Lecture 5: Homeopathy

[Music] welcome back I'm Dr Harriet Hall and this is lecture five in a series of 10 lectures on science-based medicine the topic of this lecture is Homeopathy many of the people who use Homeopathy don't have any understanding of what it is I've run across Highly Educated medical professionals who thought Homeopathy was just some kind of herbal medicine when they found out what it really was boy was their face red Homeopathy is actually incredibly silly here's a simple explanation of Homeopathy that illustrates just how ridiculous it is if coffee keeps you awake dilute coffee will put you to sleep the more dilute the stronger the effect dilute coffee acts as a sleeping pill and more dilute coffee acts as an even stronger sleeping pill if you dilute all of the coffee molecules out of the water the water will remember them and the effect will be even stronger and the water's memory of coffee can be transferred to a sugar pill by dripping the water onto a sugar pill and allowing it to evaporate quackwatch calls Homeopathy the ultimate fake and it's also been called delusions about dilutions in lecture three I explained how a single individual DD Palmer invented Chiropractic all by himself on a single day in 1895 in lecture four I explained how a single individual Dr noer invented ear acupuncture all by himself in 1957 a single individual Samuel hanaman invented Homeopathy all by himself too in 1796 to set the scene let's think about the state of medicine in hanan's lifetime science-based medicine was far in the future diseases weren't well defined they thought malaria was caused by bad air there was no germ Theory no antibiotics no anesthesia no sterile techniques no systematic testing of treatments doctors of his time did more harm than good they were treating patients on the basis of a false theory of the four humors in an attempt to balance those humors they were bleeding patients emptying their colon with purgatives and emptying their stomachs with aics they were poisoning them with medicines like Mercury they were killing people hanaman was right to criticize his colleagues but he was wrong about Homeopathy he intended Homeopathy to be a Kinder gentler more effective treatment system that would replace allopathy that was a word he coined to disparage doctors saying that they only treated the symptoms not the disease itself and that they treated with opposites instead of similars that wasn't even an accurate characterization of what doctors were doing in his day and it certainly doesn't describe what doctors do today most of us object strenuously to being called alpath doctors the term is used as an insult and it has no legitimate meaning just as one personal experience with a deaf janitor LED DD Palmer to invent Chiropractic a personal experience with tree bark led hanaman to invent homeopathy and in both in both cases they misinterpreted a single experience and extrapolated wildly from it sinona is a tree that grows in South America the bark of the tree was used to treat fevers if the fever happened to be be from malaria syona worked because it contained quinine and effective malaria treatment hanaman was skeptical and he was experimenting on himself with large doses of sinona he developed symptoms that he thought were typical of malaria he was wrong his symptoms weren't typical of malaria and today we think he probably had some unusual reaction to something in the bark anyway his experience led him to deduce that the same remedy that caused a symptom could relieve it so he tried treating with similars he found that some people got worse before they got better to reduce the side effects he kept lowering the dose by diluting the remedy here are the two basic principles of Homeopathy first the law of similars like cures like a remedy will cure a disease in a sick person if it causes the same symptoms as the disease when given to a healthy person if epicac makes a healthy person vomit it ought to cure vomiting in sick people now the idea that like cures like is really just a form of sympathetic magic second the law of infinite decimals the smaller the the larger the effect that would mean the less sugar you put in your coffee the sweeter it tastes this law is obviously false and it's contrary to everything we know about chemistry pharmacology and physics hanaman had another Revelation succussion when he made a home visit the patient was more likely to improve than if he saw the patient in his office now it's easy to see how a home visit might make more of an imp more of an impression on the patient and might enhance the contextual effects of the doctor patient encounter but hanaman thought up his own explanation the remedies got jostled in his saddle bags as he rode his horse to the patient's home he imagined that the jostling increased the potency of the remedy he never thought to test this idea by comparing jostled and non- jostled remedies because he didn't think like a scientist he just assumed he was right and he recommended that when remedies were prepared the solution should be potentized after every step of dilution by pounding the bottle repeatedly against something he used a leatherbound book today some preparers succuss the remedies by hand against a leather pad and some use machines the remedies may be sold as a liquid or as a tiny pill when the dilution is complete the