Friday, November 19, 2010

Bloggers and Libel Law - Sense About Science

Sense about Science have released a guide to the libel laws written for bloggers and online journalists, titled
"So you’ve had a threatening letter. What can you do?”
You can download it for free from the Sense about Science website, here (.pdf).

The background to the document is copied below from the Sense about Science website:
This guide was prepared following Sense About Science’s recent survey of the impact of the libel laws on online discussion.

To coincide with the guide’s publication, Sense About Science is making available a summary of the effects of the English libel laws on bloggers, drawn from cases that have come to attention since the start of the Libel Reform Campaign and from the recent survey of bloggers. The summary identifies the particular ways in which online forums are affected by the current laws, notably:

* the individual and non-professional character of much online writing, and therefore the more pronounced inequality of arms, particularly where people are writing about companies, institutions and products;
* related to the above, the relative lack of familiarity with libel law and access to advice about handling complaints;
* the liability of ISPs, leading to material being removed without consultation with authors;
* and the vulnerability to legal action arising from the international availability of Internet material, and it being possible to republish old material by downloading it.

Reform of English libel law has been promised, and if campaigners are successful, then changes that will give better defences to online publishers and writers may come into force in 2012.

This leaflet is certainly not a substitute for legal advice, but it does provide information which other bloggers and writers who have experienced libel threats say they wished they had known at the outset.

The publication of the guide comes on the day that Yahoo!, AOL UK, Mumsnet and the Internet Service Providers’ Association (ISPA) are writing to the Prime Minister calling for urgent reform of our libel laws, and in the week where the summary of the effects of libel law on bloggers has been shared with the Ministry of Justice.


This is in conjunction with the blogpost earlier this month
"Mass Blog for Libel Reform"
which was headed up by Simon Singh, who was sued by the British Chiropractic Association for an article he wrote in the Guardian on the lack of evidence for Chiropractic. After much legal wrangling, the BCA eventually withdrew their claim but face legal bills of upwards of £250,000.

So, well done Sense about Science for producing this guide (and all the other organisations involved) - I hope I never have to read it.

Sunday, November 14, 2010

Is that your diet I can smell?

If you want to make money from a product for the masses, make it a weightloss aid.

Despite literally squillions of diets available, it appears that there is always room for another one, and the hoards of people, having lost money (but not weight) on a particualr diet, seem more than ready to transfer to the next thing that will present the opportunity of having a slim physique.

Losing weight isn't particularly easy - like most health advice, it broadly falls into "don't eat too much, don't eat crap and take some excercise", and because longlasting results will take 12 months or more, people get disillusioned and wander off looking for a quicker fix to weightloss.

As a result there is a market ready and willing to try any new way you can think of to lose weight. It may be a surprise to know that most of these fall into two categories -

1. Stuff you already know, packaged in a new way.
2. Stuff that requires will-power - i.e. doesn't do anything.
3. Stuff that will cock up your innards in some way while trying to achieve its purpose.

Some are clever enough to fit into two or more of these groups.

I've came across an example which hit the main stream media over the last few months, and I'll leave it up to you to decide which category it goes into.
"Crystals Use Smell to trick you into weightloss"
said the Telegraph in Nov 2010. A clear statement for fact, no room for discussion, cut and dried TRUE.
"The smells that help you to slim"
wrote the Daily Express in 2009, less certainly, but still no room for doubt.
"Can a spoonful of sprinkles help the weight go down?"
asked the Daily Mail in Aug 2009, offering yet another candidate for Dr*T's First Law.
"Smell yourself Well"
offered the Independent in Feb 2010, the headline editor pleasantly missing the point.

(Incidentally, these last THREE offerings were all penned by Hugh Wilson - he seems pretty good at selling dubious 'science' journalism to multiple papers having recently sold the story of how sitting down can make you ill to both the Independent and the Mail.)

The nub of the product is that it has a smell/flavour, you sprinkle it on your food and hey-ho the weight the drops off quicker than you can say "calories in needs to be less than calories out".

The product is called Sensa(R), and works on the idea that if you overstimulate your body with smells and flavour, it will thinks it's already full and your appetite will be reduced. You won't even want to touch that piece of crackling that's been sprinkled with something that makes it smell really good and taste even better.

The chap who is flogging this is Dr Alan Hirsh MD who seems to have qualifications and publications aplenty, and is the Director of the Smell & Taste Treatment and Research Foundation in Chicago. Admittedly, this is an organisation he founded, but nonetheless.

As always, the important point is: evidence. What are the claims? How are those claims tested and proved?

The website proudly claims:
NO OTHER WEIGHT-LOSS PRODUCT HAS SUCH EXTRAORDINARY CLINICAL RESULTS
and a graph showing clearly that the 1436-person clinical trial found that people on the Sensa(R) product lost about 35lb whereas the control group lost 2lb.

This is quite a big thing - usually when newspapers pick up a 'science' story, it is centred around a crappy piece of PR puff, with a trial of about 6 people (I'm looking at you, University of Bath) but this looks good.

In order to find out more about the trial, I went searching in all the usual places - Cochrane Library, Clinical Trials.gov etc, but couldn't find any reference to the trial. After spending more time on this than I probably should have, I had a lightbulb realisation - it wasn't a clinical trial, it was a "clinical study". Apparently, clinical studies *sound* like clinical trials, but they're different - from what I can gather - in that the study has not been verified, validated or approved by anyone or body, outside of Hirsch's own establishments.

So, perhaps then, despite the lack of clarity of the trial - sorry, *study* - the results may be published somewhere? Surely a website wouldn't claim it had 'extradordinary clinical results' without publishing somewhere? Of course not - that would be underhand, unscientific and very, very naughty. Dr Hirsh doesn't come across as the type of fellow just to run an unregulated, unvalidated, unapproved clinical trial and not publish the results.

The link on his website takes you directly to where the results are published, and he has listed this on his publication page
Hirsch, A.R. "Use of gustatory stimuli to facilitate weight loss." ATTD Abstracts, 2008, p. 39.

ATTD Abstracts? Not one I know - a little bit of googling yields that it is an abstract for the Advanced Technologies for Treatments of Diabetes Conference in Prague, Feb 2008. You can find and enjoy his abstract here (put Hirsch into the search box) and, from his website, spend some time cocking your head at the poster he presented (pdf).

