Homeopathy: That’s Numberwang!

This morning I attended a my first ever publicity stunt. The 1023 overdose event, initiated by the Merseyside Skeptics, was held in cities around the UK and the rest of the world.

Our particular group assembled in the lightly frosted but thoroughly freezing Red Lion Square in Holborn, London. I was more than happy to hand over £5 for the 1023 t-shirt—glad of the extra layer of clothing!

1023 alludes to Avogadro’s number, 6.02 x 1023 (the number of molecules in the molecular weight in grams of any given compound). The link to homeopathy is ironic, playful, since typical homeopathic preparations involve dilutions of up to 1060. Such dilutions are extremely unlikely to contain even a single molecule of the original ‘active’ ingredient (setting aside for a moment the bizarre methods that homeopaths use to ‘prove’ that their ingredients are active) and therefore contain nothing. Recognising this, a little belatedly perhaps since Avogadro’s number was only evaluated in about 1908, homeopaths have adopted the view that water has memory and somehow can remember and impart the therapeutic benefit of molecules that have long since been diluted away. No credible molecular mechanism has ever been advanced for this memory effect. How that memory is transferred to a dry sugar pill is also mysterious.

But not curious.

Not even slightly interesting because the evidence accumulated in 200 years of homeopathy shows that it is no better than a placebo. There is an interesting discussion to be had on the ethics of treating people with placebos, since they are undoubtedly effective for minor, self-limiting ailments. But not this morning which was simply about drawing people’s attention to the fact that, by their own admission, Boots the Chemist sells ‘medicine’ for which they have no evidence of efficacy.

This kind of craziness is on a par with Numberwang.*

So this morning we stood around, chatting, stamping our feet to keep warm, watching the TV crews and journalists interviewing the organisers and celebs who had come along to participate.

Martin Robbins tries to explain
Martin Robbins tries to explain

My drugs of choice, Arsen. Alb. 30C (a 1060 dilution of arsenic) came in a handy container, a bit like a sweetener dispenser that only releases one sugar pill at a time. However, with keys and teeth I managed to prise off one end so that I would be able to take the whole lot at once. If I was going the whole hog, it might as well be dramatic.

Impotent stuff

Just before the off, there were short speeches from Simon Singh, Evan Harris MP and comedian Dave Gorman. There was a count-down to the overdose and, along with everyone else, I filled my mouth with little balls of sugar and washed them down with water (also from Boots and, at 80p, considerably cheaper than the £5 pills).

And then, of course, nothing happened.

Mass overdose
Nothing happening to a large crowd being filmed

There were a few more interviews, a few more hellos and goodbyes and people dispersed. I made my way to South Kensington and to Imperial for a couple of hours work. A quiet Saturday morning is a good time to get down to some of the donkey work needed for an upcoming paper. Appropriately perhaps, the paper will be about how drugs bind to a protein, human serum albumin, which is abundant in the blood stream and can cause problems for drug delivery since many compounds stick to it too tightly. If that happens, you have to give a higher dose to make sure that a sufficient drug concentration reaches the target organ. Because you need to have a high enough number of drug molecules at the site of action to have an effect.

This problem of drugs sticking tightly to albumin is commonly encountered in drug development and needs to be overcome if a successful therapy is to be brought to market. Our crystallographic work shows exactly where and how drugs stick to HSA, and could be used—we hope—to influence drug design and so enhance delivery and efficacy.

Molecules binding to protein
Superposition of diazepam (lilac) and a dansylated amino acid (light-blue) bound to drug site 2 in HSA

The particular study we are hoping to publish will report several new structures of dansylated amino acids bound to albumin; these are fluorescent compounds that can adhere to the drug binding sites on HSA and are commonly used during drug development in assays to determine where any new lead compound might be binding to the protein. The figure shows that one of the dansylated amino acids in our study (the stick molecule with light blue carbon atoms) binds in exactly the same place as a molecule of diazepam (lilac carbon atoms). This result neatly explains why molecules of diazepam would reduce the fluorescence of a mixture of HSA and the dansylated amino acid: the drug displaces the dansylated amino acid out of the binding pocket and into solvent where its fluorescence is quenched.

