Archive for category medicine
I’ve stated it before on this blog but these days we are surrounded by people peddling “alternative medicines” and the like in an attempt to gain funding for what ultimately, has either not been proved to work or proved not to work. One of the biggest perpetrators of this is homeopathy also called homeopathic medicine. Homeopathy was concocted by Samuel Hahnmann a little over two hundred years ago. He disliked the philosophies of the then current medicine and instead attempted to develop a field of medicine based on the principle of “like-cures-like”. Hahnmann believed that if something was to cause a set of symptoms in one amount then in a much lower amount it would surely cure the same symptoms, specifically if that substance was massively diluted in water and repeatedly shook it would release its ‘healing energy’ into the mixture which is then called a remedy. He went on to test many different substances by getting people to take them and record every symptom they then suffered. This practice is called “homeopathic proving” and the records of the symptoms from each substance are then stored in books known as “repertoires”. Using all of this the practice of homeopathy goes a little like this…
Patient: I have aches in my feet, a swollen neck and am feeling nauseous.
Homeopath: let me consult my repertoire……Ah I see, a teaspoon of X causes those symptoms. Ill prepare a remedy of diluted X and you will be better before you know it.
There is a wealth of evidence showing that homeopathy does not work as a medicine. Aside from the notion of like-cures-like not having any basis in anything other than wishful thinking the dilutions that homeopaths use ought to demonstrate to anyone that this is at best, an outrageous scam and at worse, a dangerous idea. (As a side note like-cures-like does not apply to vaccination which relies on the exposure of antigens to the immune system. I’m not going to go into immunology right now because it is a huge field but if you are interested wikipedia, contrary to popular belief, is quite a good start). To accurately describe how diluted homeopathic ‘remedies’ are I’m going to have to go over a little bit of chemistry…
All matter is formed of atoms; these atoms can bind together in groups to form molecules. Due to the different masses of different elements (for example; a single oxygen atom masses more than a carbon atom) if we have a gram of one element and a gram of another they will not have the same amount of atoms in them. This is a bit like having a tonne of bowling balls and a tonne of tennis balls; bowling balls are bigger and weigh more so there will be less of them, tennis balls are smaller and weigh less so we need far more than bowling balls to make up a tonne.
If we want to have a sample with one atom of substance A for every one atom of substance B we have to do a bit of working out. There’s a useful unit in chemistry known as a mole (not to be confused with a mole), one mole is roughly 6 billion trillion molecules or atoms (depending if the fundamental unit of the substance is a molecule [e.g. water] or an atom [e.g. iron]). To know how many grams of a substance you need to make one mole you need to find out its atomic weight, simply looking at a periodic table will tell you this (I’m not going to get into how we weigh atoms!). The atomic weight of oxygen and carbon are 16 and 12 respectively, therefore 16 grams of oxygen has the same number of atoms as 12 grams of carbon.
So how does this little chemistry lesson apply to homeopathy? I’m going to go through step by step how to make a homeopathic remedy of salt. The first thing a homeopath does is make a 1 in 10 dilution (homeopaths call this a “1X”); salt is made from the molecule NaCl (a molecule of one sodium and one chloride atom). One mole of NaCl is 58 grams; one mole of water (H2O) is 18 grams. To make a 1 in 10 dilution where we have one NaCl molecule to one H2O molecule we can put 5.8 grams of salt into 18 grams of water. Shake the sample to make sure it’s evenly mixed and voila! Now we have a 1X solution.
The next step is to do the same thing again, diluting one part of this solution into ten parts water. Now for every NaCl molecule there are 100 molecules of H2O and it doesn’t stop there. Homeopaths repeat this shaking and 1 in 10 diluting dozens of times. Remember the number of molecules in a mole? It’s 6 billion trillion (or 6×1023), at the beginning when we had an equal amount of salt to water we had this many NaCl molecules, with every dilution we’ve got 10x less so after twenty-three dilutions there will likely now only be six NaCl molecules in the entire solution. Beyond this limit of only there are only two options; the first is that every time a sample of the solution is taken to dilute in more water some of these six molecules goes with it. This would mean that the 24th dilution was not dilute 10x more than the 23rd. Secondly (and far more likely) these six molecules wont be picked up and all that will be transferred is water, in that case the sample is no longer a dilution but a pure solution of water. From then on any more 1 in 10 mixing is not diluting but merely mixing water on its own. Unfortunately the story gets worse…
Most people could probably see that half a dozen molecules of something is not going to have a great effect on your body but twenty-three dilutions only creates what’s called a 12C remedy. Apparently this isn’t good enough and this solution is then diluted further, the problem with this is that if the solution only has one molecule of a substance in it then diluting it a further ten times in water means that to maintain just one molecule you need ten times more water. After twenty-three dilutions the sample will contain only water but homeopaths advocate remedies to be diluted sixty times! This is called a 60x solution. It’s difficult to understand just how dilute this would be if it still contained just one NaCl molecule;
The Earth is nearly 8000 miles wide. Imagine a globe the size of the Earth but made entirely of water, that’s 1 billion trillion litres of water. Now make that globe a member of a team containing 100 globes. Make that team a member of a group containing 100 teams. Make that group a member of a company containing 100 groups. Make that company a member of a cohort containing 100 companies. Finally make that cohort a member of a system containing 100 cohorts. In one system there are 10 billion globes. Add to that just one molecule of NaCl and that’s how dilute a 60x salt solution is.
