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Assessing the foundations of homeopathy and the impact it has on our health
Theme: Ethics and Controversy
Zuairia Shahrin
The topic of our discussion today is one that has managed to stay on the newspaper headlines since the early 2000s. American violinist and conductor, Yehudi Menuhin, describes it as “one of the few medical specialities which carry no penalties - only benefits.”[1] Today, we are talking about homoeopathy and evaluating its effectiveness. So, I suggest you grab a drink and sit comfortably because this is going to be one lengthy read!
Going back to the late 1700s, homoeopathy is a medical system that was created by German physician Samuel Hahnemann. He believed that bodies have healing powers, which only need to be stimulated enough to encourage a response that cures the illness on its own.[2] This isn't about “one size fits all” treatment. Rather than just focusing on the diseased body part, it considers the patient’s emotional and mental health too.[3] The building block of this belief was the concept of “similia similibus curentor,” translating to “like curing like.” Based on this, two more principles were created, hence forming the three pillars of homoeopathy:
Let Likes Cure Likes: Imagine you are in your kitchen, chopping red onions. You feel a burning sensation in your watering eyes. The first principle of homoeopathy believes that a substance taken in small amounts will cure the same symptoms it causes if it is taken in large amounts.[4] In other words, chopping onions has caused your eyes to water. So, the only thing that can stop your eyes from watering is an onion itself.
The Minimum Dose: This principle trusts that the more diluted a substance is, the maximum therapeutic effect it has, with minimum side effects.[4] In our onion example, a homoeopath would first clean the onion, extract its juice and prepare a solution with alcohol and water. He/she would then vigorously shake and dilute the solution hundreds or even thousands of times. In homoeopathy, the dilution is known as potentization, and the repeated shaking of the solution is called succussion. We might start with 1 drop of onion extract and 9 drops of alcohol, but by the time we get our end product, there would be little to no onion extract left in the solution.
The Single Remedy: Homeopathy maintains that the body might experience adverse effects if more than one medicine is given at the same time. So, only one medicine is prescribed at a time, giving the body enough time to dismantle an illness from its roots.[4]
And that my friends is how allergy remedies are made - an onion used to undo its own effects!
When I first read about homoeopathy, I was impressed by its holistic approach to treatment. However, I noticed that the FDA had received 130 plus cases against acute homoeopathic remedies, where patients had lost their sense of smell. According to those affected, it happened soon after they had taken the first dose of the remedy.[7] Besides that, the FDA also saw the deaths of 10 children caused by the use of Hyland’s Teething Tablets, an oral pain relief remedy that contained unsafe levels of the extremely toxic belladonna plant.[7] Disproving the second principle, this shows that homoeopathic remedies can have fatal side effects despite super dilutions.
In an attempt to show that the second principle is valid, British homoeopath Gregory Meanwell referred to a Health Technology Assessment (HTA) produced by the Swiss government in a discussion.[13] Two authors of the HTA, Bornhoft and Matthiessen, concluded that with each potentization, energy is added to the remedy. But to make this come true, we’ll have to rewrite all of the books about the fundamental laws of chemistry and physics. According to the Law of Conservation of Energy, this isn’t possible. With each succussion, the kinetic energy imparts a marginal increase on the temperature of the remedy - no other “added energy” can be detected by science, disproving the second principle again.
Despite the criticism homoeopathy had received, I went on to read about some success stories.[6][8][10] Upon additional research, I found that in late 2014, Randomised Controlled Trials (RCT) using placebos were used to measure the effectiveness of homoeopathy, all detailed in peer-reviewed literature.[14] Out of 153 papers, 104 had data somewhat eligible for analysis. What about the other 49 though? Of these 104 papers, 43 were positive results and 5 were negative. Whilst this may seem to be in favour of homoeopathy, it isn’t, because 56 papers could not conclude if the result was positive or negative. Due to this inefficacy, the Australian National Health and Medical Research Council conducted the most thorough evaluation of homoeopathy in all of its 200-year long history. Confirming in their preliminary report that homoeopathy is a mere placebo effect,[11] they gave homoeopaths another chance to submit evidence proving otherwise. After the final review, they warned the unsuspecting public that, “People who choose homoeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness.”[9][13]
In my opinion, the principles that homoeopathy builds upon aren’t stable foundations. I don’t agree with the first principle. If the illness-causing substance isn’t even present in the remedy, how is it going to undo its effects? Since Hippocrates’ time, homoeopaths have been claiming that the substance does not need to be present in the solution to show its effects because the substance can leave an “influence” on the water and the water will “remember” it.[4][5] Since when are chemicals or elements able to imprint on water? Since when does water have memory? If that is true, the air we breathe in and the water we drink are also homoeopathic remedies - why purchase little white pills? Additionally, water anywhere has undoubtedly passed through so many people and things; you, me, fish, or even dirt. Why would it choose to remember only one substance? Even if the second principle is true, then why can't we see the results in RCTs, which are one of the most reliable ways of experimentation? As an aspiring medic, the third principle doesn’t comply with my moral and ethical values. I understand that every remedy needs its time to work, but why wouldn’t a homoeopath prescribe additional remedies if the first one is inflicting pain on the patient?
