For some time I've wanted to put my thoughts together on my understanding of homeopathy. Since it is Homeopathy Awareness Week (
UK) this seems like a good time to finally bite the bullet and get my thoughts out there.
I am neither a scientist, doctor nor homeopath (
see disclaimer at bottom). I am just a guy who reads a lot of stuff about various things and occasionally forms opinions, often whilst still having lots of questions. So take this as a
layman's guide to the often-confusing and contradictory world of homeopathy.
WHAT IS HOMEOPATHY?
From wikipedia with subsequent comments by me:
Homeopathy is a form of alternative medicine that treats patients with heavily diluted preparations that are thought to cause effects similar to the symptoms presented, first expounded by German physician Samuel Hahnemann in 1796. Homeopathic remedies are prepared by serial dilution with shaking by forceful striking ("succussing") after each step under the assumption that this increases the effect of the treatment; this process is referred to as "potentization". Dilution often continues until none of the original substance remains.
While it is true that genuine medicine (
pharmaceutical or western medicine) is often highly diluted, the active ingredient can still be measured, even if it is present in parts per million. The biological effects of these trace presences are well understood. In typical homeopathic remedies, the dilutions go well past parts per million, well past parts per billion (nine zeroes) and well past parts per trillion (twelve zeroes). Indeed, a 12C solution is diluted to a figure with 24 zeroes. 30C solutions, which are common, have 60 zeroes in the dilution rate. I don't even think that number has a name.
Once you pass 23 zeroes in your dilution rate, you'd be damned lucky to find the original active ingredient in a random sample of remedies.
WARNING: Arithmetic follows...
One popular homeopathic product sold to flu sufferers is diluted to
200C!!! That dilution rate has 400 zeroes!
Using the figure of
20,000 drops equals 1 litre, we can work out that just one drop of active ingredient (
duck heart and liver in this case) would make 1 x 10
396 litres of flu remedy. That's a one with 396 zeroes after it - litres! To try and picture how much remedy that is, imagine for starters that there's a little over 1 x 10
21 litres of water on Earth. That's only 21 zeroes.
Every zero you add multiplies the quantity by a factor of ten. This means that a billion (
1,000,000,000) Earths would only contain 1 x 10
30 litres of water.
If my arithmetic serves me correctly (
and I'll happily accept correction here since I worked it out on a scrap of paper and am not a mathemetician),
one drop of active ingredient in a 200C solution would make a remedy equal to 1 x 10375 times the total volume of water on the whole of this planet. I'm not sure, but I suspect that's more water than would be available in our entire galaxy and, perhaps, the universe.
Imagine how much you could make with a whole duck heart and liver! Unlike
TamiFlu, there's no risk you would ever run out.
Okay, so there's probably no chance whatsoever that you'd find ANY duck heart or liver in that much water - not even if you threw in every duck on the planet - but homeopaths get around this by saying the water remembers what you added to it at the start. More on that later.
To make matters more confusing, that particular flu remedy is sold in the form of small pills (
or pillules). There is no water, with or without memory, in the marketed product. Indeed, the ingredients are listed as
85% sucrose and 15% lactose. That's 100% sugar!
Okay, let's move on. Still with wikipedia for now:
PLACEBO:
Claims of homeopathy's efficacy beyond the placebo effect are unsupported by the collective weight of scientific and clinical evidence.
A placebo is essentially a pretend medicine. The idea being that the "patient" in a trial is lead to believe they are being given real medicine but what they are given has no active ingredient. The point of this exercise is to compare the results of those who are given real medicine, with those who get the placebo. The so-called "
placebo effect" is widely recognised and can effect not only the trial patients but anyone participating in the trial, including those conducting it. If a product repeatedly performs no better than a pretend medicine in trials then the product would usually be considered a failure.
It sounds, to me, like magic.
TRIALS:
Several high-quality studies exist showing no evidence for any effect from homeopathy, and the few positive studies of homeopathic remedies have generally been shown to have problems that prevent them from being considered unambiguous evidence for homeopathy's efficacy.
This is a contentious issue. Good quality trials and systematic reviews repeatedly show no significant (
better than placebo) benefit from homeopathy. Sympathisers often dismiss this by suggesting that real homeopathy is holistic and based on "the individual" and, as such, cannot be subjected to typical scientific trials. However, when a small trial delivers a seemingly positive result, using essentially typical scientific methods, the result is readily hailed as evidence of the efficacy of homeopathy.
Homeopathy for dementia
Homeopathy for Asthma
Homeopathy for ADHD
WATER MEMORY:
Modern homeopaths have proposed that water has a memory that allows homeopathic preparations to work without any of the original substance; however, the physics of water are well understood, and no known mechanism permits such a memory.
My biggest concern about this "water memory" claim is that even if we did accept it, we are then left wondering why homeopaths generally claim their remedies have no side effects. How can it be that diluting and shaking (
or "succussing") the original ingredient results only in its supposedly beneficial properties being remembered and enhanced by the water solution?
For example, homeopaths have tested an ultra-diluted solution of arsenic (
Arsenicum Album) to treat arsenic poisoning. Theoretically, the remedy remembers that it used to have arsenic in it and homeopaths perversely claim that the higher dilution, with shaking, actually increases the potency of the remedy.
The idea is that when the body encounters the product, it will react as if it were encountering real arsenic and go about doing whatever needs to be done in order to fight it. In doing so, it will also, theoretically, deal with the actual arsenic poisoning that is being treated - and there will be no side-effects like poisoning.
