Today we're going to take a tiny sugar pill, infused with specially charged water,
and cure our ills in a novel way. For today's topic is homeopathy, one of my
favorite of the many popular alternative medicine systems. Homeopathy has a
large following, but I suspect that a large number of its customers don't really
understand what it is. For example, I asked two friends who are homeopathy
users, on separate occasions, to tell me about it. By coincidence both were
attempting to treat headaches. Both friends had the same general understanding
of what homeopathy is: They said it was essentially an herbal remedy, and that
the small pills they were taking contained some sort of herbal extract. They
could not have been more wrong. I wonder if they would continue taking it if
they knew what homeopathy really is.
Samuel Hahnemann was a German physician. In the late 1700's, all medical conditions
were believed to be caused by an imbalance in the four basic bodily humors:
blood, phlegm, black bile, and yellow bile. Conventional medical practice was
to attempt to equalize these humors by such practices as bloodletting, purging,
or leeching. Hahnemann observed that these practices often caused more problems
than they solved, and so he set about developing a better, safer way to balance
the four humors. He reasoned that the body may be able to balance its own humors,
if given a sort of "kick start"
by administering a small dose of whatever poison or toxin was thought to cause
the imbalance. He called this the Law of Similars. The obvious problem was
that administering poisons and toxins would kill the patient, so he devised
a system of massively diluting the ingredients with water. Hahnemann claimed
that greater dilutions had greater effect in balancing bodily humors, and he
called this the Law of Infinitesimals. His dilutions were as high as 1 part
in 1030. This proportion is vastly larger than one grain of sand
in all the deserts and all the beaches and oceans on the Earth. He published
his theory in 1807, and homeopathy was born.
And then Hahnemann did a very subtle, a very clever, little thing. He made
up a word. The word he invented is allopathy. Allopathy is Hahnemann's
name for all evidence-based medical sciences. That's right: every medical discipline
you've ever heard of — including internal medicine, oncology, neurology,
cardiology, psychiatry, pathology, surgery, infectious disease, hematology,
geriatrics, gastroenterology, ophthalmology, radiology, orthopedics, nephrology,
urology, pharmacology, emergency medicine and critical care — they're
all simply allopathy. Allopathy is only one word, so it's no better than homeopathy.
They're equals. You have the musings of one guy 200 years ago on one hand,
and on the other you have everything medical science has taught hundreds of
thousands of researchers since then. Homeopathy vs. allopathy. It's nice to
be able to conveniently dismiss so much with just one word. This makes it possible
to offer the innocent patient Door A or Door B. Knowing nothing further about
either choice beyond its one-word name, the innocent victim will probably take
whichever the practitioner advises.
Homeopathy shares one very important component with most other alternative
medicine systems. It was developed a long time ago, by one man, during a time
when almost nothing useful or true was known about medicine, and it is rigidly
required to stay frozen in time with the same original ancient worldview. Homeopathy,
like other alternative medicine systems, does not, cannot, must not grow, evolve,
or improve as we learn more about the human body. If it did adapt to new knowledge,
it would cease to be homeopathy and would be something different.
This ability to include and adapt to new knowledge is the central strength
of modern medicine. When we learn new things about the body, when we find a
better way to treat a condition, we adapt. We publish the results and we train
doctors on the new techniques. Every day, the knowledge base that modern medicine
is built upon grows. The collective experience of researchers and doctors grows.
But for homeopathy, and other alternative medicine systems, the knowledge base
stays frozen in 1807. AIDS drugs, for example, are so much better now than
they were just ten years ago, and ten years from now, they'll be even better
(there may even be a cure). But with homeopathy, AIDS is treated the same way
that any unknown illness was treated in 1807: with a vial of water, possibly
containing a few molecules of some compound that are hoped might stimulate
a balance of bodily humors.
Dilutions of homeopathic products that are sold today usually range from 6X
to 30X. This is homeopathy's system for measuring the dilution, and it doesn't
mean 1 part in 6 or 1 part in 30. X represents the roman numeral 10. A 6X dilution
means one part in 106, or one in one million. A 30X dilution means
one part in 1030, or one followed by 30 zeros. A few products are
even marketed using the C scale, roman numeral 100. 30C is 10030.