solution can be dripped onto tiny sugar pills and allowed to evaporate some remedies like Granite diamond and platinum are not soluble in water or alcohol so they're prepared by trituration they grind them up with a mortar and pestle and then dilute them with lactose milk sugar one triturated remedy is Berlin wall they take a tiny bit of ground up concrete from the Berlin wall and they mix it with 100 parts of sugar lactose then they take one part of the resultant mixture and mix it with 100 parts of lactose they repeat that process two UND times one homeopath said it was such a powerful remedy that she had to store it away from her other remedies she kept it out of the garden shed it is used to treat feelings of confinement and oppression Shifty eyes Terror asthma and headaches according to a Homeopathy journal the wall in Berlin seems to have been immersed with the psychological emotions and thoughts of mankind again magical thinking the dilutions are where it really boggles the mind they're labeled as X for 10 and C for 100 a 6X dilution means one part of Remedy was diluted with 10 parts of water or alcohol and one part of the resulting mixture was diluted with another 10 parts of water and so on for a total of six times in the SE dilutions one part of the remedy is mixed with 100 parts of water at each step 6x ounts to a solution of one part in a million 6 C amounts to one part in 10 trillion the process is exponential by the time you get to the 13 C or the 26x level there isn't a single molecule of the original remedy left a 13c dilution is equivalent to diluting 13 of a drop of the original substance in all the water on Earth a typical homeopathic remedy is 30C at the 30C level it would take a container 30 million times the size of the Earth to hold enough water to make sure you were getting at least one molecule of the original substance another way of looking at it is that for one patient to get one molecule you would have to give 2 billion doses per second to 6 billion people for 4 billion years it gets worse the most popular flu remedy is sold as a dilution of 200 C that's 10 to the 400th power the number of atoms in the observable universe is 10 to the 80th power my brain froze when I tried to figure out how many universes it would take to find one molecule and 200 C isn't the limit there are remedies that are diluted far more above the Thousand C Level they're designated as m 1 m equal 1,00 C we're able to make those calculations thanks to avagadro avagadro's number allows us to calculate the number of atoms or molecules in a volume of a chemical substance based on the molecular mass the first calculations were done in 1865 22 years after hanan's death now we know that remedies of 13c and above are nothing but water hanaman didn't have any way of knowing that when his followers found out they had three choices one one they could abandon the dilute remedies two they could accept metaphysical explanations assuming that the water somehow remembers molecules that are no longer there or three they could look for a scientific explanation most of them accepted option two that water somehow absorbs the vitalistic essence of the remedy and remembers it some of them are still working on option three trying to find an explanation that scientists could accept homeopaths try to justify their remedies by comparing them to vaccines that's a false analogy vaccines contain measurable amounts of antigens and they work by a known mechanism homeopathic remedies contain no active molecules and they work by Magic they invoke hormesis now that's a phenomenon where a low dose of a chemical May trigger the opposite response to a high dose but hormesis is only known to apply in certain cases it's not a universal phenomenon by any means and it describes a response to a low do not to no dose they invoke water clusters clusters of water molecules do form but they only last for trillionths of a second there's no way they could register or transmit information there's been wild speculation about quantum entanglement that's the kind of thing that leaves Quantum physicists rolling on the floor laughing they keep doing ridiculous FL experiments trying to prove that water can remember one of the most famous experiments was the Ben vist Affair jacqu Ben vist claimed that he could detect biological activity of antibodies after the antibodies had been diluted out and were no longer there the study was published in nature with the condition that his lab would be inspected a team including the journal's editor and Chief and James Randy visited the lab and found a number of problems the researchers were true believers who bordered on religious fervor their blinding procedures and controls were inadequate the positive results were from a single technician and when the team instituted more rigorous controls the results couldn't be reproduced other labs tried to reproduce their findings and failed and the results weren't even compatible with homeopathic Theory the effect went up and down with subsequent delusions instead of steadily upwards Ben vist is the only person to have won two IGN Nobel Awards both for his work on Homeopathy his second IG Nobel award was for his alleged discovery that not only does water have a memory but the information can be transmitted over telephone lines and the internet drugs are tested with randomized