I write about homeopathy fairly regularly on this blog because there is no quackery that is (1) so obviously quackery and (2) such a perfect topic to use to illustrate a lot of issues relevant to medical science, such as issues in clinical trials resulting in false positives and, of course, placebo effects. Basically, homeopathy is an excellent quackery to use to illustrate just how it is that a treatment that, in most cases, is nothing but water can give the appearance of being effective when in fact it is not.
Make no mistake, either. Homeopathy is quackery. It is a modality cooked up over 200 years ago by Samuel Hahnemann that has two “laws.” The first law is the Law of Similars, which states that substances that cause a symptom in healthy individuals can be used to relieve those same systems. Thus, to treat insomnia, you might use coffee or even caffeine. Yes, it is just as ridiculous and without a basis in science as it sounds. But it gets worse than that with the second “law,” known as the Law of Infinitesimals, which states that diluting a compound chosen according to the first law makes its effects stronger. To be more specific, serial dilutions, with vigorous shaking to “potentize” the remedy make it stronger. Many homeopathic dilutions are listed in measures of “C,” which is a single 100-fold dilution. So, for instance, a 30C dilution = a (102)30, or a 1060-fold dilution. Of course, the problem with this is that Avogadro’s number is only ~6 x 1023, making a 30C dilution roughly 1036-fold greater than Avogadro’s number. Basically, anything more dilute than about 12C is water, and anything above 10C is incredibly unlikely to have anything in it at concentration that can do anything.
Do you see why homeopathy is so great for discussing placebo effects and factors in clinical trials that can cause bias and false positives? It’s water!
So whenever I see articles discussing homeopathy as though it were anything other than the rankest pseudoscience, articles that discuss it as though it were real medicine, I get a little bit perturbed. I get especially perturbed when it’s children being subjected to this quackery. I get even more perturbed when it’s special needs children being subjected to this quackery.
No wonder I got a bit perturbed when I saw this post on The Not-So-Thinking Moms’ Revolution about homeopathy in which Amy Lansky is asked about homeopathic remedies for autism. The post is entitled Dealing with the Many Complexities of Treating Autism with Homeopathy. Yes, it is just as bad as it sounds:
I have a 10-year-old son with autism, and I did take him to a classical homeopath. His main issues are extreme controlling behavior; extreme lack of impulse control; severe constipation; very poor social behavior; and lack of focus/interest. He is very verbal and bright though. He responded very well initially to Tuberculinum and Lycopodium, but they now have stopped working for him and we don’t see any benefits from them. We are now trying Carcinosin (started) and Natrum Muriaticum (not started yet). But we don’t see the big gains we did when we initially started on Tuberculinum and Lycopodium. In fact he has shown regression in some of the behaviours we had eliminated earlier.
This mother had three questions:
- Is it common for a benefit to stop working?
- Is it common for some medicines to cause regressions?
- How long do people stay on a medicine that works for them?
Of course, this history sounds very much like placebo effects, which are usually transient, hence the “regression.” Of course, homeopaths often claim that children can’t exhibit placebo effects, but certainly parents change their expectations when observing subjective symptoms after having given their child a medication.
So first, what are Tuberculinum and Lycopodium? The mother doesn’t say how dilute the remedies used were; so it’s possible that there might actually be some Tuberculinum or Lycopodium in these remedies. There’s no way of knowing. Actually, yes there is. Given that Tuberculinum is a nosode derived from a tubercular abscess, I would very much hope there’s nothing left of the it after dilution; i.e., that it’s at least a 12C dilution. Lycopodium, on the other hand, is club moss (Lycopodium clavatum).
So here we have a mother who is giving her autistic child a medicine purportedly derived from a tuberculosis abscess, along with a medicine derived from club moss. Why on earth would homeopaths think that either of these do anything? Well, if you believe in the first law of homeopathy, that “like cures like,” then take a look at the symptoms purported to be caused by Tuberculinum:
Contradictory characteristics of Tuberculinum are mania and melancholia; insomnia and sopor
Desire to use foul language, curse and swear.
Fear of dogs
Irritable, especially when awakening
head; bores head in pillow;
head; movements of head; rolling head;
One could see how, if deluded homeopaths (but I repeat myself) think that Tuberculinum can relieve these symptoms they might think that it might be useful for autistic symptoms. Head movements could be part of stimmming, for example. Of course, there’s no evidence that a tubercular abscess will do anything other than risk infection with tuberculosis, and there’s no evidence that material from a tubercular abscess diluted away to nothing will (which I hope that this is) do anything at all, other than possibly induce placebo effects. Hilariously (well, it would be hilarious if it weren’t such quackery being used on children with neurodevelopmental disorders), the same source states that if Tuberculinum fails, Syphilinum often works. Yes, it’s derived from just what it sounds like it’s derived from, if you believe homeopaths.
