The Great Divide

This article originally appeared as a blog post in March 2010.

The attacks on homeopathy have continued almost relentlessly, culminating in the pronouncement by the House of Commons Science & Technology Committee that there is no evidence to suggest that it is any more than placebo, so all NHS funding for homeopathic treatment should end.

Let’s face it, homeopathy is an easy target for the rationalists, as those who believe it is utter nonsense have no interest in learning the underlying principles on which it is based but just focus on the aspect of dilution to the exclusion of all else, ignoring the essential need for vigorous shaking (succussion) that turns a dilution into a potentised remedy (for which research here and here show that the physicochemical properties of each type of solution differ significantly, by the way).  Since doctors know that the body only works through a multitude of complex chemical interactions, how could a dilution that contains less than a molecule of the original raw material possibly have any therapeutic effect other than placebo?  (Clue: it’s nothing to do with chemistry; succussion – physics – holds the key.)

There are over 200 years of anecdotal evidence from millions of recipients of homeopathic treatment worldwide, which challenges this conventional wisdom.  Even the scientific committee of the Royal Pharmaceutical Society of Great Britain acknowledges that many patients report benefit, particularly when receiving treatment from a qualified homeopathic practitioner, but nevertheless issued a statement after the House of Commons Science & Technology Committee announcement that, following their review of the research, homeopathy offers nothing more than placebo, and pharmacists should not claim effectiveness or any scientific basis for homeopathic treatment.  And that’s despite 63 out of 74 randomised controlled trials published in peer-reviewed journals up to the end of 2009, showing in favour of homeopathic treatment compared either to placebo or established conventional treatments.  And I bet the recent paper published in the International Journal of Oncology, which shows that the potentised remedies Carcinosin 30c and Phytolacca 200c have cytotoxic effects on breast cancer cell to the same degree as the drug paclitaxel (Taxol) doesn’t count as evidence either!  (The researchers concluded “the ultra-diluted natural homeopathic remedies investigated in this study offer the promise of being effective preventive and/or therapeutic agents for breast cancer and worthy of further study.”)

And we are also told that the 200 years of anecdotes in the homeopathic literature do not count as evidence either, despite the fact that anecdotes are frequently used as starting points for research into new avenues of medical treatment.  One argument against anecdotes for homeopathy is that you only get one side of the story, i.e. what about all the failures?; another is that the patient would have got better anyway.  (I quite like the latter: homeopathic treatment doesn’t work – without them the patient would have got better anyway; drugs do work – without them the patient’s symptoms come back…)

So if all the evidence is being ignored, and the therapy publicly attacked with such venom, then surely homeopathy is perceived as a threat to the establishment?  This is indeed what Harald Walach, Research Professor in Psychology at the University of Northampton, argues in this article.  Rather than look carefully at what is actually going on and see how this could be used to benefit patients, there is a need to make it clear who has the power by spreading Fear, Uncertainty and Doubt (FUD) about homeopathy (other complementary therapies will probably follow) to the general public.

The daily experience of practitioners of homeopathy, who, it is worth mentioning, also routinely treat babies and young children (and in some cases animals) with great success (which surely is a counter to the ‘placebo-effect only’ view ), is at odds with the headline-grabbing statements being widely reported in the media.  And it’s also important to remember that these practitioners are not a group of relatively unintelligent or otherwise gullible laypeople, or, as some would like to portray, con-artists with ideas above their station.  As well as undertaking a four-year part-time professional training, the vast majority of lay homeopaths join professional organisations which provide regular updates on the latest remedies and methods of treatment, and require members to abide by strict codes of ethics.  The Faculty of Homeopathy is comprised exclusively of those with a medical background; doctors, dentists, veterinary surgeons and pharmacists.  Many of those who take up homeopathy leave successful but perhaps otherwise unfulfilling careers, often taking a considerable drop in income.  I have met former nurses, midwives, medical secretaries, marketing managers, pharmaceutical company representatives, amongst others in the UK; whereas most of the homeopaths I have met from Europe and further afield, are medical doctors who use homeopathy routinely in their practice, with no doubts about their treatment or fear of attack from campaign groups in their respective countries.

The fundamental problem behind this Great Divide is that the homeopathic approach (developed through continual experimentation and observation, by the way) is at such odds with the way conventional doctors are taught, the possibility of unprejudiced investigation and debate between the two camps is all but impossible.  As J. Ellis Barker so bluntly wrote in the 1930s (in his modestly titled book “Miracles of Healing and How They Are Done” [yes, really!]):

‘If one asks a physician or surgeon for his opinion on homoeopathy, and I have done this very frequently, one is usually told without hesitation: “Homoeopathy is quite worthless, sheer quackery,” and if, as I have done, one asks upon what knowledge that sweeping condemnation is based, the usual answer is: “I do not know anything about homoeopathy and I do not want to know anything about it.”  Herbert Spencer caustically wrote:- “There is a principle which is a bar against all information, which is proof against all arguments, and which cannot fail to keep a man in everlasting ignorance – that principle is contempt prior to investigation.” ‘

So it may surprise you to learn that some of the greatest exponents of homeopathy were conventionally trained doctors who studied homeopathy with the intention of proving that it was nothing but quackery.  For example, Constantine Hering was a student of medicine at the University of Leipzig, and in 1821 was charged by his tutor to write a book disproving homeopathy.  Reviewing the original works of Samuel Hahnemann, he tested the principles of homeopathy for himself and was surprised to find that they were successful.  This stimulated his interest in homeopathy, which thereafter became his life’s work, and in 1833 he took homeopathy to America (where he is known as the “Father of Homeopathy”).  Hering’s 10-volume “Guiding Symptoms of the Materia Medica” is a classic of homeopathic literature, and during his lifetime he introduced 72 remedies.

