Homeopathy

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"The proof of the pudding is in the eating." ^[1]

Homeopathy is a type of alternative medicine based on the idea that "like cures like", and dilution increases potency. It was created in the 18th century by Samuel Hahnemann. For some reason a few credulous people living in the modern era have decided to go back and embrace it as actual medicine. Every single scientific study has found that homeopathy has no effect above placebo and it has been completely rejected as quack medicine and pseudoscience.

[edit] Principles

Homeopathy is fundamentally different from “herbal medicine", with which it is frequently confused. While some “homeopathic” medicines are simply standard herbal supplements labeled as homeopathic, "true homeopathic" remedies actually contain no active ingredients. The only measurable ingredients are water and/or alcohol.^[2]

The term "Homeopathy" was coined by a German physician named Christian Friedrich Samuel Hahnemann in the 18th century. He based his ideas on the "Principle of Similars", the concept that “like cures like.” The ideas of homeopathy share the non-scientific nature of other discredited theories of disease, such as humors and miasmas. In order to treat a disease, a substance that produced similar symptoms, such as fever, would be administered. Homeopathic theory holds that the more dilute a solution of such a substance is, the more effective it is. Since many of the original homeopathic compounds were based on potent toxins, this is fortunate.

"Like cures like" should not be confused with modern immunology. For instance, when someone is vaccinated with a (measurable) concentration of molecules to induce immunity, antibodies are produced against the specific infectious agent. Vaccines require an enormous amount of testing to prove efficacy and safety. They involve relatively large numbers of molecules, and have a proven mechanism of action.

[edit] Dilution and memory

To make their solutions, homeopaths use a ritualized technique of step-wise dilution and shaking, called "succussion." It usually involves taking the "active" ingredient and diluting it in the ratio of 1 part ingredient and 100 parts water. The container is then shaken up-down 10 times, left-right 10 times, and forward and backwards 10 times.

This ritual is repeated a particular number of times to create the right "dilution." Most homeopathic solutions call for this to be done between 30 and 1000 times. The resulting homeopathic "strength" is referred to as 30C to 1000C. As a result, the end solution is supposed to be 1 part active ingredient in 1 x 10⁶⁰ or 1 x 10²⁰⁰⁰ parts water.^[3]

A solute, however, can not be infinitely divided, due to the finite size of molecules. Eventually there will be no molecules left of the "active" ingredient in a given sample of a solution. This divisibility is related to Avogadro's Number, and is 1:6.02 x 10²³. (Avogadro's Number is the number of actual molecules in an amount of substance with mass in grams equal to its molecular weight.) Even the least diluted homeopathic solutions do not contain any of the active ingredient. Calculating the container size necessary for a homeopathic solution to contain even one molecule of active ingredient can be an entertaining and illustrative exercise. Keep in mind that the number of atoms in the observable universe is estimated at approximately 1 x 10⁸⁰.

Homeopaths do not deny this. They say that the water has developed a “memory” for what was put in it. This represents a change from Hahnemann's original homeopathic theory, which held that the active ingredient was diluted but nonetheless present. As discussed above, Avogadro's work showed that claim to be false. The water supposedly develops this “memory” by following the “succussion” procedure, which supposedly imparts the “memory” of the chemical to the water and this is what allegedly cures the disease.^[4] If true, this "memory of water" claim would overturn all of modern chemistry.

In other words, although the solution has been diluted beyond any possibility of detection, the little magic taps which are “succussion” change all known laws of physics and turn the substance into a "medicine". It's obvious really.

[edit] Problems in concept

• The Principle of Similars was made up out of whole cloth, with no supporting evidence beyond that a malaria cure induced malaria-like symptoms in healthy patient. (Then comes the argument that radiation therapy is used to treat cancer caused by radiation, and antivenin comes from venom. For the record, melanoma, caused by radiation, is radioresistant. Also, antivenin is not simply venom, it contains the antibodies produced by the immune response (of other animals) to such venom.)
• Given the level of dilution of homeopathic solutions, there is no plausible scientific explanation for why it should be effective.
• Homeopathic "memory" has never been demonstrated. If water were to retain the “memory” of chemicals it has been exposed to, then our drinking water would be deadly, containing the memories of the sewage treatment plant, and other unsavory places.

[edit] Evidence

Given the above, we should be very suspicious of homeopathy. The concept seems impossible, a priori. But that does not mean we should discount it without investigating it. There have been several major investigations into homeopathy some of which include:

• The Lancet, one of the world's premier medical journals, published a meta-analysis on homeopathy in 2005.^[5] This paper examined 110 controlled studies of homeopathy and 110 studies of matched conventional medicine studies. The Lancet study showed that there was NO effect beyond placebo for homeopathy. This was a massive undertaking that examined a large amount of evidence.
• In 2006 European Journal of Cancer showed no effect of homeopathy in a meta-analysis of 6 studies.^[6]
• Even sympathetic researchers have problems. A study in Honduras done by homeopathic practitioners and published in the Journal of Alternative Medicine showed homeopathy to have ZERO effect treating diarrhea.^[7]

[edit] Homeopathy and the Food and Drug Administration

The 1938 Food, Drug, and Cosmetic Act established the rules for FDA regulation of drugs in the United States. Sen. Royal Copeland (who was a practicing homeopath) wrote in a specific clause that said homeopathy was a drug and would be regulated by the FDA as such, but with many exceptions. Homeopaths do not have to apply for a new drug patent from the FDA for new solutions nor do they have to provide any information about its efficacy or safety. They do not have to test this at all. The only regulation the FDA has over homeopathy is to make sure the manufacturing produces a safe product (no arsenic leaking into the bottles on the production plant floor).^[8]

Practicing homeopaths and companies that produce these products often make misleading claims about FDA approval. When a homeopathic product claims to be FDA approved for the treatment of a particular disease it only means that the FDA believes that the product will not kill you if you take it, not that it has any efficacy against that disease.