Just to clarify this, presenting an abstract at a conference is pretty much open for anyone to do. I could make a copy of the Fallen Madonna With The Big Boobies by Van Klump and articulate how it can be used to cure genital warts, and may well have my abstract accepted.

(This is not to do with low standards, but more with allowing freedom of ideas. I accept my warts cure has limited scientific plausability but that's beside the point.)

So when he says he has 'published', he is not being untruthful, more he is (consciously or otherwise) conflating different levels of evidence - one (the abstract) which requires no questioning, no approvals, no testing, no explaining, no demonstration of data, no minimum levels of scientific methodology to name a few, and two (peer-review publishing) which requires many, if not all those things.

(As I repeat often, peer-review is still open to fatal flaws, but it's certainly better than nothing)

So someone has come up with a product, which contains ingredients currently used in food (so no need for pharma-style regulation), has managed to run an uncritical PR-campaign which has been accepted by many of UK's media outlets (with Hugh Wilson pushing his stories through), without ever having had to present even the slightest snippet of reasonable published evidence, despite claiming to have the most "extraordinary clinical results" of any weight loss aid.

How on earth can the system be so screwed up as to allow this to happen?

As far as a product that is sprinkled on food to overstimulate the senses to aid weight loss, I'm pretty sure I know what it smells of.

(Belated h/t to @kashfarooq)


BPSDB

Photo by Boaz Yiftach

Wednesday, November 10, 2010

Mass Blog For Libel Reform

Following on from Simon Singh's interview in the new Strange Quarks podcast (download from iTunes here), this blog is taking part in the Mass Blog for Libel Reform - here is Simon to explain:

“This week is the first anniversary of the report Free Speech is Not for Sale, which highlighted the oppressive nature of English libel law. In short, the law is extremely hostile to writers, while being unreasonably friendly towards powerful corporations and individuals who want to silence critics.

The English libel law is particularly dangerous for bloggers, who are generally not backed by publishers, and who can end up being sued in London regardless of where the blog was posted. The internet allows bloggers to reach a global audience, but it also allows the High Court in London to have a global reach.

You can read more about the peculiar and grossly unfair nature of English libel law at the website of the Libel Reform Campaign. You will see that the campaign is not calling for the removal of libel law, but for a libel law that is fair and which would allow writers a reasonable opportunity to express their opinion and then defend it.

The good news is that the British Government has made a commitment to draft a bill that will reform libel, but it is essential that bloggers and their readers send a strong signal to politicians so that they follow through on this promise. You can do this by joining me and over 50,000 others who have signed the libel reform petition at
www.libelreform.org/sign

Remember, you can sign the petition whatever your nationality and wherever you live. Indeed, signatories from overseas remind British politicians that the English libel law is out of step with the rest of the free world.

If you have already signed the petition, then please encourage friends, family and colleagues to sign up. Moreover, if you have your own blog, you can join hundreds of other bloggers by posting this blog on your own site. There is a real chance that bloggers could help change the most censorious libel law in the democratic world.

We must speak out to defend free speech. Please sign the petition for libel reform at www.libelreform.org/sign


BPSDB

Tuesday, November 2, 2010

A new strange type of Quarkery.

Strange Quarks is a new podcast that has entered the downloadosphere looking at the Ups and Downs of science-based politics in the UK, from the Top of science to the bottom of pseudoscience, with two charming hosts; Martin Robbins off of the Guardian, and Michael Marshall off of Righteous Indignation, Skeptics with a K, Inkredulous and co-organiser of next year's QED conference.

Martin kindly asked me to do a report for the first episode, which also features Simon Singh (whose battle against being sued for libel by the British Chiropractic Association was covered on this blog) and Simon Perry, a troublemaker for the legislators of nonsense.

My own report is in there too, and it is probably the campest piece of overacting ever to be seen by this blog. (To be mentioned on the Guardian Online website made it all worth it....)

The podcast is produced in conjuction with Pulse Project and the .mp3 can be downloaded from their website here or you could wait and get it from iTunes (should be up in a few days).

For those of you who prefer their content readable with links, rather than audible, here is a transcript of the report, which may be less fun without my squeaky mixed-up regional accent and intonations. Each to their own :)

--------
Who is responsible for responsible science journalism? An itchy case study.


Earlier this year, Professor Dorothy Bishop from the University of Oxford announced that she was launching a new prize for science journalism which she called the Orwellian Prize for Journalistic Misrepresentation. It would be awarded annually to the English-language national newspaper that has published the most inaccurate report of a piece of academic work.

“Why is science reporting in the media so rubbish?” you’ll probably have heard someone ask.

“That’s because scientists are notoriously bad at engaging the public,“ will no doubt come the media-savvy reply.

“They tend to talk in the language of dry research papers because publication numbers are all that matters”

“But journalists are so lazy they just print any old nonsense and rarely have any real comprehension of the science or its impacts”, someone will chirp, probably a scientist.

In reality, all of that and more is true, and a story which was run recently by a number major news outlets in the UK is perhaps a pretty good case study.

The cure with a sting: Eczema cream meant to soothe 'makes skin WORSE” – panicked the Daily Mail, the word WORSE was in capitals for extra effect.

Moisturisers can aggravate Eczema” warned the Independent.

Eczema is extremely common and can be pretty tortuous, so this news will be of interest to millions of people. Could this eczema cream really be making eczema worse?

According the articles, the research had been carried out at the Pharmacy and Pharmacology dept of the University of Bath and published in the British Journal of Dermatology. A respectable institution publishing in a respectable journal – any wonder this story was big. The University had put out a Press Release about the research and had kindly put it on its website, with the headline

Creams used to treat eczema could make it worse

The media outlets weren’t exaggerating – here it is from the horse’s mouth (or more accurately the horse’s owner’s mouth, if you want to stretch the metaphor beyond it’s elastic limit)

Incidentally a search for that exact phrase “Creams used to treat eczema could make it worse” comes up over 5000 hits in a google search, mostly syndicated news outlets. Given the media coverage of this story, this research must be top drawer, watertight stuff. I mean, the researchers wouldn’t allow their university to risk both parties’ reputations by putting out a press release which gets global coverage and could impact the treatment regime of millions of eczema sufferers, but was based on unreplicated, duff research? Would they? Can you hear an impending air of disappointment in my voice?

The cream in question is Aqueous Cream BP, a cheap emollient – which is a substance that soothes or softens the skin. It is a light moisturiser which helps stop the outer skin layer from drying out and becoming itchy and flaky. It’s one of the main treatments for general eczema, along with not scratching, avoiding environmental triggers and using steroid cream against more aggressive flare-ups.

