I know that, since the COVID-19 pandemic hit, I keep repeating the mantra, “Everything old is new again.” I even know that I probably repeat it so much that it sometimes gets annoying. So be it. It’s a message that is important to me due to my simple hope that, if the newbies who have joined “our side” understand that none of this is new, they will learn the recurring themes, narratives, and forms of quackery, misinformation, and disinformation, the better to be prepared for the future. That brings us to homeopathy.

Remember ivermectin? Who can forget it, the repurposed drug used to treat helminthic (round-worm) diseases in animals and humans that COVID-19 quacks quickly repurposed to claim as a miracle cure for COVID-19 as evidence mounted that the last repurposed “miracle cure,” the antimalaria drug hydroxychloroquine (which is also used to treat rheumatoid arthritis), didn’t work against COVID-19, leading me to refer to it as the “Black Knight of COVID-19 treatments.” Basically, ivermectin was the new hydroxychloroquine, but its being the new hydroxychloroquine didn’t stop both drugs from remaining in the armamentarium of COVID quacks everywhere, immune to evidence, complete with conspiracy theories and dubious meta-analyses—even an appeal to the Nobel Prize!—to explain its lack of acceptance by “mainstream medicine.” Personally, I came to the conclusion that ivermectin was the acupuncture of COVID=19 treatments (a highly implausible treatment from a basic science standpoint supported by the flaws in the evidence-based medicine paradigm) and a perfect example to explain how science-based medicine isn’t just for “complementary and alternative medicine” (CAM) or “integrative medicine” or whatever advocates of combining quackery with evidence-based medicine are calling it these days.

Which brings us back to Dr. Tess Lawrie.

Lawrie, you might remember, first made her name as one of the founders of the British Ivermectin Recommendation Development (BIRD) Group, a group that teamed up with the US group the COVID Frontline COVID-19 Critical Care Alliance (FLCCC) to vigorously promote ivermectin as a highly effective treatment for COVID-19, despite all evidence to the contrary, including basic pharmacokinetics. When last I discussed Lawrie, she had done what most quacks who believe in a particular treatment eventually do and embraced ivermectin as not just a highly effective treatment for COVID-19 but as a potential cancer cure.

Given that background (and the title of this post, which gives it away), I suspect that you know what’s coming next. That’s right. Lawrie has now embraced The One Quackery To Rule Them All for COVID-19, long COVID, and a number of other things. That’s right, it’s homeopathy time, baby!

Homeopathy: The air guitar of medicine

Advocates of science-based medicine like to refer to homeopathy as the “air guitar of medicine,” because, like an air guitar, it’s performative and can appear impressive, but, just as pretending to play guitar doesn’t produce any actual music, homeopathy doesn’t produce any therapeutic effects because almost by definition it can’t. I realize that our regular readers know what homeopathy is and why it’s quackery, but whenever discussing homeopathy I always feel obligated to provide a brief explanation for those who’ve never encountered this blog before, rather than just links. I hope our regulars will bear with me.

To reiterate, homeopathic remedies are the purest quackery, and I frequently refer to homeopathy as “The One Quackery To Rule Them All.” I also generally think it’s always worth a brief explanation of why. Basically, homeopathy was invented by a German physician Samuel Hahnemann in 1796 and is based on two “laws” that have no basis in science. (I suppose calling them “laws” made them sound more important, like Newton’s Laws of Motion.) The first is the Law of Similars, which states that you treat a given symptom using something that causes that symptom. No matter how much homeopaths try to claim otherwise and cite cherry picked examples, there is no physiologic, biochemical, or medical basis for such a broad general principle, and in fact what the first law of homeopathy resembles more than anything else is the principles of sympathetic magic, specifically Sir James George Frazer’s Law of Similarity as described in The Golden Bough (1922) as one of the implicit principles of sympathetic magic.

