Health Care Reform

I have not found any reasons to believe homeopathy does anything. Certain types -those that involve injection in particular- may actually be somewhat harmful. I find such an utter lack of any discernible basis for any action of homeopathic material that it is difficult to carve out enough interest to even examine homeopathy at all. I would completely ignore it, and suggest that others also ignore it, if not for one nagging problem. The problem is that homeopathic treatments do, in some limited cases, work.

It would be especially easy to claim that any effects of homeopathic treatments are “placebo” effects since homeopathic medications are indistinguishable from placebos. It is also impossible to describe any targeted effect of any measurable physical property of a homeopathic material that is proportional to a measurable effect since there are no constituents of the medications that are not overwhelmingly present in almost everything else. In short, it is almost impossible to scientifically study homeopathic medications because it is essentially impossible to define controls.

Let me engage in a little thought experiment. A homeopathic practitioner begins making up a batch of homeopathic solution “A”. They 1st make up the concentrated solution of compound “A”. Then they begin diluting it. They take the beaker they made the original solution in and wash it. While they are diluting the original solution to the working dilution of ten to the minus sixtieth power the rinsings from the original beaker flow down the sewer pipes of the lab's building, and they then go out into a local stream. The final diluted material is packaged up for sale; and the beaker rinsings flow from stream to river to sea. When the patient receives the homeopathic medication those rinsings, now diluted by all the water on earth, are still more concentrated than the homeopathic medication. When the homeopathic medication maker makes a new batch of “A” he will be diluting the stock with material that is more concentrated than what he wishes to end up with.

One could simply drink a glass of water and imagine that it was whatever homeopathic medication one wanted it to be and actually be more correct than someone reading the label on a vial of homeopathic medication.

If it is impossible to scientifically study homeopathic medications, and they make no sense, then what do I mean by they “work” in certain situations?

Firstly the information that suggests that they “work” is not scientific; it is phenomenological. Patients with certain conditions show a statistically significant greater level of positive medical outcomes when they receive homeopathic treatment than when they do not. The patients are not magically cured, but they do enjoy markedly better outcomes.

I hope at least a couple of my readers are poking their fingers at their computers exclaiming: “Correlation does not equal causation”. I know I am. Of course the result of my poking is the typing of the words you are reading, and so my monitor is less smudgy.

You might think that I picture myself highly elevated to have my finger poking producing a literate output. That is not why I know I am highly elevated. The reason I am so highly elevated is that I am writing this on a plane. There is free facebook connection on this flight, but after a half an hour on fb I begin leaving increasingly inappropriate comments on people's status updates. I am unable to access anything else on the internet (like this blog), so I will type this up without references, and maybe post it later.

This means that those of you who think the problems with the homeopathic treatment studies are in the details will just have to look them up yourselves. I feel your pain.

There are differences between what happens during a homeopathic treatment and a traditional medicine-based treatment. There are more differences than just what substances the patient leaves with. There is a natural inclination, however, to focus on the material the patient can hold in a bottle rather than the whole process of treatment.

Meetings with homeopathic practitioners take much longer than those with traditional doctors; often several times as long. The homeopathic practitioner often asks questions about the patient that are seemingly unrelated to the illness. The homeopathic practitioners often touch their patients. I think the difference can be summed up by saying the the homeopathic treatment is often a more touchy-feely affair.

When one begins to break down the aspects of the homeopathic treatment that are most likely to provide the benefit observed it is the touchy-feely nature of the interaction that stands out as the most likely effector set.

Study-after-study-after-study have shown that kind and caring human interaction improves medical outcomes. This effect is distinct from placebo effect, and is much more effective.

Since it is difficult to buy love (in the compassion sense) it is difficult to quantify the amount of love used as supportive care. This lack of a commodity-type measure for compassion makes it difficult to target addition of compassion to treatment regimes. And forget all about the idea of getting insurance coverage for love.

The homeopathic practitioners have not simply found a new way of being loving either. As often as not these people must know that they are selling snake-oil. Those that are best at it are those that have embraced their inner oily snake; not those who have embraced their inner “Dr. Love”.

The effective nature of homeopathic treatment is the ritualisation of compassion. There are specified methods of touch, and specific lines of questioning. Since homeopathic medicine is nothing there is nothing that is done with any apparent information gathered by the connection rituals that are used in diagnosis. It is these magic diagnostic procedures themselves that cause the benefit.

There is a struggle between alternative and traditional treatments. The losers in this conflict have always been the patients.