The BP in Aqueous Cream BP means it is a British Pharmacopiea standard and anyone selling it must make it to the standard recipe. It’s basically an emulsion of paraffin and water, with some preservative. The emulsion is made using an ingredient called SLS a cheap and cheerful surfactant used in myriad household products, although SLS can be a problem as sensitivity to it is well known and can itself cause reactions which exacerbate the eczema. So perhaps this is why the “Eczema cream can make eczema worse”?

It would be valuable to know what the sensitivity of eczema sufferers is to this workhorse treatment, and given the numbers of people with eczema, it should be cheap and easy to run a test on a large random bunch of healthy-skinned and eczema sufferers, giving them either Aqueous Cream BP or an SLS free equivalent. Any questions?

Let’s have a look at the actual published research – it turns out the researchers in question Tsang and Guy didn’t quite do that:

First of all, rather than testing a large bunch of people there were 6 participants.

And they were all women.

And they were all aged 20 – 36 years of age.

Now perhaps in idle moment of fanciful daydreaming, I like to think that the population of the UK is entirely made up of 20 – 36 year old women and me, but sadly it isn’t.

So this sample is a long way from being representative, quite aside from the point that any study regardless of how rigourous, if done in 6 people is probably not worth a hill of eczema flakes on its own.

So what about the ratio of healthy-skinned people to eczema-sufferers on the trial?

Well they didn’t treat anyone with eczema, they only tested the cream on people with healthy skin. I hope I don’t need to embarrass both of us here by stating the gigantic flaw in research that doesn’t actually test the thing against the thing that you’re claiming it makes worse, but somehow that passed the researchers by.

The researchers also seemed to be doing funny things with the statistics. Each of the 6 women did the same test, twice on each forearm – so four results per person. They then claimed this meant their sample size was 6 times 4 - 24. Still not a large enough sample to carry much weight but that’s not the point. It’s like trying to find out people’s opinions and rather than asking 24 people, asking 6 people 4 times. The accuracy of the individual result should be better, but the sample size won’t change from 6.

So as a quick summary of the research, they concluded that SLS, an ingredient they didn’t control for, can make eczema, a condition they didn’t test on, worse in the population, despite only testing it in an extremely small number of young women.
To me , this is the worst kind of research – it’s trying to answer a question it didn’t ask, makes a very definite conclusion despite being incredibly weakly powered, and in actual fact doesn’t add any real knowledge to issue of whether of SLS is a problem in Aqueous Cream.

So the scientists did the research and came to a conclusion which was perhaps bolstered in order to make it to publication, the University took the conclusion and passed it through a media-friendlifier which perhaps bolstered it a bit more , the media outlets then passed it through a science-mangle which tends to bolster claims and suddenly 5000 websites around the world are informing their readers that the cream your doctor is prescribing for your eczema is making it worse!

OMG.

So to go back to Professor Bishop’s award for Journalistic Misrepresentation mentioned at the beginning – I don’t know who it would go to: The newspapers, The Journal, The University or the scientists themselves.
-------------

With thanks to @JoBrodie, @friendlylion, Sonya C, Stuart R & Peter for assistance.



BPSDB

Tuesday, October 12, 2010

Can you help the MHRA make sense of UK homeopathy advertising?


In August 2009 (that's 1 year and 2 months ago), a complaint seen by this blog went to the Medicines Healthcare Products and Regulatory Agency (MHRA) regarding a number of websites who were breaching the UK National Rules on homeopathic product advertising. (You may or may not know that there are a very limited number of homeopathic products which are allowed to claim benefits against therapeutic indications).

In some cases, the MHRA took action, with Boots, Nelson's, Neal's Yard and Holland & Barrett all being forced to remove therapeutic indications from their websites.

In the three months that followed, more complaints went in with little response, except an email in December from MRHA last year to say:
We are currently working on producing additional advertising guidance specifically for homeopathic products.
...followed by the sound of something being kicked into the long grass.

Today, a full year after the majority of complaints went to the MHRA, they have produced a draft document, which will be on their website soon, but you can download from here. Perhaps I'm being harsh, but doesn't read like it has been worked on for a year, more like a week.

To recap briefly, there a three homeopathic registration schemes;
1. PLRs - these registrations ran from 1971 to 1991 and allow products to have therapeutic indications, and are *not* covered by advertising regulations (see later), according to Medicines (Labelling and Advertising to the Public) Regulations 1978 (SI 1978/41).

2. Simplified scheme (HR license) - these ran from 1992 to 2006, and mean that homeopathic products could be licensed, but with no therapeutic indications.

3. National Rules Scheme - this is how new licenses are granted and may include therapeutic indication, but no efficacy needs to be demonstrated. It is 'hoped' that manufacturers holding PLRs will update them to NR licenses. (Fat chance, as the PLRs allow the manufacturers to claim all sorts of benefits according to the original license).

So you can see why there is some 'guidance' needed on the advertising.

This leads to all sorts of silly shenanigans - for example, Nelson's Coldenza, a homeopathic remedy for the relief of the symptoms of cold and flu, contains Gelsemium and has a PLR license, so can promote its therapeutic indications. Nelson's Homeopathic Gelsemium however, has a modern HR license, and so can't provide any indication for what it might be used for.

Nothing to do with evidence or efficacy, just a quirk of silly legislation.

The myriad complaints that were provided to the MHRA which helped prompt this document, were made because of the UK legislation and this is reiterated:
Only the information included on the product labelling registered with the MHRA, listed in Schedule 5 of the Regulations, may be included in advertisements for the product. No mention of a specific indication or therapeutic claims may be made.

Then, on top of page 4:
These restrictions apply equally to advertising on the internet. Product information, including sales material and any online purchase facility, may only be provided for licensed products.

So the MHRA are consulting on a document which has taken them over a year to form, which states that the some of the homeopathic products on sale must not include therapeutic indications and that these rules cover the internet. It also says that some may include therapeutic information, but give no idea as to which are allowed and which aren't. For instance (although this needs checking), Weleda Sulphur 30c can be sold with the indication for skin irritation, whereas Nelsons ClikPak Sulphur 30c can't. Both exactly the same product, i.e. sugar.

