Antivaccine nonsense Clinical trials Complementary and alternative medicine Medicine Pseudoscience Quackery Skepticism/critical thinking

An embarrassing critique of “The Enemies of Reason”

A couple of weeks ago, before I went on vacation, the BBC aired a two-part documentary by Richard Dawkins entitled The Enemies of Reason. Part One dealt primarily with the paranormal and various New Age phenomena, while Part Two, which aired mere days before my London trip, dealt squarely with alternative medicine in an uncompromising fashion. One key segment of Part Two discussed the bizarre magical thinking that is known as homeopathy. Although I quibbled a bit about certain aspects of how Dawkins presented homeopathy, overall I thought it was the best deconstruction on video of the ridiculousness of the concepts behind homeopathy designed for a mass audience that I had ever seen, particularly the scene where Dawkins showed just how much dilution was required for a homeopathic remedy.

Not surprisingly, homeopaths were none too pleased with Dawkins’ deconstruction (more on that in a moment). But, first, so inspired was I by this bit of video skepticism, that when I was in London last week I just had to go the Royal London Homeopathic Hospital. Sadly, I didn’t manage to get there until around 6 PM, when it looked as though it were closing up for the day. I had wanted to go in and see it and perhaps, if I could get up the guts, to walk into the lobby. Here’s Richard Dawkins under one of the signs of the hospital:


Here’s a photo I took of the same sign walking the path that Dawkins walked:


I really wanted to see the big emblem on the floor that greets visitors, as it did when Dawkins entered:


Here’s me peering plaintively through those very same doors through which Dawkins passed:


That I appear to be taking a leak on the Royal London Homeopathic Hospital is no more than mere coincidence, I assure you. I would never do such a thing. For one thing, it was still daylight, and there were lots of people around. For another thing, there were security cameras everywhere. I am much more mature than that. (Surely my EneMan and Hitler Zombie posts should be evidence enough of my high level of maturity to convince anyone.) So believe me when I tell you that I was just trying to get a look at the emblem without entering the building.

Really. Take my word for it.

Now that I’ve used this post as an excuse to post a couple of pictures that I took during my London trip, I’ll get back to business. As I mentioned earlier, homeopaths were not at all pleased with Dawkins’ treatment of their favored woo. One in particular, a London-based homeopath named Sue Young, reposted a particularly silly review of Dawkins’ documentary by Louise McLean. The howlers begin in the very first paragraph:

Professor Richard Dawkins is a man on a mission. His task seems to be to bring down anything that conflicts with his belief in Science. To this end he presents two programmes – one on mediums, astrologers, psychics and dowsers, the other on alternative medicine including Ayurvedic, homeopathy, kinesiology and other therapies.

The wag in me is tempted to retort: “She says this as if it were a bad thing.” But the entertainment doesn’t stop there. McLean goes on to define the term “science” from Webster’s dictionary, and then tries to argue that homeopathy is science:

Homeopathy, for example, is a science because all knowledge pertaining to homeopathic medicines is derived from observation, study and experimentation. In fact it is known to be an art and a science. It has been said many times that if homeopathy is proven to work (as we homeopaths know it does), it would literally turn established science as we know it, on its head. Hence it is very threatening to orthodox science. Yet even in the programme it was admitted that countless millions worldwide use homeopathy and swear by its efficacy.

Really? Perhaps McLean would like to explain upon what “observation, study, and experimentation” Samuel Hahnemann based his hypothesis that “like cures like,” that dilution makes a remedy more potent, and that succussion is necessary to release the power of a homeopathic remedy. Appeals to quantum theory, information theory, and the memory of water don’t count, because these “explanations” for the alleged efficacy of homeopathy came are post hoc justifications. After all, quantum theory and information theory were unknown in 1796, which is around the time that Hahnemann first started putting his ideas into practice or 1807, when he coined the term “homeopathy.” Moreover, Dawkins was absolutely correct to point out that appeals to the memory of water are nothing more than “boldly paddling up the creek of pseudoscience.” In addition, perhaps McLean would like to explain upon what scientific basis today’s homeopaths can show that homeopathy “works.”

