The Debate over Homeopathic Medicine
Snake oil, mercury ointment, and powdered rhinoceros horn have all been alleged miracle remedies with purported effects ranging from relieving joint pain to bestowing eternal life. However, as medical research rapidly progressed throughout recent history, their claims of effectiveness have all been conclusively debunked by good science. What these remedies have in common is that none of them are intentionally prepared to include substances that, in fact, cause the actual disorder that they are employed to treat. Nor are they still widely supported and prescribed around the world. Homeopathic treatments, on the other hand, do fall into both of these categories.
Homeopathy is a popular alternative medical practice in which the very substance which is shown to produce symptoms of an illness in a patient is used as the treatment. Of course, the patient is not directly fed the full dosage of the substance. Rather, the substance is administered through homeopathic technique, which includes diluting the substance many times over so that only an extremely small amount of it is present in the resulting concoction that is applied to the patient.
Established by the German physician Samuel Hahnemann in the early 19th century, homeopathic medicine grew from humble beginnings to become a popular form of alternative medicine today. In the late 18th century, Hahnemann lamented the ineffectiveness of many of the medical practices of his day and resolved to find an alternative to mainstream scientific thought, which had only begun to expand at that point. From then until his death in 1843, he performed many experiments which he himself believed to be scientifically sound and formulated the basic tenets of homeopathy. His experimental results and theories were published during his lifetime, and his work culminated in a treatise, now referred to as the “Organon of Medicine,” that defined his work.
Many of the philosophies that underlie Hahnemann’s confidence in homeopathy have generally been long discarded and are currently regarded as pseudoscience. The belief of a “vital force,” the mysterious ether that conducts itself within living things, is central to homeopathic theory. According to homeopathic teachings, disease is the result of disturbances, or miasms, of this vital force, and these miasms can be countered by substances that confer the disease in the first place. This seemingly paradoxical assertion is formally stated as the “Law of Similars,” which specifies that because certain substances disturb the vital force in unique ways to cause their corresponding diseases, the minute stimulation of the vital force with the same substance will cause a harmony between the disturbances and restore the balance of the vital force.
Homeopathic techniques have largely remained intact and unchanged since their inception. An undiluted preparation of the prescribed substance, usually toxic or ineffective in its native form, undergoes potentization, in which the extreme dilution of the substance, typically with distilled water, is deemed active and potent for therapeutic effect. The dilution is performed serially until the final preparation is anywhere from a 1 to 10-6 ratio of the undiluted substance, also called the “mother tincture”, to an astounding 1 to 10-400 ratio. To put these numbers in perspective, 1 to 10-6 is the equivalent of one part per million, or about one drop of a liquid diluted into 50 liters of water, and 1 to 10-400 is equivalent to one atom diluted in 10320 known universes’ equivalent in number of atoms. Between the serial rounds of dilution needed to achieve these incredible ratios, succussion of the preparation is performed through vigorous shaking or repeated striking in order to activate the ingredients at each step.
Some illness are not caused by a specific substance; in these cases, an alternative mother tincture is advised according to the “Homeopathic Materia Medica,” a list of conditions and their prescribed remedies compiled by historical and modern practitioners. For example, influenza is caused by a virus and cannot be easily isolated and processed homeopathically. Thus, oscillococcinum, a 1 to 10-400 water dilution of Muscovy duck viscera bound in a sugar coating, is prescribed for the flu.
Defenders of homeopathy cite a variety of largely unproven phenomena to explain the principles behind the effectiveness of their treatments. Among these propositions is the “water memory” effect, in which water is said to retain a memory of its solutes, even after the original active ingredient may no longer physically be present in solution, which confers the therapeutic effect. Other theories include the retention of an electromagnetic signature within the final preparation of the starting materials or vague references of quantum entanglement of the mother tincture that gives medicinal value to the preparations. However, no concrete, scientifically backed explanation has been provided to support the effectiveness of homeopathy, with the majority of evidence of success comprised of anecdotal evidence or speculation.
The overwhelming scientific consensus is that homeopathy works no better than a placebo, a result obtained from numerous scientific studies and meta-analyses of compiled studies. Studies which have shown significant positive effects of homeopathy often are thought to have poor research methods, observer bias, and various other explanations for the remedies’ success that do not directly involve the homeopathic medicine, including natural healing, cessation of a previously poor treatment, and the placebo effect. A review article published in the July 2011 issue of the peer-reviewed journal Homeopathy stated that “To date, there is no definitive evidence on the clinical effects of homeopathy which is universally accepted. Years of research in homeopathy seem to be leading nowhere.” Besides its reported ineffectiveness and costliness, homeopathy is also strongly advised against by modern physicians due to the potential it has to derail scientifically accepted treatment methods, such as drugs and surgery, for the patient.
Due to the controversial nature of homeopathy and the wide variation of acceptance it receives in different parts of the world, international regulations of the practice vary. In the United States, homeopathic remedies are under the scrutiny of the Food and Drug Administration and must undergo tests for safety and effectiveness before they are allowed to be sold over-the-counter or prescribed. However, many remedies that do not explicitly offer a promise of a cure or treatment are exempt from certain FDA regulations and are allowed to be sold relatively freely; the high dilutions required typically eliminate any unsafe substances according to FDA rules. Europe is generally very tolerant of homeopathic practices, with varying degrees of restrictions and incentives depending on the country. For example, France requires distributors of homeopathic remedies to be licensed by the government, while the United Kingdom allows them to be covered by national insurance. Though recent scientific studies debunking the effectiveness of homeopathy have encouraged certain countries such as Switzerland to remove it from national insurance coverage, its practice is still allowed and relatively unregulated. In the Middle East, Africa, and Asia, homeopathy is typically unregulated and used by a small percentage of the population, while practice is usually restricted to licensed practitioners and medical doctors.
As with any controversial practice, there are voices at both sides of the table. James Randi, the popular scientific skeptic and founder of the James Randi Education Foundation, has offered his classic $1 million dollars to any homeopathic practitioner or manufacturer if their remedies can withstand scientific scrutiny and work as proposed. On the other end of the spectrum, Nobel laureate Luc Montagnier, who won the Nobel Prize in Physiology or Medicine in 2008 for his discovery of HIV, supports the controversial practice by citing his own current research regarding electromagnetic waves emanated by high dilutions of DNA molecules.
Perhaps, in the future, the debate will ultimately conclude with a clear winner. In the meantime, homeopathy, like any proposed or established medical practice, must prove that it is indeed effective and directly responsible for improving the lives of patients if it is to gain a broader acceptance.
This article was updated on 9/4/2011.