This means that AltHealth, WWSM, ChemistDirect, Express Beauty, Garden.co.uk to name a small few amongst the sea of UK homeopathic vendors are not adhering to the UK regulations and therefore appear to be breaking the law.

The MHRA don't seem too interested in dealing with them. Luckily, these products have no effect, and possibly the worst that could happen is that someone delays getting real medicine, but I can't imagine the MHRA being this lackadaisical about medicinal products that actually have an effect.

Annex 1B reminds us that
"Manufacturers and suppliers must not provide free sample(s) of a homeopathic product to any member of the public."
Who on earth would do a thing like that? *cough* Napiers of Edinburgh *cough*

Annex 1C of the document gives a recap of what Regulation 9 states as the rules of advertising (although these don't apply to the products with PLRs).
Regulation 9 provides that advertising to the public must not:
• give the impression that a medical consultation or surgical operation is unnecessary, in particular by offering a diagnosis or by suggesting treatment by post, FAX or telephone;
• suggest that the effects of taking the medicinal product are guaranteed, are unaccompanied by side effects or are better than, or equivalent to, those of another identifiable treatment or medicinal product;
• suggest that health can be enhanced by taking the medicinal product;
• suggest that health could be affected by not taking the medicinal product;
• be directed exclusively or principally at children;
• refer to a recommendation by scientists, health professionals or persons who because of their celebrity, could encourage the consumption of medicinal products;
• suggest that the medicinal product is a foodstuff, cosmetic or other consumer product;
• suggest that the safety or efficacy of the product is due to the fact that it is natural;
• might, by a description or detailed representation of a case history, lead to erroneous self-diagnosis;
• refer, in improper, alarming or misleading terms, to claims of recovery;
• use, in improper, alarming or misleading terms, pictorial representations of changes in the human body caused by disease or injury, or of the action of a medicinal product on the human body or parts of it.

Feel free to play "Regulation 9 Bingo" on your homeopathy site of choice, but remember that these regulations apply on one website but not another, they can even apply and not apply in the same shop.

To wrap this rather rambly and confusing post, the guidance document does provide some clarity on a very confusing and pretty laughable piece of legislation. With regards to a response, I think they could sharpen it up a bit and provide more information, but it's obvious that they are trying to disentangle a hairball, when it's clear that a more fundamental look at the legislation is needed.

I'll be giving them my view, and I'm sure they'd be very keen to hear yours.

(H/t to @zeno001 & @landtimforgot)


BPSDB

Wednesday, August 18, 2010

BLEACH: Chemistry v English (or "More Mineral Miracle Solution")

The story of 15-year-old Rhys Morgan's experience on a forum when he posted an FDA press release urging people to stop using Jim Humble's Miracle Mineral Solution is well documented - amongst others there is Rhys' own blog of course, and LizDitz provides a timeline history. The interview I did with Rhys for The Pod Delusion, which sets out the story and some of the human interest can be found here.

My minor involvement started fairly early on in media terms, but very late in Twitter terms! I had seen the hastag #bleachgate on Twitter and also references to 'MMS' and 'drinking bleach'.

As a chemist by trade who has (hopefully) gained some knowledge over the years, it sounded to me like someone was channelling the People's Medical Journal, aka The Daily Mail. Would people *really* be told to drink bleach for ailments, and worse still, actually do it?

After a bit of Googling, the story became clear, and indeed some hype and hyperbole had crept into what was otherwise a fascinating story.

I wanted to get a few thoughts (and maybe some chemistry....) into a blogpost to try and put things into perspective. This is not meant to piss on anyone's parade, but just to hopefully give some explanation as to how a story like this can evolve, and how it can suffer from distortion in the hands of the 'skeptic community' (ugh) just like any media outlet.

Firstly, a bit of chemistry and nomenclature (chemical names).

Like all bulk industrial chemicals, it has to start somewhere easy and reletavily abundant, in this case salt. Sodium Chloride (NaCl) is our friend - table salt, sea salt, rock salt, whatever is prety much all salt and necessary for us to live.

The salt is electrolysed to form Sodium Chlorate (NaClO3), which is a tremendously good weedkiller. 'Good' in this case meaning 'indiscriminate and powerful'. It was banned in EU in 2009, as its risk to humans outweighs its usefulness as a weedkiller, but it is still used extensively outside the EU due to its low cost.

To make sodium chlorite (NaClO2 or Miracle Mineral Solution as it is also called), Sodium Chlorate is reduced in a strong acid using a reducing agent (e.g. sulphur dioxide) to form Chlorine Dioxide (ClO2). ClO2 is explosive in >10% in air and difficult to transport, and so it is stablised making the solution alkaline and reducing the ClO2 with hydrogen peroxide to make Sodium Chlorite.

So there is the manufacturing process - sodium chloride -> sodium chlorate -> chlorine dioxide -> sodium chlorite.
The four products are very similar in structure, yet have completely different characteristics ranging from being necessary for life to being very toxic.

The websites selling MMS weren't advocating ingesting MMS (Sodium Chlorite). They were directing the user to mix it 1:1 with an acid (usually citric acid or similar) to form Chlorine Dioxide (ClO2). (Acidification to produce ClO2 is the standard industry practice for this product when it is used in cooling towers and industrial water systems as it is the ClO2 that is effective against slimes, moulds and bacteria living in the water supply, but as stated above, transport of ClO2 is difficult and dangerous, so Sodium Chlorite is transported to the site and acidified later).

So what about bleach? Bleach (as in household bleach for toilets) is Sodium Hypochlorite (NaOCl) made from the electrolysis of chlorine in brine. As shown above, these chemicals can look and sound similar, but have completely different characteristics. So when people use #bleachgate, they are (in my view, uninformedly) talking about Household Bleach (NaOCl) and not MMS, (NaClO2). Part of this is undoubtedly part of the Twitter hashtag thing of being able to encapsulate a story in as few precious characters as possible, but IMHO, the end result was a tabloid affair, that I would have railed against had it been in any of the main stream media outlets.

So where did the 'bleach' meme come from? The FDA press release is the answer - it describes the product as "an industrial bleach" and "a potent bleach used for stripping textiles". (I have no idea what stripping textiles is). The FDA is correct is saying it is *a* bleach, but that's not the same as saying it is 'bleach', because bleach already means something in people's minds and they use it as a pretty potent chemical for cleaning loos. For instance, everyone knows that lemon juice can bleach your hair - go out in the sun with lemon juice in your hair and it will bleach. It is *a* bleach - I should be able to drink some quite happily without being accused of 'drinking bleach'.

