Download Lectures on Biostatistics (1971). Corrected and searchable version of Google books edition
Download review of Lectures on Biostatistics (THES, 1973).
Peter Fisher
As I walked back from lunch today, I passed an exhibit that advertised the UCL Haiti Development Project. It was good to see that somebody still cares.
Now the dire problems of Haitians have got worse, At least 500 people have been killed by cholera.
In stark contrast, I also had today another email form Kate Birch. She used to be vice-president of the North American Society of Homeopaths (NASH), though she now appears to be only a “registered teacher”. I wrote twice about Kate Birch in 2007
In August, Homeopathic “cures” for malaria: a wicked scam
and in October, A visit from Kate Birch.
When I googled "Kate Birch" homeopathy I was surprised to see that these two posts came in 2nd and 1st position respectively. Since then, she has emailed me from time to time. Such is her delusion that she seems to think that she’ll be able to persuade me sugar pills cure malaria, rabies, smallpox, anthrax and plage, as claimed in her book.
Largely as a result of her letters, she appeared again in June 2009, in Homeopathy Awareness Week. Like tobacco companies, discredited at home, homeopaths exploit poor countries. And again in March 2010, More homeopathic killing
Today’s first email from Ms Birch was brief.
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Subject: homeoapthy in haiti http://www.myfoxny.com/dpp/good_day_ny/haiti-earthquake-recovery-update-20101116 oh my god look what is happening now!!! those homeopaths are actually helping people in Haiti, and the nurses and doctors are learning how to do it. Kate Birch, RSHom(NA), CCH, CMT |
My reply was equally brief
"Fascinating. Are you saying that homeopathy can cure cholera?
David"
Her response, though entirely predictable on past form. is worth posting in full.
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During the cholera epidemics of Paris in the mid 1800’s Hahnemann cured many patients with three remedies: Camphora, Veratrum and Cuprum. His son Friedrick Hahnemann came to America in the mid 1800’s and cured many cased in the 1840’s and 1890’s epidemics on the east coast and in the work camps for building the railway with the remedy Crotalus horidus when the cholera developed in to the stage with hemorrhages from all of the orifices. Of cousre repid hydration is necessary too, but homeopathy helps along the way and can act preventatively, in addition to proper sanitation. If you were to look in my book that I gave you in the cholera chapter you will find many references to the success of homeopathy and cholera, even in England ( they are all referenced so that you can look them up and check for your self). Currently I am not sure of the success in Haiti, however I have collegues down there and I know that Since Cuba is using homeopathic for many of its epidemics (I was there in 2008) and they have had a hand in the relief aimed at Haiti I am sure we will see some statistics coming from them. I will be going to a Haiti Homeopathic releif benefit tomorrow and so I will have more information for you if you are interested. .Kate Birch, RSHom(NA), CCH, CMT |
Sadly. Kate Birch is not the only person to endanger lives in Haiti. Read more at Gimpy’s blog, Homeopaths go to Haiti, which was posted about a month after the disastrous earthquake.
With advanced delusions like this, it’s not surprising that Haitians now blame aid workers for the cholera outbreak.
Nothing illustrates better than this the vast schism between the (small number of) medical homeopaths, and the vast majority of non-medical homeopaths.
Remember what Peter Fisher said after the revelations that London homeopaths were recommending their pills for malaria prevention.
“”I’m very angry about it because people are going to get malaria – there is absolutely no reason to think that homeopathy works to prevent malaria and you won’t find that in any textbook or journal of homeopathy so people will get malaria, people may even die of malaria if they follow this advice.”
Fisher is, of course, the Queen’s homeopathic physician and clinical director at Royal London Homeopathic Hospital (recently renamed to remove the word homeopathy from its name). He may be a homeopath, but at moments like this he feels like an ally. After all it was Fisher who agreed with me that BSc degrees in homeopathy could not be justified. He may be a homeopath but that quotation alone means his intellect is sharper (or perhaps his honesty greater) than that of several university vice-chancellors, the QAA and UUK. Watch him say so (more detail here).