Even if we ignore all of the evidence and give homoeopathy a chance to prove itself, how will we reach a conclusion? Homoeopathic treatments are by nature highly individualized. Can we study its effectiveness if there are thousands of remedies, each with differing degrees of dilutions and prescribed in various forms, like pills, liquids, tablets, creams, and whatnot?
Upon discovering that homoeopathy is a mere placebo effect, the House of Commons’ Science and Technology Committee asked the National Health Service (NHS) to stop investing in homoeopathy in 2010. However, last year, 3,300 prescriptions cost the NHS over ￡55, 000. Whilst this may be a drop in the ocean compared to the total budget held by the NHS, it is important to note that this is equivalent to more than two full-time nurse salaries. The NHS used to spend more than￡1.75 million on homoeopathy. Fortunately, the figure is now 10 times smaller as more emphasis is placed upon conventional medicine.
With a myriad of evidence to support me, I strongly recommend that you don’t rule out other treatment options.[12] Since the World Health Organization has issued a warning against using homoeopathy to treat serious illnesses, it is highly advisable to choose conventional medicine, which has research backing it up. Ultimately, it’s your decision. If homoeopathy has been working effectively for you, nobody can tell you otherwise. However, I strongly suggest that you consult with a conventional medic as soon as the remedies begin to go out of hand. With that being said, I hope this article was able to give you an insight into the lesser-known details of homoeopathy.
GLOSSARY:
Dilution: The process of making a substance weaker in content
Health Technology Assessment (HTA): The systematic evaluation of the properties and effects of health technology to make informed decisions regarding health technologies
Randomised Controlled Trial (RCT): A type of scientific experiment that aims to reduce sources of bias when testing the effectiveness of new treatments
Inefficacy: Failure to produce the desired effect
REFERENCES:
Menuhin, Y. Homeopathy is one of the few medical specialities which carries no penalties - only benefits. Quotefancy. Retrieved 4 May 2020. [Online] Available from: <https://quotefancy.com/yehudi-menuhin-quotes>
WebMD. Homeopathy: What You Need To Know. WebMD Health and Balance. Retrieved 4 May 2020. [Online] Available from: <https://www.webmd.com/balance/what-is-homeopathy#1>
British Homeopathic Association. What is Homeopathy? British Homeopathic Association - Enabling patient access to homeopathy. Retrieved 4 May 2020. [Online] Available from: <https://www.britishhomeopathic.org/homeopathy/what-is-homeopathy/>
National Center For Homeopathy. (2017). What is Homeopathy? National Center For Homeopathy. Retrieved 4 May 2020. [Online] Available from: <https://www.homeopathycenter.org/what-is-homeopathy>
Chase, S. What is Homeopathic Medicine? American Institute Of Homeopathy. Retrieved 4 May 2020. [Online] Available from: <https://homeopathyusa.org/homeopathic-medicine.html>
Roberts, R. (15 July 2010). I don’t know how, but homeopathy really does work. The Guardian - Opinion - Life and Style. Retrieved 4 May 2020. [Online] Available from: <https://www.theguardian.com/commentisfree/2010/jul/15/homeopathy-works-scientific-evidence>
Sheikh, K. (28 February 2018). Do Homeopathic Remedies Really Work? The VICE. Retrieved 4 May 2020. [Online] Available from: <https://www.vice.com/en_us/article/evmmk4/are-homeopathic-remedies-safe>
Rose-Wilson, D. (29 May 2018). Homeopathy For Anxiety, Fear, and Panic Attacks: Does It Work? Healthline. Retrieved 4 May 2020. [Online] Available from: <https://www.healthline.com/health/homeopathy-for-anxiety#takeaway>
Blakemore, E. (11 March 2015). 1,800 Studies Later, Scientists Conclude Homeopathy Doesn’t Work. Smithsonian Magazine - Smart News. Retrieved 4 May 2020. [Online] Available from: <https://www.smithsonianmag.com/smart-news/1800-studies-later-scientists-conclude-homeopathy-doesnt-work-180954534/>
The Guardian. Is there any proof that homeopathic medicine works? The Guardian - Notes and Queries. Retrieved 4 May 2020. [Online] Available from: <https://www.theguardian.com/notesandqueries/query/0,,-9542,00.html>
Ernst, E. (12 March 2015). There is no scientific case for homeopathy: the debate is over. The Guardian - Opinion - Homeopathy. Retrieved 4 May 2020. [Online] Available from: <https://www.theguardian.com/commentisfree/2015/mar/12/no-scientific-case-homeopathy-remedies-pharmacists-placebos>
Shurtleff, D. (July 2018). Homeopathy. National Center For Complementary And Integrative Health. Retrieved 4 May 2020. [Online] Available from: <https://www.nccih.nih.gov/health/homeopathy>
Bornhoft, G., Matthiessen, P. (2011). Homeopathy in Healthcare. Springer. Retrieved 4 May 2020. [Online] Available from: <https://www.springer.com/gp/book/9783642206375>
Faculty of Homeopathy. Placebo-controlled RCTs of Homeopathy - the original data. The Research Evidence Base For Homeopathy. Retrieved 4 May 2020. [Online] Available from: <https://facultyofhomeopathy.org/wp-content/uploads/2016/03/2-page-evidence-summary-for-homeopathy.pdf>