After a slightly surreal morning, it was nice to return to a reality where numbers add up and things make sense.

 


*Apologies to our international friends who may not know Numberwang, a pointless game show comically imagined by Mitchell and Webb, who were also responsible for one of the best homeopathic sketches ever seen.

Many thanks to @carmenego, my drug-dealer du choix, for supplying my hit!

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61 Responses to Homeopathy: That’s Numberwang!

  1. Cath Ennis says:

    Stephen, I can’t believe you would do something so dangerous! Sugar rushes can be nasty!
    This was a genius idea. I love it. And I love the contrast with your actual real science…

  2. Stephen Curry says:

    That’s me – livin’ on the edge, man!
    The award for genius must go to the Merseyside Skeptics, who initiated the idea. It seems to have got quite a bit of play in the media, so hopefully it will make some people think twice before shelling out for this sort of hoo-doo.

  3. Ian Hopkinson says:

    You have to ask yourself how good their dilution procedures are, I wonder how much arsenic your pills really contained!
    For some reason dansyl always makes me think of Ted Danson…

  4. Austin Elliott says:

    Ditto Stephen’s congrats to the Merseyside Skeptics – many of us in the Bad Science blogging community have been grumbling on about homeopathy for years without generating any major publicity. The Merseyside Skepticrew managed to produce a campaign that got nationwide, national and international coverage, on a shoestring, with a bunch of volunteers and by word of mouth/Twit/F’book. Brilliant.
    I was at the Manchester event this morning chugging down the same Arsen. Alb. 30C as Stephen (the name of this remedy always makes me think of the manager of Arsenal Football Club.) I managed the sugar drops without the water just to show I was extra-tough.

  5. Ian Brooks says:

    Excellent post as usual Stephen. And well done to all took part in this “ridiculous and dangerous publicity stunt” (to paraphrase the Homeopaths)

  6. Eva Amsen says:

    So how do homeopathic units works? If 30c is 10^60 dilution, does that mean 30 times a 100x dilution? (10^(2×30)?) The c stands for 100?

  7. Stephen Curry says:

    Thanks Ian H (and to Ian B) – I confess it did cross my mind “What if they’ve screwed up the dilutions on this batch?”. However, seem to be still functioning normally…
    Well done Austin for joining in. Harmless fun but an inspired piece of publicity stunting which seems to have worked amazingly well (_e.g. on the BBC web-site).
    Spot on Eva – 1C is 1 part in 100; 30C = repeat dilution 30 times. But do remember to shake (or ‘succuss’) in between, otherwise the water will forget.

  8. Åsa Karlström says:

    Stephen: Oh I am so happy there are brave people like yourself out there to take the risks of taking all those pills at the same time. Surely you must feel like a different man now? ;) I hope they didn’t mess up the dilutions since Arsenic is a fairly bad thing to take in large quantities. (as water memory though, I guess not so much.)
    Thanks for recounting the day and even more, as Cath pointed out, the difference with your real science and bindings. There is a very large difference indeed. Hopefully other people will understand that though.
    (of course, there is something to be said about “the placebo effect” but still, everything within limitations!)

  9. Stephen Curry says:

    Why am I not in bed?
    You’re absolutely right Åsa about the potential value of the placebo effect – it can be very powerful. We humans sure are strange. There’s even a thing called the nocebo effect (_i.e._ side-effects from placebos!). But I think there is a real ethical dilemma in deliberately mis-leading people about the efficacy of treatments they are being offered. It’s not a dilemma for homeopaths since they seem to sincerely believe in the efficacy of their strange formulations.
    I’d really like to hear a real Dr talk about this…

  10. Anna Vilborg says:

    Just out of curiosity, what is the massively diluted arsenic supposed to be good for anyway? It seems like a weird thing to try to sell people as a medicine, since it’s mostly associated with murder in old detective novels?