The second “law” of homeopathy, the Law of Infinitesimals, is even more ridiculous and pseudoscientific (or even mystical). I also find it the easiest to explain to the uninitiated why this “law” is utter bunk. In brief, the Law of Infinitesimals states that homeopathic remedies become stronger with dilution. Indeed, the process of making a homeopathic remedy involves serial dilution, usually 1:100. The mother tincture (or original compound or medicine) is diluted 1:100 and then shaken vigorously (succussed), the succussion step being claimed by homeopaths to be absolutely essential to “potentize” the remedy. After that, the remedy is diluted again in the same way. Each 1:100 dilution is designated by “C”, such that a 6C dilution equals six 1:100 dilutions. The problem comes with the higher dilutions. For instance, a 12C solution is on the order of a 10^-24 dilution ((10^-2)¹² = 10^-24). Many homeopathic remedies are on the order of 30C, which is a 10-60 dilution, or more than 10³⁶-fold greater than Avogadro’s number. Some homeopathic remedies go up to 100C or more, or 10^-200. Here’s a hint: The number of atoms in the known universe is estimated to be around 10⁷⁸ to 10⁸². The math just doesn’t work, and remedies over around 12C are basically water. “Lesser” dilutions contain so little remedy that it’s highly unlikely that they have a pharmacological effect.

Even though these days Richard Dawkins gets on my nerves for a number of reasons that I will not go into here, I do have to give him props for perhaps the best two-and-a-half minute explanation why homeopathy is quackery ever committed to video:

With that explanation taken care of, let’s move on.

Tess Lawrie embraces homeopathy for COVID-19

Yesterday, as I was looking for topics to blog about, I came across an article on Tess Lawrie’s Substack entitled Homeopathy for long Covid. It is, unfortunately for my purposes, one of her articles only for paid subscribers, but, as is her wont, Lawrie had posted a promotional Substack newsletter three days before entitled There’s a reason why the Queen had a homeopath. I was half-tempted to retort that there’s a reason why King Charles III is heavily into homeopathy—something we used to criticize him harshly for when he was Prince Charles—but it’s not because homeopathy works. Instead, I noted how Lawrie had bought into the usual homeopathy narrative about its being “suppressed,” with a tagline reading: “On the pernicious rewriting of homeopathy’s history, and how well-crafted research is revealing what many have known all along: homeopathy works.”

Where have we heard that one before? Also, as our very own Dr. Mark Crislip has described, there is no good evidence that homeopathy is effective against COVID-19. As you will see, that is not unexpected given that homeopathy is basically quackery, mostly water or ethanol diluent with no medicinal value.

Lawrie, as is the case with most quacks, is not happy with Wikipedia. Indeed, she starts out by looking at Wikipedia:

Let’s start with the lies and misinformation about homeopathy. Here’s how the internet’s propaganda factory Wikipedia currently defines it:

Homeopathy or homoeopathy is a pseudoscientific^[1][2][3][4] system of alternative medicine. It was conceived in 1796 by the German physician Samuel Hahnemann. Its practitioners, called homeopaths, believe that a substance that causes symptoms of a disease in healthy people can cure similar symptoms in sick people; this doctrine is called similia similibus curentur, or “like cures like”.^[5]

The entry then describes homeopathy as ‘quackery and fraud’ and goes on to state:

During the 1970s, homeopathy made a significant comeback, with sales of some homeopathic products increasing tenfold. The trend corresponded with the rise of the New Age movement, and may be in part due to chemophobia, an irrational preference for “natural” products, and the longer consultation times homeopathic practitioners provided.

Reader, are you suffering from ‘chemophobia’? I think I may be, though I would argue that a preference for natural products is entirely rational. Out of curiosity, I thought I’d look at what the Wikipedia entry for homeopathy used to say. Here’s what it said on 31 October 2003:

Homoeopathy is a method of treating diseases and medical conditions invented, or at least popularized, by the German Samuel Hahnemann in the late 18th and early 19th centuries. It is based on the theory that each naturally occurring element, plant, and mineral compound will, when ingested or applied, result in certain symptoms. Hahnemann believed that, by diluting these substances in a standardized manner, one could reach the true essence of that substance. Hahnemann described this process of dilution as “potentizing” (German: “potenziert”) the substance. These dilute amounts could then be used to treat the very symptoms they were known to produce.

