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Anomalous Distraction

A protein crystallographer opines about science, pseudo-science & academia.

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Diluting the Truth.

January 18, 2010

Both followers of this blog (Hello Mum!) may remember THIS post, where I discovered homeopaths on THIS website were

citing THIS article in the BMJ (De Lange de Klerket al,BMJ1994; 309: 13291332) that found that Homoeopathic

medicines produce no clinically relevant improvement as proof that homeopathy works. Maybe they hoped that people would

see the title in the citation (Effects of homoeopathic medicines on daily burden of symptoms in children with recurrent upper

respiratory tract infections), and assume that paper does indeed support homeopathy.

Lets remind ourselves of what the take home messages in De Lange de Klerk et alare:

Conclusion : Individually prescribed homoeopathic medicines seem to add little to careful counselling of

children with recurrent upper respiratory tract infection in reducing the daily burden of symptoms, use of

antibiotics, and need for adenoidectomy and tonsillectomy.Clinical implications

Some children suffer more and longer episodes caused by upper respiratory tract infections than their peers

Homoeopathic doctors claim success in the treatment of such children

In this study the small difference in symptom score found in favour of the homoeopathic medicines was not significant

Antibiotic use was reduced greatly in both groups, but slightly more in the treatment group

Homoeopathic medicines produce no clinically relevant improvement in recurrent upper respiratory tract infection

The small difference in the mean daily symptom scores in the treatment and placebo groups was not significant (P=0.06 or 0.07 after correction for

baseline differences).

So, not a paper that conclusively shows any proof of efficacy for Homeopathy*.

So I thought it might be fun (think what you will of my definition of fun) to do a little digging and see in what other contexts

this particular reference was cited.

According to Scopus our paper is cited in 48 scholarly articles.There are some rather interesting ones in and amongst those 48.

Lets take a look at three of them.

omeopathy Anomalous Distraction http://xtaldave.wordpress.com/category/bad-science/homeopat

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1) Priorities and methods for developing the evidence profile of homeopathyRecommendations of the ECH General Assemblyand XVIII Symposium of GIRI

M. Van Wassenhoven

Homeopathy

Volume 94, Issue 2, April 2005, Pages 107-124

Nevertheless RCTs have been performed and meta-analyses of these studies have concluded that there is clear

evidence of efficacy in favour of homeopathic treatments that cannot be attributed only to a placebo effect. In

children, using comparison groups, significant results have been obtained for recurrent infections(my bold),

postoperative agitation, adenoids, otitis media, and stomatitis in patients with cancer (complication of

conventional treatment). There are promising pilot studies on low back pain, premenstrual syndrome and chronic

fatigue.140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 158, 159, 160, 161, 162, 163, 164, 165, 166,

167, 168, 169, 170, 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195,

196, 197, 198, 199, 200, 201, 202, 203, 204, 205, 206, 207, 208, 209, 210, 211, 212, 213, 214, 215, 216, 217, 218, 219, 220, 221, 222, 223, 224,

225, 226, 227, 228, 229, 230, 231, 232, 233, 234, 235, 236, 237, 238, 239, 240, 241, 242, 243, 244, 245, 246, 247, 248, 249, 250, 251, 252, 253,

254, 255, 256, 257, 258, 259, 260, 261, 262, 263, 264, 265, 266, 267, 268, 269, 270, 271, 272, 273, 274, 275, 276, 277, 278, 279, 280, 281, 282,

283, 284, 285, 286, 287, 288, 289, 290, 291, 292, 293, 294, 295, 296, 297, 298, 299, 300, 301, 302, 303, 304, 305, 306, 307, 308, 309, 310, 311,

312, 313, 314, 315, 316, 317, 318, 319, 320, 321, 322, 323, 324, 325, 326, 327, 328, 329, 330, 331, 332, 333, 334, 335, 336, 337, 338, 339, 340,

341, 342, 343, 344, 345, 346, 347, 348, 349, 350, 351, 352, 353, 354, 355, 356, 357, 358, 359, 360, 361, 362, 363, 364, 365, 366, 367, 368, 369,

370, 371, 372, 373, 374, 375, 376, 377, 378, 379, 380, 381, 382, 383, 384, 385, 386, 387, 388, 389, 390, 391, 392, 393, 394, 395, 396, 397, 398,

