Ben Goldacre

The Guardian

Saturday 1st November 2008

Guy Ritchie has cancelled Madonna’s order for tens of thousands of pounds worth of special Kabbalah water to fill their swimming pool. It’s always uncomfortable when we have to humour someone close to us in the name of avoiding conflict. Right now in Thames Valley University, for example, entire science departments must be feeling slightly embarrassed about their degrees in quackery. Because despite the refusal of all universities to openly disclose what they teach on these – uniquely their ideas must be shielded from critical appraisal – the leaks keep coming, and Professor David Colquhoun of UCL continues to archive the comedy on his website.

This latest batch of course notes from TVU sound more like religious evangelism than science. “Students and practitioners alike are frequently subject to negative expressions and even frank hostility from relatives… it is therefore best to be forewarned that your adherence to ‘alternative’ principles will be tested in these ways.” They talk about magical fields that cannot be detected by instruments, as if this were a personality flaw on the part of physicists, and so on.

This is not an isolated incident. The Centre for Nutrition Education and Lifestyle Management is headed by someone from Patrick Holford‘s Institute for Optimum Nutrition. You might be surprised to discover that there is a university BSc degree available from an institution where the front cover of the prospectus reads: “Caring for and Nurturing our future Evolution through the successful support of our genetic code”, but there it is, validated by Middlesex University. What they offer is in fact a mixture of nutritionism and a self help method called “Neurolinguistic Programming”, which developed in the 1970s out of the New Age movement.

The University of Westminster have consistently failed to offer me or Colquhoun meaningful information about their degree courses. The University of Central Lancashire has turned down (several times) a request from David Colquhoun under the Freedom of Information Act to see the teaching materials used on their homeopathy BSc. But we do have – via David – an authentic leaked exam paper from the University of Westminster Homeopathy BSc degree course finals, asking questions about miasma.

Miasmatic theory originated in the Middle Ages and lasted until the middle of the 19th century, when diseases like cholera and plague were believed to be spread by foul air, known as miasmas. John Snow showed in 1854 that cholera was spread through contaminated water – nothing to do with “miasmas” – and Robert Koch discovered the micro organism that causes the disease in 1883. If you know someone with cholera then do try and get hold of a sample of their watery diarrhoea, you should be able to see Vibrio cholerae under a £14.99 microscope from Argos, if you borrow some stain from a friendly microbiologist. Make sure you wash your hands afterwards, and don’t bite your fingernails during the experiment.

In fact, the story that science can tell about cholera is well characterised and fiendishly fascinating. If you swallow some cholera bacteria, they shut down to pass through your murderously acidic stomach, and then, when they detect (from the changed chemical environment) that they are in your small intestine, they start producing curly whip-like tails. These rotate to propel the bacteria through the pasty mucus that lines your small intestine, and up against the intestinal wall, where they can thrive.

Once here, they again respond to their changed chemical surroundings, and stop producing the tails, and instead, start producing cholera toxin. This toxin pulls chloride ions across the bowel wall, and so water is drawn across with them, by osmosis, from your blood supply and into the passageway of your small intestine.

This happens on a massive scale: your small intestine is suddenly full of water, which flies out of your arse at a phenomenal rate, carrying the multiplying and thriving new generations of Vibrio cholerae bacteria out into the drinking water and so on to the next host, chillingly, perhaps your brother, perhaps your girlfriend – unless proper sanitation measures are in place.

Meanwhile, as this water flies out of you, dehydration rapidly begins to set in, and the only thing you can do to save your life is make sure you consume – almost continuously – the right mixture of dilute salt water and sugar, to replace the blood’s water and salts lost in the diarrhoea.

And fascinatingly, the single most successful evidence-based medical treatment in the history of humankind is something you’ve probably never heard of: the WHO rehydration recipe, used to treat people with diarrhoea, which has saved 3 million lives a year for the past two decades. In fact, diarrhoea kills more young children around the world than malaria, AIDS and TB combined.

You can fix yourself a pair of pints in your own kitchen following this deliberately memorable recipe: simply stir one level teaspoon of salt, and eight level teaspoons of sugar, into one litre (5 cupfuls) of drinkable water. Then sit back on your balcony, toast the fact that you don’t really have cholera, and savour the flavour of a drink that saves one child’s life every 11 seconds. Imagine being a part of inventing that. If I was going to teach anything on a science degree, it wouldn’t be miasma, and it wouldn’t be a secret.

Important Note:

In the article above, I failed to distinguish satisfactorily between the fantastical miasmatic theory of disease in the middle ages and the fantastical miasmatic theory of disease as meant by some homeopaths, two equally fantastical theories (note) about the causes of disease. This will make the homeopaths fizz like a bag of wasps.

Now this distinction may, to you, feel a bit like those mediaeval philosophers’ heated debates about the number of angels that can fit on the head of a pin, but we must respect the belief systems of others, and more than that, accuracy is important. I’ve already let the Readers’ Editor know about this important error and will keep you updated on the progress of my complaint about my own work.