Follow-up
The Prince of Wales’ Foundation for Integrated Health shut down amidst scandal in April 2010. In July, we heard that a new “College of Medicine” was to arise from its ashes. It seemed clear from the people involved that the name “College of Medicine” would be deceptive.
Now the College of Medicine has materialised, and it is clear that one’s worst fears were well justified.
At first sight, it looks entirely plausible and well-meaning. Below the logo one reads
“There is a new force in medicine. A force that brings patients, doctors, nurses and other health professionals together, instead of separating them into tribes.”
"That force is the new College of Medicine. Uniquely, it brings doctors and other health professionals together with patients and scientists.”
It is apparent from the outset that the well-meaning words fall into the trap described so clearly by James May (see What ‘holistic’ really means). It fails to distinguish between curing and caring.
As always, the clue lies not in the words, but in the people who are running it.
Who is involved?
After a bit of digging on the web site, you find the names of the people on the Science Council of the “College of Medicine”, The preamble says
“Good medicine must be grounded in good science as well as compassion. The College’s Science Council brings a depth of knowledge from many senior figures.”
But then come the names. With the odd exception the “science council” is like a roll-call of quacks, the dregs left over from the Prince’s Foundation. The link (attached to each name) gives the College’s bio, My links tell a rather different story.
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Professor George Lewith You’ll find plenty about George Lewith on this blog.
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Professor Mustafa Djamgoz Superficially respectable but seduced by ‘ancient wisdom’ He once wrote to me "There are many ‘eastern’ remedies (such as acupuncture that we witnessed dismissed 25 year ago) that work. ". Well it isn’t as simple as that.
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Professor Simon Gibbons A phytochemist with exaggerated ideas of what you can get from plants.
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Professor Jane Plant A respectable geochemist who became obsessed with alternative medicine, Read about her here,
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Dr Peter Fisher The Queen’s Homeopathic Physician. Advocate of the most discreded of all forms of quackery. Lots about him here.
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Dr Michael Loughlin A post-modernist-influenced theorist who hates Ben Goldacre. Read about him here.
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Dr Hugh MacPherson An acupuncturist and fellow traveller of the Prince of Wales. Read here.
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Professor Andrew Miles I’m sorry to see him in this company after the good job he did in ejecting quacks at the University of Buckingham.
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Simon Mills A man who thinks herbs can be classified as "hot"and "cold", See here and here
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Professor Nicola Robinson Head of the Centre for Complementary Healthcare & Integrated Medicine,Thames Valley University A well known advocate of unevidenced treatments. Try Googling her
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Dr Catherine Zollman Another hangover from the Princes’ Foundation, and believer in magic medicine
It seems that the "Scientific Council" of the College of Medicine could more properly be called an "Antiscientific Council".
There are a few gaps in this table, to be filled in soon. One can guarantee that a great deal more will appear about the College on the web, very soon.
The Governing Council of the College is equally replete with quacks (plus a few surprising names). It has on it, for example, a spiritual healer (Angie-Buxton King), a homeopath (Christine Glover), a herbalist (Michael McIntyre). Westminster University’s king of woo (David Peters), not to mention the infamous Karol Sikora. Buxton-King offers a remarkable service to heal people or animals at a distance.
Meanwhile, it seemed worthwhile to provide a warning that the title of the College is very deceptive. It hides an agenda that could do much harm.
It is, quite simply, the Prince of Wales by stealth.
Follow-up
28 October 2010
Professor Sir Graeme Catto, who has, disgracefully, allowed his name to be used as president of this “College” has said to me “There are real problems in knowing how to care for folk with chronic conditions and the extent of the evidence base for medicine is pretty limited”.
Yes of course that is quite true. There are many conditions for which medicine can still do little. There is a fascinating discussion to be had about how best to care for them. The answer to that is NOT to bring in spiritual healers and peddlers of sugar pills to deceive patients with their fairy stories. The “College of Medicine” will delay and pervert the sort of discussion that Catto says, rightly, is needed.
