La homeopatía, una idea que se diluye

{"id":1804,"id_simpleblog_post":"1804","id_simpleblog_category":"66","id_simpleblog_post_type":"1","id_simpleblog_author":"0","author":"Andr\u00e9s Gomberoff","author_url":"https:\/\/www.penguinlibros.com\/es\/2577-andres-gomberoff","likes":"0","views":"3359","allow_comments":"2","is_featured":"1","access":"a:6:{i:1;b:1;i:2;b:1;i:3;b:1;i:4;b:0;i:5;b:0;i:6;b:0;}","cover":"jpg","featured":"jpg","id_product":"339705","id_category_tematica":"207172,59,57","id_category_autor":"2577,2578,7937,10637","id_category_editorial":"11355","id_event":"0","active":"1","title":"La homeopat\u00eda, una idea que se diluye","meta_title":"La homeopat\u00eda, una idea que se diluye","meta_description":"El divulgador cient\u00edfico Andr\u00e9s Gomberoff, f\u00edsico te\u00f3rico y autor de \u00abEl instinto cient\u00edfico\u00bb (Debate), explica por qu\u00e9 la homeopat\u00eda puede haber sido una buena idea en 1796 para acabar desarrollando con argumentos por qu\u00e9 hoy ya no lo es.","meta_keywords":"Revista LENGUA, Homeopat\u00eda, Pseudociencias, Andr\u00e9s Gomberoff","short_content":"<p>\u00bfQu\u00e9 cantidad de materia prima de origen animal, vegetal o mineral hay en una pastilla homeop\u00e1tica? \u00bfC\u00f3mo afecta la actitud del m\u00e9dico al recetar un placebo? \u00bfQu\u00e9 relaci\u00f3n guardan un caballo alem\u00e1n capaz de realizar operaciones matem\u00e1ticas y las pseudociencias? El divulgador cient\u00edfico Andr\u00e9s Gomberoff, f\u00edsico te\u00f3rico formado en la Universidad de Chile, donde obtuvo su doctorado en 1996, responde a estas y otras preguntas en \u00abEl instinto cient\u00edfico\u00bb (Debate, 2024), un divertido, pol\u00e9mico y absorbente viaje intelectual que explora los or\u00edgenes y fundamentos del pensamiento cient\u00edfico, proceso decisivo en la construcci\u00f3n de la cultura occidental y de la joya de su corona: la ciencia. En el cap\u00edtulo que aqu\u00ed publicamos, titulado \u00abUna idea que se diluye\u00bb, Gomberoff explica por qu\u00e9 la homeopat\u00eda pudo haber sido una buena idea en 1796 para acabar desarrollando con argumentos por qu\u00e9 hoy ya no lo es: \u00abLa historia de la ciencia est\u00e1 llena de buenas ideas que el tiempo, el escrutinio p\u00fablico y el advenimiento de otras mejores van diluyendo hasta no dejar ninguna mol\u00e9cula de ellas\u00bb.<\/p>","full_content":"","content":"[{\"id\":\"du6rfsf\",\"elType\":\"section\",\"isInner\":false,\"settings\":{\"section_layout\":\"\",\"stretch_section\":\"\",\"layout\":\"boxed\",\"content_width\":{\"unit\":\"px\",\"size\":\"\"},\"gap\":\"default\",\"height\":\"default\",\"custom_height\":{\"unit\":\"px\",\"size\":400},\"column_position\":\"middle\",\"content_position\":\"\",\"structure\":\"10\",\"section_background\":\"\",\"background_background\":\"\",\"background_color\":\"\",\"background_color_stop\":{\"unit\":\"%\",\"size\":0},\"background_color_b\":\"\",\"background_color_b_stop\":{\"unit\":\"%\",\"size\":100},\"background_gradient_type\":\"linear\",\"background_gradient_angle\":{\"unit\":\"deg\",\"size\":180},\"background_gradient_position\":\"center 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que se den cuenta de lo inconmensurable de este n\u00famero, en 1 ml de agua, es decir, en la peque\u00f1a gota con que impregnan cada gl\u00f3bulo, solo hay unas 10 elevado a 22 mol\u00e9culas de agua. Para tener alguna probabilidad de encontrar una sola mol\u00e9cula de la sustancia inicial en esta diluci\u00f3n, debemos juntar un volumen tan grande que no cabe en el universo observable. En resumen, las p\u00edldoras de Oscillococcinum, como nuestro Neuritax, no contienen m\u00e1s que az\u00facar. Por supuesto, el home\u00f3pata tiene una respuesta a esto. Nos dir\u00e1 que la base te\u00f3rica de la homeopat\u00eda alude a la \u00abmemoria del agua\u00bb. Es decir, a pesar de que no hay vestigio alguno del h\u00edgado y coraz\u00f3n de pato en el medicamento, el agua en que fue impregnado es capaz de recordar el contacto que alguna vez tuvo con la sustancia activa. \u00bfHay alguna raz\u00f3n para creer que esto es cierto? Ninguna. La fisicoqu\u00edmica del agua se ha estudiado por siglos. Hoy los c\u00e1lculos te\u00f3ricos pueden explicar con delicioso detalle cada una de sus espectaculares propiedades. No hay teor\u00eda ni experimento que d\u00e9 cuenta de memoria alguna. En resumen, y para poner a prueba nuestro instinto cient\u00edfico: primero, tenemos una teor\u00eda \u00ablo similar cura lo similar\u00bb, que no solo no tiene asidero alguno, sino que, adem\u00e1s, es incompatible con los avances de las ciencias m\u00e9dicas que se desarrollaron en los siglos siguientes. Segundo, tenemos un principio activo \u2014h\u00edgado y coraz\u00f3n de pato\u2014 que no parece ni provocar ni prevenir los s\u00edntomas de la gripe. Tercero, ese principio activo est\u00e1 tan disuelto en agua que es m\u00e1s probable encontrar una mol\u00e9cula proveniente de un h\u00edgado de pato en el agua del grifo de su casa que en el l\u00edquido en que se impregnan estos gl\u00f3bulos homeop\u00e1ticos. Cuarto, no hay evidencia de que el agua recuerde nada, y hablamos de una sustancia que ha sido detalladamente estudiada desde todos sus \u00e1ngulos.\u00a0<\/p><p>El procedimiento homeop\u00e1tico, convengamos, no parece muy convincente. Esa intuici\u00f3n de que algo no resulta del todo l\u00f3gico, de que el argumento es d\u00e9bil, incoherente, es la primera defensa del pensamiento cr\u00edtico, del instinto cient\u00edfico. Ahora bien, alguien podr\u00eda, con raz\u00f3n, contradecir mi escepticismo te\u00f3rico, afirmando que, por muy extra\u00f1o que todo esto parezca, las p\u00edldoras funcionan. Afortunadamente, esa afirmaci\u00f3n es f\u00e1cil de poner a prueba. Veamos c\u00f3mo.\u00a0<\/p><p>Para verificar la eficacia de un medicamento debemos tener en cuenta todos los posibles autoenga\u00f1os. Evitarlos a la luz de las trampas cognitivas que el pasado nos ha revelado. Fue el m\u00e9dico norteamericano Henry Beecher quien en 1955 encendi\u00f3 todas las alarmas de la investigaci\u00f3n m\u00e9dica en su art\u00edculo \u00abThe powerful placebo\u00bb \u00abel poderoso placebo\u00bb en 1955 (Beecher, 1955). A pesar de los varios errores estad\u00edsticos que hoy se sabe que este art\u00edculo contiene, su influencia fue tremenda. Puso todas las luces sobre los fallos que se estaban cometiendo al evaluar los efectos de un tratamiento, particularmente sobre la importancia de la respuesta placebo. Fue el comienzo de un nuevo est\u00e1ndar en la realizaci\u00f3n de ensayos cl\u00ednicos. Hoy se exige que estos estudios sean aleatorizados, doble ciegos y controlados con placebo. Paso a explicar estos t\u00e9rminos usando el ejemplo de nuestros gl\u00f3bulos homeop\u00e1ticos.\u00a0<\/p><p>Para verificar si el Oscillococcinum es efectivo para combatir los s\u00edntomas de la gripe, debemos partir, por supuesto, con un grupo de personas con gripe y observar el efecto que el medicamento tiene sobre el desarrollo de la enfermedad. Sabemos que la inmensa mayor\u00eda de nuestros voluntarios se recuperar\u00e1n con o sin tratamiento; despu\u00e9s de todo, es solo una gripe. Por lo tanto, debemos tener tambi\u00e9n un \u00abgrupo de control\u00bb. Este es otro grupo de agripados, a los que en lugar del Oscillococcinum se les administrar\u00e1 un placebo. El placebo debe tener id\u00e9ntica apariencia, venir en id\u00e9ntico envase y ser recetado en las mismas condiciones que a quienes se les entreg\u00f3 el medicamento en estudio. Es claro que la eficacia de cualquier medicamento solo podr\u00e1 ser validada si aquellos que lo recibieron tienen, estad\u00edsticamente, una mejor\u00eda m\u00e1s r\u00e1pida que aquellos que recibieron el placebo. A esto nos referimos cuando decimos que el estudio es \u00abcontrolado por 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que tener algunos cuidados, sin embargo, con el conjunto de voluntarios. Primero, debe ser una muestra representativa. Si queremos validar el uso de un medicamento, digamos, en todo Chile, no podemos usar solo pacientes hombres que vivan en Antofagasta. La muestra debe ser representativa, considerar todos los sexos, regiones geogr\u00e1ficas, niveles socioecon\u00f3micos, etc.\u00a0<\/p><p>Pero m\u00e1s importante a\u00fan, la divisi\u00f3n de los voluntarios en dos grupos se debe realizar en forma aleatoria. Solo as\u00ed podremos argumentar que cualquier distinci\u00f3n en el desarrollo de la enfermedad entre los grupos se debe a los distintos tratamientos y no, por ejemplo, a una diferencia en sus h\u00e1bitos alimenticios o en el clima de la regi\u00f3n en donde residen. A todo esto nos referimos cuando decimos que el estudio es \u00abaleatorizado\u00bb.\u00a0<\/p><p>Finalmente, \u00abdoble ciego\u00bb significa que ni los pacientes en el estudio ni los cient\u00edficos que les entregaron sus p\u00edldoras saben a qu\u00e9 grupo pertenece cada uno. La idea es que los voluntarios no tengan ninguna sospecha de qu\u00e9 es lo que est\u00e1n tomando. Ahora bien, \u00bfpor qu\u00e9 tampoco el m\u00e9dico tratante puede saberlo? Porque el lenguaje corporal es tremendamente poderoso y es muy f\u00e1cil que inconscientemente exista una comunicaci\u00f3n entre las dos partes que permita al paciente obtener alguna pista. Una historia muy notable que evidencia este poder de la comunicaci\u00f3n corporal inconsciente y nos alerta sobre el cuidado que debemos tener al hacer observaciones en las que pueda darse, es la de Hans el listo.\u00a0<\/p><p>Hans el listo era un caballo que a comienzos del siglo xx, en Berl\u00edn, impresionaba a sus audiencias haciendo operaciones matem\u00e1ticas, identificando al autor de piezas musicales, contando el n\u00famero de personas en una audiencia o leyendo la hora en un reloj (Samhita y Gross, 2013). Hans hab\u00eda sido entrenado cuatro a\u00f1os por el profesor de matem\u00e1ticas Wilhelm von Osten, quien se ganaba la vida present\u00e1ndolo al p\u00fablico por toda Alemania. En cada espect\u00e1culo, el caballo respond\u00eda las preguntas num\u00e9ricas golpeando sus pezu\u00f1as en el suelo un n\u00famero de veces. Para responder texto, Von Osten asignaba a cada letra un n\u00famero y exhib\u00eda las reglas en una pizarra. La precisi\u00f3n del caballo en sus respuestas era tan alta que la fama de Hans y de su entrenador crecieron r\u00e1pidamente, tanto en Alemania como en todo el mundo. Fue tan grande el revuelo que en 1904 el Consejo de Educaci\u00f3n alem\u00e1n cre\u00f3 una comisi\u00f3n para averiguar qu\u00e9 era lo que realmente estaba ocurriendo en este incre\u00edble acto. Solo tres a\u00f1os m\u00e1s tarde, el fen\u00f3meno pudo ser explicado por el bi\u00f3logo y psic\u00f3logo Oskar Pfungst. No hab\u00eda ning\u00fan truco. De hecho, Von Osten estaba convencido de que su caballo era inteligente y capaz de razonar, conocer y calcular. Hans no era capaz de nada de eso, solo era extremadamente sensible al lenguaje corporal de su entrenador. Supongamos que al caballo se le presentaba la suma 2 + 1. Inmediatamente, comenzar\u00eda a golpetear el suelo con su pezu\u00f1a. Una vez, dos veces... Cuando llegaba a la tercera, la respuesta correcta, la postura o el gesto facial de Von Osten le dec\u00edan al caballo que ese golpe deb\u00eda ser el \u00faltimo si es que quer\u00eda obtener una recompensa. Era tan espectacularmente sutil la capacidad del caballo para reconocer estas pistas, que no solo las captaba de su entrenador. Otras personas tambi\u00e9n pod\u00edan hacerle preguntas que contestaba correctamente. \u00bfC\u00f3mo sabemos entonces que Hans no era realmente listo? Porque el instinto cient\u00edfico indica que esta no es la predicci\u00f3n m\u00e1s l\u00f3gica y Pfungst ide\u00f3 el experimento que lo comprobaba: intentar que el caballo responda una pregunta cuya respuesta desconoce quien se la hace. Por ejemplo, desafi\u00e1ndolo a reconocer una pieza musical que el interrogador nunca escuch\u00f3 y de la que, por lo tanto, no podr\u00e1 entregarle pista alguna. Si Hans solo pod\u00eda responder preguntas cuando la persona que ten\u00eda al frente conoc\u00eda la respuesta, entonces es evidente que esta persona estaba, inconscientemente, entreg\u00e1ndosela.\u00a0<\/p><p>Este caso extremo de comunicaci\u00f3n no verbal entre humano y caballo muestra claramente por qu\u00e9 los estudios cl\u00ednicos deben ser doble ciegos. Si podemos entregar informaci\u00f3n no verbal, inconscientemente, a un animal, con mucha mayor probabilidad podemos hacerlo a un ser humano. Por eso, quien entrega el medicamento al paciente podr\u00eda, sin siquiera darse cuenta, darle pistas sobre lo que realmente hay dentro de cada c\u00e1psula, interfiriendo con la respuesta placebo y con todo el experimento.\u00a0<\/p><p>Despu\u00e9s de este largo desv\u00edo podemos volver a la pregunta inicial y responderla con rigor cient\u00edfico. Existen muchos estudios aleatorizados, doble ciegos y controlados por placebo que estudian la eficacia de medicamentos homeop\u00e1ticos. Porque, aunque para muchos pueda parecer inveros\u00edmil, no hay distinci\u00f3n real entre medicina y \u00abmedicina alternativa\u00bb. Sin importar las opiniones, el sentido com\u00fan o las preferencias te\u00f3ricas, cualquier tratamiento seguro y eficaz es medicina. La curiosidad humana, la urgencia por la salud y la cantidad de cient\u00edficos en el mundo hacen que se pongan a prueba hasta los tratamientos m\u00e1s inveros\u00edmiles. El Oscillococcinum no es una excepci\u00f3n y la respuesta es que no existe evidencia alguna que respalde que estos gl\u00f3bulos de az\u00facar, impregnados en una soluci\u00f3n ultradiluida de coraz\u00f3n e h\u00edgado de pato, sean m\u00e1s efectivos que el placebo para tratar la gripe (Mathie, 2015).\u00a0<\/p><p>La homeopat\u00eda puede haber sido una buena idea en 1796, pero hoy no lo es. De hecho, todas sus concepciones te\u00f3ricas est\u00e1n descartadas (ver nota al pie: 1) Tampoco suele mostrar eficacia en estudios cl\u00ednicos, aunque no podemos generalizar, ya que hay algunos productos homeop\u00e1ticos cuyos ingredientes activos no vienen en las disoluciones extremas que vimos en el caso del Oscillococcinum y, por lo tanto, no se puede descartar que tengan alg\u00fan efecto. Claro que hay que decir que es improbable, ya que su supuesta eficacia se basa en una idea sin ning\u00fan sustento.<\/p><p>La historia de la ciencia est\u00e1 llena de buenas ideas que el tiempo, el escrutinio p\u00fablico y el advenimiento de otras mejores van diluyendo hasta no dejar ninguna mol\u00e9cula de ellas.<br \/><br \/>---<\/p><p><em>Nota al pie: 1. Alguien podr\u00eda argumentar que las vacunas son precisamente un caso de \u00e9xito de esta idea. No es as\u00ed. Las vacunas usan partes del microrganismo que produce la enfermedad o una versi\u00f3n inactiva de este para entrenar al sistema inmune. Pero no es lo \u00absimilar curando lo similar\u00bb. El virus o bacteria que produce la enfermedad se utilizan para que el sistema inmune pueda reconocer y combatir al pat\u00f3geno invasor cuando se presente en su versi\u00f3n activa.<\/em><\/p>\",\"section_style\":\"\",\"align\":\"\",\"align_tablet\":\"\",\"align_mobile\":\"\",\"text_color\":\"#1a1a1a\",\"typography_typography\":\"custom\",\"typography_font_size\":{\"unit\":\"px\",\"size\":\"18\"},\"typography_font_size_tablet\":{\"unit\":\"px\",\"size\":\"\"},\"typography_font_size_mobile\":{\"unit\":\"px\",\"size\":\"\"},\"typography_font_family\":\"custom\",\"typography_font_family_custom\":\"Fort-Book\",\"typography_font_weight\":\"\",\"typography_text_transform\":\"\",\"typography_font_style\":\"\",\"typography_line_height\":{\"unit\":\"px\",\"size\":\"27\"},\"typography_line_height_tablet\":{\"unit\":\"em\",\"size\":\"\"},\"typography_line_height_mobile\":{\"unit\":\"em\",\"size\":\"\"},\"typography_letter_spacing\":{\"unit\":\"px\",\"size\":\"\"},\"typography_letter_spacing_tablet\":{\"unit\":\"px\",\"size\":\"\"},\"typography_letter_spacing_mobile\":{\"unit\":\"px\",\"size\":\"\"},\"_section_style\":\"\",\"_margin\":{\"unit\":\"px\",\"top\":\"0\",\"right\":\"0\",\"bottom\":\"58\",\"left\":\"0\",\"isLinked\":false},\"_margin_tablet\":{\"unit\":\"px\",\"top\":\"\",\"right\":\"\",\"bottom\":\"\",\"left\":\"\",\"isLinked\":true},\"_margin_mobile\":{\"unit\":\"px\",\"top\":\"\",\"right\":\"\",\"bottom\":\"\",\"left\":\"\",\"isLinked\":true},\"_padding\":{\"unit\":\"px\",\"top\":\"\",\"right\":\"\",\"bottom\":\"\",\"left\":\"\",\"isLinked\":true},\"_padding_tablet\":{\"unit\":\"px\",\"top\":\"\",\"right\":\"\",\"bottom\":\"\",\"left\":\"\",\"isLinked\":true},\"_padding_mobile\":{\"unit\":\"px\",\"top\":\"\",\"right\":\"\",\"bottom\":\"\",\"left\":\"\",\"isLinked\":true},\"_animation\":\"\",\"animation_duration\":\"\",\"_css_classes\":\"\",\"_section_background\":\"\",\"_background_background\":\"\",\"_background_color\":\"\",\"_background_image\":{\"url\":\"\",\"id\":\"\"},\"_background_position\":\"\",\"_background_attachment\":\"\",\"_background_repeat\":\"\",\"_background_size\":\"\",\"_background_video_link\":\"\",\"_background_video_fallback\":{\"url\":\"\",\"id\":\"\"},\"_border_border\":\"\",\"_border_width\":{\"unit\":\"px\",\"top\":\"\",\"right\":\"\",\"bottom\":\"\",\"left\":\"\",\"isLinked\":true},\"_border_color\":\"\",\"_border_radius\":{\"unit\":\"px\",\"top\":\"\",\"right\":\"\",\"bottom\":\"\",\"left\":\"\",\"isLinked\":true},\"_box_shadow_box_shadow_type\":\"\",\"_box_shadow_box_shadow\":{\"horizontal\":0,\"vertical\":0,\"blur\":10,\"spread\":0,\"inset\":\"\",\"color\":\"rgba(0,0,0,0.5)\"},\"_section_responsive\":\"\",\"responsive_description\":\"\",\"hide_desktop\":\"\",\"hide_tablet\":\"\",\"hide_mobile\":\"\"},\"defaultEditSettings\":[],\"widgetType\":\"text-editor\",\"editSettings\":{}},{\"id\":\"e297o14\",\"elType\":\"widget\",\"isInner\":false,\"settings\":{\"section_editor\":\"\",\"editor\":\"<p class=\\\"MsoNormal\\\"><strong>OTROS\u00a0CONTENIDOS DE INTER\u00c9S:<\/strong><\/p><p><span style=\\\"text-decoration: underline;\\\"><a href=\\\"https:\/\/www.penguinlibros.com\/es\/revista-lengua\/no-ficcion\/siddharta-mukherjee-celulas-depresion\\\" target=\\\"_blank\\\" rel=\\\"noopener\\\">Una orquesta desafinada: las c\u00e9lulas y el demonio de la depresi\u00f3n<\/a><\/span><\/p><p><span style=\\\"text-decoration: underline;\\\"><a href=\\\"https:\/\/www.penguinlibros.com\/es\/revista-lengua\/no-ficcion\/walter-isaacson-el-codigo-de-la-vida\\\" target=\\\"_blank\\\" rel=\\\"noopener\\\">Walter Isaacson: gen\u00e9tica, covid y el futuro de la humanidad<\/a><\/span><\/p><p><span style=\\\"text-decoration: underline;\\\"><a href=\\\"https:\/\/www.penguinlibros.com\/es\/revista-lengua\/no-ficcion\/hector-garcia-barnes-futurofobia-sergio-del-molino\\\" target=\\\"_blank\\\" rel=\\\"noopener\\\">V\u00edctimas de la \u00abfuturofobia\u00bb: una generaci\u00f3n triste con fotos felices.<\/a><\/span><\/p><p><span style=\\\"text-decoration: underline;\\\"><a href=\\\"https:\/\/www.penguinlibros.com\/es\/revista-lengua\/no-ficcion\/javier-cercas-paradojas-pandemia\\\" target=\\\"_blank\\\" rel=\\\"noopener\\\">Javier Cercas: paradojas de la pandemia.<\/a><\/span><\/p><p><a href=\\\"https:\/\/www.penguinlibros.com\/es\/revista-lengua\/fenomenos\/la-peste-vendra-la-muerte-y-tendra-tus-ojos\\\" target=\\\"_blank\\\" rel=\\\"noopener\\\"><span style=\\\"text-decoration: underline;\\\">La peste: vendr\u00e1 la muerte y tendr\u00e1 tus ojos<\/span><\/a><span style=\\\"text-decoration: 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