Letter Six

· February 6, 2021

A case for homeopathy, and the pain of tinnitus. I am not as obtuse as the title suggests.

A case for good homoeopaths.

Let’s preface this piece with a huge warning label, this is not medical advice. If you die, it’s on you.

Most of my life, I have been an active hater of homoeopathy. Whenever I saw someone having homoeopathic medicine, I scoffed at them, judging them for their ignorance of the sciences. In hindsight, it was a very mean spirited approach to educating them. Derision has never bought two peoples together. (That is a rant for another day). Over the past few weeks, my opinion has been changing. I hate that we have so many homoeopaths selling way too much homoeopathic medicine. The best way to alleviate their medical hazard and quackery is, in my opinion, to increase the quality of homoeopaths.

To understand why I came to this conclusion, you must know where I come from. For the past many weeks, I have been mulling over the idea of iatrogenics, a term which I learnt in Antifragile. What is iatrogenics? Here is the dictionary definition:

iatrogenic /aɪˌæt.rəˈdʒen.ɪk/: (of a disease or problem) caused by medical treatment or by a doctor

Almost all systems in India is highly unregulated (even the ones that are regulated, are poorly so). It would be fair to say, the average complex system in India is highly prone to corruption, inefficiency, and optimising for the wrong metrics 1. Medicine, in my opinion, is no exception to this. In developing countries, for every 100 patients admitted to the hospital, 7-10 get Hospital Acquired Infections (HAIs) 2. Even if I put aside the incompetencies of our medical system and poor optimisations, we are a nation that doesn’t respect regulation. Pretty much any medicine (I assume illegitimately) is an over the counter (OTC) medicine in India. We are a nation of self medicators 3. Now, here is the problem with most OTC medicine, it’s a short term solution, to a problem that we mostly don’t have. Here is what I mean by it - the human body is a beautifully complex system that has evolved over millions of years to deal with most common illnesses. A cold rarely kills people. Swellings have not done many harm. Here, I have become a believer of applying the barbell strategy, minimise the risks by clipping my downsides.

Medication is, in my opinion 4, only worth taking in case of a real possibility of long term harm to your body. Whenever we have a cold or fever, most of us pop a pill to make us feel better in the short term. We rarely wonder why the body has reacted the way it has to the viruses. In a sense, we are disrespecting evolution 5 by taking it for a fool.

A lot of OTC meds are no different than fishing for likes on Instagram, or eating a whole tub of Häagen-Dazs. It’s all about the short term gains 6. Let’s have a look at the upsides and downsides of OTC cold meds:

  1. Upside: I feel good, the headache is finally down. My body is feeling good.
  2. Downside: The meds can mess with me, and cause much worse bodily harm to me 7

What if you don’t take that OTC?

  1. Upside: You can definitely not get side effects. You will be safe, and maybe your immunity would improve.
  2. Downside: You will have to suffer through the cold, and soreness.

Now, in the second case, what you have done, is capped your downside. In the first case, you have capped nothing. Would you want to introduce unnecessary risk for immediate gratification? Hopefully. Another classic example of unnecessary intervention is icing an injury to reduce your swelling. Why do you want to reduce your swelling? It helps your body heal, and unless you have chronic swelling, you’d be stupid to get in the way of the body. 8

This poorly regulated, and downright stupid habit of people (my mother has this habit) of popping a med at the sight of the most non-harmful ailment (think mild fever, cold, sore throat, stomach upsets, etc.) is effectively exposing yourself to Black Swans 9. This brings me back to homoeopathy 10 - the cure against iatrogenics in our flawed society.

First, let’s see what is the basis of homoeopathy -

Homeopathy involves a process known by practitioners as “dynamisation” or “potentisation” whereby a substance is diluted with alcohol or distilled water and then vigorously shaken in a process called “succession”.

The results of this are Homoeopathic medicines that amount to nothing more than solutions containing one or two stray molecules of the active ingredients. A good homoeopath would prescribe good homoeopathic meds. And this would amount to nothing more than drinking inert substances like distilled water. In effect, what you are doing is not getting in the way of the body’s healing process; this is the same as not having the OTC drug. This way, you are resilient to black swans. Let’s look at the most popular Homeopathic cold medicine, Arsenicum Album -

For homoeopathic use, Arsenicum album is prepared by separating arsenic from iron (as in arsenopyrite), cobalt, or nickel by baking at high temperatures. The powder is then ground and diluted with lactose. In the final dilution, statistically, most pills will contain zero molecules of the original arsenic used; some might contain a single molecule.

Following good homoeopathic practices would make you resilient to common illnesses.

Why suggest homoeopathic remedies as opposed to promoting doing nothing? We love doing something to fix our issues to get immediate gratification. Anything. On top of that, Indians are not exactly the most science believing people when it comes to alternative medical systems. We will trust homoeopathy 11. Let’s not allow kids to play with fire. Let’s promote good quality homoeopathy to our imperfect society. It’s easier to convince people to agree with their belief than to change them altogether.

The ethics of this, you may think, are questionable. I defend this approach claiming that homeopathy in its harmful form will die over time. At worst, it would remain an opaque heuristic 12.

In any case, your takeaway from this should be as follows: Homoeopathy is bad. Treating yourself for mild illneses with real meds is bad, as it exposes you to uncapped risks, with capped benefits. If you can get someone to not take meds for such things, that’s ideal. That’s peaceful. Thats where you want to be. If that’s not an option, homoeopathy is your next best bet. Real homoeopathy is nothing. Water. Nothing. It has no effect on you. Its like no meds + lack of education. Its a tradeoff between the two evils, misinformation and harmful intervention. I think in this circumstance, harmful intervention is the greater evil. The literature on harmful intervention by real medicine is vast. Your way to health and recuperation, while using real science, is by capping your downsides. Don’t expose yourself to Black Swans. Its not worth it.

Coming to terms with my tinnitus. Or not.

If you are an ardent follower of “The Letter”, then you would know that early last year I had begun practising meditation. It was during this time, I started noticing the high-frequency tone ringing relentlessly in my ear. My first reaction was that of panic, concluding that I have been struck with the dreaded tinnitus 13. Me, being the connoisseur of rational thinking I am, decided to stop my panicked frenzy, and do some research before jumping to conclusions. On cursory readings of resources on the web 14, I decided that I may only have temporary ringing of the ears caused by a cold, or some loud music. To be on the safe side, I stopped listening to music while coding and greatly cut down on my earphone usage.

Fast forward to last month, I could hear the ringing clearer than ever. It followed me around the house. It was especially loud in my study room - the room where I meditated and worked. It bothered me a lot when I thought about it. Whenever I didn’t think about it though, it managed to disappear into the background noise. It was still bothersome while reading, or meditating. I was not too happy that I did this to my ears. It was at this juncture, I decided to read Volume Control, a book about hearing, the ears and the science of hearing loss. I wanted to better take care of my ears. I learnt about how we abuse our ears in modern society, and how we may be on the verge of a tinnitus epidemic. I also read about how tinnitus can grow into something worse, partial hearing loss, unbearable pain, the like. The worst part about it, there is no cure. In fact, we have no idea why it happens. A Harvard doctor once recommended wearing very small shoes as a cure for sharp tinnitus. It would take your mind away from the high pitch screech, and direct it to the pain in your feet 15. I was freaked

The ears are very delicate organs. We hear due to tiny “hair” that sense vibrations and convert them into electrical signals that our brain perceives as sounds. We don’t have too many of these hair cells - about 15000 of them. In comparison, we have 50-100 million rods and cones, cells that help us perceive light. Even when it comes to the number of nerve cells, our ears have been dealt the short end of the stick - they have about 30,000 nerve cells in the cochlear nerve as opposed to millions in our retina. So, it’s easy to understand why most of us get poorer at listening as we age. Its easier to go deaf, we got lesser redundancy there.

I was deeply saddened by the state of affairs in my inner ears. The ringing indicated that I had failed my cochlea. I decided that from that point on I will take great care of my ears, and prevent further damage. I talked to my brother about my tinnitus situation. He told me, he also has been having the issue of late. That prompted me to investigate why the tinnitus was so loud in my guest bedroom (I previously thought it was because that’s when I was in the most amount of silence, making me notice it the most.). Turns out the stupid inverter connected to the router had been making the high-frequency sound that I perceived as my loud tinnitus. I felt relieved that I hadn’t massacred my inner ear. This joy was short-lived though because on doing more thorough testing, it did turn out that I have mild tinnitus. This was, fortunately, something I had hardened myself to deal with over the many months of accepting I have a bad case of tinnitus.

This whole episode has changed my view towards my ears. Things are not as bad as I first thought, but they are still not ideal. I hadn’t been respecting my ears, and early signs of hearing damage is showing in the form of mild tinnitus. I will definitely take these organs way more seriously from now. Kids, take care of your ears. You will love yourself for it.


  1. Goodhart’s Law: When a measure becomes a target, it ceases to be a good measure. See here for some curious cases of this adage at play. The Hacktober Fest 2020 debacle is the modern version of the Cobra Effect. 

  2. A report on medical negligence 

  3. I recognise that this sounds like a gross, and sweeping generalisation. I hope the reader can understand that not everyone is like this in India. Rational people live everywhere. 

  4. And friends, I am not a medical expert. 

  5. And to my believer friends, we are disrespecting god. 

  6. Or as many would popularly say, it appeals to the sensibility of our indiscipline reptilian brain. 

  7. Don’t trust me, trust the good folk at Harvard 

  8. “Acute inflammation is how your body fights invaders that may cause infection, as well as being a part of the healing process,” says Dr. Luster. “In this way, inflammation is a good thing, because it protects the body.” - Source - Harvard bois 

  9. A black swan is an unpredictable event that is beyond what is normally expected of a situation and has potentially severe consequences. Black swan events are characterized by their extreme rarity, severe impact, and the widespread insistence they were obvious in hindsight. 

  10. Which I want to state in clear terms, is quackery and fraud. 

  11. We are stupid like that. I am sorry, I will stop the derision. It has helped nobody bring peoples together. 

  12. These are heuristics performed by society for a long time, for reasons not fully understood, yet they have stuck. Bad things usually die out over time. Doctors used to blood-let all the time. The process died, it was dangerous. Same with lobotomies. Toxic homeopathy will die, or the whole of homeopathy will die. We don’t have to worry about it. Time will fix everything. 

  13. My dread for tinnitus developed over time because of Archer. He made it sound like hell. Reading about how high suicide rates amongst people with a special form of tonal tinnitus certainly didn’t help my mindset. 

  14. Repeat after me, never self diagnose using the internet. 

  15. A funny anecdote I read in the book. See my review for it here 

Twitter, Facebook