jump to navigation

Homeopathy losing ground in Italy August 22, 2007

Posted by dorigo in news, physics, science.
trackback

For the series “let’s cheer up if we can”, a small reason to be optimistic about the future of mankind -or at least, of my sorry country- came today, when I read on the italian newspaper “La Repubblica” that my fellow citizens seem to be slowly withdrawing from curing their diseases with homeopathic drugs and other alternative treatments. 

Homeopathy is founded on nasty pseudo-science, and is a big business – as anything pharmaceutical companies handle. The idea is that diseases can be cured by assuming microscopic amounts of substances which in larger amounts cause the same symptoms of the disease. The preparation of the drug is usually performed by dissolving ridiculously small amounts of the active substance in water, and then shaking it such that water will “retain a memory” of the molecular structure it was in contact with. The whole concept is at odds with hundreds of years of studies of chemistry, physics, and medicine: which only shows how, if you take a lie and shout it loud enough and long enough, you will get somebody to believe it. The situation is made worse by the human mechanisms of attaching hope to whatever treatment they are subjected to: the very well known “placebo effect”.

According to a research performed by the italian ISTAT (national institute of statistics) quoted in the article, the estimated 8.2 million users of homeopathic drugs in 2000 (a huge number, reached at the peak of a boom in Italy) have gone down to 7 million in five years. A drop of 15% which does not mean collapse but still smells of crisis. Of those seven million users, the large majority say they integrate homeopathic and other “alternative” treatments with more conventional drugs – maybe a sign that, when a bacterial infection is in progress in your kid’s lungs, you are more likely to come to your senses.

More depressing is to know, however, that there is a sick correlation between the instruction level and the use of alternative treatments to standard drugs: twice as many people who completed high-school studies or got a bachelor have used alternative medicine than people who abandoned school earlier. Among the categories that make most use of homeopathy and other non conventional treatments, businessmen and white collars are above 20%, while blue-collar workers are at 12.5%.  The picture of the homeopathic drug user is clear:  the peak usage is in the category of women between 33 and 44 years of age, with a high level of instruction, and living in northern Italy.

I read the 15% decrease in the use of homeopathic treatment with some caution, anyway. A factor which has to be taken into account with care is the strong decrease in buying power between 2000 and 2005, brought about by the introduction of the new unified european currency in 2002. Homeopathic treatments are usually more expensive in my country than regular drugs, although many of them can be obtained through prescription; they also last longer. So it is unclear by how much the decrease of users is really due as I hope to an increased understanding of the total ineffectiveness of these substances. For sure, in 2004 the italian Superior Health Council has done its part, by inviting pediatricans to be careful when prescribing homeopathic treatment to children. 

I am curious to know if any of my readers who consider themselves true scientists one way or another (a nice way to say I accept PhDs and also crackpots with a ToE in their pocket to speak up, or even internationally acclaimed string theorists) have used with confidence homeopathy to cure themselves or their relatives in the past. In fact, while I am with Feynman when he says “I believe that a scientist looking at non scientific problems is just as dumb as the next guy”, I hope the same can’t be said by “a scientist looking at scientific problems just outside his narrow field of research”!      

Comments

1. strings - August 22, 2007

I don’t think this kind of survey is terribly accurate,
so I’d take with a grain of salt the claim that there has been a 15% decline in homeopathy in Italy in the claimed period.

I am surprised to hear that in Italy, physicians sometimes prescribe homeopathic treatments. (??) I am pretty certain that they never do in the U.S., and it would be considered highly unprofessional. I hope I am not wrong on this. Homeopathic “medicines” are widely sold and used in the U.S., but they are not recommended by physicians. If it is otherwise in Italy, this sounds like a real problem.

2. Guess Who - August 22, 2007

TD wrote:

there is a sick correlation between the instruction level and the use of alternative treatments to standard drugs: twice as many people who completed high-school studies or got a bachelor have used alternative medicine than people who abandoned school earlier

Maybe not so sick. I suspect the population of those who left school early has a higher incidence of independent thinkers who won’t believe everything they’re told.