399, 400, 401, 402, 403, 404, 405, 406, 407, 408, 409, 410, 411, 412, 413, 414, 415, 416, 417, 418, 419, 420, 421, 422, 423, 424, 425, 426, 427,

428, 429, 430, 431, 432, 433, 434, 435, 436, 437, 438, 439, 440, 441, 442, 443, 444, 445, 446, 447, 448, 449, 450, 451, 452 and 453

Our reference is number 206 in that lot. And our reference was significant all right if I can just remind you Homoeopathic

medicines produce no clinically relevant improvement in recurrent upper respiratory tract infections & The small difference in

the mean daily symptom scores in the treatment and placebo groups was not significant (P=0.06 or 0.07 after correction for

baseline differences). this would appear mutually exclusive with clear evidence of efficacy in favour of homeopathictreatments that cannot be attributed only to a placebo effect. Hmmm.

(and no, I havent gone through each and everyone of those references)

2)The research evidence base for homeopathy: a fresh assessment of the literature

RT Mathie

HomeopathyVolume 92, Issue 2, April 2003, Pages 84-91

In this paper, our reference, (55) is cited in table 1 in a group of 47 papers that observed a homeopathic effect superior to

placebo. Just remember this is a paper that clearly states The small difference in the mean daily symptom scores in the

treatment and placebo groups was not significant (P=0.06 or 0.07 after correction for baseline differences). Confused? You

should be.3) Antibiotics and the development of resistant microorganisms. Can homeopathy be an alternative?

Petter Viksveen

Homeopathy

Volume 92, Issue 2, April 2003, Pages 99-107

This paper states that Results in a double-blind randomised placebo-controlled trial of children suffering from upper respiratorytract infections were in favour of homeopathy (P=0.06).[de Lange de Klerk E, et al. Effects of homoeopathic medicines on daily

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burden of symptoms in children with recurrent upper respiratory tract infections.BMJ1994; 309: 13291332.68] The conclusionof this study was that individually prescribed homeopathic medicines seem to add little to careful counselling of children withrecurrent upper respiratory tract infection in reducing the daily burden of symptoms, use of antibiotics, and need foradenoidectomy and tonsillectomy.

Contrast this with the original paper: The small difference in the mean daily symptom scores in the treatment and placebogroups was not significant (P=0.06 or 0.07 after correction for baseline differences).

Once again the original paper contends that the differences between placebo and homeopathy were not significant Viksveen

says otherwise, but then in the sentence after that, quotes verbatim the negative results for homeopathy in the study. WTF?

Is mis-citing a word?

The vast majority of the 48 papers that cited De Lange de Klerk et al, cited it correctly to indicate that this particular study hasnot shown that homeopathy is really effective beyond placebo, or more research is needed in this area. The three I have gone intomore detail about have (pretty much) taken the exact opposite conclusions from the paper.

The eagle-eyed amongst you will have spotted that all 3 of these papers come from the Journal Homeopathy, the organ of theFaculty of Homeopathy. The members of the editorial board / advisory board of Homeopathy can be found here.

But wait? Whats this? Of our three papers who cite De Lange de Klerket alas positive proof for the efficacy of Homeopathyabove that of placebo effect, 2 are authored by members of the Homeopathy editorial board? Shurely Shome Mishtake?(Michel van Wassenhoven on the Editorial Advisory Board, RT Mathie on the Editorial Board).

The author of the 3rd paper, Petter Viksveen is a practising homeopath, working in Norway, and a graduate of the fine MScMasters Degree in Homeopathy, which was until recently awarded from the University of Central Lancashire. Anyone interestedin the course materials for that degree course can of course see them on David Colquhouns excellent blog.

The fact De Lange de Klerk et alhas been erroneously cited 3 times by the same journal demonstrates a failure of the individualauthors concerned to correctly reference and source their work, and a repeated failure of the reviewers and editors ofHomeopathy to spot such an obvious error. I leave the reader to make his/her own conclusions about the quality of thepeer-review process at Homeopathy.

It is interesting to note that publishing house Elsevier (who publish and distribute Homeopathy) have signed up to the committeefor publication ethics, COPE.