  11. Stephen Curry says:

    I don’t actually know what it’s supposed to treat. Astonishingly perhaps, this isn’t written on the label. Nor is there any further information about the product on Boots’ website.
    The key phrases that are on the label are “A homeopathic medicinal product”, i.e. medicine and “Boots Arsen. alb. 30c Tablets is a homeopathic medicinal product without approved therapeutic indications”, i.e. not medicine. Over on the blog by Jack of Kent, who was at yesterday’s shindig, he has been reflecting on the small print associated with these remedies. There’s an interesting discussion going on there.
    Funnily enough, as I was chatting to my kids last night about my escapades and showing them the empty medicine container my daughter at first thought it was a joke – in that she thought Boots were just selling gimmicky sweets for £5 a pop. Which, in a very real way, they are.

  12. Henry Gee says:

    Great post Stephen. Keep dansylating!

  13. Austin Elliott says:

    bq. “Just out of curiosity, what is the massively diluted arsenic supposed to be good for anyway?”
    Just about anything you can think of, Anna – see e.g. here. Homeopathic categories, indications and remedies, dating as they do from the 1790s-1820s, are not know for their stringency in terms of what is for what. Of course, that is quite helpful if you are a homeopath – not in helping people out, so much as in stringing them along.
    Re. the placebo effect and the relevant medical ethical issues. Giving placebos knowingly is mostly regarded nowadays as contravening medical ethics. So this is very much the question David Colquhoun, Ben Goldcare and many other people in the sceptical blogosphere – including me – would like to ask medical homeopaths like the Queen’s Doctor Peter Fisher (MRCP). However, it is almost impossible to get the medically trained homeopaths to engage in this argument. When you try they just say:

    “Oh, but the evidence shows us homeopathy isn’t a placebo, so that simply doesn’t arise.”

    I call this the Bind Eye to the Telescope argument. Others might call it DoubleThink.

  14. Stephen Curry says:

    That first link of yours is an absolutely astonishing web-site Austin. Truly homeopathy is, as you and I have both said elsewhere, an alternative reality. I particularly liked the claims that Arsen. Alb. “Gives quiet and ease to the last moments of life when given in high potency” and that it can also “Reduces the refractive index of blood serum”! (Not sure how that last one works since excess sugar is likely to bump up the refractive index.
    I’ll be dansylating till the cows come home, Henry.

  15. Austin Elliott says:

    PS Stephen, a reasonably extended blog-based discussion of the ethical problems implicit in “physically inert placebo therapy” (like homeopathy) can be found in the comments thread on this post at David Colquhoun’s blog.

  16. Stephen Curry says:

    That’s an interesting discussion thread Austin – good points from Ben Goldacre, Evan Harris and yourself, among others. There doesn’t seem to be a consensus that placebo treatments are proper. I think your wife’s compromise is a reasonable and humane one (if I may quote):

    Mrs Dr A’s compromise is to say “There’s no real evidence XYZ works” , and then if they are clearly determined (e.g. coming back and saying they want to try it) “Well, some people have said they thought it helped”…

    …and then she tells them our local CAM-friendly Univ of Poppleford have a “walk in clinic” where you see a CAM “student practitioner” for a tenner.

  17. Austin Elliott says:

    Funnily enough the CAM-friendly Univ in our neck of the woods (clue: it’s “A Greater Manchester University” according to its website) shut down all its undergraduate BSc alternative medicine programmes last yr, so I suspect the “walk in clinic” has gone. They are still running some “top-up” and Master’s Degrees, see e.g. here.
    Most doctors I have met feel that not alienating the patient is an important part of being their doctor, so will not “monster” Alt.Therapy beliefs the patient has. They will usually tell the patient what they think of the medical evidence for (or more likely not for) A.N.Other therapy, certainly if asked, and /or say the kind of things ‘Er Indoors does.
    If they are worried that what the patient is doing/intends doing is potentially dangerous they would be much more forthright, esp. if the patient is looking at CAM as an alternative to something conventional that is of proven benefit. Ditto if the patient is being overtly conned (e.g. told chiropractic “can help your irritable bowel but you’ll have to come twice a week at £ 40/session”, or similar).

  18. Matt Brown says:

    Great write up – I’m kicking myself that I couldn’t make it. In fact, I might just take a sugar pill to heal the bruises.
    If anyone fancies a bit of an argument, we’ve got some true believers in the comments over on Londonist.

  19. Richard P. Grant says:

    Oh God. More stupid.