3. marco - August 22, 2007

Although I am very much against homeopathy *per se*, I agree with TD’s point: conventional/scientific medicine should take the correlation between education level and interest for homeopathy as a very important alarm bell instead of dismissing it.
More and more people are looking for more ‘human’ approaches to medicine and, like it or not, they often find homeopathy physicians more human than conventional physicians.
I am afraid that conventional medicine too often gets the science right while forgetting about the human being. Homeopathy does just the opposite.
If I have to choose, I have no doubt whatsover, I choose conventional medicine. Having said that, homeopathy is the wrong answer to a very sensible question.

4. Alejandro Rivero - August 22, 2007

Well if the idea is “diseases can be cured by assuming microscopic amounts of substances which in larger amounts cause the same symptoms of the disease” then I would say everyone uses it: vaccination. Yep, it does not cure, it is only preventive usage.
I understand the current “homeopathic” preparations are not such, but I dont know enough of history of the medicine to determine if it is a recent phenomena or if XVIIIth century homeopathy was already at the level of complete scam. I think that it evolved towards this pure water bussiness in order to scape drug regulations. Also I am under the impression that alternate pharmacological industry could be reusing the term (the “label”, not the theory”) to sell actual medicine, then escaping regulations: as it is obviously a scam, no regulation agency will bother to check if there are active components. I am thinking on herbal products, for instance.
Herbal products are intriguing by itself; regulated products -official medicine- were usually controlled extractions of some herbal substance and they still are, when synthesis is expensive. What is intriguing is that both branches (herbal companies and official pharmacological industry) try to show that they are completely different bussiness.

5. Kea - August 22, 2007

…a nice way to say I accept PhDs and also crackpots with a ToE in their pocket to speak up, or even internationally acclaimed string theorists…

LOL! Well, I’ve never tried any kind of alternative therapy, but I have to say that I’m very cynical about the medical profession in general and the inability of most doctors to listen to people (and being a grumpy middle aged woman usually means nobody listens to you). And I knew a good biochemist a while back who swore by homeopathy – of course I was dubious, but I certainly couldn’t match his knowledge on the subject. My point of view on these things is that even if a substance (eg. water, or brain tissue in the case of telepathy) has genuine properties that we cannot explain with present science, the probability that these properties are being accurately exploited (clearly in ignorance) is remote.

6. Vincent - August 22, 2007

I have not used homeopathy. I however know quite a few people who do.

The most startling cases that make me not dismiss it out of hand are:

1) animals (in one particular case, bovine) reacting positively to homeopathic medicine after failure with allopathic remedies. Of course, one could argue a delayed action from the strong medicine.

2) babies reacting positively to homeopathic medicine (for example, for reducing tooth pain)

I have heard only extremely unsatisfying explanations from homeopatic `professionals’. Even someone with only a few biology classes could see the _huge_ gaps in their understanding.

What I think is a serious problem is `real’ scientists dismissing things as `the placebo effect’, as if that meant “it’s a measurement error”. As far as I can tell, it is NOT. Are people researching how the placebo effect works? It seems like an incredibly interesting question. It would also give a non-escapist explanation for a whole bunch of phenomena.

7. Charles Tye - August 22, 2007

Citizens of the UK are in real trouble. Not only do the taxpayers have to pay for this nonsense to be provided by the National Health Service, it is even possible to get a BSc from a “university”.

Some brave souls like David Colquhoun speak out against this e.g. in Nature here: http://www.nature.com/nature/journal/v446/n7134/full/446373a.html

Also, I think you explain your “sick correlation” between those with higher educations and homeopathy usage a couple of sentences later. Homeopathic remedies are expensive. Such people with long educations (I hesitate to call them better educated) tend to have more disposable income.