Obviously, as a concerned scientist I have contacted COPE about this matter, for their advice on how to get these errors

corrected.In Conclusion

Of all the qualities a good scientist must have, intellectual honesty and rigour are paramount.Any scientist worth his Natrum muriaticum would have at the very least, skimmed though any paper he is citing certainly hewill be aware of the major conclusions that a paper draws. To do otherwise is neither intellectually honest nor intellectuallyrigorous.Given the format of De Lange De Klerk et al, even when viewed alone the abstract gives a really big hint as to the conclusion ofthe paper: (hint look at the words after Conclusions) it is really exceptionally difficult to avoid the conclusions this papermakes.

I cannot conceive of a situation in which a professional scienist could cite a paper to support a hypothesis which is the oppositeof the conclusions of the cited paper, without being either woefully negligent or intentionally duplicitous.Given the credibility problems that homeopathy has in the scientific community, if homeopaths are to obtain evidence that isirrefutable and universally accepted, their actions must stand up to close scrutiny after all remarkable claims require

remarkable evidence.The examples above fail to stand up to such scrutiny. I might add that it did not take me very long to find this out I have lookedat 1 paper, cited 48 times and found 3 egregious errors. Have I been lucky enough to stumble upon the one paper that has been soerroneously cited? Or are there more examples out there?

-

*I am not commenting on the accuracy of De Lange de Klerk et al (there are a couple of letters to the BMJ from Peter Fisher amongst others complaining about the stats/methodology in

this paper) that is NOT the point I am making here. The fact is that this paper clearly and unequivocally concludes that Individually prescribed homoeopathic medicines seem to add

little to careful counselling of children with recurrent upper respiratory tract infection in reducing the daily burden of symptoms, use of antibiotics, and need for adenoidectomy and

tonsillectomy. The paper has NOT been retracted, neither has anyone published a re-analysis the data, as far as I can see. If either were the case, one would cite the re-analysis or the

retraction not the original paper.FollowFollow


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5 Comments | Bad-science, Homeopathy | Permalink

Posted by xtaldave

Blinded by pseudo-science?

January 11, 2010

This article was posted on twitter under the #ten23 hashtag today by a homeopath (who shall remain nameless), who perhaps

thought that this was good evidence to cite for homeopathy being superior or at least preferable to conventional treatment of

bacterial infection by antibiotics.

The article contains one line which caught my eye:

Research shows that homeopathy can serve as an effective alternative to antibiotics in a range of

infectious conditions for which they have been commonly used5-13

.

WOW! look at that 5-13 thats 9 references to back up 1 point must be an important one!

Lets take a closer look at these articles that show that homeopathy can serve as an effective alternative to

antibiotics:

5. Adler M. Efficacy, safety of a fixed-combination homeopathic therapy for sinusitis. Adv Ther 1999; 16: 103-111.

Abstract says: (Note I was unable to obtain the full paper as I hit a 404-wall for this journal.)

The average treatment duration was 2 weeks. At the end of treatment, 81.5% of patients described themselves as

symptom free or significantly improved. Adverse drug effects were not reported.

Hmm, NHS says:

Sinusitis often clears up by itself, and about two thirds of those who get the condition do not need to see their

GP.

On average, sinusitis takes about two-and-a-half weeks to clear.

Over-the-counter painkillers and decongestants can be used to relieve facial pain and a blocked nose. Antibiotics

are unlikely to help unless the sinusitis becomes chronic (persistent).

So, the NHS say that on average, sinusitis will sort itself up after 2 and a half weeks, and the majority of sufferers donot need to see a medical practicioner.

In the homeopathic study 100% of sufferers saw a homeopathic practioner, and 81.5% of them were better than

significantly improved after treatment.

So no improvement on no treatment at all. Hmm.

NEXT!

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6. De Lange de Klerk E, et al. Effects of homoeopathic medicines on daily burden of symptoms in children with

recurrent upper respiratory tract infections. BMJ 1994; 309: 1329-1332.

Ooh! BMJ. A real journal. And it looks promising! Design : Randomised double blind placebo controlled study.

Paper Concludes:

CONCLUSIONIndividually prescribed homoeopathic medicines seem to add little to careful counselling ofchildren with recurrent upper respiratory tract infection in reducing the daily burden of symptoms, use of

antibiotics, and need for adenoidectomy and tonsillectomy.

and elsewhere

Homoeopathic medicines produce no clinically relevant improvement in recurrent upper respiratory tract

infections.