Homeopathic products are not allowed to claim that they can cure diseases that are not "transitory" in nature. Homeopathic products can only be marketed for such things as coughs, fevers, pains, etc. Any claims made about things like cancer, AIDS, asthma, STDs or other chronic or long term illnesses violate FDA standards. Several homeopathic companies have been fined in the past for making these claims but most do not overtly make these claims. Instead products are sold for more general ailments like "liver problems" rather than hepatitis. Another way of sneaking this in is by hired sales people making the claims in one-on-one sessions with patients where it is usually difficult to prove such wrongdoing. One example of this is in England where homeopathic consultants were advising patients to take their products for malaria.^[9]

[edit] Additional thoughts

The question is: are there any examples that show an effect of homeopathy? The answer to this question is a little complicated, but essentially, no. The only studies that show an effect are studies that do not use a double-blind control. This makes them worthless, but homeopathic practitioners claim it is the only way (this is an important point we will raise again in a moment). Here is an interesting fact: the James Randi Education Foundation has a $1 million prize for anyone who can demonstrate certain “supernatural” powers (and, make no mistake, “succussion” is definitely a supernatural claim) and this prize is open to any homeopath who thinks they can demonstrate an effect. A few small time practitioners have attempted to do this but all have failed. What is more interesting is none of the major “homeopathic” producers, who would not only get the money but instant free press and fame, have even bothered to pursue it, despite many attempts by the foundation to get them to try. One should ask why they refuse to put their products to the test?

Finally, here is the most important point for “mass production” homeopathic remedies, the kinds produced in factories. Let’s ignore all of the problems with the basic foundations of homeopathy, let’s ignore all of the mountains of evidence showing zero effect of the “cures”, let's ignore the refusal of all the major proponents to be put to the test. And let’s, for the sake of argument, assume that there is something to homeopathy. Even if this is the case then mass produced cures will not work. This is the absolute basic rule of homeopathy. The reason that proponents say that you can not use double blind test is because each and every single cure must be tailor made to the specific person it is to be used on. Each ingredient, that amount, the ratio, and the procedure is painstakingly crafted on a person-by-person basis. By even the standards of proponents of homeopathy no mass cure can possibly work.

“Extraordinary claims require extraordinary evidence”: legitimizing things like homeopathy and ignoring basic concepts such as skepticism and the scientific method is a very dangerous thing. It encourages a culture where facts are relative. If you wonder why 30 percent of our society still believes that Iraq was responsible for 9/11 or that over 40 percent still believe that weapons of mass destruction were found, the answer is in issues such as this. One can not stand on the side of facts, truth, and legitimacy in only one area. When “facts” can be abandoned because we don’t like the “feeling” they give us, and lies are swallowed because it makes us feel good, the results should be obvious to any educated person.

[edit] See also

• Water memory
• Oscillococcinum
• List of scientifically controlled double blind studies which have conclusively demonstrated the efficacy of homeopathy
• Wiki4CAM: Myths about homeopathy

[edit] Footnotes

1. ↑ http://ask.yahoo.com/20020903.html
2. ↑ To be fair, alcohol is an (possibly the only) active ingredient in the cure remedy for "chronic cubicle syndrome". Source: Dilbert the animated Series, Season 1.
3. ↑ The more diluted solutions are alleged to be stronger, in stark opposition to everything that is known about chemistry.
4. ↑ Be glad sewage processing plants don't do this by accident!
5. ↑ Aijing Shang MDa, Karin Huwiler-Müntener MDa, Linda Nartey MDa, Peter Jüni MDa, b, Stephan Döriga, c, Jonathan AC Sterne PhDb, Daniel Pewsner MDa, d and ProfMatthias Egger MD, The Lancet, Volume 366, Issue 9487, 27 August 2005-2 September 2005, Pages 726-732
6. ↑ Milazzo S, Russell N, Ernst E Efficacy of homeopathic therapy in cancer treatment. Eur J Cancer. 2006 Feb;42(3):282-9.
7. ↑ Jacobs J, Guthrie, B, Montes G, Jacobs L, Colman N, Wilson A, DiGiacomo R. Homeopathic Combination Remedy in the Treatment of Acute Childhood Diarrhea in Honduras. The Journal of Alternative and Complementary Medicine. 2006 Oct;12(8):723-732.
8. ↑ FDA-Homeopathy: Real Medicine or Empty Promises?
9. ↑ BBC undercover report on malaria and homeopathy