29 October 2010
I need a press card. I see that the BMJ also had a piece about the “College of Medicine” yesterday: Prince’s foundation metamorphoses into new College of Medicine, by Nigel Hawkes. He got the main point right there in the title.
As was clear since July, the driving force was Michael Dixon, Devon GP and ex medical director of the Prince’s Foundation. Hawkes goes easy on the homeopaths and spiritual healers, but did spot something that I can’t find on their web site. The “Faculties” will include
“in 2011, neuromusculoskeletal care. Two of the six strong faculty members for this specialty are from the British Chiropractic Association, which sued the author Simon Singh for libel for his disobliging remarks about the evidence base for their interventions.”
The College certainly picks its moment to endorse chiropractic, a subject that is in chaos and disgrace after they lost the Singh affair.
One bit of good news emerges from Hawkes’ piece, There is at least one high profile doubter in the medical establishment, Lord (John) Walton (his 2000 report on CAM was less than blunt, and has been widely misquoted by quacks) is reported as saying, at the opening ceremony
“I’m here as a sceptic, and I’ve just told my former houseman that,” he said. The target of the remark was Donald Irvine, another former GMC president and a member of the new college’s advisory council.”
31 October 2010. I got an email that pointed out a remarkable service offered by a member of College’s Governing Council. Angie Buxton-King, a “spiritual healer” employed by UCLH seems to have another web site, The Beacon of Healing Light that is not mentioned in her biography on the College’s site. Perhaps it should have been because it makes some remarkable claims. The page about distant healing is the most bizarre.
Absent Healing/Distant Healing
"Absent healing is available when it is not possible to visit the patient or it is not possible for the patient to be brought to our healing room. This form of healing has proved to be very successful for humans and animals alike."
"We keep a healing book within our healing room and every night spend time sending healing to all those who have asked for it. We have found that if a picture of the patient is sent to us the healing is more beneficial, we also require a weekly update to monitor any progress or change in the patients situation. Donations are welcome for this service."
I wonder what the Advertising Standards people make of the claim that it is “very successful”? I wonder what the president of the College makes of it? I’ve asked him.
Other blogs about the “College of Medicine”
30 October 2010. Margaret McCartney is always worth reading. As a GP she is at the forefront of medicine. She’s written about the College in The Crisis in Caring and dangerous inference. She’s also provided some information about a "professional member" of the College of Medicine, in ..and on Dr Sam Everington, at the Bromley by Bow Centre….
It is one of the more insulting things about alternative medicine addicts that they claim to be the guardians of caring (as opposed to curing), They are not, and people like McCartney and Michael Baum are excellent examples.
Prince of Wales to become honorary president of the “College of Medicine?”
Last night I heard a rumour that the Prince of Wales is, despite all the earlier denials, to become Honorary President of the “College”. If this is true, it completes the wholesale transformation of the late, unlamented, Prince’s Foundation for Integrated Medicine into this new “College”. Can anybody take it seriously now?
Text messages to Graeme Catto and Michael Dixon, inviting them to deny the rumour, have met with silence.
Herbal nonsense at the College
29 July 2011. I got an email from the College if Medicine [download it]. It contains a lot of fantasy about herbal medicines, sponsered by a company that manufactures them. It is dangeroous and corrupt.
On Friday 25 August 2006, Michael Baum and I went to visit the rather palatial headquarters of the UCL Hospitals Trust (that is part of the NHS, not of UCL). We went to see David Fish, who was, at that time, in charge of specialist hospitals. That included world-leading hospitals like the National Hospital Queen Square, and Great Ormond Street children’s hospital. It also includes that great national embarrassment, the Royal London Homeopathic Hospital (RLHH).
It came as something of a surprise that the man in charge did not know the barmy postulates of homeopathy and he looked appropriately embarrassed when we told him.
Michael Baum is not only a cancer surgeon. but he has also taken the lead in thinking about palliative and spiritual needs of patients who suffer from cancer. Listen to his Samuel gee lecture: it is awe-inspiring. It is available in video, Concepts of Holism in Orthodox and Alternative Medicine.
