Wednesday, 13 April 2016

If Jesus was a Homeopath

If there was ever a patron saint of critical-thinking it would have to be St Thomas the Doubter.

At my old Church of Scotland Sunday School in a little village by the Firth of the Tay I always loved the bible stories which were read to us. But even in those days I always felt Thomas got a rough deal. All he had done was to ask for evidence, he never said anyone wasn't being truthful, he just asked for proof and he's been reviled by history for the past 2,000 years or so.

Recently I looked up the actual story in my old bible and reminded myself of the rhythm and beauty of the words of the King James version.

St. John chpt 20, vs 24-29

But Thomas, one of the twelve, called Didymus, was not with them when Jesus came. The other disciples therefore said unto him, We have seen the Lord. But he said unto them, Except I shall see in his hands the print of the nails and put my finger into the print of the nails, and thrust my hand into his side I will not believe.

And after eight days again his disciples were within, and Thomas with them. Then came Jesus, the doors being shut, and stood in the midst, and said, Peace be unto you. Then saith he to Thomas, Reach hither thy finger, and behold my hands; and reach hither thy hand and thrust it into my side: and be not faithless, but believing. And Thomas answered and said unto him, my Lord and my God. And Jesus saith unto him, Thomas, because thou hast seen me, thou hast believed: blessed are they that have not seen, and yet have believed.

The names Thomas and Didymus both mean ‘twin’ by the way.

Apparently theologists see this as an example of Jesus, not castigating Thomas but being prepared willingly to present proof when it was requested. I like this idea. It sounds like Thomas was giving Jesus a chance to shine and to demonstrate how not to take offence when questioned about a claim.

And I thought how refreshing that attitude to evidence was and I began to imagine how the scene might have gone if Jesus had been a homeopath; a group notoriously reluctant to provide anything approaching reasonable quality proof:

But Thomas, one of the twelve, called Didymus, was not with them when Jesus came. The other disciples therefore said unto him, We have seen the Lord. But he said unto them, Except I shall see in his hands the print of the nails and put my finger into the print of the nails, and thrust my hand into his side I will not believe.

And after eight days again his disciples were within, and Thomas with them. Then came Jesus, the doors being shut, and stood in the midst, and said, Peace be unto you. Then saith he to Thomas, Reach hither thy finger, and behold, my garment is rent where the spear has passed through and behold, my hands are pretty sore, I can tell you. And Thomas answered and said unto him, But I would behold thine wounds with mine own eyes. And Jesus spake unto Thomas saying, Art thou calling me a liar?

Thomas's heart was heavy and he was sorely grieved. He spake saying, No Rabbi, yet I wouldst see the marks, how about I reach thither my hand and thrust it into thy side? And Jesus was angered and said unto Thomas, No way, that's gross. Look Sonny-Jim I've got a sheaf of parchments here from people who swear they have seen the marks, what other proof dost thou need?

And Thomas read the words which were given him and afterwards he reached out to move the garments of Jesus to one side that he might better see the mark. And, he beheld there was no mark and neither were there the prints of the nails in his hands. This Thomas told unto Jesus and asked why it was so.

And the anger of Jesus increased and he said unto Thomas, It's quantum, mate. Obviously you can't actually see them; if you look at them they disappear; it's quantum. Hast thou been reading that apostate Newton again? Stick to Einstein, he was a good Jewish boy, he knew a thing or two about quantum; quantum's great, what would you know – have you even studied medicine? Anyway, why dost thou touch my person? And, turning to the disciples Jesus said unto them, You lot saw that, that's technically assault, why doest these sceptics get so aggressive?

And yea at his command the sky darkened and the heavens opened and the wrath of God descended upon them with fire and hail and a great clashing of cymbals, verily the room wherein the disciples were was filled with the Holy Spirit burning like bright flame unto the very walls and timbers and the sound of His rage was heard throughout the land and the mountains shook and the ground trembled.

At this the disciples were sore afraid and cast themselves to the ground in their misery. And Thomas was among their number and thought unto himself, I wonder if it's too late to be a Zoroastrian instead?