8. Charles Tye - August 22, 2007

Vincent, the placebo effect is very real. That is why drug trials are carried out “double blind” in which neither the patient nor the doctor knows if the treatment is real or placebo. Only the effect of the drug itself is measured.

Have you not considered the possibility that the animals and babies you speak of might just have recovered by themselves?

9. Homeopathy fading in Italy « The Bad Idea Blog - August 23, 2007

[…] fading in Italy Physicist Tommaso Dorigo reports a study in the Italian press about how homeopathy is on the decline there: reduction in about 15% in just five years. Unless Italians are chronically dehydrated, this is […]

10. Alejandro Rivero - August 23, 2007

Most probably, some working homeopathic medicine is not homeopathy in the sense described in the post, but illegal unregulated medicine in the sense I tried to describe in #4 above. after failure with allopathic remedies

And of course “file effect” is real. But the same skeptic who will argue against pseudoscientific results in grounds of “file effect” will, for instance, give credit to the claims of General Motors about having a hydrogen car working for some thousands of kilometers. Without asking how many hydrogen cars have been run for the experiment.

I am very skeptic about organised skepticism. What is needed is reason-at-work, not just a list of scientific arguments but a way to argument scientifically. Skepticism as organised today is a tool to fight pseudocience, but it does not help science because it does not promote the experience of scientific activity, of scientific thinking.

As a “gedakenexperiment”, I’d bet that it is trivial to drive any standard skeptic to agree that the transmutation of mercury to gold is unfeasible because it requires a huge input of energy. He will even mutter the word “endoenergetic”. He will agree happily because it does not contradict his system of beliefs, and furthermore it simplifies a deeper economic analisis, consideration of relative abundances and drilling costs, etc. But he will not go to the tables of atomic weights (available in internet) and check the numbers.

11. Tony Smith - August 23, 2007

Tommaso said that he is “… curious to know if any … crackpots with a ToE in their pocket … have used with confidence homeopathy to cure themselves or their relatives in the past …”.
Since that description sounds like what I think Tommaso thinks of me, I will respond here by answering the question:
No,
I have not “… used with confidence homeopathy to cure [myself] or [my] relatives in the past …”.

However,
Tommaso also describes homeopathy as being “… usually performed by dissolving ridiculously small amounts of the active substance in water, and then shaking it such that water will “retain a memory” of the molecular structure it was in contact with …”.

That is a physical question that should be answerable by experiment, and Jacques Benveniste did some relevant experiments that are quite controversial, and the controversy has led to further experiments by others. According to a 15 March 2001 article in The Guardian by Lionel Milgrom:

“… A consortium of four independent research laboratories in France, Italy, Belgium, and Holland, led by Professor M Roberfroid at Belgium’s Catholic University of Louvain in Brussels, used a refinement of Benveniste’s original experiment … [that]… involved comparing inhibition of basophil aIgE-induced degranulation with “ghost” dilutions of histamine against control solutions of pure water.
In order to make sure no bias was introduced into the experiment by the scientists from the four laboratories involved, they were all “blinded” to the contents of their test solutions. …
The ghost histamine solutions and the controls were prepared in three different laboratories that had nothing further to do with the trial.
The whole experiment was coordinated by an independent researcher who coded all the solutions and collated the data, but was not involved in any of the testing or analysis of the data from the experiment. …
the results … were a complete surprise.
Three of the four labs involved in the trial reported a statistically significant inhibition of the basophil degranulation reaction by the ghost histamine solutions compared with the controls.
The fourth lab gave a result that was almost significant, so the total result over all four labs was positive for the ghost histamine solutions.
Still, … Professor Madeleine Ennis of Queen’s University Belfast … was not satisfied. “In this particular trial, we stained the basophils with a dye and then hand-counted those left coloured after the histamine- inhibition reaction. You could argue that human error might enter at this stage.” So she used a previously developed counting protocol that could be entirely automated. …
The result, shortly to be published in Inflammation Research, was the same:
histamine solutions, both at pharmacological concentrations
and diluted out of existence,
lead to statistically significant inhibition of basophile activation by aIgE, confirming previous work in this area.
“Despite my reservations against the science of homoeopathy,” says Ennis, “the results compel me to suspend my disbelief and to start searching for a rational explanation for our findings.” …”.

