Owing to the current situation regarding the pandemic, there is a renewed public focus on healthcare, safety, and medicine. People are looking for various preventive measures and cures for the novel coronavirus or the SARS-CoV-2.
Unfortunately, it is during times like these that snake-oil-salesmen emerge from the woodwork to peddle “remedies”, sometimes dangerous ones, to earn a quick buck. Many of these are referred to as “alternative medicine.”
One of the most trusted in this line of alternative medicine is homeopathy. It has made an image for itself as benign, safe, natural, and free of side effects. But is this the truth?
I want to make a case for why homeopathy cannot work when analyzed properly through science. I will also consider why it seems to work for a few people, and suggest something which homeopaths use that science-based medicine could benefit by applying.
Index
The Origins and History of Homeopathy
To understand how homeopathy got its reputation, we need to understand the historical context of when it was formed.
Homeopathy was proposed in 1796 by Christian Friedrich Samuel Hahnemann, a German physician.
Although a trained and practicing physician, he rejected the practice of medicine of his peers, with good reason.
In the 18th century, treatments of diseases, in most cases, caused more harm than the disease itself; bloodletting, using mercury as a cure for many diseases, unsanitary practices, and the like. Germ theory was a hundred years in the future, and medical conditions that we now understand are a result of bacterial or viral infections were thought to be caused by miasms. Fuelled by this mistrust of treatments, Hahnemann went on to create his own.
One day, after he made a couple of observations, he started consuming cinchona bark, a known and effective treatment for malaria. He experienced fever, shivering, and joint pain, which were the symptoms of malaria, but to a milder degree[1].
This gave him the idea to propose his ideas in 1796 in a text titled Essay on a New Principle for Ascertaining the Curative Power of Drugs, which was followed in 1810 by his famous work The Organon of the Healing Art.
With that said, let us move on to the ideas Hahnemann proposed.
Principles of Homeopathy
In this section, I will present to you the principles which are the foundations of homoeopathic “medicine”.
- Like cures like[2]; The Law of Similars
- The Single Remedy[3]
- The Minimum Dose[3]
- The Potentized Remedy[3]
The Law of Similars
The law of similars states that: those symptoms that a substance is able to cause to appear in a person when exposed to it, that same substance also has the ability to cure those same symptoms in a person where they occur naturally as part of a disease process.[4]
To put it simply, if a substance can cause a particular symptom or a reaction in us, the same substance also has the power to cure us of that symptom.
Although there are some examples of certain substances that cause disease in high doses being able to treat disorders in low doses (Digitalis is an example), in many cases, this does not hold.
For example, treating hyperactivity by ingesting coffee[5] is probably not a very good idea, as caffeine increases stimulation[6].
The Single Remedy
This principle says that a practitioner can prescribe only one remedy at a time. This has more to do with removing the confusion when observing the effects of more than one medication at the same time[7]. The School of Homeopathy says:
Other reasons for giving only one medicine at a time are as follows:
- If you give more than one medicine, one might cancel out the action of another.
- If you give more than one medicine it is not possible to know which is having an effect.
- The possible interactions between simultaneously given remedies are not known.
In my opinion, this confusion can be reduced at least if the mechanism of the working of these drugs were understood or studied. Unfortunately, the studies conducted to analyze these effects and the possible workings of homeopathy do not give us any mechanism[8].
Modern medicine is based on scientific analysis of proposed medication and all potential mechanisms of metabolism of the active molecule in the body. A drug is released to the public only after multiple studies, even for very specific and rare diseases. Why shouldn’t homeopathy be held to the same standard when they claim to sell cures and treatments?
The Minimum Dose and The Potentized Remedy
The concept of prescribing medicines having an exceedingly low quantity of original medicinal substances is called the Theory of Minimum Dose[9].
Homeopathy claims that homeopathic medicine is effective when its active ingredient is diluted and succussed (shaken vigorously) repeatedly. Homeopathic medicine gains increased potential with each additional dilution-succussion step. These dilutions also make the remedies safer[10].
These are a couple of the more controversial principles in homeopathy. The problem with these principles is the scale to which dilution occurs. As of now, there are two main systems used to dilute the remedies, the X and C systems.
The X system is on a scale of 1:10. This means for each part of the remedy, there are 9 parts of the diluent used. This can be expressed mathematically as one part per 101. Thus a potency of 6X becomes one part in 106 and 30X becomes one part in 1030.
The C system is on a scale of 1:100. For each part of the remedy, there are 99 parts of the diluent used. Similar to the X system, it can be mathematically expressed as one part in 102 parts. A potency of 30C implies that there is one part of the remedy in 1060 parts.