One of the most horrifying battlegrounds is in cancer treatments. Many cancers are now fully treatable. As the number of potentially treatable cancer diagnosis increase the impact of patients refusing treatment becomes more significant. Refusal of treatment is a major cause of poor outcomes in cases of treatable cancer (lack of an early diagnosis is THE most significant cause, so learn the early signs of cancer and DON'T ignore them). One all-to-common reason for refusal of effective treatment is reliance on alternative treatments (This is awful, and I will probably talk about it at greater length in another blog post sometime).

It is natural for practitioners of traditional medicine to push back against treatments that harm patients. The alternative treatment folks create cover stories of health-care-industry and government conspiracies. The focus of this back-and-forth becomes the commodity; we focus on the snake oil. We ignore the poorly measured enhancements to treatment that work.

The battle against treatments that do no good, and may dissuade patients from getting effective treatments, must be constantly fought and won. It is important, however, to take everything that appears to be of use in treating patients and apply it, and apply it wherever possible.

We do not necessarily need to dress western doctors in kangaroo skins and carved wooden masks to apply the positive benefit of the witch doctor. We certainly do not need to believe that the witch doctor channels the pre-life force of trans-dimensional beings in order to leverage the healing benefit of ritual. We have studied ritual for hundreds of years, and we should be able to create effective new rituals that far exceed those accidentally derived by previous generations. What a great way of employing previously unemployable archaeologists, anthropologists, and philosophers!

Personally I picture the orderlies and nurses dressed like witch doctors. Visiting relatives will be kindly asked to wear elaborate sequined headdresses. All PA announcements will have the soothing sounds of rattles and pan-flute tastefully added to them by some complex computer signal algorithm.

I have a bunch of great ideas for health-care reform.

Kewky Kropp

I am often wrong, but this is not for lack of trying to be correct. In fact, if my observations are true, my trying has greatly increased the frequency of my being wrong. I have been wrong often enough that I have become a Connoisseur of the incorrect.

I have preferences in the way that I learn about my mistakes. One of my favorite type of discovery is of the type that might spawn the phrase “I think I understand what you mean, and I believe you are incorrect.”. This would be a thoroughly enjoyable statement if the assertion of incorrectness could be stripped from it. Communication has occurred, and there is a feeling that information was accurately exchanged. Whatever the outcome this statement suggests that a framework for discovery, human advance, and culture exists.

One of my least favorite ways to learn about being wrong could be summed up with the following hypothetical phrase: “I don't understand what you are saying, therefore you are wrong.”. I casually picture the speaker of that phrase as a snot-nosed kid with his fingers firmly implanted in his ears. He spits out the phrase -breathily- in between loud stanzas of atonal “LALALALALALALA”.

Unfortunately there is the well fit converse ignorance; the person who wishes to appear correct by being incomprehensible. I recently picked through a load of that stuff while browsing some intellectual property. I quickly became more interested in the properties of the intellect that produced the intellectual property.

I discovered a patent published by one Konrad E. Werner Kropp (5012110) that defied logical understanding. I was amazed that something that was so densely bizarre and flawed could be the product of a literate person. I formulated bad puns using Mr. Kropp's last name: “this is total Kropp”, or “ What a load of Kropp”, or “this is Kroppy”. The patent had so many layers of strangeness that I had read it through a couple of times before I realized that Mr. Kropp's initials were “KEWK'. Imagine my many minutes of amusement thinking of “Kewky Kropp”.

As far as I can tell Kewky's device is a wooden box with a bunch of magnets in it. In the center there is a coil of wire (it sounded like he used an old coil AM radio antenna with the solid core removed) where a bottle of pure water (or saline, or oil) is added. Then Kewky whistles at the water and magically transforms it into a curative liquid. The liquid is so magical that it can apparently cure just about anything. There is no definitive guidance concerning which tune should be whistled for any particular ailment.

I have known people who grasped portions of complex topics with amazing tenacity. In undergraduate physics and chemistry I befriended a fellow student (lets name him Clyde) who had suffered significant brain damage as the result of a motorcycle crash. Clyde was a affable enough fellow, but he responded to mundane conversational cues a couple of beats late. Whenever one of the great constants of nature (like Planck's constant = 6.626068 × 10-34 m2 kg / s) was mentioned (the first time in a day, Clyde would only do this once per day for each constant) Clyde's hand would slowly go up. If the professor called on him Clyde would recite the value of the constant to seven or more significant figures and put down his hand. If the professor did not call on him Clyde's hand would remain up throughout the rest of the lecture. Sometimes, if my mind was wandering away from the lecture, I would play a silent game of “guess which constant Clyde caught” when his hand was going up.