So, it seems to me that,
although a lot of medical fraud might exist using the name of homeopathy,
there is also probably some truth in the physical idea of homeopathy.
Specifically,
there is probably some mechanism by which the structure of water does retain some sort of order induced by some materials that have been dissolved in it, even in samples of water that are not in direct contact with those materials.

As an example of the subtle interesting things that happen in water, showing that it is NOT a simple fluid of identical particles,
look at the paper “Water Buckyballs”, arXiv physics.atm-clus/9807058 (cross-listed in astro-ph and cond-mat) by Keith Johnson, who says:
“… Recent scientific interest in small water clusters has been motivated by their possible roles in atmospheric and environmental phenomena, as well as by their relevance to the structure and properties of liquid water and ice. Experiment and theory agree that not only can such clusters be produced, but also they exist optimally in certain numbers (so-called “magic numbers”) and configurations of water molecules. …”.

Tony Smith

12. Bad - August 23, 2007

Tony: just because water is more complicated than a “simple fluid of identical particles” (and I don’t know ANY living scientist that would deny it) does not mean that the very specific claims of homeopathic structure memory has any validity… much less that these things would have any standard medicinal effect on the body.

Why wouldn’t the structures simply be destroyed when mixed with all the different molecules in saliva, dead skin cells in the mouth and gut, and other things? And if the structures are not that fragile, then why wouldn’t every single glass of water out of your tap be an excellent homeopathic cure, given that statistically every glass would contain molecules that had been in contact with nearly every substance known to man at some point or another?

13. Alejandro Rivero - August 23, 2007

More than “memory of water”, I’d consider the “memory of glassware”. They are doing an incubation, not a simple measurement of analytical chemistry. Bad#12 points out -as way of joking- that “statistically every glass would contain molecules that had been in contact with nearly every substance known to man at some point or another” but I would point out that *statistically* the glasses in a laboratory working with histamine have been more in contact with histamine that the ones in my kitchen. Guess which ones will detect more of the histamine when a sensitive biological experiment is run.

Reading the abstracts of the articles, it is not clear if the experimenters were able to measure the real concentrations of the products after producing the dilutions. Any data here?

To put some perspective, lets suppose that a 500 mg pill of amoxicilin is completely digested. That should be 100mg/l for a dilution in blood. One mol of amoxiciline is about 360 gr, thus it is a dilution about 10^-4 M. Most probably the active dilution atacking the infection is even smaller than that. So I would not be surprised if you tell me that biological organisms are sensitive to dilutions about, say, 10^-7 M or even more if the substance is highly toxic.

Now, check the label of your bottle of mineral water and tell how many miligrams of diverse inorganic substances does it contain. The histamine experiments are expected to compare dilutions of 10-2 M against 10-22 M and even 10-38M !. The first doubt is if they are really able to make a 10-22 M dilution; and then how do they check it is really so.

14. jeff - August 23, 2007

Lincoln used to say
“You can fool some of the people all of the time, and all of the people some of the time, but you can not fool all of the people all of the time.”

In the context of pseudo-science and bad science I prefer turning his wise sentence around to go something like this
“You can fool all the people some of the time, and can not fool all the people all of the time, but you can fool some people all of the time.”

