One of those subjects that tends to divide audiences, and which most people (including myself) feel quite strongly about. Homeopathy has been struck from the list of treatments that can be obtained on the National Health Service and will therefore no longer be reimbursed by the government when used by patients.
What is Homeopathy?
The theory of Homeopathy was developed by Samuel Hahnemann and originally published in 1796. This theory was based on a number of ideas that he borrowed or invented.
The Law of Similars
Hahnemann believed that a substance that causes an ailment can also cure it. Caffeine, therefore, can aid sleep. A pathogen can cure the very disease it causes.
This idea, based on the work of Anton von Storck, is not as utterly crazy as it initially sounds if you limit the scope to, for example, venoms. Gradual exposure to small quantities of venom can gradually bring about an immunity to that venom.
In fact, it’s not unlike the principle behind immunization – low-level exposure trains the immune system to react more aggressively and appropriately to subsequent infections. There are, however, enormous and very important differences.
Unfortunately, Hahnemann took these concepts in a different direction. Not understanding the role of the immune system, he believed that the pathogen itself, properly administered, was the cure. Vaccines do not cure, they immunize, and they use weakened or inert virus to train the immune system. The similarities are barely skin deep.
The Law of Infinitesimals
To limit the toxic effects of his potions, Hahnemann developed the idea that dilution, when properly carried out, would maintain the curative effects of the potion while removing the toxicity. His dilutions are typically measures in units of “C”, where 1C is 1 part in 100, and each successive “C” is a dilution of the previous level in a further 100 units of water. So 2C is 1 part in 10000, 3C is 1 part in 1000000 and so on.
Common dilutions in Homeopathy are 30C and 200C, or 1 x 10-60 and 1 x 10-200.
The Process Of Succussion / The Technique Of Potentization
Hahnemann believed that by vigorously shaking his dilutions, he could potentize them, thereby maintaining and enhancing their curative effects. Modern homeopaths have theorized that this allows the water in which the original material has been diluted to retain a “memory” of that material.
Does it work?
Like does not cure like
There is no reason to believe, given everything we know about medicine, biology and chemistry, that like cures like. Giving someone a low dose of a poison after they have already been poisoned does not make them better. The same applies to the flu, joint pain, sinus infections and sleep disorders. To claim the opposite is not only unsupported by anything we know, it flies in the face of everything we do know.
That’s Really Diluted
At 30C, there is 0.000000000000000000000000000000000000000000000000000000000001 percent of the original substance left. In practice, here in the real world, that means that there is none of the original substance left.
On average, this would require giving two billion doses per second to six billion people for 4 billion years to deliver a single molecule of the original material to any patient.
At 200C, which is the dose proposed for the cure for the flu… I can’t be bothered to do the math.
To claim that these dilutions can have an effect requires that we accept the original molecule is not acting on the patient (since it is not there), and that instead the memory of the molecule, carried by the water, is acting on the patient (after it has been dripped onto a small ball of sugar).
Water doesn’t remember
We know the chemical composition of water, we know of no mechanism by which water could store information of any kind, or how that information would enter into a cause-and-effect relationship with someone’s immune system.
That means that Homeopathy is hiding in the dark corner of people’s minds where they believe the ridiculous because you can’t prove it doesn’t exist. I like to refer these people to the Flying Spaghetti Monster.
To be less metaphorical and more grounded about it all:
The philosophic burden of proof lies upon a person making unfalsifiable claims, rather than shifting the burden of disproof to others.
It Doesn’t Work
Even if all the above is true, it’s entirely possible that Homeopathy works through some mechanism as yet not understood.
First of all, see above regarding the philosophic burden of proof, but since believers don’t think that way, governments and the medical community did the work for them. In order to decide what is paid for through the common purse and what follies should be borne by your own funds, governments rely upon systematic, peer-reviewed medical literature that they often commission themselves.
In 2005, the medical journal The Lancet published a meta-review of the existing literature. The conclusion was
Biases are present in placebo-controlled trials of both homoeopathy and conventional medicine. When account was taken for these biases in the analysis, there was weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions. This finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects.
Before you seize on the “weak evidence” phrase in this statement, a word from someone who’s read a few statistics articles in his life: This is pretty damning.
They gave Homeopathy every opportunity to come on top in these studies. A positive statement would have been something like, “A medium-to-strong correlation was found between the administration of homeopathic remedies and an amelioration in patient symptoms, when compared with the control group.” That’s not what this is.
It wasn’t much money. The NHS spent maybe £5 million per year on homeopathic remedies (exact amounts are hard to find), but it was a glaring misuse of funds.
It’s difficult to look people in the eye and tell them that the medicine they want, which has a 20% chance of extending their life by a year, or a 30% chance of reducing their pain by half, cannot be given to them on the NHS because it falls above the NICE threshold for the value of a quality-adjusted life year.
It’s impossible to do that when you’re, at the same time, paying for someone else’s sugar pills.
See also: How Does Homeopathy Work at http://www.howdoeshomeopathywork.com/, which makes the point much more succinctly than I do.