Hahnemann and his students approached their treatments in a holistic way, meaning that the whole of the body and spirit is dealt with, not just the localised disease. Hahnemann himself spent extended periods of time with his patients, asking them questions that dealt not only with their particular symptoms or illness, but also with the details of their daily lives.

Well, that’s quite a shift in perspective isn’t it?

Gee, Lawrie says that as though it were a bad thing to have quackery properly described as quackery and pseudoscience on Wikipedia!

It is a shift in perspective, but the shift doesn’t show what Lawrie thinks that it shows. Rather, it shows just how much alternative medicine practitioners dominated Wikipedia entries. Indeed, back in 2004-5, when I first started blogging, one of my biggest complaints about Wikipedia was that cranks and quacks had a lot more time and believers to edit entries like the one on Wikipedia, far outnumbering skeptics, leading to credulous Wikipedia entries just like the one that Lawrie posted. At this point, a shout out to Susan Gerbic and her Guerilla Skepticism on Wikipedia project is obligatory, to express gratitude for working to change that.

Complete with the narrative that homeopathy is being unduly “suppressed,” Lawrie continues, likening this “suppression” and “redefinition” to various narratives about COVID-19:

It continues to amaze me how successfully nefarious influences can redefine how we see the world. We have seen this in technicolour over the past three years, with respected dictionaries redefining words such as ‘vaccine’ to comply with a big pharma narrative, and people described as ‘variant factories’ in a clear attempt to demonise a specific group.

The claim that the word “vaccine” has been somehow “redefined” in order to encompass mRNA-based COVID-19 vaccines is, of course, a favorite conspiracy theory of antivaxxers. Let’s just say that the word “vaccine” was not “redefined,” although the definition was clarified to try to prevent misunderstandings, basically changing a very specific definition of “vaccine” to a more general accepted phrasing of the definition. There was no nefarious intent, but Lawrie, being the conspiracy theorist that she is, imputes nefarious intent.

She then likens that “redefinition” to what she perceives as having happened to homeopathy:

I was reminded of this recently, when I spoke to Dr Philippa Fibert, my next Tess Talks guest. Philippa is a practising homeopath, and also Research Fellow at St Mary’s University, Twickenham here in the UK.

She pointed out to me that the intense scepticism about homeopathy is actually a recent phenomenon. It wasn’t that long ago that homeopathy was fairly mainstream, and is still available on the UK’s National Health Service, albeit in only two locations: the NHS Centre for Integrated Care in Glasgow, and the Royal London Hospital for Integrated Medicine.

The latter used to be called Royal London Homeopathic Hospital; this was where Philippa’s great aunt, Dr Lena Banks, and her great aunt’s partner, Dr Marjorie Blackie, worked. Dr Blackie was the Queen’s Homeopath.

Only someone utterly devoid of knowledge of history can claim that skepticism about homeopathy is a recent phenomenon. Whenever I see that claim, I like to refer to a classic essay entitled Homeopathy and Its Kindred Delusions. The author? Oliver Wendell Holmes. The year? This essay was based on two lectures that he presented to the Boston Society for the Diffusion of Useful Knowledge—in 1842! It is an essay worth reading in its entirety. Other than the lack of knowledge in the 1840s of Avogadro’s number, whose first accurate measurement was at the time of Holmes’ lectures decades in the future and whose magnitude lets us know that in 30C dilutions it is unlikely that even a single molecule of starting substance remains, its devastating critique of homeopathy as pseudoscience is relevant today.