But what about Lycopodium? Here are some of the symptoms it is claimed to cause and treat:
Shakes head without apparent cause
Twists face and mouth
mind; aversions, dislikes; being approached;
mind; behaviour; shrieking;
mind; behaviour; shrieking; during sleep; ;
mind; behaviour; shrieking; before urinating; ;
mind; delirium; raging, raving;
OK, if you believe the quackery that is homeopathy, I can see how you might think such a compound might be useful for autism.
So let’s see what Lansky answers. First, she asks whether the homeopath tried different potencies before abandoning the Tuberculinum and Locopodium or changed the dosing. Of course, different potencies or dosing of water still involve administering water; so Lansky’s first suggestion is as meaningless as any homeopathic remedy. Next up, she asks:
Also, why is the homeopath using two remedies at a time? I see that he or she is giving both a nosode (Tuberculinum, Carcinosin) and a more traditional “constitutional” remedy (Lycopodium, Natrum Muriaticum). I understand the thinking, but it may be possible that it was really the Tuberculinum or the Lycopodium that was doing the work.
How long have you been on the Carcinosin and Natrum Muriaticum? A week? Three months? Sometimes it takes a month to see changes. And even the most subtle improvements can be signs of the remedy working.
Or it could be that neither of them “worked.” Notice how cleverly, albeit inadvertently so, Lansky plants the idea of subtle “improvements” meaning that the remedy is working. This cues the parents to look for very subtle changes, and if there’s one thing about looking intently for subtle changes it’s that you will usually find them, thanks to expectation. That’s why double blinding is so important in clinical trials involving behavior or other subjective symptoms, so that the observer assessing the patient doesn’t see what he wants to see.
Out of curiosity, I looked up what Carcinosin and Natrum Muriaticum are, although I had a pretty good guess beforehand. Unfortunately, I was right about the first one. It is said to be derived from cancerous tissues, specifically breast cancer. Homeopaths claim that Carcinosin is good for this:
People who benefit most from Carcinosin are those who are introverted, extremely sympathetic and touchy during their childhood. This type of children usually holds back their emotions, loathe being censured or scolded and can become offended easily. When they attain puberty, such children may often find it hard to restrict their sexual emotions. When they grow into adults, they have a propensity to be obsessive and habitually turn out to be workaholics, incessantly driving themselves to the limits. They may possibly have an intense yearning for traveling as well as thrill. Their desire for profound contentment may result in fatigue as well as ailments.
Such is the rationale for using this in autistic children. Once again, I truly hope that the “potency” of Carcinosin used on this woman’s autistic child was at least 12C, meaning that it was water.
But what about Natrum Muriaticum? Take a guess? The first word gives it away. Basically, it’s sodium chloride, table salt. Excellent! I do like some electrolytes with my hydration! Of course, this is just as ridiculous as any of the other homeopathic remedies used here, but at least if it really does have what it’s claimed to have in it at least it won’t be harmful to a child if it is “less potent” than 12C.
But what about that regression? As I said before, the parents observing an apparent improvement for a while, only to be followed by a seeming “regression.” What they’re almost certainly seeing is a regression to the mean. But what does Lansky say? She lists three possibilities. First:
For example, sometimes a correct remedy can cause old symptoms to return. However, if this is the case, then those symptoms should disappear within a few days, or at most a couple of weeks. Think of it as bringing up the symptoms and then more completely healing them.
How many times do we hear this excuse from quacks? The remedy will make symptoms worse before they make them better! Nope.
Is it possible that you have introduced some new factor that is antidoting your son’s remedies or is a “maintaining cause” that is causing this regression? These factors could be new foods, supplements, changes in social milieu at home or at school, environmental, etc.
Here we go again: Blame the victim. It must have been something the parents did to counteract the powerful magical homeopathic remedies prescribed. Did they change the child’s diet? Did they start new supplements? Did they change the child’s environment somehow? That’s right, it’s the parents’ fault. It’s always the victims fault. This tactic is also very useful to quacks because it distracts attention from the fact that their woo isn’t working and sends the patient or patients’ parents off on a wild goose chase looking for what’s changed and might be keeping the woo from “working.”
It’s also possible, of course, that the new remedies are simply incorrect and that your homeopath has to take a new approach.
If one bit of quackery doesn’t work, try another bit of quackery! Never let the thought enter your mind that all homeopathy is based on prescientific vitalism. It is pure pseudoscientific quackery. Of course, that thought would never enter Lansky’s mind.
I’m sometimes asked why I refer to “The Thinking Moms’ Revolution” (TMR) as the “The Not-So-Thinking Moms’ Revolution.” The embrace of homeopathy by several of the so-called, arrogantly self-proclaimed “Thinking Moms” should be more than enough reason.