And what about the 'drinking' part? The websites advocate 'a few drops' - Jim Humble's own website states:
Begin with taking one drop of MMS each hour for at least 10 hours a day. The drop, of course, must be activated with 5 drops of lemon juice or 10% citric acid. You wait 3 minutes and then add 1/3 glass of water or juice and drink that. Do this every hour for 10 hours straight each day
.

So clearly 'drinking bleach' is not what is being advocated and not what Jim Humble (the supposed MMS guru) has divined - because it is neither being drunk nor is it bleach.

What about the concentration of ClO2 in the final dose? How does that compare with FDA guidelines? Time is not allowing me to do this as accurately as I'd like, so there may be mistakes in here (please correct them if you spot them).

MMS is sold as a 28% solution - I'm going to assume this is by weight, i.e. 28 g in 100 g of solution, I'm also going to assume the density of the solution = 1 g/cm3.

The users are told to use citric acid (in excess, so the amount doesn't matter) to produce the ClO2 – citric acid is a strong enough acid to do this. 28 g of NaClO2 in 100 ml is 0.25 mol (RMM=110), which means there is 2.5 mmol in 1cm3. Assume 20 drops in 1 cm3 (I think this is standard), which means each time you take the MMS you are getting 0.125 mmol of NaClO2 and hence the same of ClO2. This is then added to 1/3 glass of water or juice (I'm assuming that's 100ml, so you have a solution of 0.125 mmol of ClO2 in 100 ml, or 4.69 mg in 100 ml, or indeed, 46.9 mg/l. Compare this with the FDA limit of 0.8 mg/l and you'll see that Jim Humble is recommending about 60 times the FDA limit, and that this is to be taken every hour for 10 hours.

"The dose maketh the poison" as someone wise and important pointed out. Despite the fact that most people reading this blog have ingested ClO2 at some point (swimming pools, drinking water etc) it is still a completely crazy situation where someone is suggesting taking ClO2 in the form prescribed by Jim Humble. This is out and out quackery at its highest level - a huge amount of risk and absolutely no reward possible.

The story of Rhys' treatment on the Crohn's Forum website is indicative how alt-med react when presented with scientific facts, and that this is a product which the ASA, MHRA, and Trading Standards should all be made aware of - I can't really imagine it being banned, but at least controlled somehow and the people making the nonsense claims given a penalty.

So in my view, the story is fascinating, from lots of angles, but most importantly the complaints are valid and worthwhile, even if somewhere along the way, the Twitterati hyped the story to the point where it might have been quite at home in the Daily Mail.



BPSDB

Friday, August 13, 2010

Pod Delusion: Miracle Mineral Solution

Here's this week's episode of the Pod Delusion, which contains a short interview I did with Rhys Morgan, who got thrown off the Crohn's Forum website for posting an FDA Warning about a product called Miracle Mineral Solution which had been promoted as a suitable treatment for Crohn's diseases on the site.




You can read more about the story at Science Based Medicine, NoodleMaz, PodBlack (and lots of others) and follow Rhys' story on his own blog at TheWelshBoyo.

(I think it's worth mentioning, James O'Malley kindly upgraded my humble PhD to that of a medic on the podcast - I'm not a medic & wouldn't want to suggest that I am.)

Sunday, June 20, 2010

Just Skeptics - Episode 5 - Research, media and beeeees

Episode 5 of Just Skeptics can be downloaded from here - this is a relatively new offering from Greater Manchester Skeptics , and has yours truly as guest host, blethering away on this and that, but also getting a bee in my bonnet about dubious research, on the section they call The Soapbox.

You are free to download the podcast from the link above, or in case you prefer your Soapbox in word form, here is the transcript:

I have a number of soapboxes, which come out from time on time on different matters. In a way, that was why I started writing my blog, Thinking Is Dangerous. ( Shameless plugging is not something I object to)

My major blood-pressure raiser is to do with research. Not any research, a specific kind of research. The sort of research that allows a journalist to write an article on it, but completely overstate or invent the results with the result of a grossly ill-informed public.

I’m not talking about the crazy boffins that have come up with equation for sexiest walk or the equation for the perfect Christmas dinner – they are just empty PR puffery; easy to point out and ridicule, and apart from eroding the public’s trust in science, do little damage.

No, I’m talking about the more insidious research. The little paper in the little journal with the BIG press release, that fools proper journalists – sometimes even the specialist science ones. The result is zero advancement in the knowledge, but a home win for misinformation of the public.

These are the stories where you have to go back to the original paper, and then compare it to what has come out of the science-mangler (every good news room has one). The result is usually a story with an attention-grabbing headline and narrative, all presented as fact and wonder. In some cases, but not all, the puppet-strings of PR can be seen in the shadows (usually paragraph 4) but often even these are fine and subtle, giving the impression that the marionette story is alive, dancing by virtue of its own newsworthiness.

Let me give you a few examples.

I keep bees. I own one of the estimated 80,000 beehives currently in the UK.
Bees are incredibly fascinating animals. Everything they do is interesting – for instance, They are a matriarchal society - all the worker bees are female and can sting. As the sting is a modified egg-laying organ, the male bees – or drones – can’t sting. The lucky drones manage to mate with a virgin queen, only to die quickly after as their penis and abdomen is ripped out after sex. The unlucky ones are kicked out of the hive in Autumn as they are a drain on valuable winter resources, and so become bird food. A vision of the future, laydeez?

Anyway, the bees provide mainly honey, as well as some wax, a sticky resin called propolis which the bees use to make their hive wind and waterproof and a few other smaller products. All of these products have a value and so they get marketed. And this is where things get interesting.
For two reasons;

Firstly, Bees and honey are a marketeer’s dream: a natural product with a heritage that goes back thousands of years (Judges Chapter 14 in the Biblical Old Testament tells the story of Gideon eating honey that he found in a lion’s carcass – you should read it, he goes on to murder 30 people and gives his wife to his best mate a week after the wedding – surely a sound moral tale if ever there was one?). Sorry, I digress again. Honey is a natural product with a long heritage, it is sweet, tasty, has antimicrobial properties due to the high sugar-low water content (that’s why honey never goes off, or mouldy) and has a reputation for curing all manner of ailments.
Secondly, the apocryphal quote from Albert Einstein saying that if the bee was to disappear from the earth, mankind would have less than four years to live have elevated bees to a bellweather status where everyone wants to show that their personal antichrist is what’s killing the bees (Einstein probably didn’t make the statement and it’s probably not true, but enough people think it is for it to make good copy).

