted refutation of claims that, “Homeopathy is deadly”. 

How deadly is homeopathy?

Milgrom starts with a bit of distraction: “The claim that homeopathy is deadly has never been substantiated, primarily because it cannot be proved anyone has died as a direct result of taking a homeopathic remedy.” 

This is entirely irrelevant; no critical discourse that I have come across has made the claim that the remedies themselves are toxic^*.  As I pointed out in my last post: the problem is not in the pills, but in their uselessness; and the attitudes of some homeopaths.  He then moves to the actual concerns of sensible critics: 

“The claim arises over concerns that those taking homeopathic remedies might forgo ‘life-saving’ drugs. This is a false perception: many who come to homeopathy do so only after conventional treatments have failed.”

A homeopathic refutation – part one

Lionel Milgrom recently had an essay published defending homeopathy (Milgrom, 2009).  It’s available on the Homeopathy World Community website.  In it, he notes the current parlous state of homeopathy as a mainstream medical intervention in the UK and seeks to do two things: (1) refute what he identifies as the main criticisms of homeopathy and (2) explore the context for what he views as unjustified attacks. 

In this post I shall examine Milgrom’s opening and his comments on the evidence for homeopathy.  I will be examining his arguments around: the scientific nature of homeopathy, its risks, the role of the profit motive and the influence of philosophy, in subsequent posts. 

Sitting comfortably? 

The summary starts with a familiar defence: “homeopathy has been in successful and continuous use for well over 200 years”.  This makes the usual mistake of conflating two different arguments: efficacy and popularity.  It is a common mistake to assume that the two go hand in hand.  History tells a different story. 

Homeopath says what ….

A while ago^* I came across the British Homeopathic Dental Association (BHDA).  Their website makes some amazing claims.  I decided to see what they would offer to substantiate just one of them: the claim that, “Homeopathy will give you […] Remedies that will cure ulcers cold sores etc” 

I asked, 

“You claim that homeopathy provides, “Remedies that will cure ulcers cold sores etc”.  Do you actually have any proper evidence to support this claim?  To be quite frank I don’t [believe] that you do, but I’m always happy to be surprised.”

I quickly received two replies from their Secretary:

“Dear Doubting Thomas,  sorry Adrian

The best evidence you will ever find is from the patients treated with homeopathic remedies.  Next time you have a patient, or better, yourself, with a mouth ulcer, you know they usually last 3 days. Buy some Feverfew and chew a harmless useless tablet and repeat two hourly. There will be your evidence.

Some unfortunate patients get bouts of mouth ulcers at regular intervals. Do as I say and the intervals between bouts gets longer until they no longer have any.

Be brave and try. You can do no harm and you might even surprise yourself. Do chew or suck as they do not work if just swallowed

Cheers

[…] ( Do keep in touch. You might even want to join BHDA)”

Tell ‘em about the honey …

According to Annelie Whitfield, the presenter of Channel 4′s ‘The Kitchen Pharmacy” honey is hydrating.  In an episode featuring what she calls “anti-aging” treatments, she makes an “Avocado Face Mask” with avocado and probiotic yoghurt.  Finally she adds honey, saying:

“Honey […] is deeply hydrating and it really helps to get rid of any spots that you might have […]“

The video is available here.  Lots of things that Whitfield says strike me as odd.  This is just another small example.  So, is it strange but true, or just untrue?

For something to be hydrating it needs to contain water, and that water needs to be ‘free’; not bound up with other chemicals.  Now honey does contain water, around 17% by weight.  So, at face value, it might seem that honey could be hydrating.  However, if honey had a significant proportion of its water content available for hydrating human skin, it would also allow micro-organisms to grow in it.  Clearly, honey has a long shelf life, so this would suggest that the water in honey is not ‘free’.