The problem for UCLH Trust is that the RLHH has royal patronage One can imagine the frantic green-ink letters that would emanate form the Quacktitioner Royal, if it were to be shut down. Instead, we suggested that the name of the RLHH should be changed. Perhaps something like Hospital for palliative and supportive care? Well, four years later it has been changed, but the outcome is not at all satisfactory. From September it is to be known as the Royal London Hospital for Integrated Medicine.
What’s wrong with that? You have to ask what is to be "integrated" with what?. In practice it usually means integrating things that don’t work with things that do. So not much advance there. In fact the weasel word "integrated" is just the latest in a series of euphemisms for quackery. First it was ‘alternative’ medicine. But that sounds a bit ‘new age’ (it is), so then it was rebranded ‘complementary medicine’. That sounds a bit more respectable. Now it is often "integrated medicine" (in the USA, "integrative"). That makes it sound as though it is already accepted. It is intended to deceive. See, for example, Prince of Wales Foundation for magic medicine: spin on the meaning of ‘integrated’, and What ‘holistic’ really means.
Of course the amount of homeopathy practised at the RLHH has fallen considerably over the last few years. Already by 2007 there were signs of panic among homeopaths, They are beginning to realise that the game is up. Some of the gaps were filled with other sorts of unproven and disproved medicine.
What the hospital is called matters less than what they do, The current activities can be seen on the UCLH web site.
Services:
- Allergy Environmental and Nutritional Medicine
- Autogenics Training
- Children’s Clinic
- Complementary Cancer Care Programme
- Education services
- Musculoskeletal Medicine Clinic
- Pharmacy Services
- Skin Services
- Stress and Mood Disorders Clinic
- The Marigold Clinic – Homeopathic Podiatry and Chiropody
- Womens Clinic
It would be tedious to go through all of them, but here are some samples.
The Children’s Clinic
"The mainstay of treatments offered include Homeopathy, Herbal remedies, Flower essences, Essential oils, Tissue salts and Acupuncture. We also assess nutritional status, provide dietary advice and supplementation. Psychotherapeutic techniques including Neuro-Linguistic Programming (NLP), and Visualisation are sometimes used where indicated, to gain better understanding of the presenting problems".
So a wide range of woo there. And they claim to be able to treat some potentially serious problems
"What can be treated
A wide variety of clinical conditions are being treated including:
- Recurrent infections
- Skin diseases such as eczema
- Allergic disorders including asthma
- Food intolerances and eating disorders
- Functional developmental and learning problems
- Behavioural disorders including ADHD (hyperactivity) and autism."
There is, of course, no evidence worth mentioning thar any of these conditions can be treated effectively by “Homeopathy, Herbal remedies, Flower essences, Essential oils, Tissue salts and Acupuncture”.
They describe their success rate thus:
An internal audit questionnaire showed that 70% of children responded well to homeopathic treatment
So, no published data, and no control group. This is insulting to any patient with half a brain.
These claims should be referred to the Advertising Standards Authority and/or Trading standards. They are almost certainly illegal under the Consumer Protection Regulations (May 2008). The UCLH Trust should be ashamed of itself.
Education Services offers mainly courses in homeopathy, the medicines that contain no medicine,
Pharmacy Services stock thousands of bottles of pills, most of which are identical sugar pills. It’s hard to imagine a greater waste of money.
The Marigold Clinic – Homeopathic Podiatry and Chiropody
I was rather surprised to find this is still running. In 2006, I wrote about it in Conflicts of interest at the Homeopathic Hospital. It turned out that the prescription costs if the clinic were spent on Marigold paste, made by a company owned by the people who run the clinic. UCLH claimed that they were aware of this conflict of interest, but had no obligation to make it public. That is an odd ethics in itself. Even odder when I discovered that the Trust had been notified of the conflict of interest only after I’d started to ask questions.
The same people are still running the clinic. They may well be good chiropodists, If so why surround the service with woo. There are, almost needless to say, no good trials of the efficacy of marigold paste (and it isn’t homeopathic).