  20. Stephen Curry says:

    Glad to hear that most docs take a pragmatic view, Austin. What I don’t really understand are those GPs who do actively recommend homeopathy.
    Cheers Matt – it was good but it was bloody freezing! Good luck with your commenters (to whom I trust Richard was referring!). Funny none of them showed up here. We really must publicise more…

  21. Richard P. Grant says:

    No Stephen, we mustn’t. It’s bad enough we the SB crowd found us.

  22. Austin Elliott says:

    It was double brass monkey weather at the Manchester event too, though good fun nevertheless. A surprise added benefit for me has been my unexpectedly extensive on-camera role in the video, which has amused my children greatly.
    Slightly crossing over to the turf of the more recent post about your Biochemist article on blogging as public engagement, I am now pondering if I can claim my on-(PC)-screen appearance as part of my yearly “Public Engagement Esteem Indicators” for the Univ’s internal Pets win Prizes Activity Profiling Exercise.

  23. Stephen Curry says:

    Great video Austin – short and to the point (the best combination, as has been mentioned in Richard’s latest post). I think you have every right to claim that as a measure of public esteem or impact (or whatever it is that they’ll want to measure next year…).

  24. Austin Elliott says:

    I felt a bit embarrassed when I first saw it, actually, as I had absolutely nothing to do with organising the event. I think the person doing the video just wanted “A Generic Scientist” to speak to camera.

  25. Ken Doyle says:

    Don’t some homeopathic formulas have alcohol in them? Mmmm…alcohol and sugar. I wonder if ethanol molecules have memory, too. Maybe the ethanol and water molecules communicate in a language yet undiscovered.

  26. Austin Elliott says:

    bq. “Maybe the ethanol and water molecules communicate in a language yet undiscovered.”
    Hmm, like:

    “See ‘im? He’sh my besht mate, he ish…. hic ”

  27. Stephen Curry says:

    In my experience, ethanol is mainly good for erasing memories…

  28. Austin Elliott says:

    Aha, in homeopathy in order to erase previous memories you have to double-distil your solvent.
    So next time I take a homeopathic overdose perhaps I should wash it down with some single malt… The Macallan is a personal favourite.

  29. Austin Elliott says:

    PS Opinion on homeopathy among UK GPs (family doctors), according to a recent survey, seems to be rather in line with my other half’s thinking – patients can try what they like, but no justification for paying for it with limited public money. (NB may require free registration to read article)

  30. Stephen Curry says:

    Thanks Austin – I see that 80% of GPs would like the NHS to discontinue funding for homeopathic ‘treatments’.
    The first commenter has weighed in to salute the 20% who do support it. And the 2nd commenter too focuses on the minority view (which appears him to be the main point!). But in the time it’s taken me to write this comment I see that DC has now added his view… balance has been restored.

  31. Brian Derby says:

    The really scary aspect of the “recent survey” article linked to in Austin’s post is the assertion in the comments that “In Scotland, 60% of GP’s have had training in homeopathic practice…”

  32. Austin Elliott says:

    Stephen
    Re the commenters at Pulse, Andrew Sikorski is a GP homeopath, and Brian Kaplan is the same – both are tireless boosters for homeopathy, and can often be found on the BMJ comments threads sniping at David Colquhoun (e.g. here). Brian Kaplan maintains a weird and somewhat smug website where you can find the usual misleading statements like “only 13% of conventional medicine is backed by proper evidence”.
    Hadn’t noticed the bit about Scotland. Of course “60%… have had training in homeopathic practice” doesn’t necessarily mean 60% have used it. I would suspect most Scottish GPs live in the real world and are too busy dealing with heart disease, COPD and high blood pressure to fart about with homeopathy.
    Similarly, ‘Er Indoors did a course about homeopathy as an optional unit at her German medical school in the early 90s, as did many of her contemporaries. Such course were quite common, partly because homeopathy is German in origin, but also because it was viewed as an interesting “medical humanities” alternative to yet another course in science. Despite this, though, she has never considered “melding it into her repertoire” – like most doctors, she prefers stuff based on proper evidence.