Doesn’t have quite the same ring really, does it!

Sunday, 27 March 2016

Homeopathic hypocracy and vivisection

What do you think of when you consider homeopathy - holistic, safe, trusted? Well, what about vivisection?

Even I, as someone highly sceptical of homeopathy, didn’t consider laboratory animals would be used to test homeopathic remedies. Surely that would be anathema to a practice which preaches gentleness and holism. For years I believed the British Homeopathic Association (BHA) when they proudly declared in their journal “Homeopathic medicines are NOT tested on animals and our Memorandum of Association clearly sets out that we may only ‘undertake and finance research into the problems of medicine WITHOUT vivisection’ 3(E)” [emphasis in the original].

Well, I was wrong – it appears their veterinary colleagues didn’t get the memo.

The magic of homeopathy: getting the public to believe anything

In 2014 the Honorary Secretary of the British Association of Homeopathic Veterinary Surgeons (BAHVS) stated in a letter in the veterinary press (1) “If one is bringing data, it should be the truth” and suggested the truth regarding homeopathy might be found in a series of “more than 800 veterinary papers” published on a homeopathy website owned by veterinary homeopath Mark Elliott (2).

Since first entering the debate surrounding veterinary homeopathy one of my preoccupations has been studying the evidence presented by homeopaths in support of their practice. I have gone as far as to devote a website to this activity which now contains critiques of some 200 articles and scientific papers on the subject of complementary and alternative veterinary medicine, none of which provides any evidence for the effectiveness of homeopathy – veterinary or otherwise. I had begun to despair of ever finding the proof of which homeopaths talked with such glib confidence and consequently told myself there would be little point in making a close study of the much heralded “800 papers”.

However, the question of evidence for homeopathy has always been central to the debate. So, somewhat against my better judgement, I turned my attention to the list in question. Perhaps this would be where the convincing proof homeopathy was all it was claimed to be would finally be found. I began by reading the first section, with authors whose names started with 'A'.

First impressions weren't promising - a jumble of languages, odd fonts, strange formatting and broken links greeted me as I scrolled down. Undeterred, I pressed on to discover there were thirty-nine papers in 'A' section, although after removing papers which had been published twice in different locations the number dropped to thirty-six.

Despite the claim these were all “peer reviewed papers” I found a multitude of symposia proceedings, article reviews and case reports - there was even a book review! Closer scrutiny revealed a number of studies didn't actually involve homeopathy at all; three being concerned with isopathy, and two with herbal medicine. Three others found homeopathy to be ineffective.

The potential for bias was rife, with some trials sponsored by the manufacturers of the substance under test and nineteen published in pro-homeopathic journals. Not one of the papers was double-blinded and only a handful claimed even to be single-blinded. Some dated back to the 1970's, so old no references were to be found online.

The most shocking aspect of the list though wasn’t the misleading promise of ‘truth’ from the BAHVS, it was the scale of the vivisection involved. In the name of the gentle art of homeopathy, hundreds of laboratory mammals were variously burned with lasers, scalded, incised, crushed, irradiated, had their jaw and leg bones fractured, were poisoned with strychnine, injected with formaldehyde, dry-cleaning fluid and cancer cells, and infected with sleeping-sickness. One experiment in a later section measured the effect of homeopathy in mice on “writhing induced by intraperitoneal acetic acid”. And it wasn't just mammals. One paper involved a group of unfortunate snails having their equivalent of a central nervous system dissected out for study.

And yet, even after all that, not a single one of these studies was fit for purpose. Inadequate methodologies, publication bias, vested interest and small group sizes ensured the mass sacrifice had been in vain. We still hadn’t come anywhere near proving homeopathy as a viable system of medicine.

