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You Asked: How can homeopathic teething “remedies” that essentially contain nothing have an adverse effect on infants?

question markThe FDA in the U.S has raised alarm about homeopathic teething pills that may have caused seizures in babies and possibly even caused some deaths. But how can homeopathic “remedies” do this, given that they contain nothing? The bizarre tenet of homeopathy is that a substance that causes symptoms in a health person can relieve those symptoms in a sick person as long as it is diluted to an extent that contains almost zero or a just a trace amount of the original substance. Homeopathic teething remedies are made by diluting a solution of belladonna in an extreme fashion.

Why belladonna is the preferred substance is bizarre since according to homeopathic doctrine, to relieve pain, it should cause pain when used at a high concentration. While atropine, the active ingredient in belladonna can cause many adverse symptoms, it doesn’t cause pain. In any case, when diluted homeopathically, it should have no effect.

Now it seems some homeopathic companies are not very adept at making dilutions and the effects on the babies were likely caused by an overdose of belladonna. Dilution is really a very simple process, so it is hard to see how they could get it so wrong. It seems homeopaths are not only incompetent when it comes to understanding chemistry and medicine, some are also incompetent at carrying out dilutions. Obviously homeopathy is not always just benign nonsense.

Joe Schwarcz PhD

The U.S. Toxic Substances Control Act (TSCA)

dangerAmidst the cacophony of jingoist, vacuous blather at the Republican Convention there were some noteworthy phrases that probably slipped by most viewers. A number of speakers talked about the need to reign in the activities of the Environmental Protection Agency, the “EPA.” That is something one would expect from Republicans who want as little government interference in their life as possible. But these are the same Republicans who voted to update the 1976 Toxic Substances Control Act that finally was passed in June by Congress with bipartisan approval after ten years of debate. This update was very much needed because significant information has been accumulated since 1976 about exposure to chemicals in the environment and their potential effect on health.

The old law required companies to register new chemicals that would enter commerce with the EPA but there was no requirement to furnish any safety data, and there was no provision for EPA to tackle the risks associated with chemicals already on the market at the time. The assumption was that chemicals are safe unless shown to be otherwise. The EPA did have the power to ban a chemical, but the burden of proof of harm was on the agency. Also, the economic downsides had to be factored in before the use of any chemical was limited. With companies introducing about 700 chemicals every year, and the EPA inventory building up to some 85,000 substances, the task of ferreting out dangerous ones is overwhelming. While determining risk when exposure is high, such as in an occupational setting, is relatively easy, determining risk to consumers who may be exposed to some chemical in tiny amounts over a long period is daunting.

But under the new law, EPA has to examine a chemical before it is put on the market and make a decision about safety. The risk assessment will take into account how a chemical is used. For example, a fluorinated compound may be deemed to be fine for use in airplane fire extinguishers, but not as an oil repellant in pizza boxes. An important new feature is that the agency will now have the authority to ask for information from producers about studies that have been carried out and can even ask for further studies. Another new facet is that EPA does not have to consider the economic implications of declaring a substance to be toxic. Furthermore, it is going to be much tougher for a company to withhold information claiming trade secrecy.

There are also 90 chemicals that have been identified as meriting investigation and possible regulation with EPA having to adhere to mandatory deadlines. The new bill has the support of the chemical industry because it should reduce consumer angst given that EPA will now be charged with examining the safety of chemicals before they go on the market. But here is the issue. While Republicans in the House voted for the bill, they also voted to cut the EPA’s funding and staffing for 2017. If EPA is going to carry out its new duties effectively, it will need more, not less funding. The plan is that some of the shortfall will be offset by charging companies fees for submitting chemicals for EPA to review. That may not sit well with Republicans.

Joe Schwarcz PhD

Bending Spoons and Bending Minds

spoon bendEveryone has skeletons in their closet. There’s at least one in mine. A couple of years ago while on a cruise I pinched a spoon from the dining room. It wasn’t because of any lack of spoons at home, it was because no matter how hard I tried I could not bend this one. I tried with two hands, I tried by pushing against the table, I even tried placing the handle under my heel and tugging on the head. No give at all. I had to have that spoon!

I’ve been practicing magic as a hobby ever since I was a teenager. It has turned out to be a perfect fit with my career because of the numerous scientific principles involved in creating the illusion of contravening the laws of nature. And that is what magic is all about. Seeing someone levitate, or vanish inside a cabinet, or appear out of thin air, requires an apparent suspension of the laws of nature. The key word of course is “apparent,” because all such effects are accomplished by clever scientific means. A magician, however, attempts to ensure that the audience will not discover those means. Science can also appear magical, but in this case, we relish in scuttling the magic with down to earth explanations. Just think about it. Isn’t an airplane with hundreds of people aboard flying through the air magical? How about taking pictures with your smart phone and sending them around the world in seconds? Or a seed growing into a plant or a new life being created from the meeting of cells? But magic is converted into science with an appropriate explanation.

I have found performing magic to be an excellent springboard for a discussion of scientific methodology and for fostering the critical thinking needed to prevent being swept away by the tsunami of pseudoscience generated by a rapidly multiplying bevy of charlatans. When you can demonstrate how “psychic surgery,” a procedure by which diseased tissues are apparently removed without an incision, can actually be accomplished by sleight of hand, you have given believers something to think about. Similarly, a demonstration of “mental” effects with a clear declaration that these are done by clever chicanery can help convince at least some that trickery may be involved when psychics perform seemingly scientifically inexplicable feats.

One such feat is “psychokinesis,” or the ability to move objects using only the power of the mind. Psychokinetic effects were first popularized in the middle of the nineteenth century when Angelique Cottin in France claimed that electric emanations from her body allowed her to move objects without touching them. She convinced many observers of her power, but critics offered quite down to earth explanations about how such effects could be performed by natural means. Since that time numerous psychics have claimed psychokinetic powers, with Uri Geller being perhaps the most famous. In the 1970s he beguiled audiences and even some scientists with his apparent ability to bend metal with the power of his mind. He gets credit for introducing the phenomenon of mental spoon bending, an effect upon which he built quite a spectacular career.

Magicians were also astounded. Not by the effect, which can be accomplished by a number of established methods, but by how the public was so ready to swallow a “paranormal” explanation. Conjurers were quick to reproduce the spoon bending trick, pointing out that the only requirement was a modicum of sleight of hand. This brings us back to my pilfered spoon.

When I do the spoon bending trick, I first hand out the spoon to the audience with a challenge to bend it. Once it is established that it can withstand all efforts, I proceed to bend it “with the power of my mind.” But in rare cases, some strong men have managed to bend the spoon and destroy my performance, so I’m always on the lookout for super-strong spoons. I can tell you that Crystal Cruises have such. They absolutely cannot be bent, except in the hands of a magician who is equipped with a “special something.”

But why am I talking about tormenting cutlery? Because last week, thanks to colleague Tim Caulfield, a health law professor at the University of Alberta, I learned that “Integrative Pediatric Medicine Rounds” at his University were set to feature a talk on “Spoon Bending and the Power of the Mind.” The seminar would be given by an “energy healer” who has been described as being “a Reiki Master teacher, a certified Trilotherapy practitioner, a Yuen Method practitioner and a teacher of popular Spoon Bending and Tantric Sex workshops.” So this was not to be a workshop on critical thinking, which could have been appropriate. The prospective speaker actually claimed that 75% of attendees would be able to bend spoons with their mental energy!

The scientific community reacted with vigour to this assault on reason, and the resulting extensive media coverage caused the seminar to be cancelled with some weasel explanations being provided about the workshop “being withdrawn by the presenters.”

The “presenter” was to be Anastasia Kutt, who is not some wacky outsider, but is listed in the University’s Directory as “a research assistant in the “Complementary and Alternative Research and Education (CARE) Program” and is also involved in research activities and organizing events.” What sort of events? Given her interest in topics such as Tantric Sex and spoon bending one wonders.

Criticism of this spoon bending fiasco should not be construed as an attempt by the mainstream scientific community to curb free speech or to police academic research. Rather it is an appeal for reason and for vigilance against quackery sneaking into “integrative medicine” programs which are becoming increasingly popular.

I don’t know how Ms. Kutt bends spoons, but I’d be willing to fly to Edmonton at my expense to find out. If she can bend my Crystal Cruise spoon I’ll eat a University of Alberta Integrative Health Program hat.

Joe Schwarcz PhD

A Holistic Nutritional Rockstar’s Rocky Science

margarineSometimes you can evaluate a person’s scientific acumen by a single comment they utter. This is the case with Catherine Sugrue who labels herself a “holistic nutritionist rockstar.” Of course suspicion about her knowledge is immediately raised when we learn that it was gained at the “Institute of Holistic Nutrition,” which isn’t exactly Harvard. But the giveaway of the rockstar’s untrustworthiness is her reiteration of the absurd statement that “margarine is about one molecule away from plastic.” This isn’t about coming to the rescue of margarine. I don’t like it and I don’t eat it. I much prefer butter. But I am piqued by the shoddy pseudo scientific exhortations of self-proclaimed experts. In this case I’m further annoyed that this particular pseudoexpert was interviewed for an article about fats that appeared not in the National Enquirer, but in the National Post. When there are Canadians like Yoni Freedhoff, Chris Labos and Tim Caulfield who actually are experts when it comes to nutritional issues and would never confuse the public with ludicrous analogies between margarine and plastic.

Margarine being “one molecule away from plastic” is just plain nonsense. Plastics are composed polymers while margarine is a blend of fats and water. There is no chemical similarity between the two. In any case, being “one molecule away” is a totally meaningless expression. Substances are made of molecules, which in turn are composed of atoms joined together is a specific pattern. I suppose one might say that hydrogen peroxide, H2O2, is one atom away from water, H2O, but even this is meaningless. That extra oxygen atom changes the properties of the substance dramatically. Sticking a finger into a bottle of pure hydrogen peroxide quickly reveals the effect of that extra oxygen.

So, even if margarine had some chemical similarity to plastic, which it does not, its properties could still be dramatically different. Slight alterations in molecular structure can account for very significant changes in properties.

It is true that saturated fats have been vilified beyond the scientific evidence but the pendulum is swinging too far in the other direction. Kourtney Kardashian attributing her 5 pound weight loss to drinking clarified butter every morning is without scientific merit. Catherine Sugrue correctly warns that “getting your nutritional advice from celebrities is a dangerous game.” But so is getting it from a self-proclaimed “holistic nutritional rockstar” who is a graduate of an institution where you can take continuing education courses in “energy medicine,” “clinical detoxification,” and “applied iridology.”

Joe Schwarcz PhD

Triacetone triperoxide

nail polish removerWe have become familiar with the routine at airports. Your carry-on bags are passed through an x-ray machine after which an officer will often wipe your bag with a piece of fabric which is then placed inside a box-like instrument. Within a few seconds you get the all-clear signal and you are on your way to the gate. How many travelers get handcuffs instead of an all-clear isn’t known because those stats are not released. What do these instruments actually do? When luggage is bombarded with x-rays, some of the rays pass through and some do not, depending on what they encounter. The more dense a material is, the less transparent it is to x-rays. Lead, for example, prevents any x-rays from passing through. To put it simply, the intensity of the x-rays that have passed through the luggage is a measure of the density of the substances contained in the luggage. Different substances will have unique densities and the densities of various explosives have been determined. The x-ray machine then compares the densities detected by the passage of x-rays to the predetermined densities of a host of suspect substances.

The instrument that analyzes the swabs is an “ion mobility spectrometer.” When the swab is inserted, a gust of a carrier gas dislodges some of the molecules that have been collected from the luggage. These molecules are then subjected to bombardment by electrons, commonly from a Nickel-63 isotope source. The bombardment creates ions that are swept through a tube where they are subjected to an electric field resulting in a separation by mass, size and shape of the molecules. These ions are detected and compared with those produced by known samples.

The technology is extremely sensitive and can detect trace amounts of explosives. It is not dependent on having nitrogen in the sample, an element found in almost all explosives except in triacetone triperoxide (TATP). This is what was used in the Belgian and London bombings. TATP is often the choice of terrorists because it is easy to manufacture from acetone, hydrogen peroxide and an acid, all of which are readily available. Of course an explosive in luggage can only be detected if the luggage is inspected. But in the case of the Belgian airport bombing, the explosive was set off in the pre-screening area. To try to counter this, hand held detectors have been developed for use by officers who patrol all areas. When gaseous TATP molecules enter this sensor, they encounter an acid catalyst that converts TATP back into its constituent parts, acetone and hydrogen peroxide. The peroxide then reacts with dyes in the instrument causing them to change colour. By detecting these colour changes, the highly sensitive portable scanner can detect fewer than two parts per billion of TATP. But unfortunately no matter how clever the detector chemistry, it can’t foil all terrorists’ attempts.

Joe Schwarcz PhD

Antimony!

antimonyPicture this. You swallow a little pill, wait until it irritates your intestines enough to expel its contents and then hunt through the expelled excrement to retrieve the pill. Why? So you can use it next time to get rid of the bad humours in your body that are making you sick. How can a pill survive passage through the digestive tract? It can, if it is made of metal, in this case, antimony. Now, don’t go asking the pharmacist for antimony pills. The scenario just described isn’t current, it was plucked out of the Middle Ages when the cure for disease was to expel “bad humours” from the body. Actually, that was not unlike the current craze of expelling unnamed toxins from the body with a variety of “cleanses,” many of which have a laxative effect.

Hopefully nobody today would be silly enough to use antimony or its compounds, because here we are talking about real toxicity. Of course they didn’t realize that in the Middle Ages; all they knew was that antimony was pretty good at evacuating the body. And not only through the rear portals. One method involved drinking wine that had been left standing overnight in a cup made of antimony. This resulted in the antimony reacting with tartaric acid in the wine to form antimony tartrate, a compound that induces vomiting. The idea of purging the body to treat illness persisted into the late stages of the 18th century. When Mozart came down with a mysterious illness, he was treated with “tartar emetic,” as antimony tartrate was commonly called. What ailment he suffered from isn’t clear, but he died within two weeks. His symptoms of intense vomiting, fever, swollen abdomen and swollen limbs are consistent with antimony poisoning. Of course, we cannot prove that antimony was responsible for Mozart’s death, he also suffered from rheumatic fever since childhood, a condition that may have led to his demise at a young age.

Mozart had always been sickly and it is well known that he had been often treated with antimony compounds by his physicians and that he even dosed himself when he didn’t feel well. It is interesting that Mozart actually believed he was being poisoned, but not by himself. He thought his musical rival Antonio Salieri was trying to do him in. Although the famous movie “Amadeus” alludes to this possibility, historical facts do not corroborate the poisoning story. Contrary to the portrayal, Salieri did not confess at the end of his life to having tried to kill Mozart.

Back in the 1990s a volatile compound of antimony known as stibine (SbH3) was accused of being responsible for crib death. The theory was that it was produced from antimony oxide added as a flame retardant to polyvinylchloride sheets. A fungus found in mattresses supposedly made this conversion possible, at least under laboratory conditions. The theory has now been dismissed because neither the fungus, nor levels of antimony in babies’ blood could be correlated with crib death.

More recently Greenpeace created a stir with a booklet entitled “A Little Story About The Monsters In Your Closet.” What sort of “monsters?” The subtitle brings them out of the closet: “Study finds hazardous chemicals in children’s clothing.” Yup, the monsters are chemicals. One that the Greenpeace study detected was antimony trioxide, present in all fabrics that have polyester as a component. No great surprise here since antimony trioxide is used as a catalyst in the production of polyester as well as a flame retardant. And it is true that antimony trioxide can be described as presenting a hazard. But hazard is not the same as risk.

Hazard is the innate potential of a substance to cause harm without taking into account extent or type of exposure. Inhalation of antimony compounds in an occupational setting can be a problem, and it is correct that antimony trioxide has been classified as “suspected of causing cancer via inhalation.” But this is not relevant for the trace amounts found in fabrics. Here the issue would be migration out of the fabric and subsequent absorption. This has been extensively investigated and the amounts that are encountered are well below the established migration limits. The same applies to the trace amounts that leach out of the polyester bottles that are widely used for water and other beverages. Concentrations are less than the 5 parts per billion safety limit.

Antimony does not occur in nature in its metallic form, so where did Middle Age physicians get it? Like most metals, antimony has to be smelted from its ore, in this case antimony sulfide, also known as stibnite, a substance that has been known for thousands of years. Jezebel, the Biblical temptress is said to have used it to darken her eyebrows and stibnite was the main ingredient in “kohl” used by ancient Egyptian women in a type of mascara. Exactly who figured out that heating antimony sulfide converts it to antimony oxide, which yields metallic antimony when fired with carbon, is unknown, but if you visit the Louvre, you can see a 5000 year old vase that is made of almost pure antimony.

Today, neither metallic antimony nor its compounds have a medical use, although up to the 1970s, antimony compounds were used to treat parasitic infections like schistosomiasis. These preparations did kill the parasites, but sometimes they also dispatched the patient. Up to the early twentieth century, tartar emetic was used as a remedy, albeit an ineffective one, for alcohol abuse. The New England Journal of Medicine once reported a case of a man whose wife tried to cure him of his alcoholic habit by secretly putting tartar emetic into his orange juice. The result was a trip to the hospital with chest pains and liver toxicity. Two years later the man reported complete abstinence from alcohol. Seems antimony had taught him a lesson.

Joe Schwarcz PhD

To Know or Not to Know?

question markLast week, we heard in the news about a shocking admission from the execs at the National Football League in the USA that they may finally admit to believing that there is a link between football-related head trauma and chronic traumatic encephalopathy or CTE, a degenerative brain disease that is well known to be caused by repeated trauma to the head, such as from concussions. The reason that I find that news headline to be shocking is not because there was an admission of the link, but rather because the NFL was able to deny the existence of that link up until now by simply choosing not to believe that one was there.

A little closer to home, the news over the past few days has contained stories of email conversations among the top brass at the NHL that would show them debating the merits of fighting in hockey by exchanging their beliefs over whether or not repeated concussions during one’s life may lead to mental illness, brain injury or addictions later on. As if these corporate jocks have any knowledge of the medical information required to understand this concept well enough to be qualified to decide upon it. When the medical experts have made pronouncements on this issue, they unambiguously say that getting punched in the head repeatedly over one’s career is very likely to cause brain damage of one kind or another.

How is it that scientific specialists, like the medical researchers in these previous examples, are so easily discounted as being irrelevant in the face of someone else’s belief in something else? This ability to whimsically discount science in favour of a more convenient belief is not restricted to sporting organizations. In fact, we well know that it can be observed at a larger scale, both geographically and destructively speaking, in the anti-scientific dismissal of climate change. How many times have you heard of an online poll or a talk-show pundit that asks whether or not we should believe in climate change? Unfortunately for those pollsters, brain injuries and climate change are real, whether you believe in them or not.

The thing is that the medical knowledge of brain injuries or the vast expanses of knowledge on the earth and its climate are not based on beliefs at all, but rather on thousands upon thousands of accumulated and inter-supportive facts that have not been able to be falsified. These notions form the basis of the scientific method, which is simply a process of seeking to observe and describe the universe and to explain its properties and behaviour. Incidentally, it is also the most reliable and robust tool that we have found to date that allows us to work out fact from fiction in the natural world.

One of the most pervasive problems in society today is the mistaken equivalence of a specialist’s knowledge and understanding of facts with a non-specialist’s beliefs in something else. Belief and knowledge are incompatible with one another and only one of those two is a reliable way of understanding truth. ‘So what?’, we may ask. Perhaps, I may be seen to be an academic fuddy-duddy arguing about semantics and that we should just let people live and let live, each with their own thoughts and beliefs. Well no, I say. It is a problem that has real consequences on people, such as those ex-hockey enforcers dying from brain damage or the millions of people already being affected by runaway global warming.

On a very basic level, this important issue often hinges on the flawed equivalence of the nature of beliefs vs. knowledge in society. These two terms are so dissimilar to one another that they are more like opposites than synonyms. This acknowledgement alone would go a long way to guiding society progress towards an improved health, safety and prosperity of its people. As a starting point, it may be helpful to examine the meaning and usefulness of each of these two words as concepts.

Belief is the acceptance that something is true through the acts of trust, faith or confidence. There is no requirement for evidence in order to believe in something, making it a useful option for simplifying otherwise difficult concepts to absurdity or for dismissing inconvenient truths to irrelevance. Knowledge, on the other hand, is the theoretical or practical understanding of a subject. The key word in that sentence is ‘understanding’, because to truly know something, one must be able describe what, how and why it is what it is… and this requires the use of facts as evidence.

Obviously the only reliable path towards an understanding of something is by knowing it, which requires understanding it and knowing so, in some kind of mutually-supportive conceptual symbiosis. There is no place or need for belief in this context. In fact, beliefs are useless in generating knowledge because they offer no power to explain anything.

Historically, belief has been used as a means by which to attempt to explain the unknown, arguing such baseless statements as the earth is flat or that humans didn’t evolve but instead magically appeared through divine intervention. In many ways, belief continues to have significant influence today. However, over time our scientific advances have allowed us to replace most beliefs of things with knowledge of things, eventually making faith and belief entirely unnecessary.

Furthermore, when knowledge is not currently available due to a lack in our understanding of something, there is no shame in admitting that we don’t know it. It certainly is a more noble approach than to invent a belief-based explanation for which we have no supporting evidence. In fact, the ability to acknowledge what we do not know is arguably the most important component to having knowledge.  Socrates famously pondered the nature of knowledge by stating that it may only come with an admission that one must know that they do not know what they do not know, or something along those lines.

Perhaps it was paraphrased more effectively by then US Secretary of Defense Donald Rumsfeld when justifying the attack on a country, despite the lack of evidence that it may actually have posed a threat, when he said that “there are known knowns, there are things we know we know; there are known unknowns, that is to say there are things we know that we do not know; but there are also unknown unknowns, the ones that we don’t know that we don’t know”.

I couldn’t agree more with Rummy! However, the solution to the conundrum of both the known unknowns and the unknown unknowns is not to invent a friendly fact that may likely be untrue (and often is). The right thing to do is to say that we don’t know but will try to find out. This is the only honest path to the truth and one that is built into the scientific method of knowledge building.

Whenever someone asks me what I may believe about something or other, I always answer that I don’t believe anything at all; I either know something or I don’t. That fact also applies to everyone else as well, believe it or not! Personally, I like to think that Yoda would have said it best: “Know or do not know, there is no belief”.

Adam Oliver Brown, Ph.D.

Microwaves and Blood

RBCThere is a lot of nonsense that goes around about microwaves. I’m sure you heard many of them. They destroy nutrients in food. They cause cancer if you stand next to a microwave oven. Microwaved water kills plants. All poppycock. And then there is the story about a woman who died because the blood she received in a transfusion had been warmed up in a microwave oven? The case of Norma Levitt is an interesting one and is often used by anti-microwave activists to prove that microwaves are dangerous. This case proves nothing of the sort. Here are the facts.

Norma Levitt had successful hip surgery at the Hillcrest Medical Center in Tulsa in 1989, but unfortunately died on the operating table after the procedure. She received blood during the operation which had been warmed in a kitchen microwave oven. After her death, the family launched a lawsuit claiming negligence because the blood had been warmed in a non-standard fashion. The defendants, the doctors involved in the operation, asserted that the patient had died of a blood clot, a complication of surgery. The court found for the defendants, whereupon they launched a successful lawsuit against the plaintiff’s attorneys for wrongful accusation. Each defendant was awarded $12,500.

Whenever blood is used for a transfusion it is warmed to body temperature. Heaters especially designed for this process are available in order to guard against overheating which can result in hemolysis, or destruction of the red blood cells. This in turn causes release of potassium from the cells and excess potassium can be lethal. The issue is one of overheating the blood, not of the method used. Microwave ovens heat very quickly and temperature control is difficult. That’s why they are not appropriate for warming blood. Nothing to do with microwaves being “dangerous!”

The allegations on the anti-microwave websites suggest that somehow exposure to microwaves produced some dangerous substance in the blood which killed Norma Levitt. This is nonsense. Overheating blood by any method produces the same result. No, blood should not be heated in a kitchen microwave before a transfusion, but this has absolutely no bearing on cooking with microwaves. This is a classic case of taking a smidgen of truth and twisting it out of proportion. And incidentally, the court did not find that the transfused blood was the cause of death.

Joe Schwarcz PhD
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