The Danger of Science Denial - "Alternative Medicine"-Split

Homeopathy, Chiropractic and similar "alternative" views

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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#861  Postby Dudely » Jun 21, 2010 1:52 pm

Dr. Nancy Malik wrote:
Dudely wrote:
I seriously doubt that if there was evidence to show that homeopathy works that the mere fact that a clinical trial "doesn't acknowledge the variation of individual response to disease and treatment" would prevent that from coming to light. As I said earlier in this thread- if it does work there is a reason, and you should be able to figure out why and witness this happening.



Let's take an example. Say we are doing a trial for migraine headaches.

First we have to find look at our cured cases for people with migraine headaches. Then we look at what homeopathic remedies were prescribed in these cases. We find in 100 cases we used 20 different remedies in total but 40% of them responded to the remedy Natrum Muriaticum. So we select that remedy for the trial.

Then we do the trial. Don't forget only Nat. Mur. is used for every patient in the trial. Let's say the results show that 35% of subjects reported a significant improvement in symptoms after taking the remedy. The trial concludes that homeopathy has an effect above that of placebo.

But this is less than half the story. What would happen if a skilled homeopath were then allowed to individualize the 65% of cases that reported no improvement and prescribe any remedy he or she felt was indicated? I would expect that around 80% of these remaining cases would report a significant improvement.


How do you explain that even when you give them whatever homeopathic remedy you please it STILL DOESN'T PERFORM BETTER THAN A PLACEBO? I am NOT talking about traditional medical trials, I am talking about doing whatever you like, however you like. There have been studies done like this. They have all failed to show a significant improvement over a placebo. Stop trying to obfuscate the issue by blathering on about how conventional medicine has it out for you.

What I was talking about in my post is the mechanism by which homeopathy does its job. Supposedly it's doing something, and I would think that you can look at it working. Couldn't you do a study on the immune systems of people on homeopathy and see that it triggers their immune systems or whatever your claim is?
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#862  Postby Thommo » Jun 21, 2010 2:19 pm

Dr. Nancy Malik wrote:
DST70 wrote:As long as diagnosis and treatment is centered around discrete disease entities with homogeneous causation and progression, it underplays symptomology that greatly varies from case to case and from patient to patient. It underestimates variation in human health and illness, variation in real world cases that clinical trials can not so easily replicate.


The embryology [Bhatnagar`s embryology] text says: “embryology has no explanation for the unfailing uniqueness of each individual ---face / fingerprints, pattern of sulci and gyri on the brain or the veins on the dorsum of the hand. if basically the same processes work to shape all the human beings they should all look alike; but they never are.More forces then are at work in shaping each embyro than can be described.”
and what are these different forces responsible for individualisation they are the genes


If this was true, all snowflakes would be identical.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#863  Postby Shrunk » Jun 21, 2010 2:48 pm

Dr. Nancy Malik wrote: Let's take an example. Say we are doing a trial for migraine headaches.

First we have to find look at our cured cases for people with migraine headaches. Then we look at what homeopathic remedies were prescribed in these cases. We find in 100 cases we used 20 different remedies in total but 40% of them responded to the remedy Natrum Muriaticum. So we select that remedy for the trial.

Then we do the trial. Don't forget only Nat. Mur. is used for every patient in the trial. Let's say the results show that 35% of subjects reported a significant improvement in symptoms after taking the remedy. The trial concludes that homeopathy has an effect above that of placebo.

But this is less than half the story. What would happen if a skilled homeopath were then allowed to individualize the 65% of cases that reported no improvement and prescribe any remedy he or she felt was indicated? I would expect that around 80% of these remaining cases would report a significant improvement.


So in your imaginary study you are able to achieve an 80% reponse rate? That's not too impressive. In my imaginary study, I get a response rate of 346%, plus everyone receiving my treatment wins the lottery, finds true love forever, and gets a pony.

In the meantime, in the world of studies that actually exist:

Homeopathic Prophylaxis of Headaches and Migraine? A Systematic Review
Edzard Ernst, MD, PhD, FRCP (Edin)
Department of Complementary Medicine, School of Postgraduate Medicine and Health Sciences,
University of Exeter, Exeter, United Kingdom


Abstract
Homeopathy is often advocated as a prophylaxis of migraine and headaches. The aim of this
systematic review was to evaluate the clinical trials, testing the efficacy of homeopathy for these
indications. Independent computerized literature searches were carried out in 4 databases.
Only randomized, placebo-controlled trials were included. Four such studies were found. Their
methodological quality was variable but, on average, satisfactory. One study suggested that
homeopathic remedies were effective. The other, methodologically stronger trials did not support
this notion. It is concluded that the trial data available to date do not suggest that
homeopathy is effective in the prophylaxis of migraine or headache beyond a placebo effect.
J Pain Symptom Manage 1999;18:353–357.

