Respectable “Guardian” posted a question is there any
proof that homeopathic medicine works. Here are some of the chose answers:
For two groups of
people, yes. Those who have faith in it, and those that sell it (Michael
Fisher, Brisbane, Australia).
You could have
saved a lot of time and energy by writing. Is there any proof homeopathic
medicine works? No! (Mike, Birkenhead).
Yep, homeopathy is
right up there with numerology, palm reading, tea leaf reading, crystals,
astrology and tarrot cards - it's all utter rubbish (Chris Carter,
Christchurch, New Zealand).
No. Do you know
what they call alternative medicine that works? MEDICINE! If you catch a cold
and leave it alone it will take 7 days to leave, but use homeopathic pills and it
will be gone in a week! Do not be so gullible that you reject the common sense
you were born with (Edward Jenkinson, Darlington, United Kingdom).
Well, there were other respondents who claimed that for
them personally homeopathy works just fine, the majority of answers were in the
range from moderately negative to ultimately negative.
Basic Controversy
Homeopathic "remedies" enjoy a unique status in
the health marketplace: They are the only category of questionable products
legally marketable as drugs. This situation is the result of two circumstances.
First, the 1938 Federal Food, Drug, and Cosmetic Act, which was shepherded
through Congress by a homeopathic physician who was a senator, recognizes as
drugs all substances included in the Homeopathic Pharmacopeia of the United
States. Second, the FDA has not held homeopathic products to the same standards
as other drugs. Today, they are marketed in health-food stores, in pharmacies,
in practitioner offices, by multilevel distributors, through the mail, and on
the Internet.
History of Basic
Misbeliefs
Samuel Hahnemann (1755-1843), a German physician, began
formulating homeopathy's basic principles in the late 1700s. Hahnemann was
justifiably distressed about bloodletting, leeching, purging, and other medical
procedures of his day that did far more harm than good. Thinking that these
treatments were intended to "balance the body's 'humors' by opposite
effects," he developed his "law of similars"—a notion that
symptoms of disease can be cured by extremely small amounts of substances that
produce similar symptoms in healthy people when administered in large amounts.
The word "homeopathy" is derived from the Greek words homoios
(similar) and pathos (suffering or disease).
Hahnemann and his early followers conducted
"provings" in which they administered herbs, minerals, and other
substances to healthy people, including themselves, and kept detailed records
of what they observed. Later these records were compiled into lengthy reference
books called materia medica, which are used to match a patient's symptoms with
a "corresponding" drug.
Hahnemann declared that diseases represent a disturbance
in the body's ability to heal itself and that only a small stimulus is needed
to begin the healing process. He also claimed that chronic diseases were
manifestations of a suppressed itch (psora), a kind of miasma or evil spirit.
At first, he used small doses of accepted medications. However, later he used
enormous dilutions and theorized that the smaller the dose, the more powerful
the effect—a notion commonly referred to as the "law of
infinitesimals." That, of course, is just the opposite of the
dose-response relationship that pharmacologists have demonstrated.
The basis for inclusion in the Homeopathic Pharmacopeia
is not modern scientific testing, but homeopathic "provings"
conducted during the 1800s and early 1900s. The current (ninth) edition
describes how more than a thousand substances are prepared for homeopathic use.
It does not identify the symptoms or diseases for which homeopathic products
should be used; that is decided by the practitioner (or manufacturer). The fact
that substances listed in the Homeopathic Pharmacopeia are legally recognized
as "drugs" does not mean that either the law or the FDA recognizes
them as effective.
Because homeopathic remedies were actually less dangerous
than those of nineteenth-century medical orthodoxy, many medical practitioners
began using them. At the turn of the twentieth century, homeopathy had about
14,000 practitioners and 22 schools in the United States. However, as medical
science and medical education advanced, homeopathy declined sharply in America,
where its schools either closed or converted to modern methods. The last pure
homeopathic school in this country closed during the 1920s.
Better than
Placebo?
Homeopathic products are made from minerals, botanical
substances, and several other sources. If the original substance is soluble,
one part is diluted with either nine or ninety-nine parts of distilled water
and/or alcohol and shaken vigorously (succussed); if insoluble, it is finely
ground and pulverized in similar proportions with powdered lactose (milk
sugar). One part of the diluted medicine is then further diluted, and the
process is repeated until the desired concentration is reached. Dilutions of 1
to 10 are designated by the Roman numeral X (1X = 1/10, 3X = 1/1,000, 6X =
1/1,000,000). Similarly, dilutions of 1 to 100 are designated by the Roman
numeral C (1C = 1/100, 3C = 1/1,000,000, and so on). Most remedies today range
from 6X to 30X, but products of 30C or more are marketed.
A 30X dilution means that the original substance has been
diluted 1,000,000,000,000,000,000,000,000,000,000 times. Assuming that a cubic
centimeter of water contains 15 drops, this number is greater than the number
of drops of water that would fill a container more than 50 times the size of
the Earth. Imagine placing a drop of red dye into such a container so that it
disperses evenly. Homeopathy's "law of infinitesimals" is the
equivalent of saying that any drop of water subsequently removed from that
container will possess an essence of redness. Robert L. Park, Ph.D., a
prominent physicist who is executive director of The American Physical Society,
has noted that since the least amount of a substance in a solution is one
molecule, a 30C solution would have to have at least one molecule of the
original substance dissolved in a minimum of
1,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000
molecules of water. This would require a container more than 30,000,000,000
times the size of the Earth.
Oscillococcinum, a 200C product "for the relief of
colds and flu-like symptoms," involves "dilutions" that are even
more far-fetched. Its "active ingredient" is prepared by incubating
small amounts of a freshly killed duck's liver and heart for 40 days. The
resultant solution is then filtered, freeze-dried, rehydrated, repeatedly
diluted, and impregnated into sugar granules. If a single molecule of the
duck's heart or liver were to survive the dilution, its concentration would be
1 in 100200. This huge number, which has 400 zeroes, is vastly greater than the
estimated number of molecules in the universe (about one googol, which is a 1
followed by 100 zeroes). In its February 17, 1997, issue, U.S. News & World
Report noted that only one duck per year is needed to manufacture the product,
which had total sales of $20 million in 1996. The magazine dubbed that unlucky
bird "the $20-million duck."
Actually, the laws of chemistry state that there is a
limit to the dilution that can be made without losing the original substance
altogether. This limit, which is related to Avogadro's number, corresponds to
homeopathic potencies of 12C or 24X (1 part in 1024). Hahnemann himself
realized that there is virtually no chance that even one molecule of original
substance would remain after extreme dilutions. However, he believed that the
vigorous shaking or pulverizing with each step of dilution leaves behind a
"spirit-like" essence—"no longer perceptible to the senses"—,
which cures by reviving the body's "vital force." Modern proponents
assert that even when the last molecule is gone, a "memory" of the
substance is retained. This notion is unsubstantiated. Moreover, if it were
true, every substance encountered by a molecule of water might imprint an
"essence" that could exert powerful (and unpredictable) medicinal
effects when ingested by a person.
Many proponents claim that homeopathic products resemble
vaccines because both provide a small stimulus that triggers an immune
response. This comparison is not valid. The amounts of active ingredients in
vaccines are much greater and can be measured. Moreover, immunizations produce
antibodies whose concentration in the blood can be measured, but high-dilution
homeopathic products produce no measurable response. In addition, vaccines are
used preventively, not for curing symptoms.
Stan Polanski, a physician assistant working in public
health near Asheville, North Carolina, has provided additional insights:
* Imagine how many compounds must be present, in
quantities of a molecule or more, in every dose of a homeopathic drug. Even
under the most scrupulously clean conditions, airborne dust in the
manufacturing facility must carry thousands of different molecules of
biological origin derived from local sources (bacteria, viruses, fungi,
respiratory droplets, sloughed skin cells, insect feces) as well as distant
ones (pollens, soil particles, products of combustion), along with mineral
particles of terrestrial and even extraterrestrial origin (meteor dust).
Similarly, the "inert" diluents used in the process must have their
own library of microcontaminants.
* The dilution/potentiation process in homeopathy
involves a stepwise dilution carried to fantastic extremes, with
"succussion" between each dilution. Succussion involves shaking or
rapping the container a certain way. During the step-by-step dilution process,
how is the emerging drug preparation supposed to know which of the countless
substances in the container is the One that means business? How is it that
thousands (millions?) of chemical compounds know that they are required to lay
low, to just stand around while the Potent One is anointed to the status of
Healer? That this scenario could lead to distinct products uniquely suited to
treat particular illnesses is beyond implausible.
* Thus, until homeopathy's apologists can supply a
plausible (nonmagical) mechanism for the
"potentiation"-through-dilution of precisely one of the many
substances in each of their products, it is impossible to accept that they have
correctly identified the active ingredients in their products. Any study
claiming to demonstrate effectiveness of a homeopathic medication should be
rejected out-of-hand unless it includes a list of all the substances present in
concentrations equal to or greater than the purported active ingredient at
every stage of the dilution process, along with a rationale for rejecting each
of them as a suspect.
* The process of "proving" through which
homeopaths decided which medicine matches which symptom is no more sensible.
Provings involved taking various substances recording every twitch, sneeze,
ache or itch that occurred afterward—often for several days. Homeopathy's
followers take for granted that every sensation reported was caused by whatever
substance was administered, and that extremely dilute doses of that substance
would then be just the right thing to treat anyone with those specific
symptoms.
Dr. Park has noted that to expect to get even one
molecule of the "medicinal" substance allegedly present in 30X pills,
it would be necessary to take some two billion of them, which would total about
a thousand tons of lactose plus whatever impurities the lactose contained.
NHMRC Homeopathy
Review
NHMRC (National Health and Medical Research Council),
respected governmental organization in Australia, is in process of reviewing
the evidence for the effectiveness of homeopathy. The assessment of the
evidence comprises a systematic review of available systematic reviews (an
overview) on the effectiveness of homeopathy in treating a variety of clinical
conditions in humans and a report on evidence submitted to the NHMRC prior to
the commencement of the review. NHMRC also considered published guidelines and
other government reports.
In April 2014, the first draft of the review has been
released. Based on all the evidence
considered, there were no health conditions found, for which there was reliable
evidence that homeopathy was effective. No good quality, well-designed studies
with enough participants for a meaningful result reported either that
homeopathy caused greater health improvements than placebo, or caused health
improvements equal to those of another treatment.
Homeopathy is not
Dead
In the eyes of the modern science, homeopathy is a total
fail. It should be laid to rest and relegated to a footnote in the history of
science – a pre-scientific idea that survived into modern times as
pseudoscience. We can squeeze it in somewhere after healing crystals and before
humoral theory and iridology.
However, here comes the enigma – why does homeopathy
persist at all? It seems that after the rise of science-based medicine in the
early 20th century homeopathy was marginalized, but was able to survive because
it had already entrenched itself sufficiently in politics and society. It then
flew under the radar until the recent rise of CAM – the successful re-branding
of fraudulent and unscientific modalities as “natural” and “alternative”.
So successful was this re-branding that the scientific
community was partly cowed by the incessant demands for being “open-minded” and
for “academic freedom.” This caused many scientists who should have known
better to forget themselves, to look the other way while advocates slowly
inserted nonsense into the health care structure and academic institutions.
We are beginning to see a push back in the scientific
community. Michael Baum and Edzard Ernst have recently published a commentary
in The American Journal of Medicine which reflects the new found “permission”
within the medical community to once again call nonsense a nonsense, and close
the door on failed therapies.
Should we keep an
open mind about astrology, perpetual motion, alchemy, alien abduction, and
sightings of Elvis Presley? No, and we are happy to confess that our minds have
closed down on homeopathy in the same way.
Main Danger of
Homeopathy
Many defenders of homeopathy argue that, “Who cares how
it works, as long as it works.” There is a kernel of legitimacy to this
argument (although it does not save homeopathy from being a pseudoscience) in
that even in conventional medicine, treatments are often used before their
mechanism of action is fully understood. There is a difference, however,
between not fully understanding a mechanism and, as with homeopathy, violating
basic laws of physics. In such cases, it
is necessary to demonstrate using carefully controlled clinical trials that
such treatments do in fact work.
Indeed, there has been mixed results from clinical
studies of homeopathy, but a clear trend when all the evidence is reviewed —
the better designed the study the less likely there is to be any effect, and
the best designed studies are negative. Homeopathy, it turns out, is no more
effective than placebo (an inactive treatment).
Therefore, according to everything, we currently
understand about biology, chemistry, and physics, homeopathy is highly
implausible and should not work. Moreover, when we carefully study homeopathic
remedies they in fact do not work.
Given that most homeopathic remedies contain little if
any actual ingredients beyond water and sometimes sugar, it is unlikely that
any direct harm could come from taking them. Improper preparation of remedies
made from toxic or infectious material could pose some risk, and there have
been reports of toxic contamination of homeopathic products.
Well, from time to time, it's understandable that a
simple-to-administer placebo treatment might carry some benefit for doctors,
where no medical intervention has a particular, proven effectiveness. In these
scenarios, it could be argued that homeopathy might have had a role to play,
providing a harm-free, effect-free placebo to help manage the otherwise
unmanageable. However, homeopaths abuse this minor level of legitimacy to make
claims about conditions the placebo effect could not possible treat. Cancer,
HIV, malaria, yellow fever, autism, tuberculosis. They discourage people from
seeking medical help when they most need it. It's time to stop lending support
to quackery; time to give people the facts about this 200-year-old snake oil,
before they choose to use it instead of the ever-improving and reliable
interventions of modern medicine.
However, the most
significant risk of homeopathy is that it often delays the use of accurate
scientific diagnosis and truly effective medical treatment. Unnecessary injury,
disability, and even death can result from the delusion that homeopathy is an
effective treatment for any medical condition.
Sources and
Additional Information:
