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Wednesday, January 14th, 2009 | ISSN 1556-5696

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In this week’s eSkeptic, Harriet Hall, MD explains why “homeopathy is about as silly as it gets. Silly wouldn’t matter if it worked, but it doesn’t. People think it works because they get placebo effects and the homeopath keeps them entertained while they get better on their own.”


Homeopathy — Still Crazy
After All These Years

by Harriet Hall, MD

Homeopathy is one of the longest running forms of pseudoscience in the modern world. Oliver Wendell Holmes recognized that it was nonsense back in 1842 when he wrote “Homeopathy and Its Kindred Delusions.” We long ago gave up the nonsense of trying to balance the four humors by bloodletting and purging, but the homeopathy Energizer Bunny is still marching on. What makes it so indestructible?

One reason is a lack of understanding about what homeopathy really is, even among health care providers. I recently heard about a nurse who thought “homeopathic” just referred to any mild natural herbal remedy. In case any readers are similarly confused, here’s a brief overview. Homeopathy was invented by Samuel Hahnemann in the late 1700s. It is based on the now-outdated principle that “like cures like,” and the lower the dose the better in homeopathy. If coffee keeps you awake, highly diluted coffee will put you to sleep. The more dilute the coffee, the better you will sleep.

To figure out what remedy works for what symptoms, you do a “proving” by giving a substance to healthy people and writing down every symptom they have for the next few days (without trying to determine whether the symptom was due to the substance or was just coincidental). You make a remedy by diluting that substance many times and shaking it (succussing) at each step. You look up a patient’s symptoms in a book listing all the different proving results, and you give him the remedy that best matches what ails him.

For one remedy, the book lists symptoms in 19 body systems, with entries such as this one: “Pain in back, with desire for some firm support. Every movement accelerates the circulation. Palms hot and perspiring. Nasal discharge or dry nose. Hangnails. Warts. Chill between 9 and 11 AM. Coldness of legs with congestion to head, chest, and stomach. Sleepy in forenoon. Dreams of robbers…” It goes on like that for pages. All of those symptoms were reported in provings by healthy people after they ingested Natrum muriaticum. That’s table salt. How could anyone seriously believe that table salt causes all those symptoms, or for that matter believe that a dilute salt solution could relieve all those symptoms?

How dilute? Serious dilution, as in comparable to one drop diluted in all the water on Earth. When they realized that no molecules of the original substance were left in most homeopathic dilutions, homeopaths rationalized that the water must “remember” what it had come into contact with — as in clusters of water molecules somehow holding the memory of their encounters with the allegedly curative substances. Unfortunately, homeopaths have failed to explain how water can remember what it’s supposed to remember, and forget all the other memories of coming into contact with various trace contaminants, elements, bacteria, and whatever else happened to float by at the time.

In homeopathy, any substance can be a remedy; even a non-substance. My favorite is “eclipsed moonlight.” I’ve been trying to find out how they collect it to prepare the remedy; no one’s talking. And then there was the homeopath who was selling homeopathic vaccines for smallpox and anthrax, which he said were made by diluting the real thing. I reported him to Homeland Security, because if he can get the real thing, so can terrorists. Jacques Benveniste is infamous for winning two IgNobel prizes for homeopathy studies: the first one couldn’t be replicated when proper blinding controls were used; in the second one, he claimed to have sent the electronic signature of the remedy over the Internet.

The Benveniste basophile degranulation study was a convoluted attempt to show that water could remember. It was supposedly replicated in other labs, notably by Ennis. Homeopaths are still citing these studies as evidence for the memory of water, but this is intellectually dishonest. In the first place, the studies are completely discredited by the fact that every attempt to repeat them with proper blinding has failed. When James Randi and a team from Nature visited Benveniste’s lab, his experiment stopped working. When Ennis’s experiment was repeated for Randi’s million dollar prize on the BBC show Horizon, it failed. If the experiment really worked under proper blinding conditions, someone could have easily won the million dollars by now.

In the second place, homeopaths don’t seem to realize that if the results of those experiments were valid, it would mean that homeopathy couldn’t possibly work as advertised. The effects went up and down with consecutive dilutions rather than steadily upwards, and it appears that they got a similar effect from a dilution as from the full strength solution, rather than getting the expected opposite effect.