So we have the natural cure all on one hand, and the apocalypse cause on the other. I’ll briefly give you an example of each.

Firstly, the life-giving curing properties of honey. Example: Life Mel Honey. An Israeli honey on sale in health food shops (and indeed Harrods!). The UK website is very restricted in what it claims – teh Cancer Act 1939 ensures that’s the case, but of course testamonials are different. A quick search on the Daily Mail website (a standard place for this type of drivel) reveals a testimonial from a poor chap who found Life Mel helped him through his chemotherapy and his cancer. The connection between honey and cancer cures is made. Next testimonial? Oh, look Kylie Minogue buys it from Harrod’s. The connection to cancer is made from previous articles and in the reader’s head, not on the page. Very cute. Of course it is clinically proven to help with chemotherapy – the webpage links to a study published in 2006, consisting of a test, where all 30 participants were given the honey (small sample, no placebo, no blinding) and as a result showed it helped patients avoid neutropenia, a complication of chemotherapy. In 2008 I spoke to David Fox, MD of HolyWell Health the main importers of Life Mel honey into the UK, who assured me that a secondary large scale trial would be published imminently and will no doubt show its magical effects. No research has been since been published, that I’m aware of. But that doesn’t matter, it already has a name for itself, with Kylie leading the charge. Those going through the tough times of chemotherapy are encouraged to relieve themselves of their money., with no real discernable benefit.

The second example was published more recently in The Telegraph and other newspapers that Mobile Phones are Responsible for the disappearance of bees. Firstly, we don’t really have a problem with the disappearance of bees in this country – in the US there do seem to be issues, but here in the UK we’ve above average losses for a few years, but that appears to be back on the decline (regression to the mean, if you will). 10% of bee colonies die out during winter due to food issues, disease, predators etc . We have increased instances of varroa mite, a nasty little blighter that can be destructive, but is treatable. Still, there is a section of the press that for some reason want scientific proof that modernity is bad – science, electrosmog and mobile phones versus the natural bees whose life is endangered by our advancement. As it turns out, the research was done on 4 hives by strapping a mobile phone to it and ringing it every so often. Any beekeeper would have laughed his beehat off at that – you can treat 4 hives exactly the same and get 4 entirely different colonies; bees are far too interesting and complex to demonstrate homogenous behaviour.

The research was completely pointless, and indeed Ian Douglas (Science writer at the Telegraph) blogged about how this story from his own paper was non-research. No matter, the damage was done and round the UK and further afield, a new cohort of people now think that mobile phones kill bees. The problem is, they may, but this silly research does absolutely nothing to find out whether they do. Just misinform.

For the summary, I’ll give you Ian Douglas’ final line:
“Panicked flapping around and hasty surveys masquerading as genuine, deliberate, reasoned science won’t get us anywhere.”

He’s right – and there’s probably some research to prove it.


Links for the story:

The Bee Stories:

Life Mel Honey - wiki page - My blogpost

Telegraph article on phones & beehives(by general correspondent)

Rebuttal by Telegraph blogger Ian Douglas


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Thursday, April 29, 2010

Podcast Pimping: Righteous Indignation

So, I'm pretty much a politician right now - previously apologising for something bad I did (in this case, pimping podcast rather than proper blogging) and saying how it will improve in future, and then, pretty much doing the same thing again.

This time I'm on this week's Righteous Indignation podcast, with Trystan Swale and Gavin Schofield. Normally, Hayley Stevens presents and without her gender balance there was a risk of it becoming unbalanced and blokey. Might have ended up with an overcompensation.

Hayley did the editing, removing all my idiosyncratic 'ums' and 'ers', making me sound almost coherent - I mean, how else would you explain the comments on this? :)

T


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Monday, April 26, 2010

Podcast Pimping: InKredulous


Another enjoyably self-indulgent pimp for my whoring around various podcasts - this time, InKredulous - the skeptical panel-game-style podcast from the Merseyside Skeptics Society.

On this episode were:
Rich Smith – Chief Editor and writer at Newsarse.com (@newsarse)
Brian Thompson – Writer and producer of the Amateur Scientist comedy show (@AmSci)
Trystan Swale – Co-presenter of the Righteous Indignation podcast (@ripodcast)

and me.

Having listened to the edit, I think the four or us have a pretty good shot at comedy (it was certainly tremendous craic recording it) - if you can abide me laughing like a chipmunk, usually at my own gags :/ then I reckon you'll enjoy the podcast.

You can download the whole thing from here.

I know, I know, where are the blogposts? Where is the incisive cutting-edge doggedly-determined investigative journalistic blogposts that were supposed to cover these garish pages? Well, I can only offer apologies and excuses. Time is getting the better of me these days, but hopefully soon there'll be more fun and games for your enjoyment.

T


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Friday, April 16, 2010

BCA drop libel case against Simon Singh - oh, you already knew.....

It all happened yesterday and everyone had toasted, cheered, laughed, tweeted, smoked and cajoled before you could say "chiropractors promote bogus treatments without so much as a jot of evidence."

As it was my birthday, I was drunk.

So, in the time-honoured fashion of the stable-closing post horse, I'll direct you to fuller reports:

Jack of Kent
Neurologica
Skeptic Blog
Zeno's Blog (With reference to Chiropractic awareness week)
Bad Science



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Thursday, April 1, 2010

Simon Singh wins libel appeal!

News just in, Simon Singh has won his appeal hearing for the right to rely on the defence of 'fair comment'.

I reckon the BCA will cave very soon......(some might suggest that the BCA happily promote bogus lawsuits, but I wouldn't say that, of course).

BBC report

I'll put the full ruling up once it becomes available.EDIT it's here

EDIT: British Chiropractic Association's response can be found here (pdf). It won't surprise you to read that it is full of slippery talk and transparent nonsense.

EDIT: All your Simon Singh story details can be found here, via the Jack Of Kent blog.





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Tuesday, March 23, 2010

MHRA powerless to stop unregistered medicines being sold in UK

Artrosilium is an unlicensed, evidence-free, bullshit-claiming arthritis therapy. A recent email exchange with MHRA shows it is powerless to stop Artrosilium being sold in the UK.