At his point it should be obvious that homeopathic remedies are just water and aren’t worth the tap they came out of. But homeopaths in light of this evidence still stick to their guns. When homeopathy was being concocted by Hahnmann it was not known if matter was made of fundamental units or if it could be divided infinitely. Since the discovery of atoms we have known that this is untrue and this leads to preposterous scenarios needed in the dilutions as mentioned above. But homeopaths today try to get round this by arguing that water has memory. Yes they claim that pure water when mixed with a substance and shook repeatedly remembers what was in it and takes on the properties of this substance, purportedly by forming a network of water molecules around the substance to mimic it. But this last attempt at saving their ideology is by far the easiest to prove wrong. To start with if water has memory that doesn’t bode to well for our recycling of toilet water into drinking water (hence the expression “homeopathy is full of shit”), secondly this would mean that the water’s healing properties are due to it replicating the effect of the substance in it. If this were true it would violate the idea that a dilution is stronger because instead of having just the substance in water the entire water now acts as the substance! Lastly the time in which water molecules change places and orientation to form new networks is on the order of picoseconds (meaning it happens nearly a trillion times per second), far too short a time for any memory.
In spite of having no evidence for like-cures-like, remedies so far diluted they are just water and no evidence for claims of a memory system in water homeopathy is still a huge and active movement in the western world. The matter is only complicated by figures such as Prince Charles (a man with no scientific or medical credentials) stating that homeopathy should be considered. Homeopathy should be considered as much as any unproven or disproven field in medicine, it is not fair if homeopathy get’s to sidestep the stringent drug testing that any proper medicine must undergo purely on the basis of people’s choice or popular figures ideas. The issue is far worse though, a report by the House of Commons Science and Technology Committee revealed that the NHS is spending money on homeopathic treatments. Worryingly there is no exact data on how much is being spent and on what, however it is estimated that homeopathic remedies cost the NHS over £150,000 a year (outrageous when A, it’s water from a tap and B, in an earlier post I talked about how some people feel £100,000 a year for Paul Mason was not deserved) and the cost of running the four homeopathic NHS hospitals we have in the UK is quoted as being near £12 million.
The only shred of justification modern homeopathy has is that it can act as a placebo. A placebo is a substance administered to a patient that does nothing biochemically relevant to their condition but due to the patient believing they have taken medicine they show improvement. The placebo effect is controversial as it may only work by making the patient less aware of their discomfort whilst their body heals naturally, it cannot heal beyond what the body can heal unassisted anyway and there is an ethical dilemma in lying to a patient about their treatment. But if homeopathic remedies are an effective placebo then there is no reason why they could not just be replaced, very easily, very cheaply by a nice, refreshing bottle of evian.
I hope this post has enlightened you a little on what exactly homeopathy is and how it claims to work. I hope I have stimulated a curiosity to learn about these things and how we can know if something has evidence or not. In the modern world the veracity of any medicine (and indeed any science) is only confirmed through repeated, demonstrable experiments by different parties. The data from these experiments can then be published (providing the research was logically and methodologically sound) for other scientists to examine, repeat and have their results also published. Through this long meticulous process we can ascertain what works and what does not. Now more than ever we can ill afford to allow untested, unproven medicines and sciences to gain funding at the expense of that that has fairly passed the best tests known to man.
The cuckoo is infamous for two things; regularly jumping out of clocks and laying its eggs in other bird’s nests. These cuckoo chicks when born sometimes even try to push the other eggs out of the nest before stealing the attention and food of the mother. This situation isn’t a unique one in either nature or our society, there are limited resources in this world and in this time of economic recovery and budget cuts there’s even less to go around. Ensuring that the right people get the allocation they need is vital however our society is plagued with pseudo-science, everywhere we look we can see adverts and advocates claiming ‘scientific’ proof for whatever it is they’re selling. This is done to add some cloak of authority to whatever is being said and it’s a dangerous abuse of trust that leads people to distrust real science. So how do we sort the snake-oil salesmen from the pharmacist, the nutritionist from the dietitian? In short, how can we detect the cuckoos of science?
Without a background in the field it is difficult for anybody to tell if what they are hearing is correct. This is true for all of us; everybody is ignorant of far more than they know. But you don’t have to run off and get a PhD in a subject to determine the truth. There are some tell tale arguments that people use when pretending something is science.
- You can’t prove me wrong!
Frequently proponents of ideas such as intelligent design cite the fact that they have not been proved wrong as some sort of evidence for their ideas veracity. In arguments on the subject the supporters will often make statements along the lines of “well you can’t prove it’s not true so I’m going to keep believing it”. This is flawed logic. If we assumed that things were true until we proved them wrong we would have to believe in far more than we disbelieved. You can’t prove me wrong that there are invisible, intangible pixies whispering in my ear that if I don’t jump 100 times a day they will pull my pants down in public so I should do it right? Of course not! That’s not to say that we disbelieve everything until its proven correct either, if there is no evidence for or against something then it is an unknown. Something is unknown until there is evidence for it (or evidence to show it is not possible). Remember this, if somebody is claiming to know something that is unknown or unknowable then their claim has no evidence, as such it is not science.