Placebo control trials homeopathic remedies are tested with provings these were originally done with an undiluted remedy and later with a 30C dilution healthy volunteers take it and they keep a detailed Diary of every symptom they experience for an unspecified unspecified length of time as long as they feel like doing it sometimes for months they write down everything I felt angry I burped my big toe itched at 11:00 p.m. I dreamed about my dog there's no attempt to compare those symptoms to a control group then they're inter erated to elicit even more symptoms instead of looking for commonalities they just pull all the different reports from different provs and the whole mishmash of reported symptoms is used to guide treatments with that remedy people mean different things by Homeopathy in classic Homeopathy only a single remedy is used at a time in combination Homeopathy a mixture of remedies for the same symptoms is used today homeopathic remedies are sold over the counter for self-prescription something that I don't think hanaman would ever have condoned when homeopaths take a patient's history they spend as much as an hour interviewing the patient they go into excruciating detail about the chief complaint they try to pin down the time of onset and its possible relation to life events they ask about concomitants seemingly unrelated symptoms like weak ankles or unusual sleeping positions they ask about General symptoms Syms like sluggishness feelings of hot or cold Restless sleep changes in appetite they ask about family history did anything stressful happen to the patient's mother during her pregnancy they asked seemingly off-the-wall questions like what do you love most about life what bothers you the most about other people what are you teased the most about here's a typical history that a homeopath obtained from a patient with uterine fibroids that's a tumor of the uterus he wrote down that she was loquacious loud anxious doesn't want to live desperate feels humiliated ashamed used rejected angry offended lonely religious affections relationship problems workaholic absence of nurturing in childhood parents fighting uterine fibroids constipated retains fluid the fibroids themselves are near the end of the and the homeopath May interpret other things in the history as more important after eliciting all these relevant and irrelevant symptoms the homeopath looks up the symptoms in a reparatory book it lists symptoms by parts of the body here's an excerpt from a a section on a facial expression the patient with fibroids was anxious for anxious 66 different remedies are listed there are other facial expressions like anxious when child is lifted from cradle anxious during downward movement astonished besided bewildered changed childish cold distant and that's just the ABCs it continues right on down the alphabet for 20 more categories including happy intoxicated old looking and stupid for each of these categories of facial expression there is a different list of corresponding remedies the homeopath looks up the symptoms he imagines are the most important and he selects the remedy that best matches those the Repertory is organized by symptoms the next step is to use another book The homeopathic Materia medicia that's organized by remedy it lists all the symptoms that provings have associated with each remedy here's an example for a remedy called natum muriaticum the entry for naturum muriaticum lists symptoms in all of these areas mind head Eyes Ears Nose face stomach abdomen rectum urine male female respiratory heart extremities sleep skin fever and modalities some of the examples from uh from these areas include eyelids heavy anemic headache of school girls constipation and diarrhea yes both of those sensation of coldness of heart s hot and perspiring hang nails dreams of robbers oily skin warts on palms of hands chill between 9 and 11:00 a.m. the list goes on and on for several Pages what is naturum muriaticum it's common table salt how can anyone seriously believe that table salt causes all those symptoms and can cure them hanaman listed 67 remedies today there are over 2,000 with over 1,300 officially recognized by the hpus the homeopathic pharmacopia of the US here are some examples Berlin Wall eclipsed Moonlight South Pole of a magnet dogs ear wax tears from a weeping young girl fossilized dinosaur bone rattlesnake venom arsenic Poison Ivy the homeopath follows the patient's progress and if the patient is not getting better he assumes that the first remedy was correct but that the situation has changed so he reevaluates and prescribes a different remedy the homeopath is constantly re-evaluating and there's always another remedy to try aggravations are a good sign if the symptoms get worse it means the remed is working if the symptoms get better it means the remedy is working too so you can't lose if the remedy isn't working the homeopath can blame the patient for having inadvertently used antidotes that prevented the remedy from working for instance he drank coffee he didn't get enough sleep he used a cell phone he ate spicy foods why did some patients fail to respond hanaman developed his theory of myms to explain the failures of homeopathy aathy he decided that all disease was caused by three myms syphilis psychosis or Gara and Sora scabies or itch he decided that myms had to be cleared before the remedy