The Great DBH Rant

I have recently blogged about my experiences of poking the giant bear (a practicing homeopath in Hong Kong) with a wee stick. I got the handbag treatment. I also said that I will post his response once I have digested all the Chinese thrown at my face. Well here it is. I have included the original text (in Chinese so unless your computer can read the characters, they might just be a load of garbage to you) for completeness. Of course, this outburst was translated to the best of my ability, but nevertheless it is still a translation, and by someone who has just been “cyber-yelled” at. It may be biased, although I think this is a pretty good translation. I did not add any thoughts of my own to what he said. Also I feel it is necessary to include here, my original comment to him. For the entire background to why I gave this particular comment to him and his outrage at a fairly level headed comment, see this post.

So I said (and may I point out this is all I have said):

“Hi. I am originally from Macau, but I am not sharing your delight in the “success” homeopathy is enjoying in Macau. It is scary that while homeopathy is not evidence based medicine, that practicing homeopaths like yourself will come out and say that homeopathy is better than conventional, evidence based medicine.

May I point out that homeopathy, at this moment in time, is at best only a fancy and expensive form of placebo treatment. At worst, it is life threatening, because of delays in seeking medical advice and diagnosis from trained medical professionals.

Finally, the only selling point of homeopathy – the lack of side effects, is simply because of the extreme dilutions in homeopathic remedies, where I am sure even you would agree with me, there is no active substance in the remedy really, isn’t there? This aspect of succussion and potentisation of homeopathy remains a laughing point among scientists and medical professionals who believe that medicine should be evidence based.

I apologise for the stinging attack on homeopathy (and please do not take this personally). I am sure that homeopaths are good people. Afterall, you are doing this for the noble reason of curing patients. But please exercise common sense when advertising your beliefs in homeopathy. While there is no concrete, well conducted experiments that show homeopathy actually provides significant effects, homeopathy can only be considered as a complementary form of treatment, not main stream. It would be irresponsible and dangerous to think otherwise.”

And this is what he replied (all English are my translation; all colour changes and highlighting were from the disgruntled homeopath, to emphasise how pissed off he is with me I guess):

身在United Kingdom (英國)？碩士學歷嗎？

Living in the United Kingdom? Masters level of education?

原来你是在大學讀自然科學、為左研究一ｄ有人講係違反科學定論的事、你一定是看到那套以機械来講解順勢療法的可笑節目、所以就寫順勢療法不可信吧～

So you are at university studying natural sciences, researching a topic that some think is anti-science, you must have seen that laughable TV show which used machines to describe homeopathy, that’s why you are writing that homeopathy cannot be trusted.

我都有看過BBC那套節目、用機械去模擬人體・・・研究西薬就得。模擬人體的微循環系統・・・・真的可以的話早就有有血有肉的智能機械人啦～你以為西醫洗腎？你知唔知洗腎的病人因為依頼機械去洗血個腎會壊死架？你認為現在科學的進歩真的可以解析這個世界上的所有？

I have also seen that show by the BBC, which used a machine to mimic the human body… this can only be used to research western medicine. Mimicking the micro-circulatory system… if it is really possible, then by now we would have intelligent blood and flesh robots ~ And then there is kidney dialysis. Do you know that dialysis patients have damaged kidneys because of these dialysis machines? You think that modern day advances in science can deal with everything in this world?

你是為隨波逐流而跟隨那些講順勢療法不可信但無親身體驗過的消極科學家去寫？

Are you just following the words of those scientists who say that homeopathy is not trust-worthy, when they have not tried homeopathy for themselves?

順勢療法是安慰劑效應？

Homeopathy is the placebo effect?

那你有無膽得罪那班話順勢療法無效的科學家、和證明順勢療法有效的科學家一起親身證明順勢療法是有效？

Then do you dare contradicting those scientists who do not believe in homeopathy and come prove homeopathy with scientists who do believe in homeopathy?