That must be why Lawrie invokes the fantasy of future vindication, which is a favorite of quacks and supporters of quackery everywhere—and writes:

Like many safe, natural alternatives to pharmaceuticals, homeopathy has been under a sustained and calculated attack for some time. But I do believe that is about to change – and Philippa is playing a key role in its rehabilitation as an accepted and respected form of medicine.

So what is Fibert claiming. I think you can predict. Again, as I pointed out, there is no evidence that homeopathy can effectively treat COVID-19—not that homeopaths would ever admit that—and it’s equally improbable to think that homeopathy could be used to treat long COVID. None of this stops Fibert or Lawrie:

Those suffering from Long Covid have been turning to homeopathy – and so Philippa has led a service evaluation project to document the outcomes. The results have shown that people are experiencing improvements with homeopathic treatment so now, Philippa is spearheading a well-designed randomised controlled trial to evidence the outcome of the homeopathic treatment of the symptoms associated with long Covid.

It is not my purpose to discuss all the ins and outs of why homeopathy is quackery and will not be useful for COVID or long COVID. It’s homeopathy, and we at SBM have spilled so much digital ink explaining why homeopathy is quackery that I don’t want to reinvent the wheel here yet again. Rather, what interested me is the inevitable progression we have seen in Tess Lawrie. First, she started out promoting ivermectin for COVID-19, helping an army of quacks cement the narrative that ivermectin is a cheap, safe, and “suppressed” cure for COVID-19 in the public’s mind. Then she decided that COVID-19 wasn’t enough; ivermectin should also be used to treat cancer, because of course she did. Now she has gone beyond ivermectin for COVID or cancer and embraced The One Quackery To Rule Them All, homeopathy.

I will revisit this observation. First, however, who is Philippa Fibert, besides being a homeopath?

How medical academia can promote COVID quackery

At this point, I’m going to shift gears a bit and refer to an article by Matthew Hongoltz-Hetling that appeared in this month’s issue of The New Republic entitled, A Doctor’s War Against the Right-Wing Medical-Freedom Movement, which carries the tagline, “As alternative medicine infiltrates mainstream health care, one physician is fighting back with everything he has.” I’ll come clean right here. The doctor in the article is me, and the article is basically about how alternative medicine quackery has infiltrated medicine over the last couple of decades, laying the groundwork for a lot of what we are seeing now. As the “main character” in the article, I will say that I’m (mostly) happy with the narrative and how I come off. (My quibbles might be a topic for a future post sometime. For example, I get the impression that I come across like the aging gunslinger played by John Wayne in The Shootist, whom all the young guns are looking to knock off and who is on the declining side of his career, which, come to think of it, might not be that inaccurate. I do prefer, however, to look at myself more like G’Kar in Babylon 5 episode The Long Twilight Struggle, if only because G’Kar does ultimately triumph even if he does later die a tragically foretold death. But I digress, as I often do.) What Hongoltz-Hetling gets right is how alternative medicine has infiltrated academic medicine:

Between 1999 and 2017, NCCIH had spent a total of about $2.2 billion “for clinical trials [that] produced no sound, consistent evidence for the efficacy of any alternative therapies,” Dr. Donald Marcus of the Baylor College of Medicine pointed out in a 2020 article in The Journal of Clinical Investigation. The National Library of Medicine lists 49 different NCCIH-funded studies that reference homeopathy; some of the study authors lack medical degrees, and yet have associations with top-tier medical institutions—for instance, Ted Kaptchuk, an acupuncturist who went on to direct an alternative-medicine program at Harvard Medical School; or Gary Schwartz, whose research at the University of Arizona is focused primarily on mediums and energy healing.