It seems the homeopathic definition of ‘truth’ is different from that used by everyone else. It is apparently so elastic as to allow a mere book review to be transformed into a peer-reviewed paper; studies of herbal remedies to be proof homeopathy is effective; and to allow a single paper to be presented as two separate pieces of evidence. Homeopaths must think we’ll believe anything, on the one hand promising remedies are "NOT tested on animals" yet at the same time using exactly this type of evidence in support of their cause. The only explanation I can possibly think of is the authors of the “800 papers” must simply have hoped noone would read them and in this way they could completely pull the wool over our eyes. Perhaps this then, is the real magic of homeopathy.

I am trying to resist, but now my gaze is starting to drift down the page and I notice the first paper in the ‘B’ section also has nothing to do with homeopathy, being concerned instead with testing a herbal remedy. This doesn’t bode well.

1 - Marston (2014) - Truth, evidence and marketing of drugs (letter) - Veterinary Times 7 April, vol 44 no 14 
2 - Anon (2014) Veterinary Papers Peer Reviewed: Animal/Lab Studies by Name of Lead Author, A Research Database and Information for Homeopathy and its use in Veterinary Medicine [online:]  [accessed 23/12/15]

Thursday, 4 February 2016

Homeopathy and Phrenology - kindred spirits

Few Veterinary Surgeons or Nurses would be convinced if we were told that it was possible to diagnose disease by feeling for lumps and bumps on our patients’ skulls. Yet 100 years ago many people believed just that. Phrenology, as it was called, was practiced by many prominent public figures of the day, including Royalty all of whom were convinced of its merits. It was even practiced on animals. The subject was debated at length by scholars and intellectuals and was supported by masses of detailed text books and articles in specialist journals. Nowadays Phrenology is defunct and discredited and the only sign that it ever existed is the occasional porcelean head marked with impressively named bumps usually found in curio shops.

The reason that these days few people have even heard of Phrenology is simply that real evidence for its effectiveness was found wanting. While in selected cases Phrenology apparently produced miraculous results, when the totality of cases was looked at, no clinical effect was found. Science proved what common sense should have told people all along; that there is no reason why bumps on heads should reflect anything other than... well, bumps on heads. Phrenology owed its existence solely to the blind faith of its practitioners and their willingness to rely only on favourable data whilst ignoring the rest.

Now consider something that is still used widely in human and veterinary medicine today, also by worthy and intelligent people but which has an even more unlikely basis than Phrenology. Homeopathy is a treatment invented two centuries ago at a time when purging and bleeding were common-place in the treatment of disease but which, unlike its more violent contemporaries has remained unaltered since. In homeopathy, remedies are made by taking basic ingredients such as Peregrine falcon, condoms, or the Berlin wall (these are genuine examples) and diluting them to such levels that a quantity of remedy equivalent to all the atoms in the known universe wouldn’t contain even a single molecule of the original. Yet even though there is no trace of anything other than water in their remedies homeopaths claim incredible results in the treatment of any condition you care to name including SARS, AIDS and cancer. Despite the fact that this underlying principle defies both common sense and scientific rationale, critics of homeopathy are dismissed as being out of harmony with today’s holistic New Age in the same way that critics of Phrenology were once called out of touch with the progressive Victorian Age.

When we look at the research we find that, like Phrenology, almost all supporting evidence for homeopathy is found within specialist journals and texts written by homeopaths themselves.  Much of this literature is questionable, suffering as it does from publication bias and is incapable of being replicated by independent researchers. Other, more objective studies have combined the results of multiple trials and in no case has any firm evidence been found in favour of homeopathy.

In conclusion homeopathy, like Phrenology before it, has many supporters, all of whom are convinced that it works; yet it has no basis in science and should have no place in the Veterinary profession founded as it is on rational principles.  Like Phrenology, homeopathy is an illusion sustained only by the faith of its followers and their selective use of evidence.

In the story of the Emperor’s new clothes, people are unwilling to admit what is obvious for fear of being ridiculed by others. Well, it’s about time we admitted that if our homeopathic Emperor appears to be wearing no clothes then, no matter what excuses he tries to come up with, the Emperor really is making a spectacle of himself.

(This was originally published in the letters pages of the Veterinary Nursing Times)