再者、我不理會你信不信順勢療法、你可以永遠講順勢療法無效、騙人。

Then again, I don’t care whether you believe in homeopathy, you can forever say that homeopathy is useless, and is a scam.

我認識和使用順勢療法６年多、我媽媽的高血壓用順勢療法醫好、我的鼻敏感用順勢療法醫好、我朋友的媽媽的胃病用順勢療法醫好、我見過一個小朋友食西薬食到急性類風濕、行唔到、用順勢療法醫番好、識行識走。

I have known and used homeopathy for 6 years. Homeopathy cured my mother’s hypertension, it cured my allergic rhinitis, it cured my friend’s mom stomach trouble, I have seen a child taking western medicine and got acute rheumatism, couldn’t walk, but ultimately cured by homeopathy.

我感受過、體驗過、使用過順勢療法、我就是活生生的證據、證明順勢療法是有效的。

I have felt, experienced, and used homeopathy. I am the living proof, that homeopathy works.

如果順勢療法是安慰劑效應、那你不如問一問西醫能不能醫好鼻敏感、哮喘、糖尿和高血壓？

If homeopathy is the placebo effect, then why don’t you ask western doctors if they could cure allergic rhinitis, asthma, diabetes and hypertension?

西醫能不能不用做手術、化療和電療便能醫到癌症？

Can western medicine cure cancer without surgery, chemotherapy or radiotherapy?

西醫話得番幾個月命的癌症病人、運用順勢療法来治療他的癌症、現在已活了超過西醫所講的“３個月命“X２０倍、現在還非常精神。這是安慰劑效應？

For those patients who were deemed to only have several months left by western medicine, they turned towards homeopathy to cure their cancer, by now they have lived past the “3 months” that western doctors said they have left, and by 20 times more, and at present are still very healthy. Is this the placebo effect?

西醫“可　以　嗎“？

Can western medicine do this?

西醫能醫到大部分的病嗎？

Can western medicine cure most diseases?

記住、是“醫“不是“止“。

Remember its “cure” and not “relieve”.

你認為順勢療法不可信、

You think that homeopathy is not trustworthy,

你生於澳門、那你知不知道葡萄牙也有用順勢療法？

You were born in Macau, do you know that homeopathy is used in Portugal?

你在英國生活、那你知道英國的御用醫學是順勢療法嗎？

You live in England, do you know that the primary medical treatment for the Royal Family is homeopathy?

你知道這個世界有多少個國家用緊順勢療法嗎？

Do you know how many countries in this world use homeopathy?

你有没有認真使用過順勢療法来處理自己的病？

Have you tried using homeopathy to manage your own illnesses?

你有感受過比西醫折磨的病人来找我們時的痛苦嗎？

Have you felt the pain of those patients who turned to us after being tortured by western medicine?

你有為病人的痛苦、為病人的康服而流過涙嗎？為病人的病情而緊張過？

Have you ever felt pain for a patient, shed a tear for a cured patient? Have you been anxious about your patient’s disease?

你知不知道膽石和腎石是不用開刀或用什麼震散的？

Do you know that gall stones and kindey stones do not require surgery?

你知不知道腦溢血不用開刀也可處理？

Do you know that a brain haemorrhage does not require surgery?

你知不知道癌症根本不用做手術、化療和電療？

Do you know that cancer can be cured without surgery, chemotherapy or radiotherapy?

你知不知道醫學的基楚是整全營養學？

Do you know the basis of medicine is nutritionism?

天外有天、你讀得書多、讀大學、但有好多野你真係未見識過呀。。。

You have studied a lot, in university, but there are a lot of things that you have not seen…

I don’t know about you but I found this person amusing, funny, condescending, patronising, insulting, and downright “intellectually-challenged” at the same time. I had no idea whether to laugh, feel insulted or feel sorry for this person. All I said was really that he should be a bit careful when advertising homeopathy, and to not use his imagined short falls in conventional medicine to divert patients away from life saving treatments.

