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From JAMA: http://jama.jamanetwork.com/article.aspx?articleid=202602

"19th-century homeopaths pioneered systematic drug-testing research, challenged the dangerously depleting procedures of mainstream physicians at that time, established rigorous professional standards, and valued advanced education at least as highly as their mainstream counterparts did. It was not without reason that homeopaths considered the bases of their approach to medical problems to be more logical and more promising than the inherited tradition of the ancients, upon which mainstream physicians still based their practices. [...]

This book will be useful primarily to scholars looking for specific information about particular people, events, and developments within the homeopathic movement during the period covered. Among other things, readers will find the names—and often the opinions—of hundreds of previously invisible homeopathic practitioners, publicists, and professors; they will follow fierce debates between the so-called high-dilutionists (whose therapeutic commitment to infinitesimally small doses of supposedly energized substances verged on spiritualism) and the low-dilutionists (who ultimately merged with mainstream physicians in the early decades of the 20th century); they will explore the founding and fate of homeopathic medical schools; they will listen to well-intentioned homeopaths defend themselves against attacks from the American Medical Association; and they will learn about regional variations in the character, reception, and legal standing of homeopathy around the country."

Anyway not to defend homeopathy, but I just find it sad that so many people view James Randi as a credible source despite the fact that he can rarely go five minutes without lying about something.




Thank you!

It seems a stretch to say that James Randi is lying when he doesn't include a disclaimer that the same word happened to also be used for something more scientific around 80 years ago.

Everything Randi talks about is perfectly true if you use the contemporary understanding of the word "homeopathy"

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"Everything Randi talks about is perfectly true if you use the contemporary understanding of the word 'homeopathy'.

Which he wasn't. He was specifically talking about homeopathy in the period when it was invented and when it came to the US in the mid 19th century. In fact he even talks about 'the proving', which as a far as I know isn't even actively done anymore in modern homeopathy. (I'm pretty sure the modern manufacturers are just reusing old formulas and not actually doing new 'research'.)

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He gave some historical background but also brought it around to how homeopathic preparations are presently made, with the examples of actual products using 30x and 1500x dilutions. There are lots of specifics we could be pedantic about, but I agree with the grandparent that for a 15 minute summary of homeopathy it's on target.

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Let's pull another part of that quote:

"John S. Haller, Jr, reminds us that homeopathy in the 19th century rested upon highly specific principles—all of which flowed from Samuel Hahnemann's fundamental axiom that “like cures like”"

Taking a magical axiom as a given and then using scientific principles is not science.

You can make the exact same arguments about alchemists and some schools of occult study. They used careful and meticulous methods, and even made some discoveries in the areas of lab work or procedure that were useful to many areas.

These things don't mean the beliefs are any more true.

So you're mad at Randi for not providing a small piece of historical context in a presentation about protecting people from modern con artists? That just seems like you are looking for something to object to.

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"Taking a magical axiom as a given and then using scientific principles is not science."

If that's true, then modern medicine isn't science because it works exactly the same way. It starts with all sorts of spiritual axioms, like the idea that the most effective drugs are made by isolating one single molecule out of the entire plant. And that's what modern medicine believes is a universal and inviolable law, no matter how much empirical evidence there is that this isn't always the case. (E.g. look at the efficacy trials of marijuana vs. pure THC.)

"So you're mad at Randi for not providing a small piece of historical context in a presentation about protecting people from modern con artists?"

It's not really a small piece of trivia, especially considering the idea that all homeopathy is high dilution was the sine qua non of his argument. And furthermore, low dilution homeopathic treatments still exist today, e.g. those zinc lozenges you see at the checkout counter of every pharmacy. More people probably have exposure to those than every other homeopathic remedy combined.

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You're going to disparage the scientific credibility of the entire medical profession because some practitioners are focused on isolating and synthesizing the effective components of medication?

I guess Randi could have said "only the people who believe this crazy stuff believe this crazy stuff", but he did make it clear that his history wasn't complete and comprehensive.

The damning evidence remains the same: I can go into an otherwise reputable store and pay for "medicine" that is just water with pseudoscientific incantations performed over it. And you have the chutzpah to call Randi dishonest?

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"You're going to disparage the scientific credibility of the entire medical profession because some practitioners are focused on isolating and synthesizing the effective components of medication?"

My criticism of western medicine isn't that it focuses on new molecular entities (NMEs), but rather that it focuses only on NMEs despite loads of empirical evidence pointing out that much of the best medicine is potentially neither new nor a molecular entity. My point is that it's not fair to criticize alchemy for having guiding spiritual assumptions if you're not willing to admit that western medicine has its own spiritual assumptions.

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> despite loads of empirical evidence pointing out that much of the best medicine is potentially neither new nor a molecular entity

Can you link to this empirical evidence? I'm honestly not aware of it.

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I'm not aware of any single good source on this, but a couple interesting links:

http://maps.org/

This is a non-profit pharma company working on getting MDMA through phase III trials. They've been getting tons of publicity lately, in part because of their very solid methodology and in part because of their results and the interestingness/importance of the project. No traditional pharma companies will do any research on the drug though because it can't be patented, not to mention it's schedule I meaning that each study can take literally several years to get approved.