Homeopathy is about as silly as it gets. Silly wouldn’t matter if it worked, but it doesn’t. People think it works because they get placebo effects and the homeopath keeps them entertained while they get better on their own.

One recent meta-analysis claimed to have found that homeopathy worked better than a placebo in general, but that it didn’t work better than placebo for any specific condition. I’m still trying to wrap my brain around that. That’s like saying broccoli is good for all people but it isn’t good for men or women or children. Other meta-analyses have been negative, especially the ones that looked at only the higher quality studies. A recent editorial in the British medical journal Lancet proclaimed “The end of homeopathy.”

Perhaps the most promising development is that Edzard Ernst, MD, has spoken out strongly against homeopathy. This is important because he was a practicing homeopath and the world’s first professor of complementary medicine. For the last 15 years he has led a team of researchers studying the evidence for alternative medicine, and he now concludes, “With respect to homeopathy, the evidence points towards a bogus industry that offers patients nothing more than a fantasy.”

Despite science and reason, homeopathy isn’t about to go away. It has some really good things going for it. When you visit a homeopath, he wants to know all about you. He gives you far more time and attention than your MD does. He picks a special treatment designed just for you. If it’s not working he has an explanation and something else to try next time. He’s always confident he can help you get better. Homeopathy is inexpensive. It has no side effects. It’s the ideal placebo. It’s great for the worried well and the hypochondriac. It’s great for those elusive symptoms scientific medicine cannot diagnose and cure. It’s harmless except in cases where patients are persuaded to forgo effective medical treatment, or when homeopathic vaccines are offered in lieu of real vaccines.

It’s popular in Great Britain where Queen Elizabeth uses it, Prince Charles promotes it, five homeopathic hospitals are still operating, and the National Health Service is paying a good chunk of its budget for it.

Let’s say you aren’t sleeping well. You could go to an MD and get a prescription sleeping pill that only works a little better than a placebo and has side effects, or you could go to a homeopath and get a placebo that has no side effects and is a lot cheaper. You’re probably better off with the placebo. Why don’t MDs prescribe placebos? Because it’s unethical: we don’t lie to patients; we can’t tell them a remedy is effective if we know it is no more effective than a sugar pill.

It’s easy to see how doctors could be persuaded that homeopathy works. Patients tell them they feel better. That’s why bloodletting and purging lasted so long: patients got better despite the treatment and the treatment got the credit. That’s why we have to do randomized controlled trials to make sure just as many patients don’t get better without treatment.

The arguments homeopaths use to support their beliefs would earn an F in a Logic 101 course. Here are just a few taken from “Presenting 50 Facts About Homeopathy” by Louise Mclean.

  • Hippocrates said there was a law of similars. [Hippocrates also said all illness was due to an imbalance of the four humors.]
  • Homeopathic provings are a more scientific method of testing than the orthodox model. [If you say something totally false often enough, someone might start to belief it.]
  • There are more than 4000 homeopathic remedies. [None of which work]
  • The exact substance in a homeopathic remedy is known, unlike most modern drugs where we are rarely informed of the ingredients. [What? We are informed if we know how to read!]
  • Homeopaths treat genetic illness, tracing its origins to six main genetic causes: Tuberculosis, Syphilis, Gonorrhea, Psora (scabies), Cancer, Leprosy. [Geneticists would be surprised to hear this.]
  • Homeopathy got better results than conventional treatment in epidemics of cholera and typhoid in the 19th century. [Only because 19th century conventional treatment did more harm than good. Today’s conventional medicine is a bit more effective.]
  • Lots of people believe in homeopathy. [Lots of people believe in ghosts and angels, but that doesn’t make them real.]
  • Big Pharma doesn’t want us to know how well homeopathy works. [Conspiracy theories are alive and well.]
  • Queen Elizabeth never travels anywhere without her homeopathic vials of medicine. [And Madonna uses Kabbalah water.]

Arguments like these just highlight the intellectual bankruptcy of the homeopathic belief system. They would love to find scientific validation, but they reject science when it doesn’t support them. One repeated excuse is that the remedies are individualized so they don’t lend themselves to controlled trials. That’s just nonsense. A homeopath could prescribe individualized remedies and third parties could randomly dispense either what had been prescribed or a placebo control. Neither patient nor homeopath would know which the patient got.

Homeopathy was humbug in 1842. It’s still humbug today. That’s a diagnosis you can prescribe to everyone.


skull of a Carnotaurus

January Geology Tour: It’s Our Fault!

