Thursday, October 22, 2009

Homeopathy is a disease of the mind

Earlier this week I said I found it alarming that a Heel affiliate was promoting what is probably a quack treatment for dengue. I did some googling and apparently there indeed are homeopathic remedies intended to address dengue. For instance Dr. Ana Teresa Doria Dreux, former president of the Instituto Hahnemanniano do Brasil (presumably named in honor of homeopathy's inventor Samuel Hahnemann) and currently its VP, prescribes nostrums for the prevention and treatment of dengue. Her concoction consists of 5CH and 12CH dilutions (equivalent to 10X and 24X). That's 1 part per ten billion and 1 part per trillion trillion of active ingredients respectively. The latter is simply too dilute to have any possible effect (therapeutic or adverse). She tells us that these remedies are her own creations. However, we are not told what clinical trials have been performed to test their efficacy. All she says is:
So far, with those patients who have used this formula as prevention, there have not been any cases of infection, at least not reported to me.

I distribute this formula every year to all the personnel at IHB during the periods of epidemics and since I began doing so, not one of the approximately 22 employees has contracted the disease, not even those who live in areas where it is endemic.

This of course is insufficient evidence for efficacy. When I read the above the image that pops in my head is that of Dreux tightly crossing her fingers behind her back praying her luck holds.

Despite belief in the efficacy of her anti-dengue nostrum, she cautions:
Of course homeopathy does not DO AWAY WITH or INTERFERE with the obligatory medical care in these cases, nor should we neglect to eradicate the vector (the Aedes aegypti mosquito) by eliminating its breeding sites.

Well, if "obligatory medical care" and eradication of the disease vector weren't and aren't done away with, couldn't these be the cause of the lack of incidence? Setting aside ethical issues for the moment, if Dreux actually performed a double-blind trial and subjected half of a community to her brew and half to pure sugar pills--withholding any other form of treatment including "obligatory medical care"--perhaps she could have a better idea of whether her "medicine" actually works or not. As it is, Dr. Dreux is infected with dilution delusion. And not even an hourly dose of 100,000X (ultra powerful stuff indeed!) whatnot will cure her.

Dreux and her water institute aside, what is truly disturbing is what the doctor reveals in passing--that Brazil's health department has a homeopathy division. When government legitimizes quackery and itself peddles snakeoil then it has betrayed the people. One can only hope that there are Brazilians who are making noise and who are trying to inject sanity into its department of health.

Monday, October 19, 2009

Close encounters with homeo and acupunc

Accompanied a friend to a trade exhibit last Saturday and encountered two companies promoting and selling woo.

1. Homeopathy and Homotoxicology by Biological Homeopathic Medical Corp (BHMC) / Ibarra Bio Med Int'l Trading Corp.

Let me begin with what may be a tragedy that's in the offing. After I started inquiring about their products alarms went off in my head when the representative at the booth boasted about their company having made a presentation before health officials for a preparation that addresses dengue. What these "medicines" actually are remains to be seen. I gather from the rep that they're alternative meds, perhaps homeopathic. In the recent past there have been homeopaths who prescribed homeopathic remedies for malaria. Such nostrums are completely ineffective against that disease. I'm betting that the treatment BHMC is purveying is just as bogus. These people are toying with lives. Dengue is a very serious condition. Homeopathy should be banned from peddling anything to treat/prevent such life threatening conditions. Hopefully the health department will not get duped. Lives--specially those of young children--are at stake.

Onto the reading materials I was provided. One of BHMC's flier lists the principles "proven and developed by Dr. Hans Heinrich Reckeweg":
1. Like cures like
2. The more the remedy is diluted, the greater its potency
3. An illness is specific to the individual

The first two principles were in fact laid down by the inventor of homeopathy, Samuel Hahnemann. And no they haven't been proven. The second principle doesn't even need testing. Given what we know about how chemicals work, it's implausible from the git go. It's the very opposite of what we know is true even intuitively--the more of a substance you administer the more pronounced its effect. The less of it you give/receive the less its effects--and that goes for what we commonly call poisons as well. Even cyanide poses no threat if you ingest but a microgram.

BHMC is affiliated with Heel, a company that has distributors in the US, Germany, Canada, Australia, among others. Dr. Stephen Barrett of Quackwatch tells us that Reckeweg founded BHI (later renamed Heel) back in the early 20th century. In the last few decades the company managed to earn the ire of the FDA which regarded it as the "most flagrant law violators among homeopathic marketers." Barrett issues this warning:
Heel-BHI has been marketing products with outrageous and illegal claims for more than 25 years. The vast majority are irrationally formulated and have not been scientifically tested. Using them instead of proven therapy is a waste of money and could lead to delay in getting appropriate treatment.

The BHMC pamphlet lists its services:
Electroacupuncture by Dr. Voll
Super MORA Therapy
Bio Oxidative Therapy
Ozone Therapy
Chelation Therapy
Neural Therapy
Bio-Puncture
Colonic Hydrotherapy
Traditional Chinese Acupuncture
Anti-Ageing Therapy
Natural, Nutritional and Biological Preventive Medicine

All of the above are unproved therapies. And the safety of some of them is questionable..