Homeopaths won’t like this, but, although a bit simplistic in his explanation (no doubt compressed for the brief time allotted in the special), Dawkins is also correct when, as he cited the 2005 Lancet meta-analysis showing no efficacy of homeopathy, he explains that the larger and better-designed the study of homeopathy, the less likely it is to show any sort of effect. Most “positive” studies of homeopathy are either small or have serious methodological flaws. Also, remember, even among perfectly designed studies with enough patients to give a high level of statistical power, because of the somewhat arbitrarily chosen cutoff of a p-value of less than 0.05 as designating statistical significance, on average, one out of 20 studies will be “positive” just by random chance alone. Naturally, homoepaths will always be able to cherry pick those studies, which is what they generally do, ignoring the far larger body of negative studies. That’s why, when assessing clinical studies of homeopathy, one has to look at the totality of evidence.

None of that stops McLean from bolding stating:

The truth is that no homeopathic medicine can be made using only dilution – without Succussion (vigorous shaking between each numerical potency) and no mention that the medicines are made using 40% distilled water and 60% alcohol to preserve the original substance, i.e. a plant, mineral, metal, etc. being made up.

Indeed, another homeopath also lodges the same complaint:

Dawkins blatantly omits the fact that homeopathic dilutions undergo a specific process of shaking (‘succussion’) that could produce some “memory-of-water” effect. While this description is speculative and metaphorical (as no one has yet explained scientifically how homeopathic information might be stored in water), describing the preparation process of homeopathic remedies as based on dilution alone is factually incorrect and leaves out a crucial step, as dilution alone (without succussion) produces homeopathically inactive remedies that are truly no better than placebo.

Quite frankly, from the perspective of a scientist and skeptic, appealing to succussion is not exactly a convincing argument against Dawkins’ characterization, particularly when coupled with appeals to metaphor (although I do appreciate being referred to as a “prominent skeptical blog”). Indeed, the contention that “vigorous shaking” at each step in the dilution is necessary to produce the potency of the homeopathic medicine is just as pseudoscientific as homeopaths’ contentions that “like cures like,” that water has memory of a sort that allows it to have a therapeutic effect after all the active substance has been diluted out, and that increasing dilution increases potency. There is no physical or scientific basis to claim that vigorous shaking, whether you call it succussion or something else, will do any more to make homeopathy “work” than diluting substances to nonexistence. It’s magical ritual that homepaths believe to imbue their remedies with their potency, nothing more.

The rest of the article is so full of antiscientific idiocy that it’s hard to know how to address them all without making this article balloon up to be ridiculously long even by Orac-ian standards. Even so, a few of them must be mentioned. Let’s see. Fallacious appeal to ancient knowledge? Yep, it’s there:

The fact of the matter is that acupuncture, ayurvedic, homeopathy, Chinese medicine, herbs, etc. ARE NOT ALTERNATIVE MEDICINE because these therapeutics have been practised for hundreds, if not thousands of years!

I would argue that modern medicine is in fact ALTERNATIVE MEDICINE, only having been in existence since the advent and discovery of antibiotics by Fleming in 1928 – 79 years ago!!

Which would you rather trust, something that has been used for hundreds of years, which has stood the test of time, or medicines which have only just been invented?!?

The fact is that people are turning their backs on untried and for the most part improperly tested pharmaceutical drugs and reaching back to discover the ancient and timeless wisdom and knowledge of the past.

The stupid, it really does burn. In considering this bit of idiocy by McLean, remember that “alternative medicine” is in reality more a politically correct term to describe unscientific, non-evidence-based medicine than anything else. It’s a term that has now morphed into “complementary and alternative” medicine, where the “complementary” refers to the use of unproven remedies alongside proven remedies, as if the two were equivalent. (How this “complements” scientific medicine, I fail to see.) As Dawkins points out and as I and others have mentioned many times, “alternative medicine” that passes scientific muster and shows its efficacy in properly designed clinical trials ceases to be “alternative” and becomes simply “medicine.” The reason “alternative” medicine is “alternative” is because it is either unproven or has failed to demonstrate efficacy. Besides, science does respect “ancient knowledge” that it tests and finds to have value. That’s how, for instance, we discovered aspirin, digoxin, and various other drugs that derived from herbs and plants long used for therapeutic purpose.