Another example is James Compton Burnett, a physician who completed his internship at Barnhill Parochial Hospital and Asylum in Glasgow in 1876.  Discussing his “unsatisfactory clinical results” one evening with his friend and colleague Alfred Edward Hawkes, his friend suggested that he give homeopathy a try.  After reading Hughes’ “Pharmacodynamics and Therapeutics” he found it so challenging to the established medical doctrine that “it must be either good clear God’s truth, or black lying.”  He then decided to study homeopathy in order to “…try the thing at the bedside, prove it to be a lying sham, and expose it to an admiring profession!”  However, his first experience of applying the principles of homeopathy forced him to change his mind.  The children’s ward at his hospital at that time was receiving many admissions with feverish colds and chills, who then commonly went on to develop pneumonia, pleurisy, etc.  Following the principles of homeopathy, he added a few drops of Aconite tincture to a large bottle of water and ordered that the solution be given to the children admitted to one side of the ward, whilst those admitted to the other side received conventional medical treatment only.  Following this he wrote “at my next morning visit I found nearly all the youngsters on the Aconite side feverless, and mostly at play in their beds.  But one had the measles, and had to be sent to the proper ward…. The others remained a day or two, and were returned whence they had originally come.  Those on the non-Aconite orthodox side were worse, or about the same and had to be sent into hospital – mostly with localized inflammations, or catarrhs, measles, etc.”  Burnett became one of homeopathy’s most prolific authors and greatest exponents.  (Quotes above from “Homeopathic Treatment or Fifty Reasons for Being a Homeopath” by J. Compton Burnett.)

(A timeline of the history of homeopathy with many other biographies may be found here.)

Back to today, and in order to be able to provide a robust defence of the therapy, research into homeopathy must be conducted to ensure that it’s the effectiveness of thetherapy that is being accurately measured, as argued by George Vithoulkas.

Trying to assess a treatment for individuals – where remedy selection is based on the totality of their symptoms – in the same way as a treatment for a specific diagnosis – ignoring the differentiating symptoms of the individual – does not assess homeopathy but instead only assesses the effectiveness of the selected potentised remedies for the treatment of that diagnosis.

As 200 years of homeopathic literature explains, if the remedy isn’t homeopathic for the individual, it cannot stimulate a healing response (there’s no chemical present to force a change in the body, although there may paradoxically be a slight aggravation of the patient’s symptoms).  Given that there can be any number of possible remedies for a condition – typically between 20 and 400 depending on what that condition is – choosing a couple of remedies to assess for a treatment effect in a group of people who happen to have the same medical diagnosis has to end up being nothing more than random guesswork.  Yes, there are remedies that are common first-line treatments for particular conditions – perhaps most notably Arnica for physical trauma – but each one is still not going to be ‘homeopathic’ to every single person it is given to.

And not only does the homeopath match the remedy to the patient, they also need to match the potency of that remedy to patient, based on the intensity of the symptoms experienced and the patient’s general state of health, in order to stimulate the right degree of healing response in the individual to produce an improvement in their condition without causing a major aggravation of their symptoms.

That’s the difference between homeopathy (which is actually the reason for choosing a particular remedy, i.e. similarity) and simply taking a potentised substance.

So, considering these important differences, it is even more remarkable that 85% of the studies of homeopathy published in the medical literature to the end of 2009 are positive!

Regarding the anti-homeopathy movement it’s useful to be aware that things haven’t changed in 156 years.  During London’s cholera outbreak in 1854, mortality rates for the city’s hospitals (but not the Homeopathic Hospital) were announced in the House of Commons, for which the average was over 50%.  When Lord Grosvenor asked why the rate of 16.4% at the Homeopathic Hospital had not been declared, the response from the General Board of Health was that to do so “… would not only compromise the value and utility of their averages of Cure, as deduced from the operation of known remedies, but they would give an unjustifiable sanction to an empirical practice, alike opposed to the maintenance of truth and to the progress of science.”

This time around, however, there has finally been a joint response from professional organisations, homeopathy course providers, and others (as argued for in a previous blog post), as well as many other individual responses from different organisations, support groups, practitioners and patients (for a good example, see here).

I think there is a real possibility of the campaign of FUD backfiring on those who trying to drive homeopathy to extinction.

  • Finally, all the organisations representing homeopaths are united with one voice.
  • Campaigns promoting the beneficial effects of homeopathy as experienced by the general public are gathering pace (see here).
  • Deficient areas of research have been identified and will be even more focused in the future.

But in the end, and no doubt to the disappointment of the detractors, nothing has really changed.  Those who have always been against homeopathy will feel that their opinions have been confirmed by the ‘experts’; some of those who have sat on the fence will come down on the side of the sceptics, while the rest remain on the fence; and those who have experienced its benefits will continue to use the remedies and seek treatment, trusting their own experience.

And on that note, the last words should go to Dr T.M Dishington, writing in the British Homoeopathic Journal in 1929, and again quoted by J. Ellis Barker:

“There can be no useful debate between the homoeopath, who from training and experience knows the allopathic point of view, and the allopath, who knows only his own point of view, and steadfastly refuses to investigate homoeopathy and find out what it is and what it can do.  Argument is of poor service to homoeopathy, and still less of service to those whom we could convince.  We cannot enter into an argument with men about what they do not know.  Experience is the test.  Until men experience what homoeopathy is and what it can do, it is natural to expect indifference, if not actual opposition.”