The other flier I was handed introduces their Detox Kit. It describes the contents of the kit as follows:
The Heel Detox Kit® combines three homeopathic complex remedies for a comprehensive effect.

Lymphomyosot® Oral Drops
activates the lymphatic system in order to detoxify the connective tissue and the mesenchyme

Nux vomica-Homaccord® Oral Drops
stimulates the gastro-intestinal excretion pathway as well as the hepatic system (liver)

Berberis-Homaccord® Oral Drops
activates the renal and the biliary systems (kidney, gall bladder)

I googled and found the composition of the Heel Detox Kit. The webpage lists all the active ingredients and even the amount of each per 100 milliliter bottle. With this data I created a spreadsheet which shows the actual amount each of the active ingredients taking into account their respective dilutions.

For the Nux vomica-Homaccord drops they list 22 substances:
Nux vomica D3
Nux vomica D10
Nux vomica D15
Nux vomica D30
Nux vomica D200
Nux vomica D1000

Bryonia alba D3
Bryonia alba D6
Bryonia alba D10
Bryonia alba D15
Bryonia alba D30
Bryonia alba D200
Bryonia alba D1000

Colocynthis D3
Colocynthis D10
Colocynthis D30
Colocynthis D200

Lycopodium clavatum D3
Lycopodium clavatum D10
Lycopodium clavatum D30
Lycopodium clavatum D200
Lycopodium clavatum D1000

You can't help but notice that in fact there are only 4 ingredients. They've merely used various dilutions of these four. If you look at the last column (% of total active ingredients) of the spreadsheet you'll see that the contributions of dilutions other than D3 are completely negligible.

You're probably wondering what this "Dx" rating is all about. In homeopathic terminology D stands for decimal. It's a scale to denote the degree of dilution. A D1 means there's one part of active to 10 parts inert ingredient. For a D2 it's one in a hundred. So it's a logarithmic scale similar to the Richter scale for earthquake intensity. Being logarithmic a D4 is ten times more dilute than a D3 preparation [10(4-3)], a D6 is a thousand times more dilute than a D3 [10(6-3)], and a D30 is a thousand trillion trillion times more dilute than a D3 [10(30-3)].

In the Nux vomica oral drops some of the substances are watered down to D1000. How dilute is a D1000? If you had one drop of active ingredient and were to dilute it in one go you'd have to mix that single drop with 101000 (remember, that's "1" followed by a thousand zeros) drops of water or alcohol. How much is 101000 drops? That's equivalent to 6.5 × 10992 cubic meters [see Note 1]. And just how large is that? Well, it's more than the size of our universe. In fact a lot bigger. If a bucket were the size of the universe you'd need 7.7 trillion buckets to end up with 6.5 × 10992 m3 [see Note 2]. After mixing (if you can even imagine achieving that) you can scoop a volume as large as the Earth or the Sun or the Milky Way and the chances of finding a single molecule of the active ingredient would still be exceedingly infinitesimal.

Since it is impossible to make extremely dilute preparations in a single step, homeopaths perform a series of successive dilutions. For example to obtain a D1000 they may mix a drop of the active ingredient in 105 drops of water--equivalent to 6.5 liters. This is now a D5 dilution. A drop from this is then added to another 6.5 liters of water to create a D10. And so on until it's been performed 200 times. Here's another way of looking at that. Let's say the entire Earth all the way to its inner core is made of water. You add a drop of the active ingredient and mix thoroughly. Take a drop of that and add it to another Earth-sized planet made of pure water. Remember to mix it real well. To end up with a D1000 you'd need to do this 45 times [see Note 3].

As we've seen homeopaths claim that the more diluted a preparation the more potent it is. Thus a D1000 is far more powerful than a D10 even if there's negligible chance of finding even a single molecule of the substance that's suppose to treat the condition. This is dilution delusion.

According to Heel the Detox regimen consists of "30 drops of each preparation in 0.7-1.5 liters of spring water to be drank during the course of the day." In the spreadsheet I've computed how much of the active ingredients one actually gets daily.
Nux vomica-Homaccord: 0.00030 drop (equivalent to 0.00020 ml)
Lymphomyosot (or Lyphosot): 0.0087 drop (equivalent to 0.00057ml)
Berberis-Homaccord: 0.084 mg.

These are very minuscule amounts indeed. Which means to say they probably have neither therapeutic nor adverse effects.

Just to get a perspective on how small those amounts are, let's compute for how many days it would take to ingest a drop or milligram of the active ingredients. To compute, just get the inverse of the above values. We obtain:
Nux vomica-Homaccord: 3,333 days / drop
Lymphomyosot (or Lyphosot): 115 days / drop
Berberis-Homaccord: 12 days / mg

Finally, is there anything to the notion of detoxification? None. It's bunk. It's crap. It's woo.


2. Shaolin Electronic Acupuncture Apparatus

The apparatus consists of an oval plastic device with a major diameter of around two and half inches, with "wings" on either side made of some pliable material under which are attached a black, sticky material they call the plaster or patch. Click the above link for photos. Here are a couple of infomercial videos I found on Youtube: the original is in Chinese but here's one in English.