http://download.journals.elsevierhealth ... 000950.pdf


Note: These studies used "individualized" "treatments" as you suggest above.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#864  Postby OHSU » Jun 21, 2010 2:51 pm

Dr. Nancy Malik wrote:In Homeopathy, we do not treat diseases based on their medical diagnosis, but remedies are chosen based on the individualizing features of each case, hence 100 patients of, say, high blood pressure, may probably need 100 different remedies, each patient receiving a remedy to suit him/her best.


How do you know what remedy is "best" for a given set of individualizing features if you haven't done any kind of study to determine which remedy treats a given set of symptoms best?

Then we do the trial. Don't forget only Nat. Mur. is used for every patient in the trial. Let's say the results show that 35% of subjects reported a significant improvement in symptoms after taking the remedy. The trial concludes that homeopathy has an effect above that of placebo.


You realize that 35% is within the expected parameters for the placebo effect in analgesics, right?

Variation in the placebo effect in randomised controlled trials of analgesics: all is as blind as it seems.
McQuay H, Carroll D, Moore A.


"The proportion who obtained more than 50% of the maximum possible pain relief with placebo varied from 7% to 37% across the trial."
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#865  Postby Shrunk » Jun 21, 2010 3:04 pm

OHSU wrote:You realize that 35% is within the expected parameters for the placebo effect in analgesics, right?


As was clear from her very first post in this thread, Nancy Malik doesn't know what a placebo is.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#866  Postby Dr. Nancy Malik » Jun 21, 2010 4:07 pm

TMB wrote:
Shrunk wrote:
DST70 wrote:
Homeopathy is said to be ineffective mostly because it gives inconclusive or poor results in clinical trials. Clinical trials are the product of a medical paradigm that assumes a 'normal' level of diversity in human health. It's focussed on diagnosing and grouping common symptoms, and doesn't acknowledge the variation of individual response to disease and treatment. It's not a surprise to me that homeopathy doesn't show a lot of success in clinical trials.


Wrong. It is precisely because of the "variation of individual response to disease and treatment" that randomized controlled trials are necessary. If there was uniformity in response, then trials would be unecessary.



I would say wrong again. Randomised, controled trials exists to ensure that causation is not mixed with correlation, when it comes to efficacy of various drugs and treatments. However it also highlights just how much of any medical process is taken as self evident. We do not conduct randomised, controled trials to confirm that swelling arises following a bone break, we infer this on anecdotal evidence and using our judgement of inference. If someone does not feel well and they are also running a fever, we do not run a trial to make sure we are not confusing cause with correlation. This are extreme examples, but it highlights just how much we rely upon self-evident things in any human system, not only conventional medicine.

To dismiss judgement and inference in experienced practitioners as anecdotal evidence, would also mean that much of conventional medicine also is dismissed for the same reason. The actual scope of trils is very limited and mnay doctos infer from anecdotes.

This also applies to normal life. If a kid at school gets bullied and then feels upset, next time around he infers that bullying makes him upset, he does not need a trial to confirm this for him. The process around just about every form of human behavior is based upon direct experience and inference, not trials. This does not mean that trials are not useful to ensure that causation and correlation are not confused, but it means they are just a small part of conventional medicine.

The range of apparent symptoms arising from food intolerances seems bewildering. Should we suspend judgement and treatment until every one of these has been verified by a trial? If we consider food intolerances to be part of conventional medicine, imagine how limited we would be if we could only operate on the basis of things proven in multiple trials. There is also a big difference between using trials to ensure that treatment works and does not have side effects, and trials that are conducted to establish cause and correlation.


Any audit of a competent homeopaths' practice is all that is needed to verify homeopathy's theory and prove that homeopathy medicines are effective. If a patient who has had eczema for 10 years despite the best efforts of their conventional doctor goes to see a homeopath and is eczema free three to 6 months later would one consider that convincing evidence? Grateful patients would be happy to verify it was so.

Oh yes, I forget, this is anecdotal evidence and is therefore considered invalid.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#867  Postby Dr. Nancy Malik » Jun 21, 2010 4:12 pm

Shrunk wrote:
I would just add that a basic principle of scientific investigation is that all potential confounding variables should be controlled for as much as possible. Since the placebo effect is a known variable in clinical investigation, RCT's are the most effective method of dealing with this. As GenesForLife has already mentioned, this does not mean that an RCT is required in all basic science research. When physicists detonated the first hydrogen bomb, they did not need to compare it to a placebo bomb to ensure that the resulting explosion did not just occur randomly.


And speaking of research, can I assume that you all believe that surgery is unscientific quackery due to the lack of randomized double-blind placebo controlled trials? how come skeptics tend to ignore this one?
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#868  Postby Shrunk » Jun 21, 2010 4:16 pm

Dr. Nancy Malik wrote: And speaking of research, can I assume that you all believe that surgery is unscientific quackery due to the lack of randomized double-blind placebo controlled trials? how come skeptics tend to ignore this one?


Go here. Do a search for "surgery randomized controlled trial". Come back and tell us how many hits you get.

(Hint: The answer is greater than zero.)
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#869  Postby Dr. Nancy Malik » Jun 21, 2010 4:24 pm

RPizzle wrote:
Dr. Nancy Malik wrote:

Homeopathy medicine for various disease conditions http://www.trusthomeopathy.org/research ... dence.html


Looking at the list of conditions in which homeopathy treats (from the site provided):

Dry mouth

HIV infection

While I think I can work out the mechanism in which homeopathy fixes the first condition, could I get an explanation on the mechanism for the second one?


http://ecam.oxfordjournals.org/cgi/cont ... 5/2/221#T2
http://www.ncbi.nlm.nih.gov/sites/entre ... d_RVDocSum
http://www.ncbi.nlm.nih.gov/sites/entre ... d_RVDocSum
http://www.ncbi.nlm.nih.gov/sites/entre ... d_RVDocSum
http://www.ncbi.nlm.nih.gov/sites/entre ... d_RVDocSum
http://gateway.nlm.nih.gov/MeetingAbstr ... 31175.html
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#870  Postby Dr. Nancy Malik » Jun 21, 2010 4:28 pm

campermon wrote:
Dr. Nancy Malik wrote:
I repeat. Many things in this world cannot be explained by 'science' and that is the beauty of the wonder of life. You can either live in the mainstream and wait until its widely accepted, then you believe it, or you can look back thousands of years and believe what your forefathers believed before 'science' came along.


Correct me if I'm wrong 'Dr'. But didn't most of our ancient 'forefathers' tend to lead short lives made miserable by medical conditions that are routinely cured by modern medicine today? Also, is it not a fact that on average humans live longer than they ever have in recorded history?

:coffee:


And how did you assume that it is only due to 'modern' medicine?
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#871  Postby DST70 » Jun 21, 2010 4:31 pm

Dr. Nancy Malik wrote:
DST70 wrote: *snip*


Dr.Syed Ahmed (SFA) have an example to illustrate this

1- Hot days, loose motions, water, several times a day with pains. (call it diarrhea).
2- Hot days, loose motions with severe cramps coming in waves.(call it diarrhea too).
3- Travelling man, never without watery stools that want him to rush to the utility. (diarrhea again)

Now for an effective homeopath, it never mattered to call it diarrhea or xyz. As the symptoms are varying to an extent that the remedies are changing - every condition must have been different is some respect.

Carefully selected remedy would clear the complaint quickly.


Thanks Nancy. This is a useful point to illustrate cases where the disease state is not best viewed as a single discrete entity, which presents problems for a reductionist science.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#872  Postby Shrunk » Jun 21, 2010 4:33 pm



:lmao:

Just quickly looked at the first article you provided. It doesn't answer RPizzle's question in anyway, but instead says this (my bold):

This study was designed to assess AIDS knowledge and attitudes among homeopathy physicians and educators for the purpose of developing a more effective training program. Findings revealed that knowledge of AIDS transmission, the nature of HIV and the impact of the AIDS virus on the immune system was higher than other cognitive knowledge items. Few homeopathic physicians were aware that AIDS could damage the brain. In addition, <75% of physicians were aware that a person with the AIDS virus can look or feel well, or that infection with the HIV virus and having the disease AIDS were separate stages of disease, these findings may partly be due to conceptual differences in the perceptions of disease in conventional medicine and homeopathy. The lack of cognitive knowledge was not surprising given that these participants verbalized in the previous focus groups a lack of organized CME for homeopathic practitioners; in fact, most of the participants had not received any training in HIV/AIDS and, therefore, demonstrated limited knowledge of HIV/AIDS. Clearly, education might assist with more information about the signs and symptoms of HIV/AIDS and clinical manifestations ranging from asymptomatic to symptomatic stages of HIV/AIDS for all health care providers.


Are the other articles as "supportive" of homeopathy as this one? Do you even read things before you post them?

Is it part of the "holistic, treat the whole patient" philosophy of homeopathy to ignore the fact that HIV commonly affects the brain, with often devastating consequences?

(Note: When they refer to "physicians" above, they mean homeopaths, not actual doctors.)
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#873  Postby Shrunk » Jun 21, 2010 4:36 pm

DST70 wrote:
Dr. Nancy Malik wrote:
DST70 wrote: *snip*


Dr.Syed Ahmed (SFA) have an example to illustrate this

1- Hot days, loose motions, water, several times a day with pains. (call it diarrhea).
2- Hot days, loose motions with severe cramps coming in waves.(call it diarrhea too).
3- Travelling man, never without watery stools that want him to rush to the utility. (diarrhea again)

Now for an effective homeopath, it never mattered to call it diarrhea or xyz. As the symptoms are varying to an extent that the remedies are changing - every condition must have been different is some respect.

Carefully selected remedy would clear the complaint quickly.


Thanks Nancy. This is a useful point to illustrate cases where the disease state is not best viewed as a single discrete entity, which presents problems for a reductionist science.


Any semi-competent "allopathic" practitioner would take a history focussing on the same factors. The claim that medicine considers "diarrhea" a single, monolithic entity is a ridiculous lie.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#874  Postby DST70 » Jun 21, 2010 4:37 pm

Paul wrote:So in other words homoeopathy can't be validated in any way? We just have to have "faith"?


I don't see a way to validate any mechanism of homeopathy within current understanding of the physical sciences. I think it's logically and empirically possible to validate the efficacy of a homeopathic remedy, but not without considerable shifts in the viewpoint of medicine. Can't see it happening for a while, but who knows what the future holds?

Is faith really the only thing you're left with after all this?
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#875  Postby Shrunk » Jun 21, 2010 4:40 pm

DST70 wrote:
Paul wrote:So in other words homoeopathy can't be validated in any way? We just have to have "faith"?


I don't see a way to validate any mechanism of homeopathy given current understanding of the physical sciences. I think it's logically and empirically possible to validate the efficacy of a homeopathic remedy, but not without considerable shifts in the viewpoint of medicine. Can't see it happening for a while, but who knows what the future holds?


What kind of "shifts in viewpoints" are you suggesting? Homeopathy is perfectly suited for verification by randomized trials, as it is simply a matter of comparing "active treatment" to placebo. And the answer is clear: Homeopathy doesn't work.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#876  Postby Dudely » Jun 21, 2010 5:05 pm

Shrunk wrote:
DST70 wrote:
Paul wrote:So in other words homoeopathy can't be validated in any way? We just have to have "faith"?


I don't see a way to validate any mechanism of homeopathy given current understanding of the physical sciences. I think it's logically and empirically possible to validate the efficacy of a homeopathic remedy, but not without considerable shifts in the viewpoint of medicine. Can't see it happening for a while, but who knows what the future holds?


What kind of "shifts in viewpoints" are you suggesting? Homeopathy is perfectly suited for verification by randomized trials, as it is simply a matter of comparing "active treatment" to placebo. And the answer is clear: Homeopathy doesn't work.


To make Shrunk's point clear- he is not talking about medical trials where you take one medicine and test it. He is talking about the studies that have been done which focused on its efficacy as a whole- one of which is posted by him further up this page. In that study homeopathic practitioners were allowed to treat the patients however they liked. They were allowed to "individualize", as it was put by the good Doctor. This was compared against a control group of placebos and it was found to be no more effective. I would say the efficacy has been validated quite clearly in this case- practitioners were allowed to practice as they liked with no intervention by the current "viewpoint of medicine", and it was found lacking. am I missing something here? How is this not evidence that it is no more effective?

If I claimed I could cure people by talking to them on the phone and attempted to do so thousands of times (or, hell, even a half dozen) I would have a great many successes. There would be many people completely convinced and ready to back up my powers with the greatest of conviction. I could even cure powerful diseases like cancer and HIV, since there have been cases where those diseases go away randomly on their own for no apparent reason. If I "treated" someone right before that happened then it would appear to be my doing. Yet none of this is evidence and, most importantly, none of this makes my claim even INTERESTING to those who understand what's at work. I'd just be some random guy spouting bullshit and ripping people off (Oh I would charge of course. Can't let such a gift go to waste). Such things are common.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#877  Postby Dr. Nancy Malik » Jun 21, 2010 5:18 pm

Shrunk wrote:
Dr. Nancy Malik wrote: I repeat. Many things in this world cannot be explained by 'science' and that is the beauty of the wonder of life. You can either live in the mainstream and wait until its widely accepted, then you believe it, or you can look back thousands of years and believe what your forefathers believed before 'science' came along.


You keep contradicting yourself. First you say that "Real science is homeopathy", but then you say we shouldn't trust science. If science says homeopathy works, and science is always wrong, then that means homeopathy doesn't work, doesn't it?

OTOH, if your position is that homeopathy has no scientific evidence to support it, and people who use it are just blindly and randomly trusting their health to a bunch of magical rituals with no evidence to back it up, then we can end this discussion on a note of complete agreement.


False. I have not said not to trust science

It's not my position. I think you are worn down with the length of discussion and can't take it more
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#878  Postby Shrunk » Jun 21, 2010 5:19 pm

As a slight digression, one of my hobbies is Hi Fi equipment, an area which is beset by many claims quite similar to those made by homeopaths. A company exists, Machina Dynamica, about which I remain undecided as to whether it is a scam, a joke, a sociological experiment, or a sincere but misguided business enterprise. One look at their website should give an idea of the reason for my confusion.

Their most audacious product so far goes by the name The Teleportation Tweak, and is described thusly:

The Teleportation Tweak is a phenomenal new product discovered and developed by Machina Dynamica for improving audio and video systems remotely over long distances. The fundamental principle of operation of the Teleportation Tweak is quantum teleportation. How the Teleportation Tweak works is the proprietary property of Machina Dynamica.

The Teleportation Tweak is independent of distance and will work anywhere in the world you happen to be located. The Teleportation Tweak is performed frequently for distances between 1000 and 4000 miles and has been performed for distances greater than 10,000 miles. The Teleportation Tweak works equally well using your landline phone or cell phone.

The Teleportation Tweak has a profound effect on the sound of your system: (1) Clearer, (2) More information, (3) Greater frequency extension and (4) Lower distortion. You obtain the the Teleportation Tweak during a phone call to Machina Dynamica from your landline phone or cell phone; you can make the call from any room in your house. The tweak itself takes about 20 seconds and will sound like a series of sharp, mechanical pulses.

The Teleportation Tweak will also improve any video system in your house, including plasma, HDTV and high end projection systems -- better contrast, color saturation, color fidelity and definition. The Teleportation Tweak works for iPhone and other smart phones when listening to music is a priority.

It is not necessary for your audio or video system to be ON at the time of the telephone call. However, for ease of A/B comparing the Teleportation Tweak before and after the telephone call, you should turn the audio and/or video system ON prior to the call. Then you can evaluate a few favorite tracks BEFORE AND AFTER the Teleportation Tweak is performed. You can also evaluate the picture quality of the video system before and after the call.

You will find that the effects of the Teleportation Tweak are instantaneous and that the improvement to sound quality is immediately audible. In fact, if the system is playing at the time of the telephone call, you will be able to hear the improvement taking place while the Teleportation Tweak is being performed. You will find the Teleportation Tweak excels in 3-dimensionality, lushness, inner detail and air. The picture quality of any video system in the house will also be improved -- better contrast and integrity of color and blacker black. You will especially notice better skin tones, saturation of colors, shininess of surfaces, textures of fabrics, etc.


Audio internet forums have experienced impassioned debate, not unlike this one, regarding the validity of these claims, and audio magazines have even reviewed the products, with some claiming positive results.

Just thought I'd share that.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#879  Postby Dr. Nancy Malik » Jun 21, 2010 5:21 pm

DST70 wrote:
Paul wrote:So in other words homoeopathy can't be validated in any way? We just have to have "faith"?


I don't see a way to validate any mechanism of homeopathy within current understanding of the physical sciences. I think it's logically and empirically possible to validate the efficacy of a homeopathic remedy, but not without considerable shifts in the viewpoint of medicine. Can't see it happening for a while, but who knows what the future holds?

Is faith really the only thing you're left with after all this?


I can think of two ways to do it, and there are probably more.

1. Find a group of patients who all need the same remedy, and then either give them the remedy or a placebo -- double blind.

2. Have a homeopath prescribe an individual remedy for each patient, and have an assistant decide who gets the remedy and who gets the placebo.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#880  Postby Shrunk » Jun 21, 2010 5:22 pm

Dr. Nancy Malik wrote: [False. I have not said not to trust science

It's not my position. I think you are worn down with the length of discussion and can't take it more


Science says homeopathy does not work.

You say disregard that, and rely on personal, anecdotal experience instead.

IOW, you say not to trust science.
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