  33. steffi suhr says:

    Stephen, I only now got around to reading this post – well done being so brave. Will now post this on facebook to help publicise :)

  34. Stephen Curry says:

    Thanks for the background to those two Austin, though their comments on the Pulse website had given me a clue to their homeopathic sympathies. It is a strange kind of reality distortion field that surrounds them. A bit like Steve Jobs’s but at least his produces some lovely tech.
    Cheers Steffi, though I didn’t feel the least bit brave. There was no need. Thanks for re-posting on FB; the more people that get to hear about this campaign, the better.

  35. Austin Elliott says:

    The 10-23 campaign has a Facebook page you could also link to, Steffi, and many of the component skeptical groups have them too. And I see the Saturday events made it into Der Spiegel.

  36. Stephen Curry says:

    Das ist sehr gut, das ist!

  37. steffi suhr says:

    Thanks Austin – actually, I think most of my facebook contacts don’t speak a word of German :)
    Anyway, I just found out that homeopathic remedies apparently even have a certain personality.
    For some reason, the following jumped out at me:
    Thuja – ‘sexual guilt’
    Hyoscyamus – ‘erotic psychosis’
    Platina – ‘hysteria, pride, nymphomania’.
    Must be my racy current ‘Doppelgaenger’ profile picture on facebook.

  38. Austin Elliott says:

    The homeopaths are prone to suggesting sceptics should take the remedy Lachesis (homeopathic pit viper venom), whose homeopathic “personality profile” you can find here.
    Though I wonder whether their repeated suggestion of this particular stuff isn’t telling us more about them, than about what they think of us.

  39. Ken Doyle says:

    Are all proud nymphomaniacs hysterical?

  40. Cath Ennis says:

    The publicity is building. I saw some friends from my undergrad days, who I haven’t seen in years and who I don’t think are part of the blogosphere, becoming fans of the 10:23 campaign on Facebook.

  41. steffi suhr says:

    @Ken: we should definitely find one and ask.

  42. Kausik Datta says:

    steffi said: “…homeopathic remedies apparently even have a certain personality”
    Members of my family have been firm believers in Homeopathy (which is a big thing in India), and I have grown up ingesting/applying a lot of Arnica (for pain), Rhus tox (for flu-like symptoms), Nux vomica (for gastric complaints), Chelidonium (liver disorders), Calendula (cuts and wounds), Gelsimium (nerve stimulant), Pulsatilla (for anxiety), Apis mel (inflammation), Bryonia (constipation), Carbo veg (exhaustion), China (weakness), among many others; so please commiserate with me! My parents were steeped in woo-woo, though thankfully they never denied me the vaccinations and access to conventional medicine when needed.
    From what I gleaned from the homeopathic gobbledygook is that each homeopathic nostrum is to be individualized to each person. Therefore, two individuals with the same symptoms may not be given the same strength of the homeopathic “medicine”, or indeed, the same “medicine”. Apparently, their personalities have to be considered as a whole, which is, needless to say, absolute bull.
    Impervious to Science and evidence, various homeopathy-proponent websites are already bleating out statements dissing the 10-23 experiment, largely along those lines of “individualization”.
    @Stephen: “It seems to have got quite a bit of play in the media, so hopefully it will make some people think twice before shelling out for this sort of hoo-doo.”
    Don’t hold your breath. I am not, since there is no dearth of woo-meisters this side of the pond, too. Homeopathy still lingers on as a therapeutic option, because much like religion, it offers a refuge from rationality, and a vague but unsubstantiated belief that ‘it works’ aided and abetted by a lot of spin, hype and egregious misinformation.

  43. Ken Doyle says:

    @Kausik: Just curious (my mother is still a proponent of homeopathy), were you exposed to Ayurvedic medicine?
    @Steffi: I’ll get right on that :)

  44. Kausik Datta says:

    @Ken: Thankfully, no. I guess that was because we did not have a reliable Ayurvedic practitioner known to the family or living close by. In India, IMO Ayurvedic medicines are perhaps slightly better regulated than are homeopathic medicines quack nostrums. There are a few institutions under the aegis of the central government that purportedly do research on Ayurvedic medicines. However, a few highly-touted medicines that these institutions had put out had to be withdrawn from the market because of lack of efficacy and/or unwanted side effects, AFAIR. Strangely, in India, the so-called ‘alternative medicines’ do not have to go through the same rigorous, phasic system of approval as do real medicines. To me, personally, this seems very counter-intuitive since India does have a rich source of potentially useful medicinal herbs.