The apparatus is manufactured by Zhengzhou HuiHao Technology Co.,Ltd in Zhengzhou, China. The device is powered by a coin battery and is said to incorporate a microprocessor. They probably mean microcontroller but then the terms are sometimes used interchangeably in reference to embedded systems.

The flier I got explains how it works:
A Microprocessor [sic] generates a low frequency magnetic field while [sic]controls a modulated pulse that provokes slight vibrations to simulate therapy by acupuncture. This function stimulates the channels and collateral in our body thru a patch helping to promote blood circulation to relieve pains; eliminates [sic] dampness to invigorate the kidneys; expel toxins to lose fat, etc. It also achieves [sic] and has very good healing effects on inflammations and aches of the neck, shoulders, waist, legs and joints.

The following are the diseases and conditions the device can purportedly "prevent and cure": Arthritis, diabetes, rheumatism, backache, sciatica, impotence, joint pain, Bell's palsy, kidney problems, stiff neck, vertigo, insomnia, constipation, gastroptosis, nausea, gastroenteritis, tennis elbow, hangover, hypertension, stroke, headache, gonarthritis, bone diseases, cervical spondylosis, scapulohumeral periarthritis, hip pain, inflammation of the lumbar discs, hemiplegia, carpal tunnel syndrome. It can also help rid (excess) fat, expel toxins, relieve pain, provide energy, free the "channels and collaterals", and promote blood circulation. I'm surprised they left out the big C--cancer.

According to the video the sticky patch contains a secret Shaolin concoction made from 13 herbs. These seep into the skin five times deeper than without the electronic apparatus. As to how deep the herbs penetrate without the device they don't say.

The exhibit representative urged me to try the apparatus for just ten minutes. Although reluctant at first I did give in and allowed myself to be a guinea pig just to see what the gizmo would do. Boy, was I in for a surprise. The lady strapped the device onto my forearm and pressed a button. Within seconds it started delivering electric shocks. Not very pleasant at all! My hand twitched violently with every shock as the device caused my arm muscles to contract. The pulse frequency was approximately one per second. But every half minute the frequency would change.

Given its shocking output I believe this gadget employs an inductor--a coil of (enameled) wire (probably with an iron core)--to produce a very short but high voltage output. Whenever current passes through a conductor a magnetic field is produced. When wire is formed into a coil the magnetic field around the entire length of that wire becomes concentrated--the inductance increases. When current stops flowing the magnetic field around the coil collapses. But that collapsing field now induces a voltage in the coil--a voltage that is many times that which was present when current was flowing. But while voltage is high there is very little current that flows--and it's the amount of current that can kill, not necessarily the voltage. Thus while static buildup in our body can easily reach a thousand volts, we don't feel more than a sting when we discharge the accumulated charge.

If the acupuncture gadget does employ an inductor then it works on the same principle as the ignition coil in a gasoline engine. But in this case you and I are the spark plug. Try the following (if you dare). With the engine off, pull the cable off one of the spark plugs. Hold the end of that cable--called the boot. Best if you hold a metal rod and stick it inside the boot so you can make contact with the metal shroud inside. Have that hand also touch the body of the car (ground). As a safety precaution put your other hand behind your back and avoid having any other part of your body in contact with the vehicle. Now let someone crank the engine. Unless your body is made of plastic, rubber, glass or some excellent insulator, you'll get a pulsing jolt. I've had my share of surprises when I was still tinkering with engines decades ago. So in case you want to experience electronic acupuncture, your automobile will gladly assist you.

A car's ignition coil delivers around 20,000 volts to the spark plug causing an arc to jump across the electrodes. It's this arc which ignites the gas-air mixture in the cylinder. Now think about that. What do you think will happen if you bring this acupuncture gizmo to the gas station and turn it on as you're filling up? Well most likely nothing (unless perhaps you put it right next to where you pump gas into car's gas tank). But put it inside a jar with a rich gasoline-air mix, set the gap between the electrodes to less than 5 millimeters, program the apparatus to maximum output, and maybe, just maybe, you'll have an early New Year's Eve celebration.

Instead of acupuncture the manufacturer should've called it The Portable Electro Shocker. Does it work? It certainly does! For those who have a masochistic streak in them, that is.




Notes:

1. One drop = 0.065 ml = 6.5 × 10-8 m3
Cubic meter equivalent of 101000 drops:
101000 drops × 6.5 × 10-8 m3/drop = 6.5 × 10992 m3

2. Volume of the universe = 3 × 1080 m3
number of universe-fuls of water (or alcohol) required to dilute one drop of active ingredient to D1000:
[6.5 × 10992 m3] / [3 × 1080 m3] = 7.7 × 1012

3. Volume of the Earth = 1.08 × 1015 m3
Let 10x = volume of the Earth in drops
6.5 × 10-8 m3/drop × 10x drops = 1.08 × 1015 m3
10x = [1.08 × 1015] / [6.5 × 10-8]
10x = 16.6 × 1021
x log10 = log (16.6 × 1021)
x = 22.2

number of Earth-sized successive dilutions to achieve D1000:
1000 / 22.2 = 45 Earths