Hang on a minute the homeopaths are actually citing a paper which concludes homoeopathic medicines seem to add

little to try and bolster the case for homeopathy as an effective therapeutic strategy? Either someone didnt read this paper, or

someone didnt think that someone else would read this paper.

I believe FAIL is suitable internet vernacular for an occurance such as this.

7. Frei H, Thurneysen A. Homeopathy in acute otitis media in children: treatment effect or spontaneous resolution?

Br Homeopath J 2001, 90: 180-182.

Another disease where sponaneous resolution is a factor. Treatment of the disease is not relevant in this case, as

the study looks a pain management. A notorious placebo mine field. However I cant find the full text of the paper to

comment on how the study was conducted. If you have a .pdf of this leave a comment and Ill get in touch.

EDIT: Tom Johnston kindly provided me with a copy of this paper.

The conclusion is the usual homeopathy arm-wavey fewer treatment failures in the group receiving

homeopathy. positive treatment effect of homeopathy when compared with placebo in uncomplicated

AOM cannot be excluded.

Basically Because of the preliminary nature of this study and its small sample size, definitive results

were not found.

8. Friese K-H, Kruse S, Ludtke R, Moeller H. Homeopathic treatment of otitis media in children: comparisons with

conventional therapy. Int J Clim Pharmacol Ther 1997; 35: 296-301.

I finally tracked down the .pdf of this paper (I can send it to anyone who wants a copy add a comment below) and

it is a curious paper.

there were no statistical differences between the 2 group in any of the outcome measures

those 2 groups being homeopathic treatment and antibiotic treatment.

They also note that 5 children involved in the study took antibiotics after homeopathic treatment but apparently, any comment

on that would be beyond the scope of this article O RLY?FollowFollow


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However given that they state:

it was found that 95% of patients with acute otitis could be treated without antibiotics

a trial that compares treatment with antibiotics versus treatment with homeopathic remedies seems utterly pointless.

A placebo controlled study is clearly required.

9. Jacobs J, Springer DA, Crothers D. Homeopathic treatment of acute otitis media in children: a preliminary

randomized placebo-controlled trial. Pediatr Infect Dis J 2001; 20: 177-183.

Oh look! A randomized placebo-controlled trial!

CONCLUSIONS: These results suggest that a positive treatment effect of homeopathy when compared with

placebo in acute otitis media cannot be excluded and that a larger study is justified.

Doh! So close, and yet so far.

10. Riley D, Fischer M, Singh B, Haidvogl M, Heger M. Homeopathy and conventional medicine: an outcojmes study

comparing effectiveness in a primary care setting. J Altern Complement Med 2001; 7: 149-159.

Hmmm one thing we can all take home from this is that Google Scholar is much better at finding papers in obscure

alternative med journals than PUBMED cant think why. The full text of this paper lives here.

The conclusion to this paper is that:

the information from this study will improve clinical trial design in the real world medical setting and

offer a better understanding of how homeopathy and other alternative medical therapies are and can

be integrated into the practice of medicine.

So it looks like it was more of a methods paper. However, the study seems poorly designed there were largedescrepancies in age ranges of participants in the homeopathic (lots of under 12s) and conventional groups

(mostly adults) and this paper looked at a broad range of pathologies:

(1) upper respiratory tract complaints including allergies; (2) lower respiratory tract complaints including

allergies; or (3) ear complaints.

No mention is made in the paper of what conventional therapies (antibiotics?) were used, what the actual diseases were (i.e. were

they diseases that spontaneously resolve anyway) so it is impossible to draw any sort of conclusion about this paper. No

placebo control was used (unethical in primary care setting, I guess).

11. Steinsbekk A, Fnneb V, Lewith G, Bentzen N. Homeopathic care for the prevention of upper respiratory tractinfections in children: A pragmatic, randomised, controlled trial comparing individualised homeopathic care and

waiting-list controls. Complementary Therapies in Medicine 2005, 13, 231-238.

This paper lives here (you need to pay or have access) has a small sample size (169) and, again, does not look at

specific diseases and therapies. There is no placebo control.

The authors note:

But, as this was a pragmatic study, it provides no evidence to sustain an argument that homeopathic medicinesFollowFollow


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have specific efficacy.