This level of dilution would not leave even a few molecules of the active ingredient in the medications that are given to us as cures.
The reason given for why these principles work is ‘Water Memory’. Water memory is the purported ability of water to retain a memory of substances previously dissolved in it even after an arbitrary number of serial dilutions[11].
The concept of water memory goes against our knowledge of physical chemistry. If water did have memory, anything dissolved in it and agitated should theoretically be able to express its properties when we consume water in our daily lives, but this is not so.
Moreover, there hasn’t been any study published that could be replicated in a controlled double-blinded study, and as of now, cannot be relied on to provide an explanation.
But it Works?!
Studies and reviews that have been published show that homeopathy does not fare any better than a placebo[12], a substance that is made to resemble drugs but does not contain an active drug.
The placebo effect is defined as a beneficial effect produced by a placebo drug or treatment, which cannot be attributed to the properties of the placebo itself. It must, therefore, be due to the patient’s belief in that treatment. It is a powerful effect, but can only get one so far. Placebos work on symptoms that are modulated by the brain, like the feeling of pain or nausea. It cannot help shrink a tumor or reduce cholesterol.
Another significant factor is the activities associated with the ‘medicines’. Homeopathic treatment involves not just remedies, but also doctors’ orders like sleep, rest, exercise, and a healthy diet. These things on its own are enough to help one recover from most diseases.
A third factor is time. Given enough time, the body can repair itself after a bout of disease like a fever or colds. A homeopathic regimen might help soothe the sufferer, and this could be attributed to the regimen and not merely the passing of time.
The Difference in Approach
One significant advantage that homeopathy has is the homeopath itself[13]. When visiting a homeopathic institution for a consultation, it can take hours and involves a lot of questions, sometimes very personal. In essence, this is a sort of mini-psychotherapy. This level of attention and empathy can in itself play a role in helping one heal, especially in the case of diseases like insomnia or depression, that respond positively to this reassurance and conversation.
Modern medicine is very efficient, and in many people’s mind, it is very machine-like. Add to this a distrust of “Big Pharma”, a general lack of understanding of how medications are made and how they work, and people with vested interests spreading misinformation on social media, and you may understand why people seem to distrust evidence-based medicine prefer alternative treatments. A possible way to combat this would be to reach out and make science and information more accessible to the general public.
What is unknown is scary; the more science and medicine are shared and spread to everyone, the greater the trust for science-based treatments and better the state of public health.
In Conclusion…
It is not accurate to suggest that homeopathy is harmless just because it is a placebo. Even if it does not actively harm, there is an element of danger associated with trusting such alternative treatments. In almost all cases of illness, the sooner one is treated, the better. Unfortunately, many seem to turn first to homeopathy and other complementary practitioners for relief from their disease, delaying proper medical care and thus, causing irreparable damage.
The Australian Government reviewed all the available evidence and concluded that homeopathy does not work[14]. The NHS of the UK made similar findings[15]. The science is clear; currently, there is no evidence to support homeopathy. Unless there are breakthroughs that completely overturn the current models and theories, it is unlikely that homeopathy might be shown to work.
References
[1] A brief history of homeopathy
[2] Owen, D., 2007. Principles And Practice Of Homeopathy, The Therapeutic And Healing Process. 1st ed. Elsevier.
[3] Basic Homeopathy
[4] The Law of Similars
[5] Tutorial 1: The Law of Similars
[6] Caffeine effects
[7] The American Institute of Homeopathy
[8] Almeida, Renan Moritz V. Rodrigues. (2003). A critical review of the possible benefits associated with homoeopathic medicine. Revista do Hospital das Clínicas, 58(6), 324-331. https://doi.org/10.1590/S0041-87812003000600007
King, A. BAD science: Homeopathy – can the undetectable cure?. Br Dent J 224, 128 (2018). https://doi.org/10.1038/sj.bdj.2018.94
Ernst, E. (2002). A systematic review of systematic reviews of homeopathy. British Journal of Clinical Pharmacology, 54(6), 577-582. doi:10.1046/j.1365-2125.2002.01699.x
(and more)
[9] https://www.nhp.gov.in/homeopathy_mty
[10] The minimum dose and potency
[11] Water Memory
[12] Cukaci, C., Freissmuth, M., Mann, C. et al. Against all odds—the persistent popularity of homeopathy. Wien Klin Wochenschr 132, 232–242 (2020). https://doi.org/10.1007/s00508-020-01624-x
[13] Homeopathy: Curing with Kindness
[14] NHMRC Report
[15] NHS Statement
