Two hundred years ago, medical understanding was minimal and treatments tended to be ineffective; sometimes brutal. So it’s not surprising that a therapy which combined the maximum solicitude for the patient with the minimum amount of actually doing anything proved popular. Thus was homeopathy born, developed by physician Samuel Hahnemann. It’s now a $200 million industry in the US alone and one of the most popular alternative health approaches – but is it really medicine?

Like cures like

Hahnemann believed that symptoms of disease could be cured by giving the patient small doses of substances that caused such symptoms in healthy people: thus homeopaths use tiny doses of caffeine against insomnia, or onion extract for the weepy eyes of hay fever. Sometimes they match substances with personalities — oyster shells, for fearful patients who feel better when constipated! Hahnemann used a huge range of extracts from plants, animals and chemicals to produce artificially induced symptoms to drive out disease — he believed no-one could be infected with two diseases at the same time. So arsenic is used to treat symptoms similar to arsenic poisoning, such as vomiting and diarrhoea. There are now over 2,000 extracts in use, many dating back to Hahnemann, and there are many different preparations for the same complaint (250 for treating headaches alone).

Dilutions of grandeur

While it may seem reasonable that such extracts would have some physiological effect, the homeopathic concept of serial dilution ensures that none of these substances actually comes into contact with the patient.

In a serial dilution, one part of the substance is mixed with nine parts of water. This diluted solution is then diluted again with another nine parts of water, and so on many many times. At each stage the mixture is vigorously shaken (in homeopathic jargon, “succussed”), to impart an “active spirit” to it. Homeopaths claim that this process alters the physical nature of the water molecules so that it “remembers” the extract that was in it. How it remembers which substance was the important one is not that clear…. This “potentised” solution is also believed to have the power to affect the water within a patient. Solid drugs are typically diluted with lactose (milk sugar) in a similar manner, with long and vigorous grinding.

Practitioners describe a twelvefold repetition of the above dilution as 12X (X=ten). A more rapid dilution is obtained by using 99 parts of water or lactose at each step. A 2C (C=100) caffeine dilution is 99.99% water and just 0.01% caffeine; a 6C solution would have 0.000 000 000 1%. Greater dilutions are believed to be more potent, which is like saying that if you add lots more tonic to your gin and tonic, it will get stronger (and this means something like an oceanful of tonic).!

Basic chemistry tells us that homeopathic remedies can’t contain any molecules at all of the original substance. A 30C solution would have one molecule of the original substance in a minimum of 1,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000 molecules of water.

Observations of the real world has shown us that drugs have a “dose-response” relationship — the higher the dose, the greater the effect, quite the opposite of the homeopathic “law of infinitesimals”.

Over the past 30 years, a large number of studies have compared homeopathic treatments with placebos (materials known to have no effect on the condition being treated). They have shown consistently that there are no benefits to homeopathy beyond the psychological value of the placebo effect, where people feel better because they think they are getting treatment.

Regular reviews of homeopathic claims show that that the most positive results come from companies producing or selling homeopathic preparations, reported in homeopathic-supportive magazines, rather than in the gold standard of independent, peer-reviewed objective testing that medicines should be held to. The US National Council Against Health Fraud has warned that there are “serious questions about the trustworthiness of homeopathic researchers”.

Danger exists

The lack of side effects is one commonly cited advantage of homeopathy. However, use of homeopathy as an alternative to conventional medicine can have disastrous consequences. In one case in the New Zealand Coroner’s Court, a mother refused antibiotics for her baby’s ear infection, preferring to take homeopathic advice. Two weeks after the initial consultation, the baby was taken again to the homeopath, who expressed concern about its poor health but who did not suggest seeking conventional medical treatment. The mother, a registered nurse, commented that the symptoms looked like meningitis and, two days later, took her baby to her GP. The doctor insisted on the baby being hospitalised immediately.It took some time to convince the mother to do this. The Wellington Hospital paediatrician reported a “great sense of frustration in dealing with the mother, who opposed him every step of the way”. Despite intensive treatment, the child died a week later from brain damage due to bacterial meningitis.

While such documented cases are rare, particularly as there is little consumer protection or oversight of this industry, the website lists many cases where homeopathic practices have caused people harm.

One major concern has been the industry marketing homeopathic preparations as “vaccines”, particularly during the New Zealand meningitis campaign, citing its “like cures like” approach that sounds vaguely like genuine vaccination practice.

It is rare for the pseudoscience underpinning homeopathy to be clearly explained in media coverage, so people are under-informed and left with the impression that there is something to it.

In most cases, homeopathic preparations are used to treat conditions that are minor or which get better spontaneously. But relying on the placebo effect – where it’s your psychological response making you feel better — can be dangerous for your health and your wallet.

The most effective practice of homeopaths is the lengthy time they spend with their clients to establish a case history and a personal relationship that can improve health outcomes. That too is a form of placebo effect.

There are campaigns to discourage pharmacies from selling homeopathic products alongside tested effective medicines, as it is unethical and unsafe for them to do so.

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