could work he thought this led to an improved approach to selecting remedies this all sounds so silly but scientists don't reject something just because it sounds silly we still need to test whether it works homeopaths site epidemics and early successes where patients treated with homeopaths did better than patients treated with conventional medicine but those successes were because doctors of that era were doing more harm than good Homeopathy did nothing so the results were better homeopaths point to high levels of patient satisfaction but that doesn't mean it works remember all the ways that patients can be satisfied by bogus remedies and a charismatic provider remember medicine's beautiful idea no matter how convinced you are you still need to test every treatment and Homeopathy was tested as early as 1832 in a hospital in Russia one Ward got conventional treatment one Ward got homeopathic treatment and one Ward got no treatment but was given fake pills made of breadcrumbs and cocoa to make them think they were being treated the no treatment Ward had the best outcomes that means that Homeopathy did no good and the conventional treatments of the day didn't do any good either in those days before science-based medicine it was better for patients to steer clear of both conventional doctors and homeopaths and just just let nature take its course with no treatment it's a wonder they didn't conclude that breadcrumbs and cocoa were an effective treatment Homeopathy has been tested over and over since that time modern clinical trials have not shown that Homeopathy was is effective David Riley said either Homeopathy works or control trials don't in a sense he was right control trials don't work very well for studying Homeopathy and other implausible health claims as my colleague Kimbell Atwood put it Trials of ineffective claims championed by impassioned Advocates will appear to yield equivocal rather than merely NE negative outcomes the inevitable continual citations of dubious reports will lead some to judge that the aggregate data are weakly positive or that the treatment is better than Placebo so they just call for more studies Dr Atwood also pointed out that Homeopathy can't possibly work as claimed is the sort of basic science that can reasonably be called established knowledge is it realistic to assume that this level of evidence can be overthrown by ambiguous clinical trials of dubious design the evidence against homeopathy ay is as strong as the evidence that the Earth is spheroid rather than flat that the planets orbit the sun rather than the earth that mass and energy are conserved that the Earth is several billion years old and that species evolved by a process of variation in natural selection J Shelton wrote a book about Homeopathy Homeopathy how it really works it's listed in the course guide he concluded that Homeopathy often helps people but the remedies don't contribute it helps through non- remedy factors like unassisted natural healing attention suggestion contextual effects of the treatment encounter regression to the mean cessation of harmful or unpleasant treatments lifestyle assisted healing and different perceptions of internal reality versus external reality when results of clinical trials disagree with each other we can try to resolve the disagreements with systematic analyses of all the data of 11 systematic reviews of Homeopathy only two were positive when those two were reanalyzed with the lowquality trials omitted they were negative2 the most favorable systematic review said that overall Homeopathy worked better than Placebo but it didn't work better than Placebo for any specific condition that doesn't compute it it's like saying broccoli is good for everyone but it's not good for men men or women or children Homeopathy is a good example of changing attitudes about cam in 1900 there were 10,000 homeopathic physicians in the US along with 79 homeopathic hospitals and 22 homeopathic medical schools as scientific medicine gained ground Homeopathy lost ground the last us homeopathic medical school closed in 1920 by 1950 the last homeopathic Hospital en closed and by 1970 there were only 75 homeopaths still practicing in the US but today home Homeopathy is having a Revival and remedies are sold over the counter in pharmacies ocelo oxum can be found on the shelves of any local pharmacy it's the most popular homeopathic remedy and perhaps the funniest one ever during the Spanish flu epidemic of 1918 a f a French doctor named Joseph Roy looked at the blood of flu victims under a microscope and he thought he had observed an oscillating bacterium he named it ocelo cacus no one else ever saw it he was probably confused by Brownie and motion he was probably seeing tiny particles of dust or whatever that were being jostled by the constant movement of water molecules but he thought he'd discovered a new pathologic organisms and when he thought he'd spotted the the same organism in the liver of a duckling he assumed that a homeopathic flu remedy could be made from the duck liver today it's manufactured from the heart and liver of the muscovi duck diluted by one in 100 to the 200th power to get one molecule of the original extract the patient would have to consume an amount of the of the remedy many orders of magnitude greater than the number of atoms in the observable universe osoc coxim is