  45. Austin Elliott says:

    bq. “Strangely, in India, the so-called ‘alternative medicines’ do not have to go through the same rigorous, phasic system of approval as do real medicines.”
    That is the same in the UK, Kausik, provided you are careful to call your alternative medicine a “food supplement”. Then all you have to do is prove that it is acceptably safe as a food (in effect).
    There is some suggestion that this will change a little with the EU-wide adoption of the Codex Alimentarius, which will mean common (and probably slightly stricter than at present) food supplement safety standards, and rules that will likely mean supplements which exceed certain dosages must be assessed as medicines (i.e. under stricter standards).
    Predictably, this is being vehemently opposed by all the Alt.Med nuts. (See numerous conspiracy theories circulating on the net).

  46. Stephen Curry says:

    Cath – good to know the campaign is reaching people. I hope there’ll be a further impulse of momentum when Parliament’t Sci & Tech committee reports on its homeopathy evidence check (which I mentioned on this post).
    Hi Kausik – thanks for giving an Indian perspective. I suppose that the individualisation of the treatment by homeopaths probably acts to boost the placebo effect (in the same way, as Ben Goldacre has pointed out, that more dramatic treatments such as injections are more effective than pills).
    We’ve already discussed — lightly — the ethics of prescribing placebos but I’m now wondering if many GPs in this country have perhaps prescribed paracetamol or aspirin (or antibiotics) effectively as a placebo so as to placate a demanding but not very ill patient .

  47. Kausik Datta says:

    @Austin, I am curious. Will the Codex Alimentarius cover stuff such as Coffee enema that many alt med crazies swear by?
    OT: While browsing through alt med stuff, I came across this gem. It is sickening to know that such arrant nonsense is out there and possibly influencing people!

  48. Ken Doyle says:

    Kausik:
    To me, personally, this seems very counter-intuitive since India does have a rich source of potentially useful medicinal herbs.
    I agree. Our family physician sometimes used them in conjunction with standard “Western” medicine.

  49. Kausik Datta says:

    Just as our family physician used Homeopathy in conjunction with Western medicine. But sorry Ken, I don’t subscribe to that line of therapeutic thought at all. I want my medicines to be evidence-based, empirically-proven, researched and documented, not pushed in through a lot of hand-waving and nonsensical blather about Eastern-style mysticism.
    I remember, this one time when my mother had an attack of conjunctivitis. She was putting saline drops, and cleaning out the rheum regularly, and probably would have convalesced naturally. But no, the friendly neighborhood quack had to butt in and suggest putting on the eye the juice of some kind of herb, supposed to cure conjunctivitis, which my mom foolishly did. Boy! She almost lost her eye to a massive, acute inflammatory response, and we had to rush her to the local doctor’s chamber for an epi shot and other anti-inflammatory treatments.

  50. Stephen Curry says:

    Just come across Digital Cuttlefish’s poetic contribution to the homeopathy ‘debate’. I like it!

  51. Ken Doyle says:

    Kausik, quackery takes many forms, but I make a distinction between herbs that have proven benefits in clinical trials, and stuff like homeopathy, which has no clinical basis whatsoever.
    An example in the news lately is the use of artemisia for treatment of malaria.

  52. Stephen Curry says:

    As I understand it Ken, some herbal medicines clearly have an effect and do contain powerful ingredients. But my wife has certainly been warned about them by our GP since some of the preparations that you can buy over the counter contain high doses. I get the impression — but don’t have much evidence on this score — that herbal medicines are not as well regulated as they might be.

