WEBVTT 1 00:00:00.000 --> 00:00:04.020 My name's Duncan Steele. I'm a member of the Advisory Committee for the Adelaide Festival of Ideas, 2 00:00:04.040 --> 00:00:10.160 and the wonderful thing about being on that little committee is that we get to put the programme together, 3 00:00:10.320 --> 00:00:14.040 which means we fight over who we're going to invite from all around the world to come and speak to you. 4 00:00:14.560 --> 00:00:18.020 And very often it is a bit of a fight. We're trying to persuade our fellow committee members 5 00:00:18.780 --> 00:00:23.540 that this is a person who's just fantastic, great speaker, great ideas and everything else. 6 00:00:24.240 --> 00:00:28.500 And quite often we walk in with a whole page of reasons why this person should be invited. 7 00:00:29.100 --> 00:00:32.340 I only went through two or three bullet points on mine before they said, 8 00:00:32.400 --> 00:00:34.320 yes, we want Simon Singh to come along. 9 00:00:35.440 --> 00:00:38.720 Again, I'm not going to waste his time and your time by going through all of his accomplishments, 10 00:00:39.040 --> 00:00:43.680 the books he's written, the TV programmes he's made and so on, because you're here to listen to him, not to me. 11 00:00:44.820 --> 00:00:48.980 But you would have seen him on TV. Maybe in the last few days you would have heard him on the radio. 12 00:00:49.120 --> 00:00:52.860 You may have seen him speaking already. I'm going to hand straight over to him. Simon Singh. 13 00:00:57.020 --> 00:00:57.880 Thank you, Duncan. 14 00:00:58.500 --> 00:01:01.060 Thank you for inviting me here. It's been a real pleasure to be here for a couple of days 15 00:01:01.060 --> 00:01:05.440 and to enjoy Adelaide and enjoy some of the other events that have been going on. 16 00:01:06.940 --> 00:01:13.920 I'm going to talk this morning only for about 20, 25 minutes to then throw it back to you for questions 17 00:01:14.480 --> 00:01:18.100 on the subject of trickle treatment, which is a book about alternative medicine. 18 00:01:19.940 --> 00:01:25.140 But if you've read any of my other books, you'll know this is quite a departure from what I've written about in the past. 19 00:01:25.220 --> 00:01:28.360 I've written about mathematics and I've written about cryptography. 20 00:01:28.500 --> 00:01:30.120 I've written about chemistry and information security. 21 00:01:31.140 --> 00:01:36.080 Because I'm a science journalist and I write about anything and everything that interests me or fascinates me. 22 00:01:36.420 --> 00:01:40.740 In fact, the last book I wrote was, if I can get my PowerPoint up and running. 23 00:01:41.060 --> 00:01:41.720 Here we go. 24 00:01:41.860 --> 00:01:44.480 The last book I wrote was about cosmology. It was called Big Bang. 25 00:01:45.840 --> 00:01:49.580 And just to put me into context, I thought I'd tell you a little bit about this very briefly. 26 00:01:50.080 --> 00:01:53.980 And how, as a writer, you become so obsessed about your topic. 27 00:01:54.260 --> 00:01:58.480 Many of the academics here take one subject and devote their entire lives to it. 28 00:01:58.500 --> 00:02:01.980 I take a subject for three or four years and focus on it. 29 00:02:02.040 --> 00:02:03.920 But still the obsession is very real. 30 00:02:04.240 --> 00:02:10.620 And my obsession on this subject, I think, was best typified when I'd just finished writing the book 31 00:02:10.620 --> 00:02:15.120 and I was sat at home one day and I was obsessed about the universe and how the universe was created 32 00:02:15.120 --> 00:02:17.400 and when it was created and how it evolved. 33 00:02:17.800 --> 00:02:20.000 And I'll be talking a bit about that later this afternoon. 34 00:02:20.900 --> 00:02:23.200 But I became so obsessed that there was a song on the radio. 35 00:02:24.660 --> 00:02:26.240 And it caught my attention. 36 00:02:26.320 --> 00:02:28.020 It was a song by somebody called Katie Mellower. 37 00:02:28.500 --> 00:02:31.320 And the song was called Nine Million Bicycles. 38 00:02:31.580 --> 00:02:32.900 And the song goes, 39 00:02:32.980 --> 00:02:34.320 There are nine million bicycles in Beijing. 40 00:02:34.380 --> 00:02:35.120 That's a fact. 41 00:02:35.260 --> 00:02:37.100 Just like the fact that I love you. 42 00:02:37.180 --> 00:02:38.000 La-di-da-di-da. 43 00:02:38.160 --> 00:02:38.980 It's a very nice song. 44 00:02:39.220 --> 00:02:41.800 The second verse, however, goes like this. 45 00:02:44.140 --> 00:02:48.820 We are 12 billion light years from the edge. 46 00:02:50.200 --> 00:02:51.340 That's a guess. 47 00:02:52.540 --> 00:02:55.580 No one can ever say it's true. 48 00:02:56.160 --> 00:03:00.060 But I know that I will always be with you. 49 00:03:01.520 --> 00:03:04.480 Now, I'm sure you can see the problem with that just as clearly as I can. 50 00:03:05.840 --> 00:03:07.660 We're not 12 billion light years from the edge. 51 00:03:07.760 --> 00:03:12.460 If that's an implication for the age of the universe, the universe is 13.7 billion years old. 52 00:03:13.180 --> 00:03:14.120 It's not a guess. 53 00:03:14.220 --> 00:03:15.620 In science, we don't make guesses. 54 00:03:16.520 --> 00:03:17.920 No one can ever say it's true. 55 00:03:19.360 --> 00:03:20.340 That's fair enough. 56 00:03:20.380 --> 00:03:22.140 But in science, we can get closer to the truth. 57 00:03:22.240 --> 00:03:23.140 That's the important thing. 58 00:03:23.500 --> 00:03:25.240 But I know that I will always be with you. 59 00:03:25.240 --> 00:03:27.260 Well, at this point, I can't trust a word this woman says. 60 00:03:28.400 --> 00:03:31.660 So I wrote an article for The Guardian. 61 00:03:31.900 --> 00:03:36.060 And I explained why this song annoyed me. 62 00:03:36.080 --> 00:03:37.040 And it was only a piece of fun. 63 00:03:37.220 --> 00:03:41.540 I was just trying to say it's amazing that we're tiny animals on a tiny planet with tiny brains. 64 00:03:41.780 --> 00:03:43.420 And yet we can look up into the universe. 65 00:03:43.680 --> 00:03:45.420 And we can begin to unravel it. 66 00:03:45.720 --> 00:03:48.660 So it was just a piece of fun with a semi-serious point. 67 00:03:49.000 --> 00:03:51.040 And at the end of the article, I rewrote the lyrics. 68 00:03:51.440 --> 00:03:52.940 So my version of the lyrics went, 69 00:03:53.860 --> 00:03:55.220 We are 13.7 billion light years from the edge. 70 00:03:55.240 --> 00:03:57.100 We are 13.7 billion light years from the edge of the observable universe. 71 00:03:57.360 --> 00:03:59.000 That's a good estimate with well-defined error bars. 72 00:03:59.320 --> 00:04:02.300 And with the available information, I predict that I will always be with you. 73 00:04:07.680 --> 00:04:09.860 But amazingly, the same day this article was published, 74 00:04:09.920 --> 00:04:11.520 actually the following day that the article was published, 75 00:04:13.220 --> 00:04:14.280 I got a phone call. 76 00:04:14.440 --> 00:04:15.600 And it was Katie Mellower. 77 00:04:17.340 --> 00:04:19.240 And it turned out that when she was a young girl, 78 00:04:19.280 --> 00:04:20.740 she was a member of the astronomy club at school. 79 00:04:20.880 --> 00:04:21.800 And she liked science. 80 00:04:21.820 --> 00:04:22.500 And she liked astronomy. 81 00:04:22.600 --> 00:04:23.760 And she kind of liked the fun of this. 82 00:04:23.760 --> 00:04:26.880 And she re-recorded her song. 83 00:04:26.940 --> 00:04:27.800 We met up at the BBC. 84 00:04:27.980 --> 00:04:31.040 And she re-recorded her song using my lyrics. 85 00:04:31.900 --> 00:04:34.600 So I'll just play you this very, very briefly. 86 00:04:34.720 --> 00:04:35.960 High point of my career. 87 00:04:37.220 --> 00:04:40.060 Katie Mellower singing her song, but with my lyrics. 88 00:04:40.420 --> 00:04:45.900 We are 13.7 billion light years from the edge of the observable universe. 89 00:04:46.860 --> 00:04:50.000 That's a good estimate with well-defined error bars. 90 00:04:50.500 --> 00:04:52.500 And with the available information, 91 00:04:53.760 --> 00:04:58.280 I predict that I will always be with you. 92 00:05:04.280 --> 00:05:07.900 So, how did I get from there to writing about alternative medicine? 93 00:05:08.140 --> 00:05:11.060 Well, it started off with acupuncture. 94 00:05:11.140 --> 00:05:16.160 I was watching a TV program just back three or four years ago now. 95 00:05:16.200 --> 00:05:17.400 I was sat at home watching a program. 96 00:05:17.780 --> 00:05:23.260 And I was watching it because it was called... 97 00:05:23.780 --> 00:05:25.660 Alternative Medicine, The Evidence. 98 00:05:26.460 --> 00:05:30.060 And alternative medicine is one of those things that's becoming increasingly popular. 99 00:05:30.380 --> 00:05:32.120 And I was curious, what is the evidence? 100 00:05:32.380 --> 00:05:33.120 And here was a program. 101 00:05:33.200 --> 00:05:33.840 It was the BBC. 102 00:05:35.620 --> 00:05:41.320 And it was BBC Two, the kind of most academic channel, perhaps. 103 00:05:41.900 --> 00:05:44.500 It was made by the Open University. 104 00:05:44.940 --> 00:05:46.460 Again, very respected institution. 105 00:05:46.960 --> 00:05:52.020 And it was presented by Professor Kathy Sykes, who's a professor of science communication. 106 00:05:52.520 --> 00:05:53.740 And someone who has a degree in medicine. 107 00:05:53.740 --> 00:05:54.000 ... ... 108 00:05:58.300 --> 00:05:58.460 ... 109 00:06:05.780 --> 00:06:05.940 ... 110 00:06:08.920 --> 00:06:09.080 ... 111 00:06:09.080 --> 00:06:09.220 ... 112 00:06:10.100 --> 00:06:10.260 ... 113 00:06:11.560 --> 00:06:11.720 ... 114 00:06:13.360 --> 00:06:13.520 ... 115 00:06:14.460 --> 00:06:14.620 ... 116 00:06:14.620 --> 00:06:14.640 ... 117 00:06:14.640 --> 00:06:14.680 ... 118 00:06:14.680 --> 00:06:14.820 ... 119 00:06:14.820 --> 00:06:14.880 ... 120 00:06:14.880 --> 00:06:14.940 ... 121 00:06:14.940 --> 00:06:14.960 ... 122 00:06:14.960 --> 00:06:14.980 ... 123 00:06:14.980 --> 00:06:15.020 ... 124 00:06:15.020 --> 00:06:15.040 ... 125 00:06:16.320 --> 00:06:16.480 ... 126 00:06:16.480 --> 00:06:16.540 ... 127 00:06:16.540 --> 00:06:16.580 ... 128 00:06:16.580 --> 00:06:16.600 ... 129 00:06:16.600 --> 00:06:16.620 ... 130 00:06:23.560 --> 00:06:23.720 ... 131 00:06:23.720 --> 00:06:29.640 to China. And a journalist called James Reston suffered a severe appendicitis, I think, had an 132 00:06:29.640 --> 00:06:36.920 operation in China, had stomach pains afterwards, and then was surprised when somebody came into 133 00:06:36.920 --> 00:06:43.580 his room and started putting needles in his leg, which immediately reduced the pain in his stomach. 134 00:06:43.860 --> 00:06:47.720 And he went back to America, wrote about this amazing thing called acupuncture, 135 00:06:47.720 --> 00:06:56.040 and the boom in acupuncture started from the early 70s. Now, this program was about acupuncture, 136 00:06:56.100 --> 00:07:01.260 and I thought, well, you know, does all of this ring true? Is it real? Is it, you know, 137 00:07:01.260 --> 00:07:04.580 what is the evidence? This was the subtitle of the program, so I thought, well, I can rely on 138 00:07:04.580 --> 00:07:11.560 this program. And the opening scene of that program, let me explain it to you, showed a woman 139 00:07:11.560 --> 00:07:17.640 in a hospital in Shanghai, having a young woman, probably in her 20s, 140 00:07:17.720 --> 00:07:27.360 having major heart surgery. And she was still conscious because instead of general anesthetic, 141 00:07:28.860 --> 00:07:33.840 she was having acupuncture. This was the opening bit of the program. You switched on, 142 00:07:33.900 --> 00:07:39.700 the first thing you saw was this woman having this major heart surgery, acupuncture instead 143 00:07:39.700 --> 00:07:46.940 of general anesthetic. And Kathy Sykes said, you know, what can this miraculous treatment tell us 144 00:07:46.940 --> 00:07:47.700 in the 20s? 145 00:07:47.720 --> 00:07:51.840 And I thought, well, this is the 21st century. Did anybody see it? I think it was broadcast here in 146 00:07:51.840 --> 00:07:57.800 Australia as well. Maybe it wasn't. Okay. Oh, I see a few hands going up. Okay. So, 147 00:07:59.060 --> 00:08:05.160 and I was shocked and stunned. Could it really be true that here was a woman having acupuncture 148 00:08:05.160 --> 00:08:11.060 instead of general anesthetic for major heart surgery? And because I'm a journalist, I did a 149 00:08:11.060 --> 00:08:14.580 bit of digging. I thought either this is the most miraculous piece of TV I'm going to see all year, 150 00:08:15.120 --> 00:08:17.000 or there's something suspicious going on. 151 00:08:17.720 --> 00:08:20.860 So, I started ringing around a few people. I started ringing up heart specialists, 152 00:08:21.060 --> 00:08:26.400 ringing up anesthetists. I rang up the Royal College of Anesthetists. And they actually 153 00:08:26.400 --> 00:08:30.940 done a report for this very program. They'd written a report for the BBC based on the 154 00:08:30.940 --> 00:08:35.300 footage that they'd seen. And they sent me their report. And sure enough, this woman had 155 00:08:36.320 --> 00:08:43.060 acupuncture instead of general anesthetic. But in addition to the acupuncture, she had three of the 156 00:08:43.060 --> 00:08:47.700 most powerful sedatives known to mankind, more powerful than morphine, and large volumes of 157 00:08:47.720 --> 00:08:55.540 local anesthetic. In other words, the acupuncture was purely cosmetic. It wouldn't have mattered if 158 00:08:55.540 --> 00:09:00.220 the acupuncture was there or not. She was so pumped full of drugs, she wasn't going to feel any pain. 159 00:09:01.200 --> 00:09:05.480 And I rang up a few other people. I said, look, you know, what impression did you get from this 160 00:09:05.480 --> 00:09:10.260 program? And everybody I spoke to, including TV reviewers who'd written about it in glowing terms, 161 00:09:10.340 --> 00:09:15.080 said, well, we assumed it was just simply no general anesthetic and acupuncture instead. 162 00:09:15.380 --> 00:09:17.520 And when I told them about all the other things that were going on, 163 00:09:17.540 --> 00:09:17.700 they were like, oh, my God, this is a real pain. And I said, well, what do you mean? And they said, 164 00:09:17.720 --> 00:09:21.480 we're quite shocked. So I submitted a complaint to the BBC, and eventually, after about a year, 165 00:09:21.540 --> 00:09:28.700 the complaint was upheld. But this got me thinking. If I hadn't done some digging, 166 00:09:28.920 --> 00:09:33.400 I would have been left with the impression, as probably a million other people were who 167 00:09:33.400 --> 00:09:39.620 watched this program, that acupuncture could indeed do miraculous things. And if I had a pain 168 00:09:39.620 --> 00:09:44.480 or if I suffered from any condition, I probably would have run down to my local acupuncturist the 169 00:09:44.480 --> 00:09:46.780 next day to see what they could do to help me. 170 00:09:47.340 --> 00:09:52.020 So I thought this program was... I love the BBC. I think it does amazing things. But I thought this 171 00:09:52.020 --> 00:09:58.800 particular program was disastrous because it gave such a misleading impression to the public. 172 00:09:59.900 --> 00:10:04.520 And I thought... And once you do a bit more digging, once you look around on the internet 173 00:10:04.520 --> 00:10:10.120 and you read more magazines and you begin to investigate a bit more, you realize there's 174 00:10:10.120 --> 00:10:15.720 huge amounts of wild and exaggerated claims made for alternative medicine. So I thought, 175 00:10:15.740 --> 00:10:16.760 why not write a book on this? And I thought, well, I'm going to do a book on this. And I thought, 176 00:10:16.760 --> 00:10:16.920 ... 177 00:10:16.920 --> 00:10:17.260 ... 178 00:10:20.500 --> 00:10:20.820 ... 179 00:10:27.460 --> 00:10:27.780 ... 180 00:10:29.680 --> 00:10:30.000 ... 181 00:10:31.560 --> 00:10:31.880 ... 182 00:10:31.880 --> 00:10:31.920 ... 183 00:10:36.700 --> 00:10:37.020 ... 184 00:10:37.020 --> 00:10:37.040 ... 185 00:10:37.040 --> 00:10:37.060 ... 186 00:10:37.060 --> 00:10:37.080 ... 187 00:10:37.080 --> 00:10:37.100 ... 188 00:10:37.100 --> 00:10:37.120 ... 189 00:10:37.120 --> 00:10:37.140 ... 190 00:10:37.140 --> 00:10:37.160 ... 191 00:10:37.160 --> 00:10:37.260 ... 192 00:10:38.260 --> 00:10:38.580 ... 193 00:10:38.580 --> 00:10:39.020 ... 194 00:10:39.020 --> 00:10:39.040 ... 195 00:10:39.040 --> 00:10:39.220 ... 196 00:10:39.220 --> 00:10:39.240 ... 197 00:10:40.160 --> 00:10:40.480 ... 198 00:10:46.420 --> 00:10:46.740 ... 199 00:10:46.760 --> 00:10:48.800 where the evidence was negative, say so. 200 00:10:49.340 --> 00:10:52.120 Where the evidence was non-existent, again, be open about that. 201 00:10:52.340 --> 00:10:54.860 If something was biologically implausible, say that. 202 00:10:55.100 --> 00:10:57.320 If there was risks of harm, point that out. 203 00:10:57.400 --> 00:10:59.640 If it seemed relatively safe, point that out as well. 204 00:11:00.020 --> 00:11:01.760 So I think what we've done in the book 205 00:11:01.760 --> 00:11:04.780 is be very open and honest about alternative medicine 206 00:11:04.780 --> 00:11:07.080 and the evidence for and against it, 207 00:11:07.120 --> 00:11:09.040 the evidence for effectiveness and risks. 208 00:11:09.300 --> 00:11:11.500 That's my co-author, Professor Edzard Ernst. 209 00:11:12.740 --> 00:11:14.320 I co-authored the book with Edzard 210 00:11:14.320 --> 00:11:15.840 because I sort of bumped into him 211 00:11:15.840 --> 00:11:18.120 when I was looking into acupuncture in the BBC investigation. 212 00:11:18.620 --> 00:11:21.540 And if you get interested in alternative medicine, 213 00:11:21.740 --> 00:11:23.280 you can't really avoid Edzard. 214 00:11:23.400 --> 00:11:24.740 Very quickly, you bump into him 215 00:11:24.740 --> 00:11:28.560 because he was the world's first professor of complementary medicine. 216 00:11:29.320 --> 00:11:31.420 About 16 or 17 years ago, 217 00:11:31.460 --> 00:11:34.720 he took up a post at Peninsula Medical School or Exeter University. 218 00:11:36.000 --> 00:11:38.460 And he has a background in alternative medicine. 219 00:11:38.760 --> 00:11:42.600 He practiced homeopathy at a German hospital for a while. 220 00:11:42.760 --> 00:11:44.220 His family brought him up. 221 00:11:44.320 --> 00:11:45.080 He taught on herbal remedies. 222 00:11:46.780 --> 00:11:51.540 He used manual therapies when he was a professor in Vienna. 223 00:11:52.500 --> 00:11:54.600 But while having an interest, 224 00:11:54.820 --> 00:11:56.580 an ongoing interest in alternative therapies, 225 00:11:56.840 --> 00:11:59.700 he also had a very strong career in mainstream medicine, 226 00:11:59.880 --> 00:12:00.680 especially in research. 227 00:12:01.720 --> 00:12:03.520 So 15 years ago, when he moved to Britain, 228 00:12:03.700 --> 00:12:06.720 his goal was to take his knowledge as a researcher, 229 00:12:07.180 --> 00:12:08.820 as a rigorous researcher, 230 00:12:09.220 --> 00:12:11.240 and apply that to alternative therapies. 231 00:12:11.920 --> 00:12:14.060 And to do some research of his own, 232 00:12:14.320 --> 00:12:15.440 but more importantly, 233 00:12:15.620 --> 00:12:18.080 to look at all the other research that's already been done. 234 00:12:18.220 --> 00:12:19.160 Because again, people will say, 235 00:12:19.280 --> 00:12:22.660 oh, the problem is that not enough research has been done on alternative medicine. 236 00:12:23.020 --> 00:12:24.960 In fact, there's been a huge amount of research done. 237 00:12:25.440 --> 00:12:29.360 And the problem is pulling it all together and making sense of it all. 238 00:12:29.500 --> 00:12:31.040 And that's what Edzard's been doing. 239 00:12:31.400 --> 00:12:33.640 So the idea of the book was to look at his research, 240 00:12:33.860 --> 00:12:35.780 to look at his overview of other people's research, 241 00:12:36.120 --> 00:12:37.920 to look at other people's overviews, 242 00:12:37.940 --> 00:12:40.940 and to bring it all together in one book that 243 00:12:42.280 --> 00:12:44.300 mum's, dad's, anybody who cares about their own health, 244 00:12:44.320 --> 00:12:46.460 or their children's health, could look at. 245 00:12:48.220 --> 00:12:50.280 Let me see if I can... 246 00:12:50.900 --> 00:12:52.420 The first thing we did in the book, 247 00:12:53.140 --> 00:12:55.340 and the first thing I want to point out to you now, 248 00:12:55.540 --> 00:12:59.420 is how do we work out whether a treatment is effective or not? 249 00:12:59.820 --> 00:13:02.220 And this is the same for a conventional medicine 250 00:13:02.220 --> 00:13:03.880 as it would be for an alternative medicine. 251 00:13:04.720 --> 00:13:07.720 There are various subtle variations on this, 252 00:13:08.440 --> 00:13:11.580 but the key breakthrough is the invention of the clinical trial. 253 00:13:12.280 --> 00:13:13.760 For thousands of years, 254 00:13:14.320 --> 00:13:15.800 doctors practiced medicine, 255 00:13:16.780 --> 00:13:18.440 plucking ideas out of thin air. 256 00:13:19.180 --> 00:13:22.380 Or they would pluck ideas given to them by the Greeks. 257 00:13:22.680 --> 00:13:25.940 Or they would come up with ideas based on their own personal experience. 258 00:13:26.580 --> 00:13:29.140 But it was a pretty shoddy way to do medicine. 259 00:13:30.200 --> 00:13:32.180 So the idea of bloodletting, for example. 260 00:13:32.520 --> 00:13:34.680 Bloodletting was practiced all over the world 261 00:13:34.680 --> 00:13:36.540 because the idea was that if you were ill, 262 00:13:36.600 --> 00:13:38.980 there was a poison that had accumulated in your blood somewhere. 263 00:13:39.200 --> 00:13:41.660 If you bled the patient, you released the poison, 264 00:13:41.700 --> 00:13:42.620 you could make them well. 265 00:13:43.100 --> 00:13:43.940 And in fact, 266 00:13:43.940 --> 00:13:44.300 if you were ill, you could make them well. 267 00:13:44.300 --> 00:13:44.900 And all that was happening, 268 00:13:45.100 --> 00:13:47.620 instead of bleeding out the poison, 269 00:13:47.800 --> 00:13:50.440 the life force from people was being bled out of them. 270 00:13:50.580 --> 00:13:52.760 And bleeding was doing a lot more harm than good. 271 00:13:53.040 --> 00:13:55.300 But doctors were convinced it was effective 272 00:13:55.300 --> 00:13:56.620 because the Greeks told them, 273 00:13:56.660 --> 00:13:57.980 because their professors told them, 274 00:13:58.100 --> 00:14:00.360 because they would remember those patients who survived 275 00:14:00.360 --> 00:14:01.800 and forget those who died. 276 00:14:02.540 --> 00:14:04.580 If a patient was feverishly ill 277 00:14:04.580 --> 00:14:06.760 and they had some bloodletting, 278 00:14:07.640 --> 00:14:10.340 the immediate effect was to sedate the patient. 279 00:14:10.700 --> 00:14:13.280 And that gave the impression that the doctor was doing good. 280 00:14:13.380 --> 00:14:14.220 But in fact, 281 00:14:14.300 --> 00:14:15.140 they were only doing harm. 282 00:14:15.580 --> 00:14:18.020 So it's only with the invention of the clinical trial 283 00:14:18.020 --> 00:14:19.720 that we can begin to show 284 00:14:19.720 --> 00:14:21.900 that something like bloodletting is dangerous and ineffective 285 00:14:21.900 --> 00:14:25.280 as opposed to being relatively safe and effective. 286 00:14:25.700 --> 00:14:26.880 And the first clinical trial, 287 00:14:27.000 --> 00:14:27.960 there's some debate about this, 288 00:14:28.040 --> 00:14:29.380 but one of the first clinical trials 289 00:14:29.380 --> 00:14:31.240 concerned the condition of scurvy. 290 00:14:32.060 --> 00:14:34.720 In the 18th century and before that, 291 00:14:34.860 --> 00:14:37.760 scurvy was killing thousands of sailors around the world. 292 00:14:38.000 --> 00:14:40.380 As sailors went further and further afield, 293 00:14:40.560 --> 00:14:43.340 they began to succumb to this condition whereby, 294 00:14:43.340 --> 00:14:49.540 by, their gums and their joints would literally disintegrate, and their bodies would fall apart. 295 00:14:49.760 --> 00:14:54.260 It was a horrendous way to die, and thousands of sailors were dying, far more were dying of scurvy 296 00:14:54.260 --> 00:15:00.040 than of, say, shipwrecks or battles and so on. But nobody could work out how to treat scurvy 297 00:15:00.040 --> 00:15:05.820 until this guy came along, James Lind, a Scottish naval surgeon. And Lind came up with the idea of 298 00:15:05.820 --> 00:15:10.940 a clinical trial. It was only in the English Channel. He wasn't far, far out to sea, but the 299 00:15:10.940 --> 00:15:16.180 ship was in the English Channel, and it had been away from the coast for a long time. So the sailors 300 00:15:16.180 --> 00:15:23.360 started succumbing to scurvy. And he took six pairs of sailors, and he put them in the same part of 301 00:15:23.360 --> 00:15:29.340 the ship, so they had the same environment. He gave them the same diet. They all had the same 302 00:15:29.340 --> 00:15:35.240 level of scurvy, but they were all treated differently. So you could control for different 303 00:15:35.240 --> 00:15:40.320 things, like conditions and diet and so on, and compare and contrast between different therapies. 304 00:15:40.940 --> 00:15:47.480 So he gave one pair of sailors vinegar. One pair of sailors got seawater. Another pair of sailors 305 00:15:47.480 --> 00:15:56.260 got cider. Another pair of sailors got sulfuric acid. But one pair of sailors got lemon juice. 306 00:15:57.280 --> 00:16:03.840 And within a few days, while everybody else was pretty sick still and getting worse, the lemon 307 00:16:03.840 --> 00:16:10.260 juice pair were making a remarkable recovery. And that was just absolutely concrete evidence that 308 00:16:10.940 --> 00:16:15.780 lemon juice was the cure for scurvy. Lind had no idea about vitamin C. He had no idea what was going 309 00:16:15.780 --> 00:16:22.720 on, but he knew that lemon juice cured scurvy. Actually, the sailors who took cider also showed 310 00:16:22.720 --> 00:16:28.060 some levels of recovery, because apples, I think, have vitamin C in them as well, but the manufacturing 311 00:16:28.060 --> 00:16:34.220 of cider destroys most of the vitamin C. But some residual vitamin C seemed to have helped, to some 312 00:16:34.220 --> 00:16:40.440 extent, another pair of the sailors. So that's how you tell if something works. You give one group of 313 00:16:40.440 --> 00:16:46.560 patients a certain therapy, and you give another group of patients either nothing, or a rival 314 00:16:46.560 --> 00:16:53.900 therapy, or most likely of all, a placebo therapy. Because if we just give this group of patients a 315 00:16:53.900 --> 00:16:59.120 therapy and that group of patients nothing at all, this group will benefit from the so-called placebo 316 00:16:59.120 --> 00:17:04.400 effect. You're being cared about. You're waiting for a remedy. When you get that remedy, you have 317 00:17:04.400 --> 00:17:07.880 an expectation. That gives you perhaps a psychological boost. It allows you to perhaps 318 00:17:07.880 --> 00:17:09.300 tolerate your symptoms. 319 00:17:10.440 --> 00:17:16.780 You maybe want to give positive feedback to the people involved in the research. So there are all 320 00:17:16.780 --> 00:17:20.980 sorts of what are called non-specific factors, including the placebo effect, which means that 321 00:17:20.980 --> 00:17:26.940 even if I give you a sugar pill and I give you nothing, you will respond better than this group 322 00:17:26.940 --> 00:17:33.140 over here. So to account for those non-specific and placebo effects, I'm going to give you the 323 00:17:33.140 --> 00:17:38.400 real treatment, but I'm going to give you something that looks like the real treatment, but which 324 00:17:38.400 --> 00:17:40.420 isn't. And nobody will know which group of patients is the real treatment. So I'm going to give you 325 00:17:40.440 --> 00:17:42.280 a group of patients. So if you give me a group of patients, and I give you a group of patients, and I 326 00:17:42.280 --> 00:17:49.660 then if both groups have similar benefits, we know that you're just responding to the non-specific 327 00:17:49.660 --> 00:17:56.460 effects, which can be important. But if this group does better than that group, then we know there's 328 00:17:56.460 --> 00:18:01.280 something more going on and that the treatment you're receiving actually is genuinely beneficial 329 00:18:01.280 --> 00:18:06.120 beyond these non-specific effects. And that's how we work out which therapies work and which ones 330 00:18:06.120 --> 00:18:10.420 don't. So very briefly, I thought I'd look at one clinical group of patients. And I'm going to give 331 00:18:10.440 --> 00:18:14.040 you a look at one condition in particular, one therapy in particular, one alternative therapy, and just 332 00:18:14.040 --> 00:18:18.360 look at the evidence for that. And I was going to look at homeopathy, just because it's one of the 333 00:18:18.360 --> 00:18:24.200 most popular therapies, and it's been one of the most tested therapies. So first of all, what is 334 00:18:24.200 --> 00:18:27.280 homeopathy? I'm going to go through this very, very quickly, just to leave plenty of time for 335 00:18:27.280 --> 00:18:33.080 questions. Homeopathy was invented 200 years ago by a German chap called Samuel Hahnemann. Hahnemann 336 00:18:33.080 --> 00:18:39.280 could see that conventional medicine at that time was useless. Bloodletting was going on. We've already 337 00:18:39.280 --> 00:18:40.060 talked about that. 338 00:18:40.440 --> 00:18:45.080 Patients were giving mercury and arsenic, all sorts of terrible poisons that were doing more 339 00:18:45.080 --> 00:18:51.460 harm than good. So as a reaction to that, he invented homeopathy. Two key principles of 340 00:18:51.460 --> 00:19:00.980 homeopathy. Like cures like. Whatever harms you can potentially make you better. Or for example, 341 00:19:01.020 --> 00:19:05.700 actually, let me look at it a different way. If you get hay fever and you get runny eyes, 342 00:19:06.020 --> 00:19:09.180 well, what else gives you runny eyes? Well, onions do. 343 00:19:09.180 --> 00:19:15.580 Onions make your eyes water. So onions could become the basis of a homeopathic cure for hay fever. 344 00:19:16.180 --> 00:19:23.520 That's the basic principle. The second principle there is dilution increases potency. So if you 345 00:19:23.520 --> 00:19:29.760 dilute the onion juice over and over and over again and make it weaker, it actually has a stronger 346 00:19:29.760 --> 00:19:37.700 curative ability. So those are the two key principles. Like cures like, but the greater the dilution, 347 00:19:37.760 --> 00:19:38.540 the bigger the effect. 348 00:19:39.180 --> 00:19:45.000 This sort of makes sense. I've said here it's a bit like vaccination. A little of what harms you, 349 00:19:45.140 --> 00:19:51.600 the virus or a fragment of the virus can cure you. And you only want a little bit of it to be 350 00:19:51.600 --> 00:19:59.960 beneficial. So it sounds appealing at first sight, but when you look at it in more detail, you realize 351 00:19:59.960 --> 00:20:07.160 how ridiculous it is. This is from a Materia Medica, which is sort of a guide that a homeopath 352 00:20:07.160 --> 00:20:08.200 would have in their office. 353 00:20:09.180 --> 00:20:15.440 It lists all the homeopathic remedies and all of the things that it can cure. So this is a page for 354 00:20:15.440 --> 00:20:23.540 acetic acid or vinegar. And that list is all the things that acetic acid can cure. Presumably because 355 00:20:23.540 --> 00:20:29.220 these are all the things that acetic acid can cause, because like cures like. So acetic acid, 356 00:20:29.300 --> 00:20:35.640 vinegar can cure and cause things like worries about business affairs, pain across the root of 357 00:20:35.640 --> 00:20:39.160 the tongue, a putrid sore throat, scurvy down there we can see. And then there's also the list of 358 00:20:39.180 --> 00:20:46.480 anxiety, anxiety, even sausage poisoning. All can be cured and caused, caused by vinegar, but cured 359 00:20:46.480 --> 00:20:51.060 by homeopathic vinegar. And when you look at a whole list like this, you realize this is a little 360 00:20:51.060 --> 00:20:56.540 bit ridiculous. But let's look at it in more detail. Let's look at the dilution process, which 361 00:20:56.540 --> 00:21:02.120 I would argue is even more ridiculous. When we talk about dilution, we're talking about a level 362 00:21:02.120 --> 00:21:08.880 of dilution, which is absolutely and utterly extraordinary. If I take a drop of vinegar, 363 00:21:09.180 --> 00:21:14.200 or let's say acetic acid here, a drop of acetic acid probably contains 10 to the 22 molecules. 364 00:21:14.480 --> 00:21:22.440 That means about 10,000 million, million, million molecules. So what you do is that you start off 365 00:21:22.440 --> 00:21:29.720 with your drop and you put it into 100 drops of water and you shake it. Now I take one drop of 366 00:21:29.720 --> 00:21:35.960 that, which I've now diluted by a factor of 100, and I put that into another beaker of water and I 367 00:21:35.960 --> 00:21:39.160 shake that. So I've now diluted that by another factor of 100. And I've now diluted that by another 368 00:21:39.160 --> 00:21:42.820 which we call 2C, C being the Roman numeral for 100. 369 00:21:43.180 --> 00:21:45.980 So I've now got 100 less times 100 less molecules. 370 00:21:46.140 --> 00:21:49.680 I've only got 10 to the 18 molecules in one drop of this water 371 00:21:49.680 --> 00:21:50.960 which is still a huge amount. 372 00:21:51.620 --> 00:21:53.980 But if you repeat this process of dilution, 373 00:21:54.080 --> 00:21:56.140 you only need to do it about nine more times 374 00:21:56.140 --> 00:21:58.400 and you end up with a drop of water 375 00:21:58.400 --> 00:22:01.580 that contains only one molecule of acetic acid. 376 00:22:02.900 --> 00:22:05.160 But you carry on diluting if you're a homeopath. 377 00:22:06.000 --> 00:22:08.400 Typically, you'll dilute another 18 times. 378 00:22:10.220 --> 00:22:12.200 Which means you're diluting pure water. 379 00:22:12.660 --> 00:22:16.600 Your final beacon has nothing in it, but you carry on diluting. 380 00:22:16.640 --> 00:22:19.800 And in fact, sometimes homeopaths will dilute maybe 300 times. 381 00:22:19.900 --> 00:22:22.760 It's extraordinary the level of dilution that can go on. 382 00:22:23.040 --> 00:22:25.800 And then you take a sugar pill and you dilute it. 383 00:22:25.900 --> 00:22:28.260 You put a little drop of water on the sugar pill 384 00:22:28.260 --> 00:22:29.940 and that's your homeopathic remedy. 385 00:22:31.020 --> 00:22:32.800 It just sounds utterly ridiculous. 386 00:22:33.220 --> 00:22:35.600 Like cures like sounds ridiculous from what we've seen, 387 00:22:35.780 --> 00:22:37.840 the level of dilution sounds impossible 388 00:22:37.840 --> 00:22:39.140 because the final pill is the only thing that can go on. 389 00:22:39.140 --> 00:22:40.400 The final pill has got nothing in it. 390 00:22:41.520 --> 00:22:45.320 So it's an utterly ridiculous, bizarre and absurd notion. 391 00:22:46.140 --> 00:22:50.220 But science actually kind of likes bizarre and absurd notions. 392 00:22:50.580 --> 00:22:53.340 In fact, the whole of science is built on these kind of notions. 393 00:22:55.720 --> 00:22:58.200 And as a scientist, you have to be open-minded. 394 00:22:58.580 --> 00:23:00.740 So you can't just ignore this straight away 395 00:23:00.740 --> 00:23:02.920 and say this is just ridiculous, we're not even going to look at it. 396 00:23:03.140 --> 00:23:05.940 Especially when you hear homeopaths and patients 397 00:23:05.940 --> 00:23:07.620 talking about it so positively, 398 00:23:07.900 --> 00:23:09.120 you have to be open-minded. 399 00:23:09.140 --> 00:23:12.040 You have to look at it in some detail. 400 00:23:12.120 --> 00:23:14.380 My favorite example of this, and I mentioned this the other night, 401 00:23:14.580 --> 00:23:16.920