Once again, it’s not hard to point out that medicine men and shamans believed for thousands of years (and, sadly, many still believe) that disease is caused by evil spirits. Does that mean we should respect such “ancient wisdom” and accept the hypothesis that disease is caused be evil spirits as being the equal of the scientific contention that infectious disease, for example, is caused by bacteria and viruses? I think not. The same is true of aspects of alternative medicine. Its practitioners invoke mystical concepts such as the “memory” of water, life force (qi) undetectable by any scientific instrument, treatments involving the “unblocking” of the flow of qi without any evidence that qi exists or that what the practioner is doing has any effect on it, ridiculous claims that our DNA once had twelve strands instead of two, and many others. Holding such claims on par with scientifically tested and verified claims is ludicrous and a false equivalency.

Naturally, McLean is an antivaxer as well:

Vaccines is one of the great hallmarks of modern medicine. The injecting of disease and poisons into the healthy body. These cause all manner of new and increasingly difficult to treat chronic illnesses such as the epidemic of autism through massive accumulative doses of mercury which lodges on the brain, impeding its functions.

Anyone who regularly reads this blog knows what a steaming, stinking pile of B.S. the above statement is.

Of course, McLean can’t resist topping off one legitimate criticism of modern medicine (i. e., the overuse of antibiotics) with pure silliness:

The liberal use of antibiotics which suppress, not cure an illness, also causes candida. Antibiotics can be lifesaving in certain instances but not in people who have had too many of them and there will always be a homeopathic medicine that can equally successfully do the job without the side effects.

Germ theory was trundled out in the programme and its discovery hailed as a great landmark. In fact the theory is incorrect. It is one of the basics of modern medicine. Not long ago I watched ‘How Clean is Your House’, a programme most Brits have heard of. The childless couple living in West London had a FILTHY house, filled with dogs. They could not have cared less about the dirt and the wife was filmed allowing the dogs to lick her lips as she kissed them. Items were sent off to laboratories and they were severely rebuked for their unhygenic lifestyle, yet the wife assured the presenters that they had never suffered any ill health.

What about all the doctors and nurses who go about their healing in virulent epidemics, yet never ‘catch’ the illness. Many so called epidemics, especially the so called Spanish Flu were caused by mass vaccination and those unvaccinated remained well.

Personally, I’d be very interested in seeing which homeopathic remedy can “equally successfully do the job” treating bacterial diseases as antibiotics. Perhaps McLean would volunteer to be exposed to a particularly virulent bacteria, allowed to develop the illness it causes, and then to cure herself with homeopathy. My only suggestion to her, should she be foolish enough to agree to such an experiment, would be not to buy any long playing records. (Yes, I know that quip reveals just how old a fart I am.) As for the bit about doctors and nurses in epidemics, I would point out that the history of epidemics is littered with tales of doctors, nurses, and other health care professionals who have fallen in epidemics, along with the patients they treated. They may not get the diseases at the same rate, because, after all, they do take precautions, but no precaution is foolproof.

McLean finishes up in a flurry of appeals to conspiracy:

Running Zeus Information Service for 4 ½ years and reading extensively has shown me quite clearly that there is a relatively small number of very powerful people who dictate international policy and who control the money flow of this planet. These people want to continue that way and anything, whether it be alternative medicine, whether it be free energy, whether it be true democracy, will not be aired in the media which they control and suppress to prevent all attempts at revealing the truth.

You knew it wouldn’t be long before she devolved into tinfoil hat territory. She and Mike Adams would make beautiful woo together.

Of course, the problem is not, as McLean laments, that people like Dawkins get “so much airtime,” but rather that people like Dawkins get so little time in the media. In reality, there the forces of woo rule supreme. Credulous stories about homeopathy and all manner of alternative medicine abound, both here in the U.S. an in the U.K. The reason that The Enemies of Reason stands out is not because documentaries like it are so common, but rather because they are so rare. Despite the major tendency towards woo in the U.K., our British friends do win out in at least one respect: There’s no way a documentary like The Enemies of Reason would ever be produced in the U.S, much less aired during prime time on a major broadcast network.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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