Artrosilium has been a regular guest on this blog. It is an 'organic silica' gel which the sellers claim can treat arthritis, eczema, psoriasis, verrucas, various skin irritations, haemorrhoids and even prostate problems.

Of course, in the true nature of dodgy products, there's no need to prove any of the above claims - if you're flogging duff medicines and flouting the UK laws then bullshitting about your product's ability won't cause much moral panic. The product was deemed a medicinal product in 2001 by MHRA but is not licensed for sale in the UK.

This blog has featured 5 blog posts on artrosilium, originally on a tip-off from Ben Goldacre on the Bad Science forums; The UK is Unregulated in 2008 introduced Artrosilium and how the MHRA were able to get the company to amend its baseless claims. However, even though the website was a .co.uk domain, this didn't count as a UK presence, and so they were powerless to go any further. The second post in July 2008 looked at The Business Model of Quackery, showing how to get round the pesky UK legislation that stops rogue traders selling unlicensed medicines to unsuspecting (and often vulnerable) people. The third mention was on the 1 year anniversary of this site in Sept 2008 and detailed the involvement of Members of Parliament to get www.artrosilium.co.uk closed down. It now redirects to www.artrosilium.com, which is safe from the meddling hands of the UK authorities, and has stayed that way since Aug 08, as The Wayback Machine will testify. The last 2 posts (here and here) centred on Intramed's disregard for the Advertising Standards Authority, by continually putting unsubstantiated drivel and bullshit in their adverts for their quack products. (Indeed, they are still at it - there have been 10 ASA rulings against Intramed in the last 3 years, the most recent one in March 2010 - This to me indicates a company which doesn't give a rat's ass about advertising, safety or legislation. But you can buy their 'medicines' of you want to - I can't believe anyone would be crazy enough to.)

As a result of this infatuated blogging, this site now comes up 2nd on a Google search for 'artrosilium', and 40% of the keyword traffic to this site is associated with either artrosilium or IntraMed.

As a result, even though the above blogposts are quite old, new comments are still made, often from people who have among other things tried it, been conned by it and been wary of it.

At the tail end of last year (2009), a chap called GrimsbyLad scanned in and emailed an Artrosilium mailshot to this blog, offering a free sample of the product, as well as 11 pages of the usual nonsense of claims like 'guaranteed arthritis relief'. It seemed like a good time to have another crack at the MHRA and trading standards and so dialogue was opened and the email conversation has been sent to this blog for coverage.

The first reply came in late November 2009, which stated:

The product Artrosilium was classified as a medicinal product by the MHRA, in December 2001. It is manufactured in France and has been sold by both Bodywell SA and IntraMed Ltd operating from outside the EU. In both cases the business set-up has rendered enforcement action under medicines legislation through the courts, impossible. There are several other products involved as well, as you will have seen from the ASA adjudications, and other Agencies have experienced similar difficulties in bringing complaints to justice.
For this reason, the MHRA, alongside certain Trading Standards Services, has referred the matter on to the Office of Fair Trading. Your e-mail and the attachments have been forwarded to them also.
My bold. That's a pretty big admission from the organisation in charge of licensing medicines in the UK to say that due to the way company has set itself up, it is no longer able to come under the MHRA's jurisdiction.

The MHRA were then prodded for an update in March 2010, 4 months later. Surely, having noticed that it is possible, by setting up your business in a certain way, you can circumvent UK legislation, the MHRA had made strides to close the loophole?
Unfortunately, OFT have declined to investigate the activities of Intramed. The MHRA and the Trading Standards Service are making a combined effort to exercise some control over the company's agents in the UK but, you will recognise, Intramed are well aware of the advantage their Hong Kong status confers in terms of the regulations.

No explanation was given as to why the OFT have declined to investigate - one hopes that it is because the public are savvy enough to see the product for what it is and that even a cursory investigation into IntraMed sets alarm bells ringing, and so the number of people suckered by this company are few.

The point however remains - if you set your business up correctly, you can sell unregulated medicines into the UK with impunity. And that's according to the people responsible for licensing the medicines in the UK, the MHRA. That, to me, is a breathtakingly dangerous situation to be in.

I have a feeling this won't be the last blogpost on this site about Artrosilium.


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Tuesday, March 9, 2010

Righteous Indignation Podcast

Just a quick note to say I can be heard jibber-jabbering in this week's Righteous Indignation Podcast, self-appointedly standing in for Marsh. First 'live' podcast I've done, and in fairness I could have benefited from a whisper less Dutch courage and ounce or two more coherence.

Still, the edit is kind, and you can hear Trystan Swale, Hayley Stevens, Gavin Schofield and myself discuss skeptical news, ghosts and interview Rose Shapiro, author of "Suckers: How Alternative Medicine makes fools of us all" here (download).

It was great fun to do - thanks to the RI team for the opportunity.



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Thursday, March 4, 2010

HA! Ha! Nelson's Natural World forced to change website by MHRA


Hot off the heels of the 10:23 campaign and the UK Parliamentary Science & Technology "Evidence Check" on homeopathy, a major UK supplier of homeopathic products has been investigated by the MHRA Enforcement Division, and forced to make website changes.

Nelson's had previously stated that their homeopathic product 30c Sulphur
is known amongst homeopaths for its many skin benefits.


This is, of course, not in keeping with the UK legislation on homeopathic products which says that homeopathic products not licensed under the EU's National Rules Scheme must not provide therapeutic indications but bear the legend:
“This is a homeopathic medicinal product without approved therapeutic indications.”

The website now looks like this.

Of course Nelson's know that therapeutic indications are not allowed when selling or marketing homeopathic products, and yet didn't seem to have an issue with disregarding the legislation. I know they know this, because in the UK, there is only one homeopathic product licensed with the MHRA under the National Rules Scheme which is allowed to state therapeutic indications - guess who it's made by? Indeed - Nelson's. Their Arnicare 30c Arnica was licensed by the MHRA last July, some 18 months after the application by Nelson's.

I would have thought that a homeopathic pill supplier, such as Nelson's, leading the way in the industry by providing the necessary documentation over a period of 18 months to the MHRA, would have known the legislation pretty well and known that selling homeopathic remedies with therapeutic indications is not acceptable in the UK. Seems not - it's very tempting to suggest they knew *exactly* what they were doing, but with the UK's libel laws as they are, I'll not be making that suggestion.