The values and units of the great constants describe how the technology of mankind weaves the concepts of science into a working tapestry of understanding. The significant digits of the constants illustrate the greatest resolution with which we can project our understanding onto what really is. The constants are very cool, but I have never bothered to memorize them to nine significant digits. On a great day I might be able to tell you that Planck's constant was a little less that seven times ten to the minus thirty-fourth power. On a typical day I could say that it was “really-really-really small”.

Regardless of the precision or familiarity with the constant it's use in a conversation draws upon allusion to those theoretical constructs that use it. The gravitational constant assumes gravity, and acceleration, and inertia, and may even inspire thoughts of gravity waves and black holes. I do not hear the term “gravitation constant” and think that it would be nice if someone decided that it was actually orders of magnitude smaller that I had grown up believing so that interstellar spaceflight could become routine. If someone told me a profoundly specific value for the gravitation constant I would assume that they could answer a question like “how did you come up with that number?”. I would also think the answer would be something like “I read it in a book” or “I performed a series of mind numbingly sensitive experiments”; not “I ate some bad cheese and it just came to me”.

Homeopathy is supposedly derived from the theories of Christian Friedrich Samuel Hahnemann who died in 1843. Hahnemann lived during a period where medicine often was more harmful that no treatment at all. Offering patients elixirs that would at least not kill them must have been a significant leap forward in medical technology. His theory was to treat “Like with Like”. Somewhere he got the idea that highly diluted materials would do this best. Certainly if the material was highly toxic better medical outcomes would be expected if it was highly diluted.

Typical homeopathy  uses dilutions in the range of ten to the minus sixty. These magnitude of these dilutions make Pklanck's constant look unbelievably huge. At such phenomenal dilutions it would be nescesary to consume a vial containing an amount of fluid equal in mass to the entire plannet to have a descent chance to consume a single molecule of the material. For some reason these lavels are too concentrated for some pratitioners who believe they can achieve the same effects without ever touching the original material.This is where Kewky's invention, and the dozens inspired by it, come into play.

Kewky's patent is almost impenetrable. There are many areas where he simply assumes knowledge. For instance: “The information energy may be imparted to the substrate ...with frequencies which differ according to the desired character of the transformed properties”. I read phrasing like that and my immediate reaction is to say: “I don't understand what you are talking about, therefore you must be wrong.”. How embarrassing! If I take a couple of minutes to stop my bile from spinning I can fashion a more constructive criticism. I prefer something like: “How do you know the frequencies associated with the character of your transformed properties?” I like that question because it sounds like one that might have an actual answer.

The process of imparting “informational energy” on liquids by waving magnets around them is an entire field of research in homeopathic practice. The effectors, which can be magnets (or moonlight, or sunlight, or sound waves, or laser beams), are called “imponderables”. I had previously thought of an imponderable as a philosophical question which could not be answered, and where the examination of the question raised more questions (Like: “if a tree falls in the forest and no-one is there to hear it, does it make a sound?”). In the practice of homeopathy the imponderables apparently are effectors whose activity is unmeasurable and unknowable. Yet despite the fact that one cannot know about them there are folks that can design complete apparati to utilize their effect for maximum potential. But what do the imponderables effect?

Kewky injected (IM) a 0.9% saline solution that had been magically transformed in his apparatus to 'normalize' a woman's gut flora. This is an interesting claim, but the wonders of the internet provide long lists of health benefits possible through the use of magically-transformed water. One malady that can supposedly be treated with magnetically “altered” homeopathic fluids is prolapsed rectum. I would think that a prolapsed rectum would be an easy thing to demonstrate the healing of. Even if a person began feeling better you could visually decide whether they had been cured.

There is also the problem of negative effects. I found it difficult to get information about magnetically transformed water ever causing harm. If a special waving of the magic wand creates a rectum de-prolapsing fluid shouldn't there be a wand-waving sequence that causes prolapsing. Perhaps warnings should be placed on all items that have any magnetic field “Danger rectums may prolapse while using this device”.

Songs transmitted on the radio have electromagnetic informational energy. What if Justin Bieber records a song whose very transmission over FM radio causes entire market areas to suffer prolapsed rectums?

The Earth itself has a magnetic field.  What if just visiting certain locations caused a prolapsed rectum?Kurt Vonnegut called Ithaca New York “The country's rectum”. It would be uncomfortably ironic if visiting Ithaca caused prolapsing of a visitor's rectum.

Strange as the imponderables are there is an even weirder branch of homeopathic medicine. In this one the vial of water is just placed next to a material whose properties it is supposed to take on. Kewky references this approach in his patent. In some cases one need only write the name of the substance on a scrap of paper and store the vial of water near it.