Conclusion
At the moment, it appears that the renaming of the RLHH is empty re-branding. No doubt UCLH Trust see homeopathy as something that brings shame on a modern medical service. But to remove the name while retaining the nonsense is simply dishonest. Let’s hope that the name change will be followed by real changes in the sort of medicine practised, Changes to real medicine, one hopes.
Other blogs on this topic
Gimpyblog was first, with Farewell to the RLHH, hello to the RLHIM
Quackometer posted An Obituary: Royal London Homeopathic Hospital, 1849-2010
Follow-up
Malaria in the news, yet again.
Today I had a not-very-friendly letter from Kate Birch
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From: kate birch <katebhom@hotmail.com> As I said we keep on working. while you and your kangaroo committee put on a good show. Try to take this one to the cleaners and more and more people will begin to see the fools that you really are. I hope western medicine saved you for your health crisis but that maybe when you depart you will see the how your bitterness twisted things and made you suffer so. |
You may recall the expose in which homeopaths in the UK were caught, in 2006, recommending their sugar pills for prevention of malaria, Lethal advice from homeopaths about malaria prevention
You may remember the saga of the taking down of Andy Lewis’s classic post in 2007 on The Gentle Art of Homeopathic Killing
Despite all this, in 2008, the trendy Covent Garden company, Neal’s Yard, tried marketing a homeopathic malaria "remedy". The quackometer’s post Neal’s Yard Remedies Offers Lethal Homeopathic Malaria Advice is a corker. Under pressure they withdrew the “remedy” (see Neal’s Yard Ethical Bullshit Remedy . Eventually Neal’s Yard was censured by the MHRA ( Neal’s Yard Remedies ‘rapped by medicines regulator’ )
Then there was Kate Birch of the North American Society of Homeopaths, who advocates sugar pills for every disease under the sun (and follow-up to these claims). Memorably, she visited me in late 2007 and gave me a copy of her book. A visit from Kate Birch sitll comes top of the front page if you google ‘kate birch homeopath’.
Attached to the unfriendly letter was a web page from Abha Light. It is an advertisement for a homeopathic malaria treatment. As far as I can see, it doesn’t say anywhere what the “remedy” contains, but that doesn’t matter if, as in most homeopathic products, it contains nothing whatsoever.
This document contains a direct claim that the treatment "has been successfully been used to prevent and treat malaria . . ."
There follows more utter fantasy
Nonsense like this would be a joke if it were not for the fact that they must be killing people.
Peter Fisher, clinical director the Royal London Homeopathic Hospital, said, of the original malaria scandal,
“I’m very angry about it because people are going to get malaria – there is absolutely no reason to think that homeopathy works to prevent malaria and you won’t find that in any textbook or journal of homeopathy so people will get malaria, people may even die of malaria if they follow this advice”
Like most quasi-religious subjects, homeopathy is split into sects, at war with each other.
Follow-up
Twenty-five hospitals from London and southern and eastern England have already either stopped sending any patients to the Royal London Homeopathic Hospital or agreed to fund only a handful A campaign has started o save it, but the arguments are far from convincing.
This is reposted from the original IMPROBABLE SCIENCE page
The news is out. It was in February this year when I first saw some “Commissioning Intentions 2007-08” documents from several London NHS Primary Care Trusts (PCT), indicating their intention to break their contracts with the RLHH on the very reasonable grounds that homeopathy doesn’t work. It seemed better to wait for the intentions to be implemented before saying much, because of the inevitable outcry from those who want sugar pills at the taxpayers’ expense.
Then, in March 2007, the Health Services Journal carried a story “PCTs consider alternative to homeopathic hospitals” (free registration, or read it here).
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On 8 April 2007, The Observer carried a special report, prominently featured on page 3.
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 Fisher and Queen, Observer 8 April 2007 |
Peter Fisher, clinical director of the RLHH, is quoted as saying
“Twenty-five hospitals from London and southern and eastern England have already either stopped sending any patients to the RLHH or agreed to fund only a handful.”