12. Weber U, Luedtke R, Friese KH, Fischer I, Moeller H. A non-randomised pilot study to compare complementary

and conventional tretaments of acute sinusitis. Forsch Komplementarmed Klass Naturheilkd 2002; 9: 99-104.

What? Acute sinusitis again? Weve already seen that:

Sinusitis often clears up by itself, and about two thirds of those who get the condition do not need to see their

GP.

On average, sinusitis takes about two-and-a-half weeks to clear.

Over-the-counter painkillers and decongestants can be used to relieve facial pain and a blocked nose. Antibiotics

are unlikely to help unless the sinusitis becomes chronic (persistent).

However, the conclusions of the paper offer no succour to homeopaths in search of peer reviewed support:

Conclusions: Both treatments appear to be equally effective (or ineffective). Results might be biased because

both treatment groups differed substantially. Randomised trials including at least 400 patients are needed to

produce valid results.

(Also the homeopathic remedy used was at 3X dilution so not at sub-avagadros concentrations.)

13. Wiesenauer M, Gaus W, Bohnacker U, Haussler S. (Efficiency of homeopathic preparation combinations in

sinusitis. Results of a randomized double blind study with general practitioners.) Arzneimittelforschung 1989; 39:

620-625.

The abstract can be found here. The full text of this paper is not available online.

Sinusitis (again).

The paper concludes:

there was no remarkable difference in the therapeutic success among the investigated homeopathic drug

combinations nor between the active drugs and placebo.

Once again, the homeopathic rememdies were not at sub-avagadros concentrations.

So in conclusion.

Despite the disparity between homeopathy and science, it would appear that homeopaths are all too willing to try and blind

unwary readers with science. Here I have taken a closer look at 9 references provided by homeopaths to provide evidence for the

efficacy of their treatments. Of those 9 references:

4 say that there is no evidence for the efficacy of homeopathy,

5 are poorly designed / need bigger sample groups,

2 use homeopathic remdies at dilutions not greater than 12C (so we might expect to find some active ingredient),

1 paper is openly dismissive of the clinical relevance of homeopathy.

4 of them admit that they are looking at diseases which normally resolve without medical intervention anyway *.FollowFollow


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So when someone shows you something with a list of references to support their claim make sure you

look at the references!

Because people WILL use references that say the exact opposite of what they are saying in the

hope that you wont bother reading them!

*Yes I know this doesnt add up to 9 some papers fall into more than one catagory

4 Comments | Bad-science, Homeopathy | Permalink

Posted by xtaldave

Cochrane reviews on Homeopathy.

January 10, 2010

So just for information here are the conclusions of all four five

finished Cochrane reviews of Homeopathic treatment.

Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes

http://www.cochrane.org/reviews/en/ab001957.html

Summary > Current evidence does not support a preventative effect of Oscillococcinum-like

homeopathic medicines in influenza and influenza-like syndromes.

Homeopathy for dementia

www.cochrane.org/reviews/en/ab003803.html

Summary > No evidence that homeopathy is effective in treating dementia

Homeopathy for attention deficit/hyperactivity disorder or hyperkinetic disorder


Summary > There is currently little evidence for the efficacy of

homeopathy for the treatment of ADHD

Homeopathy for chronic asthma


Summary > Until stronger evidence exists for the use of homeopathy in

the treatment of asthma, we are unable to make recommendations about

homeopathic treatment.

Homeopathic medicines for adverse effects of cancer treatments FollowFollow


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http://www.cochrane.org/reviews/en/ab004845.html

Summary > Two studies with low risk of bias* demonstrated benefit: one

with 254 participants demonstrated superiority of topical calendula

over trolamine (a topical agent not containing corticosteroids) for

prevention of radiotherapy-induced dermatitis, and another with 32

participants demonstrated superiority of Traumeel S (a proprietary

complex homeopathic medicine) over placebo as a mouthwash for

chemotherapy-induced stomatitis. Two other studies reported positive

results, although the risk of bias was unclear, and four further

studies reported negative results.