Got it? No? Good, that means you're getting it.
Now, here's my problem... if the remedy acts like a potent form of genuine arsenic, to the extent that it stimulates the body's natural defences, then why is it not also toxic, just like genuine arsenic? How is it that the detrimental properties of the toxin are diminished by ultra-dilution while the beneficial properties are enhanced by shaking?
I have studied a little chemistry and physics - though that isn't required to see some potential flaws in this line of thinking. From the traditional viewpoint of science, it makes sense that dilution would reduce effects - but it would likely do so for both detrimental and beneficial effects. How does shaking the solutions and diluting past the point of retaining any active ingredient result in the coincidental diminishing of one effect (
toxicity) and the increasing of another effect (
immune response)? It sounds, to me, like magic.
LAW OF SIMILARS:
Through further experiments with other substances, Hahnemann conceived of the "law of similars", otherwise known as "like cures like" (Latin: similia similibus curentur) as a fundamental healing principle. He believed that by inducing a disease through use of drugs, the artificial symptoms empowered the vital force to neutralise and expel the original disease and that this artificial disturbance would naturally subside when the dosing ceased.
I'll translate that with an example. If a patient as a sore stomach, dizzy spells and blurry vision, then the appropriate homeopathic remedy is one which would cause a normal person (
not sick) to suffer those same symptoms. This helps explain why a homeopath would even consider treating arsenic poisoning with arsenic since arsenic would clearly cause similar symptoms in another person.
Looking back at our arsenic patient, another question naturally follows from this "law of similars". If the body's natural defences can be stimulated by a pretend solution of arsenic into fighting the very real presence of arseninc that caused the poisoning, why weren't those defences similarly stimulated by the very real presence of arsenic in the first place. Is this just another seemingly magical property of homeopathic water currently unknown to chemists or physicists?
IS HOMEOPATHY LIKE ANTIVENOM?:
When I first read about the law of similars, or "like cures like", I assumed this was much the same as occurs with the administering of
antivenom to snake bite victims. I was wrong.
Snake venom is indeed used to make snake antivenom but what is adminstered to a bite victim is not diluted venom. The venom is used to produce antibodies in an animal and these antibodies are harvested and used to treat bite victims.
IS HOMEOPATHY LIKE VACCINATION?:
This thought also crossed my mind when I first began reading about homeopathy. Vaccines generally contain the very thing they are intended to guard against. That sounds a lot like "like cures like". But vaccines are administered to healthy people and they essentially "train" the immune system to recognise a specific risk and build immunity to it - and they contain very real and measurable active ingredients. The method by which vaccines work is also well understood and is not based on the vague notion that
"something" that would make a normal person experience particular symptoms will treat an unwell person experiencing those same symptoms.
RECENT QUOTES:
During the recent trial of Australian parents Thomas and Manju Sam, homeopath
"Doctor" Vinay Katyal told the jury in the Sam trial that
"homeopathy had nothing much to offer for acute patients."
It appears the general recommendation of homeopaths is
supposed to be that if you really are sick, you should see a real doctor. Only a homeopath can explain why they would think their chosen form of therapy is unable to cope with acute cases.
From wikipedia, we find a comment from Boiron spokesperson Gina Casey who, when asked if a product made from the heart and liver of a duck (
Oscillococcinum) was safe, she replied:
"Of course it is safe. There's nothing in it." (
see also Oscillococcinum)
From The house of Lords in what could be called "
Homeopathy on Trial". Question 538 is especially telling:
Q538 Lord Broers: I have a simple, technical question about homeopathy and drugs. Is it possible to distinguish between homeopathic drugs after they have been diluted? Is there any means of distinguishing one from the other?
Ms Chatfield: Only by the label.
There really isn't much I can add to that reply. She didn't say "by smell" or "by laboratory testing" or even "by testing on patients". Ms Chatsfield is from the Society of Homeopaths Research and Ethics Committee and her response suggests, quite directly, that the only difference between one homeopathic product and the next is the label.
SUMMARY:
From all this we can derive the following points about a homeopathic remedy:
- It is diluted to the point where it doesn't contain the product named on the label.
- It somehow remembers the active ingredient but does so by no means known to modern science of any discipline.
- It carries all intended beneficial effects but has no side effects that would occur if it really did contain the active ingredient.
- There is not nearly enough water on Earth to make all the 200C remedy that could theoretically be made from a single drop of active ingredient.
- It is not recommended to be used in "acute" cases of illness.
- No homeopathic product can be distinguished from any other homeopathic product (or from the water, alcohol or sugar it is made from) by any means whatsoever except by trusting the label.
- Good quality trials repeatedly show homeopathy to perform no better than pretend medicine.
That pretty much sums up homeopathy as I understand it currently. If I've missed something or messed up, let me know in the comments.
For a far more scholarly review of homeopathy, you might want to read Dr Steven Novella's Neurologica Blog article:
Homeopathy Awareness Week or Orac's (
Respectful Insolence) article on
Homeopathic Plutonium.
See also:
Homeopathy website ordered to retract dubious Arnica claims
MORE:
10:23 - Suicide by homeopathy
I am not a doctor, homeopath, scientist or statistician. This is just a layman's assessment of homeopathy as I understand it currently. Readers are reminded to draw no conclusions from my opinions but to use them only as a springboard to their own research. You are free to disagree.