“Prince Charles is sympathetic, supportive and concerned. But he doesn’t feel it’s appropriate to intervene in any way because there’s been some adverse publicity before about him ‘meddling’. ”
Fisher attributes this to the letter sent to PCTs by 13 of us, last May, in which we advocated that the NHS should not be paying for “unproven or disproved treatments”. The leading signatory on this letter, Professor Michael Baum, is quoted in the Observer thus.
“If the Royal London were to close because of PCT deficits we would scarcely miss it”.
“Homeopathy is no better than witchcraft. It’s no better than a placebo effect. It’s patronising and insulting for adults.”
“Instead you could have a centre for palliative and supportive care, which would be of greater benefit and involve half the cost. Rather than losing something, we would gain something.”
The backlash
The reaction seems to have started with a letter from homeopath Carol Boyce. Her letter starts thus.
| ROYAL LONDON HOMEOPATHIC HOSPITAL UNDER SIEGE “Death by stealth. The Royal London Homeopathic Hospital (RLHH) – the visible presence of homeopathy within Britain’s NHS – an institution putting homeopathy in the public mind for the last 150 years – the place where homeopathy was seen to perform so well in the cholera epidemic of the 1840s – is being dealt a DEATH BLOW” |
I’d guess the very first sentence must be something of an embarrassment to the RLHH’s clinical director, who is far too sensible to believe that cholera can be cured by homeopathic sugar pills.
The red herring about cholera is repeated ad nauseam on hundreds of homeopathy sites (though most are curiously silent about whether they really believe that sugar pills can cure cholera). It is based on the report that during the London Cholera epidemic of 1854, of the 61 cases of cholera treated at the London Homeopathic Hospital, 10 died (16.4%), whereas the neighbouring Middlesex Hospital reported 123 deaths out of 231 cases of cholera (53.2%). Apart from the lack of any knowledge of the state of the patients on entry to hospital, it was also the case at the time that conventional medicine was no more based on evidence than homeopathy. Indeed the initial popularity of homeopathy could well have resulted not only from wishful thinking, but also because doing nothing at all (i.e. homeopathy) was less harmful than blood letting. The fallacy of the argument was spotted very early on by Oliver Wendell Holmes (senior) in his famous essay, Homeopathy and its Kindred Delusions.
But medicine moved on and homeopathy didn’t. The history of cholera, like that of tuberculosis, contrary to what is suggested by homeopaths, is a triumph for evidence based medicine. The epidemic was halted not by homeopaths but by the careful observations of John Snow that led to his removing the handle of the Broad Street pump. If medicine had been left to homeopaths, people would still be dying of these diseases.
Carol Boyce invites you to write directly to Queen Elizabeth II, to save the RLHH. She has also started an e-petition on the UK government site. The petition includes the words
| ROYAL LONDON HOMEOPATHIC HOSPITAL UNDER SIEGE
“The RLHH has been part of the Health Service for 150 years. ” “In 2005, 67% of GPs and 85% of practices in it’s [sic] Primary Care Trust, referred patients to the hospital. The hospital provides effective and most importantly, COST-EFFECTIVE treatments.” |
Ms Boyce seems not to have noticed that the Prince of Wales’ own Smallwood report decided that there was not enough evidence to come to firm conclusions about cost-effectiveness.
Peter Fisher himself has appealed for the survival of the RLHH in a letter dated 9 March 2007 [download copy of letter].
“The Royal London Homoeopathic Hospital needs your support
09/03/2007By Dr. Peter Fisher, Homeopath to Her Majesty, the Queen.
There is no silly talk about cholera here, but there is a useful list of Trusts who have decided to abandon "unproven and disproved treatments". Fisher recommends you to read Marcia Angell’s book to learn about the deficiencies of the drug industry. I recommend that too. I also recommend Dan Hurley’s book on the even greater deficiencies of the quackery industry.
Fisher suggests you write to your MP to prevent closure of the RLHH.
I suggest you write to your MP to support closure of the RLHH.