one of the top selling drugs in France and it brings in $15 million a year in the US but it's an impossibly dilute solution of something that never even existed in the first place here's my version of the recipe for ocelo coxm take a bit of duck liver dilute the duck out of it hope the water remembers the duck and hope the memory of duck cures cold in reality All That Remains is the quack would you believe there are homeopathic vaccines they're prepared with noodes material taken from the saliva blood pus urine or disease tissue from victims of the disease Health Canada has officially licensed homeopathic remedies to prevent flu polio measles and pessis I reported one homeopath to Homeland Security CU I figured they'd like to find out where he got his smallpox and Anthrax noodes because if he could get them so could terrorists do you believe in magic a well-known homeopath described how a car was fixed homeopathically it appeared to be having electrical problems so they wrote electricus 2 200C on a piece of paper and they placed it near the engine the problem was resolved sometimes dowsing is used to Select Remedies the customer takes a pendulum to the store and holds it over each remedy until it swings the right way provings are done where the subject doesn't actually take the substance but meditates about it or dreams with it under the pillow or prepares it by trituration or writes it on a piece of paper and keeps the paper close to his body homeopaths have treated patients by telephone or telepathy in grafting one potentized sugar pill is added to a bottle of inert pills and it converts them all to remedies there are even Homeopathy first aid kits for accidents and emergencies you can buy one of these for $54.99 on amazon.com it contains 18 vials of sugar pills labeled 200C they're recommended for accidents injury infections GI problems burns muscle pain etc for certain illnesses they advise depending on severity seek medical care the list includes anaphylaxis Animal B bone injuries third degree burns carbon monoxide poisoning drug overdose electrocution eye injuries poisoning puncture wounds and shock it's appalling to think that patients are left to their own assessment and might think that these conditions were not severe enough to Merit Medical Care there's a hilarious YouTube video making fun of these kits a young man goes out to save the world he drops a pill from each bottle into a local stream that runs to the ocean so the remedies will eventually reach everyone on Earth in an even more dilute form this will eliminate all the diseases the kid instructions cover from heart attacks and strokes to throttling and drowning people say even if Homeopathy is only a placebo what's the harm in using it it can't cause any side effects so it's safer than other treatments and patients seem to like it but it can be very dangerous if it's used in place of effective treatments janz podgorsek was harmed in Slovenia a homeopath named darer ersen treated him with homeopathic drops to pre prevent malaria he got malaria anyway and then the homeopath treated him with homeopathic remedies for the malaria he died in 1996 at the age of 42 the homeopath license was revoked and he got two years probation jacn alderslade was harmed she was a a 55-year-old woman who lived in Ireland her homeopath told her to stop taking her asthma medication and she died of an asthma attack and little Isabella dley was harmed she was a 13-month-old baby in Australia and her epilepsy was treated with Homeopathy and she died and the remedies are not always benign sometimes remedies sold over the counter is homeopathic are low delusions like one in a 100 that they actually contain enough active ingredient to harm patients a teething remedy Highland's baby teething tablets was recalled because babies developed symptoms of belladon toxicity Zam caused adults to lose their sense of smell manufacturing standards were LAX and the amount of active ingredient in the products varied a skeptic group in the UK did an experiment they sent a young woman to various homeopaths for advice about area prophylaxis for a trip to Africa 10 out of 10 advised homeopathic protection instead of standard prophylaxis one explained they make it so your energy your living energy doesn't have a kind of malaria shaped hole in it the malarial mosquitoes won't come along and fill that in the remedy sorted out there was a case reported in the British medical journal where a woman relied on homeopathic vaccine during a trip to Togo she developed a severe case of malaria spent 2 months in intensive care and had multiple organ failure water passes through the oceans in the water cycle and it gets succussed by the waves if it can remember why wouldn't it remember fish poop there's no such thing as absolutely pure water or absolutely clean glassware tiny amounts of contaminants are always present and dust and pollen grains fall out of the air into open containers of water there are far more molecules of contaminant in a homeopathic dilution than there are molecules of the original substance so how could the water know which substance it's supposed to remember this poster pretty much says it all if water has a memory then Homeopathy is full of and sugar to end with here's a t-shirt that says Homeopathy making all difference since 1796 in the next lecture I'll talk about naturopathy