In reality, the new website is an example of silly, pointless legislation. On one hand, Nelson's aren't allowed to describe any symptoms that the sugar pills are supposedly an aid for, but must state:
"If symptoms worsen or persist, consult a doctor"

Symptoms? What symptoms? I can't say, but take these pills until they clear up!

In any case, Nelson's are in good company - a similar event happened in Oct 09, when Boots were similarly forced to amend their website in accordance with UK legislation. Indeed, an email I've seen from the MHRA says that due to the number of 'non-compliant' websites, they will be releasing a guidance document on the advertising of homeopathic products. I wouldn't hold your breath though, it's taken them 4 months to get Nelson's to change their website, imagine how long a document will take....


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Monday, February 22, 2010

"Come in homeopaths, your time is up" - MPs urge Government to quit funding homeopathy


And about time to.

The UK Parliament Science & Technology Committee today published their 'Evidence Check' into homeopathy.

Lots of blogs and news outlets have been tiggerish with excitement and covering this excellently, so no need to repeat it all here - XtalDave has a good roundup of the blogs covering it, but suffice today the report (.pdf here) concluded that the NHS shouldn't fund Homeopathic hospitals, that the theory behind homeopathy was 'weak', that homeopathy trials have shown it is no better than placebo (very different from there being no evidence), that homeopathy decreases patient choice, and that homeopathy advocates cherry-picked the data they presented to the committee.

Pretty much what this and other blogs have been saying for some time.

So, instead of providing sharp, insightful, thought-provoking analysis of the event, I've settled on a sub-Jagoist cheap laugh based on a weedkiller. Ta-dah!



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Friday, January 29, 2010

The Pod Delusion - 10:23 campaign



Just a note to say that I've got a bit on The Pod Delusion this week (see above or download from here) blethering about homeopathic labelling and registration. (I know, pretty raunchy, huh?)

Please don't leave any comments about my voice making me sound like a dick - that is already an established fact.

The last two words on my bit were in response to Skeptic's With A K podcast - episode in question here. Please add SWAK podcast to your list of weekly podcast downloads here.


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Sunday, January 24, 2010

Why homeopaths should support the 10:23 campaign.

You may have already come across the 10:23 campaign, a project that aims to raise awareness about the reality of homeopathy coordinated by the Merseyside Skeptics Society.

At 10:23am on January 30th 2010, more than three hundred homeopathy skeptics nationwide will be taking part in a mass homeopathic 'overdose' in protest at Boots' continued endorsement and sale of homeopathic remedies, and to raise public awareness about the fact that homeopathic remedies have nothing in them.

The campaign has been picked up by a number of media outlets - The Independent here and here, The Telegraph, The Times, The Observer, and, hilariously, the Daily Mail. (The Daily Mail got so confused with the big numbers associated with homeopathy, that they managed to inflate the NHS homeopathy budget by a factor of 1000. Basic editing has never been the Daily Mail's strong point).

There has been a backlash (of sorts) from the homeopathic community regarding the campaign, along with the standard name-calling that comes from proponents of alternative medicine any time it is criticised.

But why?

The campaign centres around Boots, the high street pharmacist. Boots is selling homeopathic products (own brand and branded) of varying dilutions, from various mother tinctures, with no restriction on amount to any old Horace, Jocasta or Gyles.

One thing that skeptics and homeopaths can surely agree on, is that this is not how homeopathy should be available.

Some skeptics would say that it shouldn't be available at all, whilst others would say that buying sugar pills isn't illegal and providing homeopaths don't make any claims as to its (lack of) effects, then caveat emptor.

Both sets of skeptics would agree that Boots should be propounding evidence-based medicine and selling pharmacy and health products which have a proven efficacy and safety record. Selling magic sugar pills based on 18th century silliness is not what a respectable Pharmacist should be indulging in.

Homeopaths, on the other hand, like to espouse the benefits of homeopathy as a 'holistic' philosophy, treating each person as a unique individual. The symptoms of having a cold are nothing to do with the cold virus that settled in your shnoz and reproduced at a rate of knots. No. It's to do with dis-ease and having an imbalanced immune system, and perhaps a poor mental state. For instance, see this on the Alliance of Registered Homeopaths' website:
Homeopathic medicines are chosen to treat the whole person, because homeopaths believe the mind and body operate as one, and you cannot treat one part of the body without affecting the whole. Medicines are chosen to fit all the characteristics of the patient, so physical disorders are considered in relation to the individual’s mental and emotional state.

The HMC:21 website states that:
It should be emphasised, however, that homeopaths base treatment on the totality of the symptoms of the patient, not on a general disease definition.

The Society of Homeopaths' website states:
Homeopathy treats all your symptoms - mental, emotional and physical.

Boots *own* website has a .pdf to download on alternative therapies. It states that homeopathic assessment takes in to account the following:
stress levels
lifestyle
level of exercise
diet
food preferences
family medical history
other factors such as weather

Indeed. The weather. This is the origin of the phrase "feeling under the weather". No, you're right, it isn't.

So, if a homeopathic assessment is of vital importance and the patient requires a highly trained homeopath to use their knowledge of symptoms, simillima, and remedies, in order to put the patient back on the road to recovery (for the meagre sum of £100/hour), how on earth are Boots able to sell the remedies to any old misguided dabbler?

(Sharp-eyed readers will remember the same argument being posed in a previous TiD blogpost when Napier's were holding a Homeopathy for Families workshop, which provided the attendants with a free vial of Arnica 30c. Individualised, my arse).

I am genuinely surprised that homeopaths have not complained that this accessability to homeopathic medicine is dangerous and can't be given to those without the secret knowledge; otherwise, of what value is the secret knowledge?

(Results of self-diagnosis are undoubtedly as good as homeopath-diagnosed patients, as the actual remedies given will have been identical - just sugar pills - and the placebo will probably have been similar in each case).

For this reason, I'm calling on all homeopaths to stand up for what you believe and to complain to Boots about how they are making homeopathy accessible to untrained patients. Homeopaths should be calling on Boots to remove homeopathic products from their shelves, lest these terribly potent homeopathic medicines get in the wrong hands.

I look forward to seeing armies of homeopaths outside various branches of Boots on 30th Jan 2010 demanding that Big Pharmacy has no right selling homeopathic products and that the livelihood of the highly trained homeopath should be respected.

Whether or not you are a homeopath but would like to help get homeopathic products removed from Boots shelves, then join up at 1023.org.uk.


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