  53. Kausik Datta says:

    You are right, Stephen, they are not. But they ought to be. Not just because of the herbal medicine content either. A few years back in India, a particular herbal medication was banned after a high dose of steroids was discovered in it.
    @Ken: I like to make a distinction, too; only I tend to err on the side of empirical evidence. Consider this statement: Artemisia is not used for treatment of malaria (in standard medicine); Artemisinin is.
    I am actually glad you brought up the example of Artemisinin, because the use of empirical, evidence-based approaches is highly evident in this drug. Artemisinin is a sesquiterpene lactone isolated from some species of Artemisia (result of empirical chemical research). Not all species of this herb/plant produce Artemisinin, and even then, ones who do, do so under certain stress conditions (from empirical biological research). WHO discourages the monotherapeutic use of Artemisinin because of reports of emerging resistance of P. falciparum malaria to this agent (from empiricial clinical research). This is what modern medicine is all about.
    The lazy quacks mugging up ancient texts and prescribing a witches brew with Artemisia annua in it don’t know these, do not care about these observations, and don’t have a clue about what to do if there is clinical resistance.
    Whom would you rather believe and entrust your life to?

  54. Kausik Datta says:

    Oh, and Cuttlefish ABSOLUTELY rocks. At Pharyngula, I had proclaimed a FATWAH on him once – For All The WIN, Always, Hands-down!

  55. Austin Elliott says:

    We had an interesting argument about artemisinin with a chiropractor (sic) who works for the World Health Organisations’s Section on Traditional Medicine (sic) at a thread over at the Economist a while back. More on the chiropractor in question and their job at WHO here and here. Don’t be thinking that the Alt.Medicine lot can’t lobby and try to influence WHO just like the Pharmaceutical companies no doubt do, because they can.

  56. Stephen Curry says:

    Kausik – FATWAH – that’s a new acronym on me!
    You’re not wrong there Austin – there’s a lot of money to be made by selling nothing for something and I imagine the practitioners and pharmacists involved will be keen to wield whatever political influence they have to preserve the status quo. This holistic, touchy-feely shenanigans is a good disguise for what much of CAM is: business.
    It’s a shame that the WHO doesn’t take a firmer line. I guess that’s politics…

  57. Ken Doyle says:

    Kausik, good point about the active ingredient(s) vs. the whole herb. This is one area that would benefit from regulation, as it makes possible the direct comparison of activity from various manufacturers–something that’s not easy to do at the moment.
    And yes, I am familiar with the combination therapy approach, although in a different context. We used Artemix (artemisinin + artesunate + artemether) to treat our dog’s osteosarcoma with good results. I don’t know what has been published about its antitumor properties in humans, but there have been several clinical trials in dogs.

  58. Kausik Datta says:

    Yes, you are right, Ken. As the resistance of P. falciparum against Artemisinin gets documented, I guess there was a rush to find out alternate uses for the drug, and it has shown some degree of promise against some forms of cancer.

  59. Brian Derby says:

    The Guardian had quite a good article in their comment section last weekend on the 10:23 event and it now has well over 1000 comments, mostly sceptical of homeopathy.
    There is a good definition of a homeopathic overdose:-
    Apparently it is possible to overdose on H “remedies”, though, but this is normally referred to as “drowning”.

  60. Stephen Curry says:

    Har, har, Brian! This fake news report is by far the funniest take on the 10:23 overdose that I have seen…

  61. Austin Elliott says:

    Kausik, Ken and Stephen
    If you take herbal supplements, the best way is to look for one made by major manufacturers (the big German herbal outfits like Lichtwehr, for instance) where you can tell they have made efforts to standardise them in some way. This will often be when they have a straight medical market to serve. The German St John’s Wort preps are an example of this; since they sell as conventional medicine in Germany they have to be tested and standardised as “equivalent to a certain dose of hypericin” (one of the presumed active ingredients).
    Of course, when you go in a herbal shop in the UK and ask which of the 15 different formulations of St J’s W is “good”, what you will get is a shop assistant (not a pharmacist) telling you which ones are “popular”, or which are pills vs. capsules.
    While standardised is obviously better than not standardised, and is vital for comparing trials, it is also, as David Colquhoun likes to say, just like pharmacology 70-odd years ago. If you go back far enough into the medical literature you can actually find eras when you could treat (e.g.) high blood pressure with either a medicinal plant extract, or with one or more of the isolated active ingredients from the medicinal plant. The latter tended to quickly win out because it would be much more reliable, predictable and reproducible.