* The two positive results are not diluted to sub-10^23, and are

more accurately herbal preparations andNOThomeopathic remedies. With

topical calendula sub 12C dilutions are not used for topical

applications. Traumeel S is a proprietary mix of plant extacts final

concentrations are as follows:

Composition of Traumeel S

Arnica montana D2

Calendula officinalis D2

Atropa belladonna D2

Aconitum napellus D2

Bellis perennis D2

Hypericum perforatum D2

Echinacea angustifolia D2

E. purpurea D2

Symphytum officinale D6

Matricaria chamomilla D3

Achillea millefolium D3

Mercurius solubilis Hahnemanni D6

D2 is equivalent to 1C diution so 1 part in 100 not a true

homeopathic dilution. D6 is equivalent to 1 part in a million.

Leave a Comment | Homeopathy, Science | Tagged: Evidence, Homeopathy | Permalink

Posted by xtaldave

The Molecular Mechanisms of Homeopathy.

January 10, 2010

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With the launch of the 1023 campaign against homeopathy, it seems appropriate for me to write a bit onthat very subject. But where to start there are so many blogs that talk about the issues that people have

with homeopathy. The ethical reasons for campaigning against it and the slap in the face that

homeopathic medicine is to scientific thinking have been subject to in-depth coverage. Recently Prof

David Colqhoun has finally gained access to teaching materials for a now-defunct BSc in Homeopathy,

via a freedom of information request. He is reviewing them systematically on his excellent DCs

improbable science blog.

So with all this covered by other, more eloquent and seasoned bloggers than myself, I have decided to

look at homeopathy from my own niche in science from a structural/molecular biologists point of

view.

How medicines work.

To understand the issues that science has with homeopathic remedies, one needs to know how

conventional drugs work. They work by interacting with another molecule in your body. Generally they

will either activate or inhibit the activity of protein molecule that is involved in some sort signal

transduction pathway, or in the catalysis of a particular chemical reaction. Structural biology,

particularly X-ray crystallography is an immensely powerful tool for understanding the nature of these

drug: receptor interactions. For example, crystallography has revealed the nature of interactions

between a bacterial ribosome and the antibiotic chlorampenicol and HINI (Swine flu) neuraminidase

interaction with anti-influenza drug, Tamiflu. These structures reveal the nature of the interaction at an

atomic level. We can see Electrostatic interactions (negatively charged atoms/groups interacting with

positively charged atoms/groups) such as salt bridges and hydrogen bonds. We can see aromatic stacking

interactions (aromatic groups stacking alongside each other) and other hydrophobic interactions. We can

precisely map out the atomic nature of an interaction.

Such information is invaluable in understanding how a drug works. We dont have this information for

every single drug that is used. But in time we will.

A conventional drug, eg Tamiflu, consists of a chemically defined active ingredient at a known and

measurable concentration. Each adult dose of Tamiflu contains 75 mgs of Tamiflu. Given that Tamiflu

has a molecular weight of 312.4 g/mol, each 75mg dose of Tamiflu contains 1.4

10

20

(~140,000,000,000,000,000,000) molecules of Tamiflu (0.075/312.4 * Avogadros constant).

Your body takes up a known percentage of this drug this is known as bioavailability. In the case of

Tamiflu, the bioavailability is ~60% so of the 1.41020 molecules of Tamiflu that you swallow, only

8.61019 get into your blood stream. These then circulate for until broken down/excreted. Tamiflu works

by mimicking the natural substrate of influenza virus neuraminidase, sialic acid. By preventing influenza

virus neuraminidase binding to endogenous sialic acid presented on the surface of your cells, Tamiflu

prevents infection of host cells. Simple. FollowFollow


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How Homeopathy works.

Homeopathic remedies are based upon highly dilute samples of a compound that causes a similar effect

to the symptoms of a given disease (like cures like). For example, if disease X gives me hiccups, and

plant extract Y gives me hiccups, I would take a dilute solution of plant extract Y to cure the symptoms

of disease X.

Well overlook the fact that this is treating a symptom (by causing it?), and not addressing anyunderlying cause because homeopathic remedies are potentised during their production. The

originator ofhomeopathy was Samuel Hahnemann, who described a process whereby the effect of these

cures could be enhanced by serially diluting them until one reached ultra low concentrations. Each

dilution step would be accompanied with succussion of the solution ten hard strikes against a soft,

often leather-covered object. The wikipedia page on Homeopathy has a good description of this process.