There should be some measurable effect other than the magical cure. There should be something to tell if anything is going on. One of the important aspects of Kewky's patent is that it actually provides a bit of intermediate evidence. Kewky provides actual spectrophotometric data showing that his water has been altered.

Kewky ran his samples on a Perkin Elmer Lambda 3 UV-Visible spectrophotometer, and noticed differences. Here is a bit of real data. I can look at this and formulate a conclusion.

For those of you not familiar with spectrophotometers; these are common laboratory instruments. They basically shine a beam of light through a sample and then run the sample attenuated beam through a prizm. The resulting rainbow (which extends into the invisible UV and IR ends of the spectrum) is measured for intensity with a photocell. The spectrophotometer can produce a plot of the frequency of light vs the signal intensity through a sample. It is important to note that the darker the sample the more sensitive the spetrophotometer needs to be in order to produce an accurate spectrum. Some samples are dark to light outside of the visible spectrum. Water, for instance, is very dark to light just a little into the UV end of the spectrum. Here is a plot of the absorption spectrum of water (notice how the line shoots up just to the left of the rainbow designated visible light spectrum).

Kewky used a solid instrument for his measurement, but for some reason decided to use a strip-chart recorder for his output. By 1991 (the date on the patent) it would have been difficult to find a strip-chart recorder in most laboratories. More difficult still would be finding someone who could run one accurately. One of the problems with strip-chart recorders is that they do not accurately designate the X axis. On a sample's spectrum that axis would be the frequency of light. The deviations on Kewky's spectra that do not look like simple table bumping blips (a problem with strip-chart recorders) occur right at the beginning of the trace. This is the zone closest to the darkest portion of the water's native absorption spectrum.

So, as I see it, Kewky's only real data was produced on an instrument rigged to be highly inaccurate in a portion of the spectrum that would be the most sensitive to machine inaccuracies. Kewky could go to almost any laboratory in the world and have this data reproduced with much greater sensitivity.

My friend Clyde would listen to lectures till the name of a constant leaped out for his attention. I poured through thick layers of apparently purposefully misleading Kropp and found data. This blog entry is me slowly raising my hand. I can thankfully now say: “I think I understand what is being presented in this, and they are wrong”.

Wavy Hair

Although there are many cherished moments of contemplative introspection I have enjoyed in my bathroom I can remember none that have occurred in the pre-dawn moments of hygienic confusion that start a typical workday. There must be an invisible thought sucking field that is generated by the interaction of my toothbrush, the metal toilet paper holder, the sun and moon, and (as I now suspect) certain haircare products. To be truthful, I am only really sure about the haircare products.

A couple of days ago I noticed the following equation on a bottle of shampoo:

Which I think is a relation between Energy(E) and Magnetic flux(β) through a medium(µ). This is a strange thing to see on a shampoo bottle. At the bottom was a notation describing the MDL as being at 5. After some searching I found that MDL is an abbreviation for “Magnetic Density Level”. I was intrigued. Just what is a Magnetic density level? How are they measured in shampoo? What are the MDLs of other haircare products?

It turns out the MDL denoted the amount of –get this- magnetite (an iron oxide) that they put in the shampoo. Sure enough the shampoo was silvery in color; just like you would expect if it had bits of metal in it. Later I went to the Giovani cosmetics (the makers of the magnetic shampoo) web site and this is what they had to say about magnetite:

“Magnetite! Its result is total domination over the negative electrical charges that have left hair desolate and bleak.”

Magnetism is often accurately described as action at a distance. This is the essence of magic. Why not put it on your hair. It does not take a very in-depth search to find multiple magic effects of magnets on health and wellbeing:

“Magnetic therapy is a non-invasive remedy that addresses both prevention and treatment of chronic ailments with an impressive success rate”

“There have been years and years of research to prove that people can benefit from this new technology. Today, millions of people around the world are feeling better because or health magnets.”

“Dr W Philpott MD, a practitioner of magnet therapy for over 40 years explains that negative magnetic fields oxygenate and alkalise by aiding the body's defences and helping to relieve pain. Further, they combat inflammation and infection and enhance deep restorative sleep.”  

You can also strap magnets onto your car’s fuel lines to improve gas mileage. Strapping them onto your home’s water pipes reduces “effective hardness” of the water. If you did not know that waving, strapping, or implanting magnets will make everything better it only requires a small amount of research to find out that it would.

Magnets actually have easily measurable effects. Strong enough magnets can alter the growth of cells, or the shape of crystals, or even change the ionization of salt solutions. Waving magnets over copper wires can produce electricity; this is the way almost all of our commercial electricity is produced. Magnets are awesomely interesting, and their effects (especially on complex systems like the human body) are far from simple.