Saturday, January 31, 2009   SOLD OUT
San Andreas Fault,
Southern California

added tour date:
Sunday, February 1, 2009   SOLD OUT

By popular demand, we have enough sign-ups to run an identical trip on Sunday, February 1, 2009. Hurry — this trip is filling up fast!

Sorry! Both the January 31 and the February 1 San Andreas Fault Tours are now sold out.

18 Comments »

18 Comments

  1. Margarita says:

    Soooooo tired of reading about the placebo effects of homeopathy… So arrogant to say it doesn’t work when so many people, including myself, have seen the effects. When a child with atopic dermatitis is condemned to treatment of cortisone and, in three months, all the symptoms disappear with homeopathy, is that also placebo effect? He was 2 years old at a time and he’s going on 10 at the moment without the symptoms ever recurring… The conclusion: the homeopathic treatment worked!

    • moil4gold49 says:

      Margarita #1:

      “Soooooo tired of reading about the placebo effects…arrogant to say it doesn’t work when so many people, including myself, have seen the effects”

      I am getting soooo tired of cognitive dissonance.

      Your case wasn’t Placebo Effect. It was healing/remission. Happens all the time.

      YOU are the arrogant one. People who have “seen the effects” of aromatherapy/homeopathy have performed a “lab study” with n=1, and used an unskilled observer. But despite your pitifully narrow body of evidence, you arrogantly think your study is more valid than massive research studies and the vast majority of medical establishment.

      Humans have all kinds of faulty observations. That’s why scientific study, double blind testing, and reproducibility of studies is so critical to modern science. It is designed to reduce the impact of human error, wishful thinking, and bias. I’ll side with the scientific method over the “Margarita method” every time, and that’s hardly arrogant – it’s just sensible.

    • Toby says:

      The placebo effect can also happen in children and in animals. Often those who are treating the afflicted child or animal will often spend more time with them, talk to them more, feed/water them more regularly which can all contribute to the healing process. Also, how do you know that it was indeed the homeopathic remedy that cured the ailment? It could be a number of things. That is the main reason for using trials to determine whether it is the remedy itself that produces a cure and not the placebo effect.

  2. Don Johnson says:

    Wow! I once hear somebody says homeopathy doesn’t work. He took real medicine and got better.

    My story is clearly more right than yours, because I know my guy and I don’t know your guy.

  3. Brian says:

    As a medical student at a traditional allopathic medical school, I spent the summer between my first and second years at an alternative school so as to be educated about any potentially therapeutic alternatives that might be beneficial to my future practice. I can now say without bias that nearly ALL alternative medicine is bogus. Perhaps homeopathy is the most egregiously false, but other forms such as traditional Chinese medicine and accupuncture have equally disappointing clinical evidence. Margarita, unfortunately your son’s homeopathic treatment is in fact a placebo effect. Atopic dermatitis can come and go over one’s lifetime. Because traditional medicine has few effective treatments for atopic allergies, alternative med quacks have been exploiting desperate patients for years.

    • vera says:

      Brian, it seems you have bought into the pharmaceutical industry’s propaganda hook, line and sinker. You claim that ‘almost ALL’ forms of alternative therapies are useless. Have you never looked at the statistics of what percentage of pharmaceutical drugs are of plant origin? It is the vast majority, with only a small number being truly man-made in origin.

      While many plant based chemicals are later synthesized artificially, most of them remain nature identical, with the only difference being in the medical dosage being strictly controlled, as compared with the variability of a biological/herbal dosage.
      This does not mean that the herbal remedy won’t work, but it may have a more variable effect on some patients. So dismissing TCM/herbal remedies as bogus is basically shooting down your own belief in allopathic/pharmaceutical drugs.

      And I will say that I am not defending all forms of alternative therapies. I have serious doubts as to the efficacy of homeopathy, but lumping all alternative treatments into one basket is incredibly unscientific of you, especially considering you have based this observation on one summer’s study. I hate to think how little time each alternative treatment you assessed actually received before it was dismissed as ‘bogus’.

      • German Bonilla says:

        So I guess you consider “not bagus” a remedy where you drink a mixture of several (there are over 80 known chemicals in green tea, plus many more unknown), mostly unknown “natural” chemical compounds whose effect over human health at different dosages and combinations are poorly understood. Of course if you put so many things into your system, you’re surely going to have SOME kind of effect!