- It’s been around for ages.
This argument I’ve always found particularly odd. People often claim that the older something is the more valid it must be. There is perhaps a grain of truth to this if a method is old then it must work to some respect for it to be used for all that time, but that doesn’t mean that a better and newer method doesn’t exist. Often with this people claim “science changes its mind all the time”. No, science adjusts its views based on what’s observed and progresses. If a text book is different to a text book from four years ago it’s a good thing, the latest will be more up to date and have more accurate information. Ideas such as herbal medicine and fundamentalist religion often tout how long their practices have been about as if that were evidence for their truth. Be particularly wary of this when it comes to medicine, when people claim that such-and-such medicine has been used to great effect for thousands of years ask them why it is that it is not used in real medicine. The answer may be something along the lines of “big pharma just want to make money and so make synthetic poisons”. If you ever hear any conspiracy crap like that just walk away, anything that works as a medicine is investigated thoroughly over years of intensive study. If it works it’s called “medicine”, if it doesn’t it’s called “not medicine”. There is no such thing as “alternative medicine”.
- It’s 100% natural.
Alternative medicines and fashionable diets are particular perpetrators of this statement. There is an idea that if something is natural it is better and if something is manmade or synthetic then it must be poison. This fails to take into account that most medicines are natural! Whether a chemical is synthesised by a plant as a byproduct of its biology or in a lab with beakers and test tubes as long as it is the same chemical it will do the same thing. The advantage of synthesising medicines in the lab is that you get just the medicine you need. A prime example is aspirin, derived from willow bark it is an effective analgesic. Eating the willow bark by itself is likely to cause you to throw up. If you’re still not entirely convinced just ask yourself this; if natural, unprocessed material straight from Mother Earth was all we needed then why do we have so much disease? Why weren’t hunter gather societies healthier than those of today?
There are many other signs to look for that I will probably go into more in later posts. Key things that I look for are the credentials of the proponent of an idea (remember not everyone who calls themselves a doctor ever got an MD or PhD) and their agenda (are they pushing religion? A product they are selling?). It is important for us all to remain vigilant towards those who would deceive us to either get our money or take funding from worthwhile causes. Beyond the economy is it really good for our health if we let medicine that is unproven or proven not to work into our health service? Or that we teach religious views on the origin of our species over what we have evidence for?
At the end of Christmas time I settled down to watch what I thought would be one of those typical Channel 4 documentaries called Britain’s Fattest Man. If you missed it the documentary was about Paul Mason who became the world’s heaviest man weighing in at over 440kg (that’s 70 stone or 980lb for all you imperialists)! Not to go through the whole documentary but in essence it was very sad, Paul became this size after suffering a series of devastating blows in his life before becoming addicted to food. He was bedridden and required carers to wash and feed him. Paul was desperate enough to go for a gastric bypass (a procedure that shrinks the available stomach size) which enabled him to shed 120kg in just a matter of months.
You may ask why I am bothering to blog about this, I had no plans to. It was merely one of those stories we hear about and perhaps relay in a shocked tone to others. The thing that really got me about this documentary was the way people treated Paul. Other than receiving hate mail I was dismayed to see a wealth of articles both online and in newspapers lamenting the cost of Paul’s care and medical treatment. Per year Paul costs slightly over £100,000 to the NHS and over the fifteen or so years Paul has needed this care he has topped over £1,000,000. Reading through some comments online I couldn’t believe the amount of people who were advocating Paul either not receiving this care or not deserving it. This is a bit of a problem for me, I believe in social healthcare. I think medicine should be a right not a privilege. There’s two dangerous mentalities here, one is that if you don’t contribute you don’t deserve (ridiculous, what about students, mentally ill, prisoners and those down on their luck) and the other is that if you did it to yourself you don’t deserve help. To me that’s a pretty slippery slope to start on.
It is possible to go through your whole life without smoking or exposing yourself to any airborne carcinogens and still get lung cancer. The following numbers aren’t real but they illustrate a real point; out of 100 non smokers 20 get lung cancer and out of 100 smokers 60 get lung cancer. Now out of those 60 smokers with cancer 1 in 3 could have contracted the disease independent of their smoking. If we adopt the mentality of “you don’t deserve healthcare if you did it to yourself” we have to deny or charge for care for 40 of them. But it’s impossible to tell! Do we just deny all of them because they took a risk? Even though every third man didn’t cause it themselves? This principle is very damaging and whilst I don’t condone Paul Mason eating himself to that size I certainly don’t think he is any less deserving than a healthy taxpaying member of society. The whole philosophy of social healthcare is that those who can contribute so that all can receive any and every medicine or treatment that they require.
What do you think? Is Paul justified in receiving medical treatment? At the end of the day would you rather live in a society which takes care of those in need or one that dismisses those who can’t help themselves?