The BBC show he was referring to was the “Horizon” production where they showed on TV that homeopathic dilutions indeed have no (big fat surprise) pharmacological effect. The show is still on YouTube broken down into 5 parts (1, 2, 3, 4, 5). The “machine” he was referring to was a flow cytometer. The experiment did not attempt to mimic the human body, they were only trying to repeat the Benveniste “water memory” experiment (using histamine instead of IgG) in a more controlled manner. Flow cytometry was used as a high throughput method of quantifying activated basophils, in addition to the conventional counting methods. No Frankenstein stuff here, no intelligent blood and flesh robots, just good old science.

How very dare he accuse me of coming to a conclusion about homeopathy just because of one TV show. And for the record, I never knew about that Horizon production until after I read his reply. Subsequently of course I went off and searched for this show and watched it. Good show though.

For those of you who may have a better command of Chinese than myself, feel free to point out my mistakes in the translation. I promise I am not going to throw a hissy fit.

So would a rational medical professional or scientist talk like this in a seminar when someone questions his/ her work? There may be some sarcastic or snide comments, all to the amusement of the audience, but rarely more than that. Because that’s how science works, its discussion, being critical in order to improve on current thinking. But I am sensing a hint of extremism from this man, and that is worrying.

It is not everyday you see a full blown hissy from a “professional”.

Check out this title: “Ejaculation as a potential treatment of nasal congestion in mature males”. It is not a title for a male health magazine article, nor a female magazine for that matter! It’s not a sex advice article. It is an article which appeared in the medical journal Medical Hypotheses (2008 71(2) pp308). Who says scientists and doctors don’t have a sense of humour – or do they? This person is not joking! Sina Zarrintan, author of this fabulous piece of work, describes the shortfalls in the current treatments, decongestants, anti histamines etc. Decongestants typically act by stimulating the alpha adrenergic receptors in the sympathetic nervous system. One of the effects of stimulating the alpha adrenergic receptors is – nasal vasoconstriction, a constriction of the blood vessels in the nose and kaboom symptoms relieved.

However, alpha adrenergic stimulation is not without side effects – hypertension is one of them. Also prolonged use of decongestants may make the symptoms worse.

Then came the truly sensational observation – that male ejaculation too has an effect on the sympathetic nervous system. Put two and two together and you get the title of this ground breaking piece of medical drivel – masturbate to get rid of that blocked nose. This is truly up there with all the high-priority medical questions, no? This piece of news is already being brilliantly mocked and covered elsewhere, like here. There are no actual data in this publication, just a suggestion. But real data might be on its way on the comments in this blog post here.

But what I wanted to point out here is that in the next issue, of Medical Hypotheses, there was a response from a Mohammad Fakhree, with this title: “Ejaculation as a treatment for nasal congestion in men is inconvenient, unreliable and potentially hazardous”. He pointed out all the flaws with this method of managing a blocked nose – its unsafe (because having sex too much is linked to prostate cancer, apparently), it is not feasible to masturbate regularly several times a day for chronic sufferers, and apparently it is not “feasible” if the sufferer does not have a sexual partner (can you spot the problem with this statement?).

This is so trivial! Bickering and handbags over a blocked nose and giving yourself the ol’ “low five”. And these stuff gets published! True it gave me no end of amusement poking fun at it, but still.

Then I noticed something – the authors of both publications are from the same city in Iran, and very likely to be from the same institution! Which led me to think – is this a lovers’ squabble in the bedroom department that has boiled over just a tad?

“Nothing that is worth having in this world comes easy”

How great would it be if everything came with the click of a finger? But it doesn’t. The same goes for your health. It is something definitely worth having, so it doesn’t come easy. You need to work at it, somedays harder than others. When things get really bad, you might have to go through painful procedures, agonising pain for family and friends alike. And to cap it all off, sometimes, it just doesn’t work, and people die. Doctors cannot say why a particular procedure did not work, sometimes things are just incurable. He or she has got 30 other patients to see, so he or she moves on. This is where I think alternative medicine has the upper edge and why many patients claim it “works” when we all know they are taking nothing but sugar. It is because the patients “believe”. Consultation sessions in CAM (Complementary and Alternative Medicine) clinics are a lot more personal, a lot more lengthy, and a lot more patient (Hell because they do not have the patient load that real doctors have). That makes the patients genuinely believe that the practitioner cares for them. It’s comforting, it reduces stress, and coupled with that placebo pill, suddenly things appear to be so much more rosy. Almost like a “super placebo” effect (I hope this catches on). Then – check – another statistic that homeopathy can “cure” diseases.

But why are patients turning to CAMs in the first place? Watching a particular episode of Scrubs last night gave me a bang up idea. Conventional medicine is not “magical” anymore. It is simply not amazing anymore. The reason? Anyone can get all the information in bite size chunks on the internet. Everything from symptoms, to diagnosis, and to management of every disease imaginable is on the internet. When a doctor tells you so and so about what you have, you are not surprised anymore, because you already knew. All you wanted is that drug. If you could get it without prescription, you probably wouldn’t even have bothered to go see a doctor in the first place!

The respect and awe that patients have for doctors is gone!

And then there is the blame, when shit hits the fan (pardon my French), you can bet your bottom penny the finger is going to be pointed at doctors, and the media machine will go up in arms about it. But when things go well, no one gives them a pat on the back and admires what they had just done – they just saved a life, for God’s sake, give the guy a hug, or thumbs up! But no, instead, things “should” go well, because otherwise why are they paid to do their jobs?

Back to CAMs. People cannot get a lot of information on the stuff. Afterall there is not much real information on the stuff. Scientists are struggling themselves to find information and evidence of the stuff. So bang, it suddenly becomes mystical, it becomes interesting. Now couple this with the knowledge that your “friend’s wife’s mother’s sister’s husband’s” – high school mate was just cured of his cancer with, say, homeopathy. No surgery, no incision, no painful poison pumped into veins (chemotherapy), no going bald. Just pills, and a few chats. It’s magic! Now couple this further with the news that celebrities like David and Victoria Beckham, Bill Clinton, and even Her Majesty the Queen uses homeopathy. Well if they use it, it must really work! Because these people really know their science and medicine, don’t they? See where I am going with this? We can bitch and bitch all we want about the science and the evidence and the fact that these hocus pocus treatments are really in fact, bull-crap! But in the patients’ minds, is medicine evidence based? I don’t think so.

They need to have the respect and awe back for real doctors! I suggest this. Let’s clear out the internet and keep conventional medicine in the dark for the lay person. Let’s not tell the patients that drug X could have 15 side effects but only tell them – “Take this magic pill, it will make everything go away”. Is that what is required? A massive dumbing down of medicine? Because it seems like the more they know, the more they get diverted to “magic”, i.e., things they don’t know. The general public needs to shape up and start facing facts – Because nothing in life that is worth having comes easy. There is no easy way out when it comes to health and wellbeing. You need to put in the work, you need to keep disease at bay. There is no “magic” pill that will get rid of that lung cancer because you smoke 40 a day. It’s painful chemotherapy, surgery, hair loss, etc etc etc. There is no “magic” pill to rid that diabetes once and for all, you need to work extra hard, to keep on top of things.

Because let’s face it, when something sounds too good to be true, it most likely is not.

Having got quite interested in the subject of homeopathy and its crack-pot view of medicine, I did a simple search to look at the state of matters in and around my hometown, Macau and Hong Kong (both ex-European colonies). Did not take me long to find pro-quackery (in particular homeopathy) posts littered everywhere, and the most shocking thing is, no-one is making a stand! Doctors and scientists are keeping quiet. All post replies on these blogs of practicing homeopaths were of astonishment and awe at the magical wonder that is homeopathy. Sensing a niche (and also the argumentative side of me was getting antsy), I set up shop and proceeded to gently lay on a few truths about homeopathy. The “pseudoscience can kill” blog is here. I borrowed one of Professor Colquhoun’s figures (the distance from earth to sun figure) to make a point, hope he doesn’t mind. Mind though, it was properly referenced. One of the things which immediately got my back up was the outrageous claims from blog authors (which are either trainee or practicing homeopaths), and also the Hong Kong Association of Homeopathy (HKAH) website as well as the Macau Association of Homeopathy (MAH) website that homeopathy is superior to western medicine. They have their usual mumbo-jumbo of how it works, like cures like, succussion and potentisation, etc… but also the following phrase, which I find highly disturbing (the thing was in Chinese so I had to translate it; and in the interests of good scientific practice I have to hold my hand up and say now that this translation by yours truly may have some experimental bias in it and should be translated again in a controlled environment by several neutral people):

“…from the homeopathic point of view, the correct method of medical treatment should involve non-invasive procedures, and toxicity free remedies, to restore imbalances in the body, to strengthen the body, to strengthen the immune system, so as to minimise the negative effects that symptoms have on the body, but must not counteract the symptoms, and suppress the body’s self protection powers, for instance through the use of drugs to control coughing, emesis, inflammation and pain etc, doing so will inevitably lead to serious and dire consequences.”

I apologise for the excessive use of the comma, but that’s how Chinese is written. To minimise bias, I feel it is necessary to include all the commas. This seems to be a swipe at western medicine to promote their hocus-pocus beliefs and frankly I found that out of order. A closer read at blog posts by practicing homeopaths reveals even more shocking statements. How the future of medicine should be left with homeopaths, western medicine should be an obsolete method of treatment, that patients should stop using western medicine. The final straw was when I found a post hailing “success” that homeopathy is now “mainstream” medicine in Macau (they held a large conference apparently), and how Hong Kong should follow suit to avoid being seen as “backwards” and “closed off”. So I proceeded to poke the bear with a wee stick with this reply to his post:

“Hi. I am originally from Macau, but I am not sharing your delight in the “success” homeopathy is enjoying in Macau. It is scary that while homeopathy is not evidence based medicine, that practicing homeopaths like yourself will come out and say that homeopathy is better than conventional, evidence based medicine.

May I point out that homeopathy, at this moment in time, is at best only a fancy and expensive form of placebo treatment. At worst, it is life threatening, because of delays in seeking medical advice and diagnosis from trained medical professionals.

Finally, the only selling point of homeopathy – the lack of side effects, is simply because of the extreme dilutions in homeopathic remedies, where I am sure even you would agree with me, there is no active substance in the remedy really, isn’t there? This aspect of succussion and potentisation of homeopathy remains a laughing point among scientists and medical professionals who believe that medicine should be evidence based.

I apologise for the stinging attack on homeopathy (and please do not take this personally). I am sure that homeopaths are good people. Afterall, you are doing this for the noble reason of curing patients. But please exercise common sense when advertising your beliefs in homeopathy. While there is no concrete, well conducted experiments that show homeopathy actually provides significant effects, homeopathy can only be considered as a complementary form of treatment, not main stream. It would be irresponsible and dangerous to think otherwise.”

Note that I said “please do not take this personally”. I have read somewhere that trying to reason with a homeopath will always incur the wrath of the said homeopath (because someone who has the answers will try and debate with you). I got a reply to my (I must say fairly level headed) comment with what can only be described as “verbal diarrhoea” (you think homeopathy could cure that?). The guy went berserk and as if one reply was not enough, he came back on two other occasions to add to his emotional outburst. Obviously I hit a nerve there! His response was simply a whole list of questions to me and I was pretty sure he was crying while composing the said outburst. I could feel the emotion in the reply. There were font changes, colour changes, highlighting going on. This guy was properly pissed! I am still in the process of digesting all the Chinese thrown at me (I can read but not fast or fluent) and will formulate a level headed response to it soon. You’d think that a professional would at least try to reason and debate instead of throwing a hissy fit when queried and doubted? All I wanted to do was to induce some intelligent scientific debate, and this was what I got? Handbags?!