        But on the same reasoning, you should take soil infusions to have the same effect. I understand there are over a million different species of bacteria in a single gram, and at least half of them produce secondary metabolites, so you’re surely having an effect as well.

        (on second thought, I might patent this and get rich selling this idea to stupid new-age neo hippies)

  4. Gisela says:

    I liked the article of Dr.Hall. Don’t you know that homeopathy is occult. The occult medicine ( homeopathy, holistic) comes from Satan. Off course it will help for a time. The dark side wants you to stay, That’s why one believe in homeopathy and holistic if it helps. If one of you is a christian then you know what I mean.

    All the holistic medicine is the further on bondage to the antichrist. People do not believe in Satan because they do not believe in Jesus Christ God’s begotten Son. There is darkness and light in our world. Darkness Satan and Light Jesus Christ.

    The holistic ( homeopathy) medicine is giving you the wrong direction.It is more healthy to turn back to God through His Son Jesus Christ to become eternal life.

    You may believe it or not!

  5. Robert says:

    re Margarita and Gisela: If these responses are typical of the individuals the online magazine attracts, perhaps Skeptic could rename itself “Flake.”

  6. Appalled says:

    Re: Gisela

    Is anyone else amused that someone thinks the best way to counter 200 year old hoax is with a 2,000 year old one?

    Enjoy your dreamworld, you deluded creature.

    A.

  7. George says:

    I knew a girl in her twenties suffered from a moderate acme. She went to homeopaths and they gave her a “medicine”. They told her that her organism will “react to this medicine with a worst outburst of acme. When her body will be cleaned up from “toxins” she will be cured. But, as they told her, they did know how long it would last. And this happened. She got a really red face which she covered with a veil to protect it from the sun and from the eyes of her friends.
    Back then I was a physics student and was really surprised. I could not understand how a “medicine” with an active substance of zero concentration could cause any effect.
    But know I know what happened. The girl was in love with one of the “doctors”. They are usually charming charismatic people. So she decided (subconsciously?) to be affected from the “medicine” for a really long time in order to pay to him frequent visits. I would not be suprised if I learned that they are know a happily married couple.

  8. George says:

    Many years ago I knew a girl, in her twenties, suffering from a moderate acme. She went to homeopaths and they gave her a “medicine”. They told her that her organism will “react” to this medicine with a new and severe outburst of acme. When her body will be “cleaned up” from “toxins” she will be cured. But, as they also told her, they did not know how long this outburst would last. And this really happened. She got a red face for many years which she used to cover with a veil to protect it from the sun and from the curious eyes of her friends.
    Back then I was a physics student and I could not understand how a “medicine” with an “active substance” of zero concentration could ever cause any effect.
    But now, I think, I know what happened. The girl was in love with one of the “doctors”. They are usually charming charismatic people. So she decided (subconsciously?) to be affected from the “medicine” for a really long time in order to pay to him frequent visits. I would not be surprised if I learned that they are now a happily married couple.

  9. Duncan says:

    Excellent article and full of sense. The key to all this is the research and how the research is carried out. Faulty tests and cherry picking evidence are easy ways to get the results people want. Like all ‘psychics’ and claimers of paranormal powers, under a clinical, scientific test, they have nothing and cannot prove anything. Homeopaths are, at best, misguided and at worst charlatans. I point you to an excellent website: http://www.badscience.net/ run by Ben Goldacre. He has also written an excellent book, Bad Science. Keep up the good work.

  10. Jim says:

    Homeopathy as a healing practice is difficult. So is conventional medicine. And there will always be charlatans in every type of medicine.

    The physics behind homeopathy is also difficult:

    http://www.homeopathyoz.org/downloads/Roy-StructureOfWater.pdf

    However, at one point people thought the world was flat and that the sun rotated around the earth. Because that was how it appeared, and there was no evidence to oppose it. For the same reason people thought that it would be impossible that a metal could be compressed in such a way that it would explode and destroy a city, or that volumes of information could be sent thousands of miles in a few seconds through fibres smaller than a human hair. But the evidence emerged, and these things became accepted.

    So, which side do you want to be on?

  11. Lapin Jaune says:

    I was a skeptic
    I tried classical homeopathy
    I am a skeptic no more
    It works better than anything else
    Stop it with YOUR pseudoscience
    Try it and you’ll see

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