15. Tony Smith - August 23, 2007

The publication by Ennis is at
Inflammation Research 50 (Supplement 2): 47-48
Please refer to it for details of her experiment such as dilution levels etc.
Here is what Springer-Link says about the paper:

“… No Abstract …

Flow-cytometric analysis of basophil activation: inhibition by histamine at conventional and homeopathic concentrations

Journal Inflammation Research
Publisher Birkhäuser Basel
ISSN 1023-3830 (Print) 1420-908X (Online)
Issue Volume 50, Supplement 2 / April, 2001
DOI 1023-3830/01/02S47-02
Pages S47-S48
Subject Collection Biomedical and Life Sciences
SpringerLink Date Thursday, February 19, 2004

Access to this resource is secured.
Add this item to your shopping cart for purchase later.
Description Price
Individual Article (Electronic Only) $32.00 …”.

So, there is no abstract on Springer-Link,
and I don’t plan to pay $32.00 for the paper.

Tony Smith

PS – Another dilute water experiment is described in the paper

Thermoluminescence of ultra-high dilutions of lithium chloride and sodium chloride
by Louis Rey
Physica A: Statistical Mechanics and its Applications
Volume 323, 15 May 2003, Pages 67-74
Its abstract says:

“Ultra-high dilutions of lithium chloride and sodium chloride (10 to the -30 gcm to the -3) have been irradiated by X- and γ-rays at 77 K, then progressively rewarmed to room temperature.
During that phase, their thermoluminescence has been studied and it was found that, despite their dilution beyond the Avogadro number, the emitted light was specific of the original salts dissolved initially.”.

It is an Elsevier publication, and also it costs money to see the full article, and I don’t plan to spend that money. You are welcome to spend and read if you want to know more details.

16. tulpoeid - August 23, 2007

Well, I have neither read enough on homeopathy nor am I acquainted with pharmacology, but as far as I know homeopathy DOESN’T claim that the same _substance_ is a cure; instead, it claims trying to produce the same _symptoms_, in the sense that symptoms are nothing more but the manifestation of the body’s attempts at self-cure so they should be promoted instead of repressed. (Just think of fever as a handy example.) One could say that homeopathy is a phenomenological technique which has yet to be systematized.

More importantly, I’m a phd in physics, a complete atheist etc. etc. (I’m mentioning it cause it also refers to all superstitions and “alternative” stuff), and I’ve personally had successful homeopathic treatment. This had been for chronic issues of respiratory and ear system [damn, which is the correct english word for this?!] back in my childhood and I don’t call it placebo effect cause my family and me didn’t know what kind of therapy it was, we didn’t even know it was a “different” one (that doc must have been one of the first homeopathics in Greece — yes, he was a proper doc). I can’t know whether it’s been a coincidence or not, but the problem receded permanently where dozen of other therapies had failed. I was still in the middle of elementary school so I don’t bet it’s been a matter of age.
On the other hand, my mum tried the same doc for hair loss but saw no notable improvement, which I kind of find sensible given the different nature of the problem.
Imho scientists being blind to certain fields for the sole reason that no explanation has been offered _yet_, is almost as bad as superstitions to me; it doesn’t let us go on. It’s non-scientific explanations that should be rejected by default, not facts and strong hints.

As a last note, my medicine had been in the form of powder which I swallowed without any water.

17. dorigo - August 23, 2007

Hi all,

Strings, indeed some homeopathic treatments are passed by the italian health system (and it is not the only country where that happens) – some doctors do prescribe them.

GW, I would love it if it was “common wisdom” that kept those with a lower level of education away from overhyped placebos. I think it is the cost, however, as Charles has pointed out later in this thread.

Marco, you raise a good point, but I have no answer to it… I am only able to comment on the scientific aspect of selling healing drugs which are not proven to have any effectiveness.

Alejandro, that is a good suggestion: indeed, homeopathic treatments do not need to pass all the screening of regular drugs. And yes, herbs contain many powerful substances, yet they pass as “alternative treatments” and people will believe they are curing themselves with more “natural” means…

I think the contest for the wittiest remark is won by Kea here. I totally agree with you Marni:

even if a substance (eg. water, or brain tissue in the case of telepathy) has genuine properties that we cannot explain with present science, the probability that these properties are being accurately exploited (clearly in ignorance) is remote.

