This article was first published in the Montreal Gazette.
The British press is gushing with articles about King Charles’s appointment of Dr. Michael Dixon as head of the royal medical household. Most accounts are highly critical because of Dixon’s record of promoting various “complementary” therapies such as acupuncture, herbal remedies and homeopathy.
It is his championing of the latter that has raised the most eyebrows since, in the eyes of the vast majority of physicians and scientists, homeopathy is scientifically bankrupt.
Before going any further, let’s clarify that homeopathy, contrary to what most people believe, is not an umbrella term for all treatments that fall into the “alternative” category. It is a very specific practice invented more than 200 years ago by German physician Samuel Hahnemann, who was troubled by the brutality of the medical interventions used by physicians at the time attempting to drive ailments out of the body. There had to be a gentler way than bloodletting, purging and the use of toxic substances such as calomel (mercury chloride) to treat illness, Hahnemann thought.
One remedy at the time that really did work was the use of the ground bark of the cinchona tree imported from South America for the treatment of malaria. The bark contains quinine, a compound that is deadly to the parasite that causes malaria when it finds its way into the bloodstream through the bite of a mosquito. However, the amount of bark to use in a patient was guesswork. Hahnemann, by all accounts a caring physician, tackled this problem by experimenting on himself. He wanted to find out how much cinchona bark could be given to a patient before causing harm, and was surprised when he developed a fever typical of malaria after taking a large dose.
At that moment, the central concept of homeopathy was born: A substance that causes symptoms in a healthy person will cure like symptoms in a sick person. But Hahnemann knew that he had been giving much smaller doses of cinchona bark to his malaria patients than what he had taken, and that resulted in the second tenet of homeopathy: The smaller the dose, the greater the potency. This was a logical non-sequitur, but when Hahnemann began to get positive responses from patients whose symptoms he treated with tiny doses of substances that at a high dose he had “proven” caused those symptoms in healthy subjects, he was sold.
The remedies seemed to work even better when the solution was shaken between further dilutions, and that became the third tenet of homeopathy.
Today, scientists bristle at the idea of nonexistent molecules having a therapeutic effect. And that is exactly what we are dealing with, because with our current knowledge of chemistry, it is possible to determine that after a sequence of hundred-fold dilutions repeated 12 times, there is not a single molecule of the original substance left. Because homeopaths now have to admit this, they have forged an alternate explanation for how homeopathy works: The shaking between dilutions leaves an imprint, a ghost if you will, of the original substance in the solution. Not only is there no evidence that the structure of water can somehow be altered in this fashion, there is no explanation offered for how this ghostly image can cure disease.
To put it succinctly, homeopathy is scientifically implausible. Its precepts defy the laws of chemistry, physics and biology. It cannot possibly work.
But it does, claim its proponents! King Charles, Queen Elizabeth and numerous other royals have sung its praises. So have millions of people in India, Germany and France. How can this be?
Scientists maintain that any benefit of homeopathy can be explained by the placebo effect. No, say homeopaths, as they point to placebo-controlled trials that “prove” homeopathic preparations work.
They don’t prove any such thing. If you carry out enough studies, you will occasionally get positive results by chance alone. That is why in science we don’t set store by single studies, but look at the totality of evidence. And when we do that, it is clear that homeopathy works no better than a placebo.
That, though, does not mean that homeopathy should be swept under the carpet, because the placebo response is in the 30-40 per cent range — certainly not insignificant. But there is a potent caveat here: Relying on nonexistent molecules is fine when dealing with minor aches and pains, but placebos can only change the perception of a disease, not its underlying cause. If the symptoms are due to a serious ailment, use of a homeopathic “remedy” can delay potentially effective treatments.
Dixon and King Charles would agree that homeopathy should not be used instead of conventional medicine, but as a “complement” to it. They argue for “integrated medicine,” which Charles describes as “the best of both worlds.” But the issue here is that one of those worlds, namely conventional medicine, strives for evidence, while the world of alternative medicine is satisfied with anecdotes.
In truth, conventional medicine is the real integrated medicine. When some treatment is shown to be effective through proper trials, it is embraced and incorporated into practice. But when Dixon or King Charles speak of the need for integrated medicine, what they mean is that doctors should consider recommending modalities such as reflexology, herbalism, Traditional Chinese Medicine, Ayurvedic Medicine and homeopathy, all of which lack compelling evidence.
The argument for integrating these alternative approaches often introduces the claim that scientific medicine treats only diseases, not patients, and is not “holistic.” Anyone familiar with current medical education knows that claim to be bogus. The patriarchal days of “just do as I say, doctor knows best” are long gone, and medical students are taught to discuss every facet of a patient’s life before coming to a mutually agreed-upon treatment protocol. True, overburdened physicians cannot spend as much time with patients as can alternative practitioners, but the answer to that problem does not lie in asking doctors to legitimize treatments that lack evidence.
Dixon claims that his professional life turned “from grey into colour” when, frustrated by the “blunt instruments” of his medical training, he gravitated toward offering his patients the likes of acupressure, a range of herbs, meditation, dietary advice and homeopathic pills. “I have witnessed the beneficial effects in so many patients (and) that has been proof enough for them and for me,” he said.
But that is not how science works. As we are fond of saying, the plural of anecdote is not data. As far as data goes, we have it for the benefits of meditation, diets and even some herbs, and these are by no means solely in the domain of alternative practitioners. But homeopaths promoting the idea that something that contains nothing can cure something misleads patients.
Homeopathy is pure folly.
