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Homeopathy: Aware or Beware?

April 10 - 16, 2018 - “World Homeopathy Awareness Week”. So let's spread some awareness about the practice, shall we?

April 10-16 is “World Homeopathy Awareness Week” with the stated aim of “celebrating homeopaths and those who have been healed with homeopathy.” While I don’t think anyone has ever been healed with homeopathy, and I’m not inclined to celebrate homeopaths, I do think that pursuing awareness about homeopathy is a worthy endeavour. That’s because I do not think most people are aware of what homeopathy actually is. I say that based on having carried out a number of ad hoc surveys in my public lectures and classes encompassing the general public, health care professionals, scientists of all sorts and students. The usual view is that homeopathy is an umbrella term for unconventional treatments such as acupuncture, reiki, reflexology and herbology. It is nothing of the sort.

Homeopathy is a system of alternative “medicine” introduced in 1796 by German physician Samuel Hahnemann based on his doctrine of “like cures like.” Hahnemann claimed that an extremely dilute version of a substance that in larger doses causes the symptoms of a disease in healthy people would cure similar symptoms in sick people. This has no basis in science.

Dr. Hahnemann, was trained in traditional medicine but quickly became disillusioned with the treatments he had learned.  Bleeding, leeches, suction cups, purges and arsenic powders seemed to do more harm than good. Ignoring his training, he began to prescribe a regimen which at the time was revolutionary: fresh air, personal hygiene, regular baths, exercise and a nourishing diet.  Since this was not a particularly financially lucrative regimen, he supplemented  his income by making use of his fluency in eight languages to translate medical texts.  During one of these translations he encountered an explanation of why quinine supposedly cured malaria.  The substance fortified the stomach!

Intrigued, Hahnemann took some quinine to see if it really had an effect on the stomach.  It did not.  But pretty soon he began to feel the effects of a fever!  His pulse quickened, his extremities became cold, his head throbbed.  These symptoms were exactly like the symptoms of malaria.  Then came his dramatic conclusion: the reason quinine cured malaria was because "fever cures fever."  In other words, like cures like.  Homeopathy, from the Greek "homoios" meaning "like," and "pathos" meaning suffering, was born!

Hahnemann went further and began to systematically test the effects of a large variety of natural substances on healthy people.  Such "provings" led him to conclude that belladonna, for example, could be used to treat sore throats, because it caused throat constriction in healthy subjects.  But belladonna is a classic poison.  Was homeopathy therefore dangerous?  Not at all.  Hahnemann had another idea.  He theorized that his medications would work by The Law of Infinitesmals.  The smaller the dose, the more effective the substance would be in stimulating the body's "vital force" in warding off the disease.

The dilutions were extreme.  "Active preparations" were made by repeated tenfold dilutions of the original extract.  Hahnemann was not bothered by the fact that at these dilutions none of the original substance remained; he claimed that the power of the curative solution did not come from the presence of an active ingredient, but from the fact that the original substance had in some way imprinted itself on the solution. In other words, the water somehow remembered the original material that had been dissolved.  This imprinting had to be carried out very carefully.  A simple dilution of the solution was not enough.  The vial had to be struck against a special leather pillow a fixed number of times to be "dynamized."

Conventional medicine did not take kindly to these peculiar rites.  In fact, the American Medical Association was formed in 1846 largely as a reaction to homeopathy with a view towards cleansing the profession of homeopaths.  These efforts were sometimes absurd in the extreme.  One Connecticut doctor lost his membership for consulting a homeopath, who happened to be his wife!

Nevertheless homeopathy did not disappear and now is actually enjoying a rebirth.  People disillusioned with scientific medicine are resorting to homeopathy, gleefully pointing out studies in peer-reviewed scientific journals which apparently show that homeopathy works.  But wait a minute. 

A careful review of these studies reveals unimpressive results.  In some minor conditions homeopathy does seem to be slightly more effective than a placebo.  This has no practical implication but does raise some academic interest.  How can there be any positive results at all if there is no active ingredient?  Publication bias is a likely explanation.

This term means that if enough studies are carried out, some will show positive results by chance alone.  Reporting these while maintaining silence on negative findings can create the illusion of effectiveness.  Then of course there is the question of plausibility. We have accumulated enough knowledge about biology, physiology, chemistry and pharmacology to be able to conclude that non-existent molecules cannot cure existing disease. Any talk of water having “memory” makes zero sense, and even if there were such a magical effect, how would it be transferred to a sugar pill, and in what way would this have anything to do with treating disease?

The only reasonable conclusion to arrive at about homeopathy is that it functions through the placebo effect. If you believe it can relieve symptoms, it can. But it will not affect the underlying disease. And that is something to be aware of.

@joeschwarcz

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