Vincent, I know there are cases which are difficult to explain otherwise: as always, science requires experiments to be reproducible. That is the reason why medicine is not a science if patients are involved. I keep my skepticism, even if it is an organized one Alejandro😉

Tony, I do not look at you as a crackpot, rather an early-retired scientist who is still fiddling with the idea of a comeback. And thank you for your quotes. As always, you seem to be a happy fish in the middle of controversial ideas🙂 Too bad Elsevier is such a mafia! I am happy to see a reaction against their monopoly raising lately.

Alejandro, I am also curious of the way they measure such allegedly ridiculous concentrations. I hope they do not just go on diluting, that is a quite silly way of determining a concentration. I admit my ignorance though, and I will seek remedy by reading some literature.

Jeff, I agree – and I think some people do like to be fooled, that is the real problem!

Tulpoeid, you are the specimen I was looking for. An atheist, a PhD recipient, a scientist, and a successfully healed patient from homeopathy (albeit you did not choose the drugs yourself given your age). I think you do not make a statistics, though. I might add my own experience, with my very superstitious mother doing some kind of magical ritual to heal me from a wart on a finger when I was eight years old, and the wart healing by itself a week afterwards. I just shrug my shoulders at these things, but the powder you used might have contained real active substances in non-microscopic amounts.

Cheers all,
T.

18. Bad - August 23, 2007

“One could say that homeopathy is a phenomenological technique which has yet to be systematized.”

A better way of saying this would be that it’s a fairly random proceedure with no plausible known mechanism or validated model that has yet to show valid or convincing results.

Your particular cure sounds exactly like the sort of “it can clear up on its own over time, and then retroactively you decide that this or that worked” that makes anecdotal claims so problematic. As a wise man said upon being shown all the crutches at Lourdes, supposedly thrown away by cripples that had been miraculously healed: “What, no wooden legs?”

19. Alejandro Rivero - August 23, 2007

The more abstracts I see (thaks Tony!) the more it seems poor dilution technique.

20. dorigo - August 23, 2007

“What, no wooden legs?” —> LOL! (and my wife coming from another room with the WTF look)…

Thank you Bad, you made my day with this one!

Cheers,
T.

21. tulpoeid - August 23, 2007

Hi again, I understand dorigo’s and Bad’s skepticism, although you can see why I disagree with it if you re-read my post, but then why are you looking for a scientist claiming to have been homeopathi-cally cured?

22. dorigo - August 23, 2007

Hi tulpoeid, sorry – I did not explain my point in the comment. I was not looking for a scapegoat🙂 rather, in my twisted mind, I wanted to hear what people with a very high level of education in science think, and what are their experiences. So I salute your contribution. I hope you do not mind if I am skeptical – it is a very healthy attitude in science. On the other hand, I do understand that believing in a healing remedy is part of the cure: we are compex beings and our brain does interact with our body chemistry heavily…

Cheers,
T.

23. tulpoeid - August 27, 2007

This discussion is getting obsolete in the light of more interesting and recent ones (and also, the site was under maintenance when I tried to upload this 2 days ago:) , but I however meant to add that my post includes the reasons why I’d try homeopathy once more now that I know about it. I’ll repeat that imho skepticism is not something to be applied _beforehand_ or we’re bound to miss something sooner or later — Hippocrates had written somewhere that rinsing the doc’s hands with boiling water will increase the probability of delivering a surviving baby, but it was dismissed as superstition or plain stupidity in the following millenniums… you see my point. (This is also a good chance to add that I’m a phd _student_ which was omitted by mistake in my previous post.)

24. Dr. Nancy Malik - June 10, 2008

Homeopathy cures where Conventional Allopathic Medicine (CAM) fails

25. dorigo - June 10, 2008

Homeopathy has never been proven to work better than placebos.

Cheers, Dr. Malik
T.


Sorry comments are closed for this entry

%d bloggers like this: