Jeremy Hunt – Show me the evidence!

October 6, 2012

Him again. Sorry.


Jeremy Hunt, Weymouth, 11 June 2010

The emperor reveals his evidence?

Jeremy Hunt MP, the current health secretary, has recently said that he would back a call for the legal limit for abortion to be cut from 24 weeks to 12 weeks – he also states that his decision to do this is evidence-based.

I don’t claim to have a particularly comprehensive knowledge of the medical/scientific evidence surrounding the time during pregnancy beyond which abortion is not safe/feasible/practical, but I have never seen any evidence that claims to back a 12 week limit. Certainly, it is clear in the 2006-7 parliament report into scientific developments relating to abortion[PDF] that no evidence appears to have been presented that supports a 12 week limit. Perhaps there is some new evidence I have not seen?

I would be very interested indeed to see the evidence upon which Jeremy Hunt has based his decision. So interested, in fact, that I have submitted a freedom of information request to the department of health so that I might see this evidence. Without this evidence I cannot possibly make an informed decision on this matter, so it is imperative that the evidence be made available for everyone to read for themselves.

I would also echo calls made on twitter that “There should be a legal requirement, any time an MP says their view is backed by evidence, they must publish said evidence.”

The department of health have until the 2nd of November 2012 to reply to my FOI request. Any and all responses I get will be blogged.

EDIT – 19/10/2012
Today Jeremy Hunt appeared on the Radio 4 Today program. He was asked by Justin Webb about where he got the evidence for his stance on reducing the legal limit for abortion from 24 weeks to 12 weeks, and on his views on the efficacy (or otherwise) of homeopathy. Hunt does a superb answer of answering almost any other question he can think of. He was pointedly asked what his evidence was, and where he got it from. He did not answer the question. You can listen to a clip of the interview here. As of today, I have had an acknowledgement from the DoH about my FOI request, but nothing further. They have until the 02/11/2012 to reply.

If Nelsons goods are banned from being imported into the US…

August 10, 2012

…guess which US homeopathy advocate is still flogging one of their products on his website?

UK based manufacturer of homeopathic remedies Nelsons have been severely reprimanded by the US FDA for a slew of manufacturing cock-ups. [ Quackometer | FDA letter to Nelsons]

Cock-ups include:

  • “glass fragments present during the manufacture” and ” in the Clikpak Assembly”
  • “one out of every six bottles did not receive the dose of active homeopathic drug solution due to the wobbling and vibration of the bottle assembly during filling of the active ingredient. The active ingredient was instead seen dripping down the outside of the vial assembly. Your firm lacked controls to ensure that the active ingredient is delivered to every bottle.”
  • “The dosing process has not been validated appropriately. Specifically, your surrogate validation study, “Medication of un-medicated pillules with (b)(4),” visually demonstrates the variability of the amount of (b)(4) for the pillules in one vial. Your firm lacks control of the variation for the amount of the active ingredient in the pillules.”
  • “Your firm does not have an established written program to calibrate/qualify the Perkin Elmer Clarus gas chromatograph (GC) at suitable intervals.”
  • ” Your firm did not calibrate and qualify the Jasco high performance liquid chromatography (HPLC) instrumentation adequately, in that there is no periodic qualification or evaluation of the pump, oven, injector, or detector. The “Use and Calibration of HPLC” procedure does not include criteria to define adequate calibration of the instrument.”

Basically – they don’t manufacture their remedies in a controlled and consistent manner, and they cannot monitor this because it’s homeopathy, there’s nothing to monitor they don’t maintain the equipment for doing so in the correct and proper fashion.

If this was a real drug company, the implications could be disastrous. If one in six packs of antibiotics was duff, you can bet that we’d hear about that and there would be huge fines levied all round.

One wonders if users of the duff batches of remedies noticed the lack of “powerful gentle natural effective” homeopathic active ingredient, and promptly complained to Nelsons about this?

This failure to adhere to best practice has landed Nelsons on the FDA red list [Link - scroll down to United Kingdom] – “Detention Without Physical Examination of Drugs From Firms Which Have Not Met Drug GMPs” – it seems (from my reading of this notice) that Nelsons cannot export their goods to the US, and if US customers officials discover people bringing Nelsons products into the US they are to confiscate the goods. This will clearly have a negative impact on their US exports, and Nelsons are clearly rather proud of their export success [Link].

NB. Nelsons also make the Prince Charles’ Duchy Orignal line of herbal remedies [Link - Warning - Daily Mail].

So, can Nelsons products be sold in the US?

I don’t know about the legal ramification about being on the red list, but I cannot find mention of a US based manufacturing facility. Indeed, the Nelsons website states that

Our range of products meet the appropriate UK and global regulatory and licensing requirements, and are made in our Wimbledon manufacturing facility which operates to Good Manufacturing Practice (GMP) and rigorous procedures. [Link]

Clearly the FDA might have something to say about the “Good Manufacturing Practice (GMP) and rigorous procedures”.

However, as Nelsons homeopathic products are manufactured in Wimbledon, UK, it follows that any Nelsons products sold in the US must have been imported. I don’t imagine that the FDA red notice acts retrospectively, but obviously, as we are repeatedly told that “homeopathy is exceedingly popular and therefore it must work” :) – one imagines that US stocks of Nelsons goods will soon run dry. I invite you to keep your eye on this page [link - warning - may cause nausea and temporary blindness ;)] to see when then this occurs.

Obviously, such a high profile and conscientious homeopath will ensure that the information on his website will remain up-to-date and entirely responsible. Moreover, given the concerns about the quality of Nelsons goods, one wonders if said homeopath will stop supplying them, to avoid the stigma of being tainted by Nelsons new-earned reputation for poor quality goods.

As relevant in 1677 as it is today….

June 12, 2012

…there is no greater folly than to be very inquisitive and laborious to find out the causes of such a phenomenon as never had an existence, and therefore men ought to be cautious and to be fully assured of the truth of the effect before they venture to explicate the cause

The displaying of supposed witchcraft by John Webster, 1677.

Relevant to real scientists, and to those quacks and charlatans seeking a mechanism of action for medicines that do not yet have a proven effect.

Blogpost: Should homeopathy be banned on the NHS?

March 20, 2012

A quickie about this poll:

Prof Edzard Ernst has said that homeopathy should not be offered on the NHS.


In a nutshell, it is an implausible modality which lacks robust scientific evidence to demonstrate:
A) that it works
B) how it works.

Application of Occam’s razor (still a valid tool in scientific deduction) suggests that it is nothing more than a highly ritualised placebo (see posts passim).

However, this poll in ‘Teh Grauniad’ has been worded (either accidentally or not) in a way to polarise opinion and push any undecided liberals (small ‘l’ – them who generally dislike banning of anything – myself included) in the direction of the ‘no’ button, and add to the popular fallacy/delusion amongst the altmed community that OMG THE SKEPTIKZ ARR FACISTS.

The wording Prof Ernst, should not be offered, is a much better way of posing the question, as it sticks to the heart of the matter without invoking any sort of totalitarianism amongst those that seek to only offer evidence-based treatment on the NHS.

I strongly believe that homeopathy should not be offered on the NHS, because it has not been conclusively demonstrated to work any better than a placebo. A cash-strapped NHS (whatever may become of it) should not be spending taxpayer’s money on stuff that does not work.

If people want to waste their own money on some of the most expensive sugar imaginable, that’s their own business.

Besides, this poll is nothing more than a “who can spread the word around their community fastest” competition, and irrespective if the outcome, is just an appeal to popularity.

University of Manchester! Y U host Psychic?

February 11, 2012

Why is a top five-rated UK university with recent Nobel prize wins for research staff hosting a Psychic Night at one of its conference centres?

Woo at UoM

I know times are hard in the HE sector, but UoM is an esteemed centre of learning, not some dodgy two-bit end-of-the-pier show.

At least the events page at the Chancellors Hotel has the sense to state that:

Theatre demonstrations are to be deemed for entertainment purposes only.”

Still, given that there is zero/zilch/nada/none credible evidence that there is “life after death”, or that certain people can communicate with the dead, should an academic institution with the credibility of UoM give oxygen to this brand of charlatanry?

Hat tip to @Andrew_Taylor for pointing this out.

Quickie – Homeopathy for Radiation poisoning?

April 27, 2011

Taken from here

A few quack websites (e.g. such as the one discussed here) have lept on the terrible events surrounding the earthquake and subsequent tsunami in Japan to make a fast buck off the backs of scared and vulnerable people.

This one is no better than the others, but it couches and prefaces the descent to batshittery with some sensible advice about emergency planning and what have you.

See if you can spot the odd one out in this list:

Having a preparedness plan should put in place now, not when you need to go to the store and purchase goods that the rest of the population is wanting also. Stores will sell out within hours in an emergency. Things to have on hand are;

  •  Bottled water and food for at least one week, preferably longer.
  • A camp stove and fuel to cook with.
  • Flashlights and extra batteries
  • Portable radio that is battery or crank operated
  • Access to a computer if possible.
  • Thin plastic sheeting, staple gun and duct tape to seal windows and doors
  • Extra fuel in case you need to leave
  • Dust masks and protective painters coveralls.
  • Potassium Iodide or Potassium iodate tablets
  • Homeopathic remedies stored in a lead lined film bag with information on how to use them.
  • Personal documents in a handy place and organized
  • A family plan that everyone knows – where to meet, who to call. etc.

Did you spot it?

The page then talks sensibly about some of the effects and symptoms of radiation sickness before plunging head first back into the woo, suggesting lots of homeopathic remedies for cancer. And fear of cancer.
  • Cadmium Metallicum – For stomach cancer. Violent vomiting, loss of appetite and emaciation. Bright red bloody diarrhea. Blood changes, anemia, problems in the intestinal tract. Fatigue and lassitude like in influenza. Dull ache all over. Concentration difficult. Fear of Cancer. Indifference, does not want to see people anymore.  Irritability alternating with deep depression.
  • Cadmium Sulphuricum –  Similar to Arsenicum Album. Cancer of the stomach. Persistent vomiting. Black vomit. Chief complaints are the stomach and breathing. Chilliness and cold even next to the fire. Restless. Gray complexion. Nause, retching with burning and cutting pains. Worse from motion.
  • Cadmium Iodatum – Very similar to Cad Met but warmer. The Iodine component brings aggravation from heat or extreme cold. A distinctive mental trait is hatred and a high degree of self pity.
  • Fluoric Acid – Affects the bones. Necrosis and bone decay. Deep acting in slow, progressive, destructive effects. Wants open air.
  •  Phosphorus – Affects mucous membranes, destroys bone, disorganizes blood and inflames nerves. Hemorrhages. Desires cold drinks. Suddenness of symptoms. Excitable and impressionable. Wants sympathy. Great fear creeping out of every corner. The human barometer. Profundly effects the nutrition and function of every tissue. Chronic effects of radiation exposure.
  •  Radium Bromatum – Effects nerves skin. Radiation burns. Destroys the nucleus of the cell. Severe aching all over. Pains suddenly shift, electric like pains. Joint pain and gout. Fear to be alone, wants company. Apprehensive, depressed. Cancer.
  •  Strontium Carbonicum – Effects the bones. Shock after surgery or loss of blood. Pains fleeting, can hardly tell where they have come from, felt in the marrow of the bones. Pains appear and disappear gradually also. Violent involuntary starts. Burning, gnawing pains. Great prostration. Anguish as from guilt. Angry, tendency to fly into a rage. Depression.
  • X-Ray – Low vitality, chonic fatigue and sick feeling. Cancer. Skin burns and lesions. Affects the blood, lymphatics and bone marrow. Anemia, leukemia. Sadness. Aversion to company.
It should go without saying that NONE of these remedies have any proven efficacy what-so-ever. The ‘potency’ is not mentioned, but it is worth repeating that there is no known mechanism of action for remedies that are diluted beyond 12C, i.e. those that do not contain any molecules of the original substance.
Another sickening example of people pushing unproven quack remedies on scared and vulnerable people, much like the ‘homeopaths without borders’ incursion into Haiti, following the earthquake there.

ASA swamped with complaints re: Homeopathy.

March 18, 2011

Quickie about a letter from the ASA to all who have complained about website with homeopathic levels of honesty.

As you may or may not be aware, the Nightingale Collaboration has co-ordinated a campaign to highlight and complain about some of the ridiculous and unsupportable claims that alternative medicine practitioners make on their websites – the current project is targeting homeopathy websites within the UK.

As someone who has complained recently about a homeopathic website or two, I recently received this bulk mail-out from the ASA:

Dear Sir/Madam


Thank you for your recent complaint.

As you may know, the Advertising Standards Authority (ASA) has received over a hundred and fifty complaints about over a hundred different websites for homeopathy.  Complaints cover a range of issues from specific claims made by individual advertisers to general concerns about the sector as a whole.  Because of the volume of complaints, we are sending this letter to everyone who contacted us on these issues to let you know what action we intend to take.

The ASA has an established position on claims that can be made, and those claims that are not likely to be acceptable for homeopathy, based on the requirements set out in the CAP Code and previous ASA adjudications.  Although we have not historically received many complaints about advertising for homeopathy, the Code has general requirements for substantiation of claims in the health sector and the Committee of Advertising Practice (CAP) offers specific advice on marketing health-related products and services. Further information about the requirements of the advertising Code is available on our website and from

We are seeking to enforce compliance with the Code even-handedly across the sector by contacting all of the advertisers we have received complaints about as well as the bodies that represent homeopaths and homeopathy in the UK.  We will be explaining the Code’s requirements, giving advice on how to ensure advertising claims do not breach the Code, and asking advertisers to remove any claims which do not comply.  More information about what that means in practice is provided in the CAP Help Notes on Substantiation for Health, Beauty and Slimming claims and Health, Beauty and Slimming Marketing Communications that Refer to Medical Conditions.  You can find these documents on our Copy Advice website, as indicated above.  Because the ASA has only been regulating websites since 1 March many of the advertisers we contact will not be familiar with us or the work we do and will need help and assistance from us.  For that reason, we plan to monitor compliance 3 months after making our expectations of them clear. We feel that this will give advertisers, some of whom are very small and have limited resources, sufficient time to make the necessary changes.

The ASA will not be publishing individual adjudications on this occasion.  We will however publish specific, up-to-date advice to the industry and its representative bodies in due course and we will work with them to ensure that advertising for homeopathy is compliant with the Code.

Thank you for taking the trouble to contact us.  While you will not see immediate results please be assured that we are working hard in the background to resolve the issues that have been complained about.

Yours sincerely

What do I think about this?

First off  it shows that the Nightingale Collaboration (NC) has been successful in co-ordinating a fair few complaints within the 2-and-a-half weeks it has been running this campaign – whether this number of complaints matches the expectations of the NC, only they know.

It would appear that the ASA recognise that UK-based homeopaths are often making unsupportable claims about the efficacy of their sugar pills on their websites – to such an extent that they are going contact both the complained-about homeopaths and their ‘regulatory’ bodies (ARH, SoH, BHA etc) about these breaches, and make them aware of the rules that they should be adhering too. If after 3 months they have not complied with UK advertising regulations – the ASA may take further action.

Whilst individual complainers may miss out on the satisfaction of seeing adjudications against the websites they have complained about – the end result should be the same – and in fact much more far reaching. This wholesale action against all UK-homeopaths (via their ‘professional’ bodies) by the ASA should ensure that they are no longer allowed to make outrageous claims about efficacy (or claim that they were unaware of the rules).

Provided the ASA take a suitably tough line with the homeopaths, and they ensure that the rules are adhered to, I think that this can be seen as a very effective first strike by the Nightingale Collaboration.

Homeopathic guide to “conflict of interest”

March 10, 2011

Skeptics of alternative medicine are often accused of being in cahoots with the pharmaceutical industry (the “big pharma shills” argument).
Here is a ‘handy-cut-out-and-keep’ guide to COI.

I could go on…

Homeopathic Suicide is Painless…

February 6, 2011

Ten23 day!

Today, as this blog is posted, I will be taking a massive overdose of homeopathic ‘medicine’.

Unless the laws of chemistry, biology and physics momentarily lose their grip on our reality, the only thing that will happen is that the sugar in pills will enter my blood stream, via my digestive tract, and give me a mild sugar rush.

The fact that these sugar-pills-dressed-up-as-medicine continue to be offered by persons acting on behalf of the (cash strapped and under funded) National Health Service, and are available from supposedly reputable high street pharmacies like Boots the Chemist is an affront to reason.

The ten23 overdose is not (and was never) designed to be a scientific proof of the lack of efficacy of homeopathy – we rely on tried and tested methods like meta analyses to do that for us – rather ten23 is a public awareness exercise.

Please be aware. “There is nothing in it”

If you feel moved to do so, follow @xtaldave for updates through out the day.

Psorinum therapy – homeopathy for cancer?

January 31, 2011

A quick look at another paper doing the rounds

There is an update to this blog post that follows the original post

These papers [1], [2](pdf) have recently been pimped around twitter by various homeopaths, apparently as proof that a homeopathic remedy can cure cancers, including the very nasty pancreatic cancers. Paper 1 (published in a sensible-looking oncology journal) is just an abstract from a meeting, and paper 2 (published in Evidence-Based Complementary and Alternative Medicine) is the actual paper with all the juicy details – but they essentially detail the same study.

Taken on face value, the results are pretty amazing, with 5-year survival rats of around 40% for patients with stomach, gall bladder pancreatic and liver cancers (paper 2, table 3).

Compare these with current 5 year survival rates for stomach and pancreatic cancers of roughly 12% and 2% respectively.

So, if kosher – these results would be a fantastic addition to the arsenal in the war on cancer.


… the studies were conducted without any controls whatsoever. The mind boggles. Why bother going to the effort of a 5 year study, and not including a control arm? Whether it be an ‘untreated’ arm, a placebo arm or a comparison against current best practices and therapies, a control arm would have increased the viability of this study no end. Even if they failed to recruit any more patients, and just split the patients into to two randomised groups with 20-odd patients in each arm, the power and impact of the study would be massively enhanced. To not control anything is just a massive fail.

This massive fail is then compounded by a failure of peer-review at eCAM. Did the reviewers not ask themselves where the controls in this study where? However, this was published in eCAM and this is clearly labelled as a prospective study – maybe I am being too harsh.

However, for those totting this paper as evidence for homeopathy curing cancer,  let’s make this absolutely clear: the only conclusions that can be drawn from this study are that the study is ultimately a waste of 5 years and is utterly meaningless in it’s current form. It should have been designed properly 5 years ago, and it should have contained some sort of control arm, and should have been properly randomised and blinded.

The authors are clearly aware of this and allude to it themselves in the final sentence of the paper:

“…randomized double-blind clinical trial, detailed molecular, pharmacokinetics,and pharmacodynamics studies should be conducted for further scientific exploration of this alternative cancer treatment to determine if it can be integrated into the mainstream oncology.”


It is perhaps telling that in this final sentence in the paper, that the authors mention “detailed molecular, pharmacokinetics,and pharmacodynamics studies.” That use of the word ‘molecular’ is the only appearance of the word molecular or derivatives thereof in the entire paper, maybe unsurprising given that this is a homeopathic study.

The wonder remedy that the researchers are testing out is ‘Psnorium’ – a homeopathic remedy made from the fluid from scabies blisters (yuck) – that apparently has indications for a large number of symptoms, including, “generalities; sensitive; to pain” – well, that rules out the ~48 people on the planet that suffer from CIPA, then…

Of more note to people with an interest in molecular mechanisms (myself included), is the fact that the dilution factor used in the study is only 6x. So, 1 in 1,000,000.

Wait a minute! That’s cheating! There is an outside chance that Psnorium 6x actually has “something” in it!

Let’s assume for a minute that the results are genuine, and Psnorium 6x has had an effect on these cancers. The fluid from scabies blisters will likely contain serous fluid – but depending upon the exact contents of the blister it could contain all manner of biochemical goodies.

Given that scabies blisters are apparently intensely itchy, there may be some histamine around. The fact that the scabies mite (a foreign object) has penetrated the skin, means that some sort of immune response will have been mounted, and therefore it is inconceivable that scabies blisters would not contain some cytokines or chemokines. Was the remedy prepared from crusted or normal scabies? Because patients with crusted scabies secrete higher levels of cytokines IL-5 and IL-13, and lover levels of IFN-gamma than normal patients [3]. Other studies have shown that scabies mites, or extracts thereof alter secretion levels of a whole range of cytokines:

Active mites on the surface of the HSE induced secretion of cutaneous T cell-attracting chemokine, thymic stromal lymphopoietin, interleukin (IL)-1alpha, IL-1beta, IL-1 receptor antagonist (IL-1ra), IL-6, IL-8, monocyte chemoattractant protein-1, granulocyte/macrophage colony-stimulating factor, and macrophage colony-stimulating factor.

So, biochemically speaking, scabies blister fluid likely contains some very interesting molecules, some of which may have an effect on cancer cells. Oral administration of Interleukins has been shown to have physiological effects in some studies, and cytokine therapy is an avenue being explored in the fight against cancer.

<Insert vaguely witty sub-heading here>

Let’s assume that the DBRCT has been done properly, and it shows a clear, statistically significant effect in cancer patients. What next? Would it be the killer blow that shows that skeptics have been wrong and homeopathy works? Sadly not – because of the likely presence of actual molecules of something. That being said, if there is an effect to be seen, it does at least give us the possibility of conducting an interesting experiment to test homeopathy:

  • Take the scabies blister fluid.
  • Give one-third of it to a homeopath, get them to make up their remedies as usual, with all the serial dilutions and succussion.
  • Give another third to a competent postgraduate student. Get them to make a 1 in 106 dilution of it, but without the homeopathic rituals like succussion.
  • Give the final third to a well-equipped, well-staffed biochemistry lab. Get them to fractionate the fluid by HPLC or FPLC, and then test the fractions for biological activity in a suitable assay, and identify the molecules present are responsible for the effect, (assuming it’s not some arm-wavy, unsubstantiated guff about the vital force or EM fields) they will presumably isolate one or more fractions that contain the molecules responsible for the therapeutic effect. These molecules could then be purified for trial in patients.

If only the homeopathic remedy recapitulates the results of the DBRCT, then homeopathy works. Elseif, science works, and someone just got lucky feeding diluted extract of scabies blister to cancer patients.



A blog post at Anaximperator that I was alerted to by a pingback is well worth a look as it contains a rather interesting graph from the conference presentation that was not included in the publications -

“Psorinum+Allopathy+Homeopathy” does not look significantly different from “Psorinum+Allopathy”. “Psorinum+Homeopathy” comes a distant 3rd. The authors of the study apparently didn’t think to include an “Allopathy” or “Homeopathy” alone group. Looking at this, I would suggest that psorinum gives little, if any, benefit above and beyond the conventional treatment that patients were receiving. You will note that the only group without conventional/allopathic treatment fared significantly worse than those groups receiving it. As the anaximperator author wryly observes –  “It appears that conventional treatment is necessary for homeopathy to work.;-)


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