For a comparison of marijuana with marinol, this is a good link:

http://norml.org/component/zoo/category/marinol-vs-natural-c...

There are lots of plants that compare well with pharma drugs safety and efficacy wise in preclinical studies, but there are basically zero actual clinical studies done on them because they can't be patented or prescribed.

Andrew Weil has a great writeup on why plants are usually better than drugs here:

http://www.huffingtonpost.com/andrew-weil-md/why-plants-are-...

Obviously there are many famous counterexamples where the isolated molecule really is much better, like with aspirin. But often with just the whole plant or some extract you can get at least 80% of the benefits but with only 10% of the side effects. (Plants kill only a couple hundred people in the US per year, whereas pharma drugs kill 200k+ per year.)

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> (Plants kill only a couple hundred people in the US per year, whereas pharma drugs kill 200k+ per year.)

Well in all fairness, the volume of people being treated with plants and the volume of people being treated with pharmaceuticals probably isn't near enough to proportional to make that a fair comparison.

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That's true, but even the most benign of pharma drugs like aspirin, ibuprofen, and tylenol kill around 7,500 people per year combined. Whereas no one is dying from marijuana, aloe, cranberry juice, etc. Virtually all of the plant deaths in the US are from people eating poisonous plants, either accidentally or to commit suicide. Despite the tens of millions of Americans using plant medicines each year, I doubt there are more than a few dozen adverse drug events from all of them combined.

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I'm not sure those support your points (except the huffpo article which I find ... unconvincing), isn't MDMA a "molecular entity"?

There are many plants that work very well indeed, much of modern medicine is based on them. I'm just not sure why you would not take the next step and isolate the active ingredients and synthesize them so that people can benefit from something with predicable dosages and a price affected by economies of scale.

In terms of drug research being hampered by prohibitionist drug laws we are in agreement. What I still don't understand is why you think that some beneficial compound that's adulterated and present in unpredictable amounts in plant form is better than the alternative? I'm definitely going to challenge you on this 80%/10% statement.

Something either has a biological effect or it doesn't. The cases like aspirin (where the natural form also had a second active ingredient that acted as a buffering agent) are rare, it's more common that the plant form has other active ingredients that are harmful.

I sympathize with your bias towards the naturalistic fallacy, since I'm prone to it as well the facts aren't on your side here.

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"isn't MDMA a 'molecular entity'?"

Yeah but it's not patentable. There are many drugs that have the potential to cure all sorts of diseases that never make it to market for this reason.

"I'm just not sure why you would not take the next step and isolate the active ingredients and synthesize them so that people can benefit from something with predicable dosages and a price affected by economies of scale."

Because often they work less well and have more dangerous side effects. There literally is no isolated molecule that on average will produce better results than the whole plant, even though what you're getting from the plant is a little different each time.

The first rule of recreational drug use is rotate your receptors. E.g. if you keep hammering the exact same receptor with the exact same molecule each time, bad things are going to happen. The same thing often applies to medicinal drugs, in which case standardization tends to be worse on average than taking a random cocktail of chemicals, even if you don't know what it is your taking. Again, c.f. the research on marijuana vs pure THC for a good example of this.

"What I still don't understand is why you think that some beneficial compound that's adulterated and present in unpredictable amounts in plant form is better than the alternative?"

Because that's what the evidence says is often the case. It doesn't really make any logical sense, it's just what happens to be true. A good example of this is the TED video Eating To Starve Cancer, where they talk about how mixing a bunch of different types of tea together is more anti-angiogenic than any individual tea:

http://blog.ted.com/2010/05/17/can_we_eat_to_s/

Even if you were to standardize some mixture, there is no reason to believe that taking the same mixture day after day would be more effective than taking a different mixture each time.

Also, you can actually standardize plant medicine now. Plants are cloneable, and you can grow them in highly controlled conditions and then blend them together the same way they blend tea or champagne. (Which is why champagne from a good house tastes almost exactly the same despite the wildly different growing conditions each year. Same for things like Lipton english breakfast tea or whatever.)

"I sympathize with your bias towards the naturalistic fallacy"

The naturalistic fallacy is assuming that if something comes from nature it must be better. That's not at all what I'm saying here.

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> those zinc lozenges you see at the checkout counter of every pharmacy

So those other things that don't work? Zinc as a common cold treament has never had a convincing effect size and when controlling with equally bad tasting placebos has no effect.

> like the idea that the most effective drugs are made by isolating one single molecule out of the entire plant. And that's what modern medicine believes is a universal and inviolable law, no matter how much empirical evidence there is that this isn't always the case. (E.g. look at the efficacy trials of marijuana vs. pure THC.)

I'm not aware of any universal and inviolable laws in modern medicine other than the need to prove a treatment actually works. There are certainly scientists and doctors looking at non-THC cannabinoids. To suggest that anyone is using non-scientific principles to do anything useful in this area is absurd.

The reason that active ingredients are isolated is to provide a predictable and safe result for all patients. When you skip that step you get other results: Like the people who lost their sense of smell by taking Zicam because low dilution homeopaths told them it would cure the common cold.

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