One would think that, with both magnetism and therapeutic value being measurable quantities, that there would be loads of clinical studies proving the effectiveness of magnets. One would think that the abundance of claims for “significant successes rates” would point to an entire body of therapeutic literature. One would think that, with over a century of development and billions of dollars in sales, that magnetic therapies would culture their own engineering and development communities. Unfortunately this is not the case. Most magnetic therapies enjoy less developmental thought than the logic that went into the Heidelberg Electric Belt that was very popular around 1900 (electricity is also magic).

“For weakness in men and women, personal exhaustion bringing back lost strength and power, over brain work, vital , impotency, rheumatism, sciatica, lame back, railroad back, insomnia, melancholia, kidney disorder, Bright's disease, dyspepsia, disorders of the liver, female weakness, poor circulation, weak heart action and almost every known disease and weakness.” -- Sears, Roebuck & Co. Catalogue 1900

The way that most magic magnetic devices are designed is through inspired insight. This is a wordy way of saying they are simply made up. I do not want to use terms like “intelligent design” or “invention” when refereeing to the creation of magnetic therapy devices as both terms insinuate a thoughtful process derived from cause and effect. There is no apparent structure in the development of magnetic therapies. If any magnetic therapies actually worked at all there exists no system to tell if one therapeutic device works better than another.

Many of the magic effects of magnetic therapy devices are fraudulently conceived. If any working magnetic therapy device were ever conceived it would be impossible (using the means by which the benefits of magnetic therapy are currently examined) to see this. The interest by the distributors of magnetic devices in a patient’s outcome appears to be significantly diminished once the patient is separated from the purchase price for the magnetic device. I have not heard stories of magnetic device distributors dancing around a hospital bed wildly waving their magic electromagnetic wands over a stricken patient, and this is not because they have yet to invent suitable wands.

Beside the sink AYD had left her newest hairbrush. The handle of the hairbrush proudly announced that it was made with both ceramic and “Ion Technology”. Since charged molecules (ions) are affected by magnetic fields a magic wand for magnetic therapy should conceivably have something like an “Ion Technology”. Certainly practiced waving of a hairbrush-wand around a bedridden patient could, if nothing else, arrange their hair so they looked a little less ill in photographs.

AYD’s hairbrush was a marvel of thoughtful design. It was honeycombed with holes, and the body was hollow. The handle contained a large removable hidden aluminum pick; like a giant version of the toothpicks on old Swiss-Army knives. I pictured the “Ion Technology” existing as some battery-driven transmitter whose antennae were embedded wires in the complex pattern of perforations in the brush’s body.

Unfortunately the “Ion Technology” consisted of tourmaline. Tourmaline is a complex silicate crystal. There was no word as to how they applied the magic stone to the brush. I imagine they simply added some tourmaline dust to the molten plastic before they poured the brush. I wondered what would happen if they forgot to add the magic dust to a batch of brushes. Would anybody ever notice?

“Negative ions generated by the high quality tourmaline have positive effects on health.”

Apparently negative ions are another source of magical health benefits. Somply by putting a little tourmaline crystal into water you can purify the water, kill bacteria and remove chlorine smell (which is interesting since the chlorine in the water kills bacteria). I was particularly interested in the chlorine smell reduction. The chorine smell in chlorinated water is caused by hypochlorite ions, which are negative ions. Apparently increasing the number of negative ions actually decreases the number of negative ions if it is done right.

The shampoo was supposedly designed to “dominate” negative ions in the hair. Perhaps one needed to generate negative ions with the hairbrush so the shampoo could properly exert its dominance?

Needless to say I was a bit confused. I decided I needed to go to the source of the magic haircare products. I ran AYD down and tried to initiate an over-breakfast haircare de-briefing session.

“Dad!” exclaimed AYD “You don’t think anyone actually believes that stuff do you!”

I asked why she purchased the material if she so thoroughly thought the magical claims were false. Apparently a product with obviously false claims to magical benefit is superior to one that lacks such claims. I attempted to extract more specific detail on this phenomenon. AYD said something about shoes that I did not follow at all.

I attempted to steer the conversation towards things I could get a handle on. I wrote some of Maxwell’s equations on the whiteboard we usually use for messages and grocery lists. I diagramed the square/cube effect of magnetic flux on ionized particles in a conducting medium. I asked her about the beta-pleated sheet protein structure of hair fibers.

Breakfast went quickly. Between bites AYD clipped answers to algebraic questions I fired at her. Finally the clock ran out, and it was time for her to leave to catch the schoolbus.

I hit her with one last question as she was putting on her boots to leave: “So… Are you going to keep your shampoo and stuff in your own bathroom from now on?”

“You know it!” she replied.