The alternative-health industry also influences academia through overt lobbying. And even as it enjoys the financial benefits that come with being embraced by the political right (Americans spent $34 billion on products and services in 2007), it has aggressively wooed the academic circles that are usually dominated by the political left. For example, in 2017, after receiving a $200 million gift from the Henry and Susan Samueli Foundation, the University of California Irvine earmarked funds for up to 15 faculty chairs supporting a curricular focus on integrative health in its College of Health Sciences. Deep-pocketed alternative-medicine groups have also funded partnerships with University of California San Francisco, Harvard Medical School, Brigham and Women’s Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, and Vanderbilt University School of Medicine. As of 2017, 15 research medical schools had begun offering alternative medicine to the public, according to Marcus. Johns Hopkins offers Reiki “to transmit Universal Life Energy to the client”; Duke University offers acupuncture for stroke victims.

Why do I mention this—other than wanting to slip in a link to an article in a mainstream magazine about myself, something that has never happened before?—and point out how medical academia has been corrupted by quackery? Simple. Let’s take a look at Philippa Fibert. She is indeed a Research Fellow at St. Mary’s University Twickenham in the Department of Psychology and Pedagogic Science. Interestingly, this department is listed as a department of the Faculty of Sport, Allied Health and Performance Science, which lists itself as offering programs in these areas:

• Applied Physics
• Health and Exercise
• Nutrition
• Physiotherapy
• Psychology
• Sport Rehabilitation
• Sport Science
• Sports Coaching
• Strength and Conditioning

Worse, Fibert describes her history thusly:

I am a Research Fellow with a particular interest in improving long-term outcomes for children, and assessing the effectiveness of non-pharmacological treatments.

I started out working with children with special needs as a teacher, then as a parent educator. I then came across a treatment that seemed to be really helpful for them, however few think it can work apart from those who have experienced it first hand.
So, to start untangling the evidence, I embarked on research into this area. I completed a psychology research MSc at Goldsmiths University where I conducted a comparative case series examining the effectiveness of this treatment for children with ADHD. This was partly funded by Turner’s Court Youth trust, an ex borstal supporting crime prevention measures (1:4 prison inmates have had a diagnosis of ADHD).

The treatment is called Homeopathy. The Case Series findings were significant, and in several cases, life changing. Patient stories are available in articles in Green Parent and Autism Now Magazines, case reports in the European Journal of Integrative Medicine, and the full case series in the journal ‘Homeopathy’.

Quelle surprise. She plied her quackery on autistic children and children with ADHD, and Goldsmith University supported this research as part of her degree program. But let’s get to the quackademic medicine that allowed her to test water on children with significant medical conditions:

A pilot randomised controlled pragmatic trial was then conducted at the University of Sheffield to provide more substantial information about the long-term effectiveness of non-pharmacological approaches. It assessed the effectiveness of homeopathy and nutritional therapy. Results suggest that both treatments may be helpful: in particular nutritional therapy for restlessness/inattention, and homeopathy for emotional dysregulation (https://link.springer.com/article/10.1007/s00431-019-03374-z).

I now work at St Mary’s University, Twickenham: within the department of Psychology and Pedagogic Science where we’re running a trial exploring the effects of Kefir on ADHD, sleep and the microbiome; and I teach on the MSc in Chronic Disease Management.

Meanwhile I continue to pursue my research interests in improving health outcomes. A recent study explored the effectiveness of the homeopathic remedy bacillinum for ringworm in rural Africa, and found it better and cheaper than conventional care over the long term. A service evaluation of homeopathic treatment for long COVID suggests that patients feel 47{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} better after 2 consultations (12 weeks).

Let’s look at her study cited above. Basically, it claims to be a randomized trial of homeopathy and nutritional therapy in ADHD, but it was not blinded, much less double-blinded. Those assessing the subjects after interventions knew which child was in which group. So basically, it was a useless trial, even as a “pilot” trial.

As for bacillinum? I hadn’t heard of this particular homeopathic remedy before, but a quick Google search revealed that it is purported to be made from the sputum of a patient with tuberculosis. I kid you not. It is claimed to be useful for:

Addison’s disease. Alopecia. Consumptiveness Growth, defective. Hydrocephalus. Idiocy. Insanity. Joints, affections of. Phthiriasis. Pityriasis Ringworm. Scrofulous glands. Teeth, defective; pitted. Tuberculosis.