A typical homeopathic remedy has a concentration of 30C, that is to say, 1 part compound in 100 30 (so

1060). After Hahnemann first devised homeopathy, Avogadros constant (number of molecules in a mole

of substance) was calculated, and shown to be roughly 61023 (hence 1023 campaign). So in a 1023 or

11.5C solution one might reasonably expect to find 1 molecule of compound. The odds of finding asingle molecule of active compound of a 30C homeopathic remedy are very roughly 1 in

10,000,000,000,000,000,000,000,000,000,000,000,000 (10 million million million million million

million).

When this was pointed out to the homeopaths (that their remedies had zero active ingredients) they

happily discovered that the water in which the active ingredient was dissolved in had a memory and not

only remembered the active ingredient (doubtless both its molecular structure and pharmokinetic

properties), but the water could also pass this memory on to other water molecules. Cool, huh?

Note the succussion process allows the water to remember the therapeutic ingredient, but not all the

other stuff that the water has seen down the years. And given that a molecule or two of the watercurrently in the coffee I am drinking were likely to have at sometime been intimately associated with an

Ebola virus particle or a molecule of the Ricin toxin I sincerely hope this is the case. The molecular

mechanism of succussion, and how it selects for particular solutes, is currently not understood.

But in order for a homeopathic remedy to work, not only does the water need to retain a memory of the

active ingredient, it needs to actually mimic it, so it can then interact with the required target molecule

to exert an effect. It has to adopt a similar/identical form.

How water interacts with other (bigger) molecules

Crystallographers can show that molecules such as proteins and DNA interact with solvent water atomsin quite specific ways. Ive even generated a little picture to show precisely that:

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The grey surface represents the molecular surface of a particular protein Im working on. The red

spheres represent ordered water molecules that interact with the suface of the protein.

We see these bound water molecules in pretty much every crystal structure we solve, as the vast majority

of crystals are formed from aqueous solutions. Indeed, water molecules can become trapped inside

proteins and help them fold correctly and bind substrates or metal ions. Water molecules also participate

in chemical reactions often being split to protenate leaving groups.

So the idea that water adopts a structure around another molecule is not that far fetched. So, being

inquisitive, scientists tried to determine if this water structure persisted after the molecule was removed.

And to their surprise, it did but for only ~50 femtoseconds (0.00000000000005 seconds not very

long at all and not much use for a remedy thats going to sit on the shop shelf for weeks).

And another thing

For the sake of further enquiry, lets assume that the peer-reviewed letter to Nature above is wrong (it

isnt), and water can retain a memory of whats been dissolved in it for much longer than 50

femtoseconds (it cant).

This isnt enough an empty shell of water molecules around a compound that was once there isnt

going to be enough to interact with and engage protein receptors they actually have to then rearrange

and mimic the chemical and physical properties of the molecule that induced the formation of that shell

in the first place.

Not only this this water structure then has to be robust enough to occupy a protein-binding site and

fend off other molecules that might normally bind to that site with a high affinity molecules that will

displace water molecules all the time in order to get into that very binding site. The original therapeuticFollowFollow


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molecule will not only have a particular shape and form it will have an inherent stiffness and rigidity

water molecules in solution move relatively freely and will shift to surround any molecules dissolved it

them that is why water is such an excellent solvent. But not homeopathic solutions. Oh no.

In order to circumvent this, the energetics of homeopathic remedies must be amazing water molecules

typically interact with each other via low energy, transient hydrogen bonds each hydrogen bond

requires 5-30 kJ/mol to break it (depending upon solvent conditions, temperature, etc), but a permanent

covalent bond that links atoms in a drug molecule typically requires over 300 kJ/mol to break it i.e.at least over 10 times stronger. And yet the homeopathic shell of water molecules manages to be as

strong as this. Utterly fantastic stuff.

The properties of homeopathic solutions are beyond comprehension and to think that all this was

achieved by diluting something to a point where no original molecules remain whilst periodically

banging it on something leathery.

Homeopathy is truly unbelievable.

It is the fantastic and unbelievable nature of homeopathic remedies that leads scientists to question their

validity as an effective form of therapy. Experiments to investigate this show that homeopathy is nomore effective than placebo. When a therapy has no active ingredient, no conceivable mechanism of

action, and cannot be demonstrated to be more effective than a placebo, to claim otherwise is both

dangerous and immoral. It certainly has no place whatsoever in a public funded health service like the

NHS.

18 Comments | Bad-science, Homeopathy, Science | Tagged: Homeopathy, Molecular mechanism |

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