If you ever want more of an indication that homeopathy is quackery, just look at the list of the diseases supposedly treated by a homeopathic remedy claimed to have been made by diluting the sputum of a patient with tuberculosis! Then be thankful that the sputum was diluted to nonexistence and bacillum is basically water, just as I was thankful to learn that Lyssinum, a homeopathic remedy purported to have been made from the sputum of a rabid dog, is also generally diluted to 200C, far beyond nonexistence. Ditto a homeopathic remedy to treat Ebola made from the sputum of Ebola patients. Again, you can’t make stuff like this up. (At least, I can’t.) It makes me wonder why the homeopaths didn’t use diluted SARS-CoV-2 to treat COVID.

Quackademic medicine, COVID, and homeopathy

We at SBM have been writing about quackademic medicine ever since the very beginning of this blog. Although I wish I could claim to have coined the term “quackademic medicine,” unfortunately I can’t. (Dr. R. W. Donnell has that honor.) The point, however, is how before the pandemic quackery had so thoroughly infiltrated itself into medical academia that even “hard core” academic medical centers, like Duke, Stanford, the Cleveland Clinic and even my alma mater, the University of Michigan, have embraced quackery, to the point where U. of M., for instance, has a naturopath in a high-ranking faculty position in its Department of Family Medicine who promotes homeopathy there.

Across the pond, Philippa Fibert is fundraising £40,000 to do a “pilot RCT” of homeopathy for long COVID. with this preliminary data:

Dr. Fibert told HINT: “This trial provides an excellent opportunity to develop much-needed evidence for the effectiveness of homeopathy at a time when other healthcare providers are struggling to develop effective protocols for the treatment of Long-COVID.

“In a prelude to the pilot RCT, we have already been collecting the MYMOPs (Measure Your Own Medical Outcome Profile) of Long-COVID patients and found a 36{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} improvement after just one consultation. After their second consultation the improvement climbed to 48{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}.”

We hope this project will put homeopathy front and centre as the medicine of choice for the symptoms associated with Long-COVID. You can be part of this ground breaking project by helping us raise the funding needed.

We have the enthusiasm, now all we need is £40,000 and with your help we know we can do it!

There’s nothing like subjective outcome measures in a survey as “evidence” that magic water helps a poorly understood condition that often has vague symptoms and whose diagnostic criteria aren’t fully solidified yet to guarantee that placebo effects will provide a seemingly positive outcome to justify raising money for a pointless RCT. Let me remind you what the remedies used in the “preliminary trial” were:

If this is what homeopaths treated hospitalized COVID patients with, what else will they add to the list to treat long COVID?

Basically, it’s just a grab bag of common homeopathic remedies, including the quite rightly mocked Oscillococcinum®, which includes extract of duck liver and heart. Basically, it’s a “throw everything but the kitchen sink” approach to COVID-19, if that everything is the water in the kitchen sink without the actual, you know, kitchen sink.

I argued in Matt Hongoltz-Hetling’s piece that quackademic medicine is both a cause and symptom of what led so many doctors to embrace COVID quackery, antimask stances, and antivax beliefs. Certainly, homeopaths in universities and medical schools doesn’t help. It should thus be no surprise that people like Philippa Fibert exist and are now promoting homeopathy for long COVID, after having promoted it for so many other conditions.

Unfortunately, this example of Tess Lawrie expanding her quackery suggests two things that seem new but are not. First, once a doc starts down the dark path of quackery, forever will it dominate her destiny. Consume her it will (with only rare exceptions). This has clearly happened to Lawrie, who started out embracing the then “sort of” quackery of ivermectin, which is now COVID quackery because the evidence clearly shows that it does not work, and then progressed to embracing ivermectin quackery for more diseases (like cancer), and then ran headlong into the arms of The One Quackery To Rule Them All. It is incredibly likely that there is any coming back from this for her. The question is: Is there any coming back from this, period?