That's a staggering number; it's 1 followed by 60 zeros, about the number of
atoms in our galaxy. In 1807, they knew more about mathematics and chemistry
than they did about medicine, and it was known that there is a maximum dilution
possible in chemistry. Some decades later it was learned that this proportion
is related to Avogadro's constant, about 6 × 1023. Beyond
this limit, where many of Hahnemann's dilutions lay, they are in fact no longer
dilutions but are chemically considered to be pure water. So Hahnemann designed
a workaround. Hahnemann thought that if a solution was agitated enough, the
water would retain a spiritual imprint of the original substance, and could
then be diluted without limit. The water is often added to sugar pills for
remedies designed to be taken in a pill form. So when you buy homeopathic pills
sold today, you're actually buying sugar, water, or alcohol that's "channeling"
(for lack of a better term) some described substance. The substance itself
no longer remains, except for a few millionth-part molecules in the lowest
Let's look again at Avogadro's number. 6 × 1023 atoms is
called a mole, a term any chemistry student is familiar with. How big is that
number? Well, if you had 500 sheets of paper, you'd have a stack about two
and a half inches high, like a ream that you'd buy at the stationery store.
If you had 6 × 1023 sheets of paper, your stack would reach
all the way from the Earth to the Sun. And not only that: it would reach that
distance four hundred million times. Think about that for a moment.
One sheet of paper, in a stack that's 400,000,000 times the distance from the
Earth to the Sun. That's a typical homeopathic dilution. Sounds pretty potent,
One explanation made by some homeopaths is that it works the same way as a
vaccine: putting a tiny amount of a disease-causing agent into the body — not
enough to cause the disease, but enough to stimulate the body's natural defenses
into fighting off that disease. Well, this is indeed the way a vaccine works,
but it's got nothing to do with the way Hahnemann defined homeopathy. Vaccines
are used to prevent an illness which does not yet exist in the body by triggering
the production of preventive antibodies; and homeopathy is used to fight a
disease already in the body, in which case any antibodies would already be
in production. The number of the antibodies triggered by a vaccine can be measured
in the bloodstream, whereas homeopathy is not intended to, and does not, produce
any measurable reaction. Vaccines insert inert versions of the disease-causing
agents into the body, where homeopathic substances are the same as that which
causes the disease. Finally and most obviously, vaccines contain a large and
fully measurable amount of active ingredient, whereas homeopathic remedies
contain no measurable active ingredient. So homeopathy can indeed be said to
work just like a vaccine; well, at least, it works just like a spiritual imprint
of a vaccine.
So why do so many people claim that it works, and swear by it? Homeopathy
has been tested over and over again, and though most studies show its effects
to be consistent with the placebo effect, a surprisingly large number of studies
do show that homeopathy produces results superior to a placebo. But in every
one of these cases, doubts have been raised about the quality of evidence in
the studies. According to the National Institutes of Health,
"Problems include weaknesses in design and/or reporting, choice of measuring
techniques, small numbers of participants, and difficulties in replicating
results." A favorite study of homeopaths is that of the British Medical
Journal in 1991, a meta-analysis of 107 controlled trials over a 25 year period.
The majority of the studies did show some positive results, and homeopaths
stop there. They stop short of the Journal's final conclusion, which was "At
the moment the evidence of clinical trials is positive but not sufficient to
draw definitive conclusions because most of the trials are of low methodological
quality and because of the unknown role of publication bias." If you need
the term "publication bias" translated, it means that the studies
showing positive results were conducted and/or published by the homeopathy
industry. The British Medical Journal went on to say "This indicates that
there is a legitimate case for further evaluation of homeopathy, but only by
means of well performed trials."
Well, good luck to you, gentlemen. The UK Society of Homeopaths has stated "It
has been established beyond doubt that the randomized controlled trial is not
a fitting research tool with which to test homeopathy." In other words,
homeopathy has given itself a Get Out of Jail Free card. Tests are
not adequate to test them. If you perform a clinical trial, and find that homeopathy
is no more effective than a placebo, the reason for the failure is that homeopathy
should not be tested. Claimed immunity from scientific scrutiny should stand
out as a huge red flag. When you hear anyone defend their claim by stating
that its effect cannot be detected through testing, be skeptical.
The upside of homeopathy is that it's not going to hurt anyone, since it lacks
any measurable active ingredients. And when treating conditions that are not
life threatening, like headaches or fatigue, there's no harm done. There is
massive harm done when practitioners or store owners recommend homeopathy as
a replacement for real medical treatment when a serious illness exists. Be
vigilant, and protect the health of your family, your friends, and yourself.
Cite this article:
Dunning, B. "Homeopathy: Pure Water or Pure Nonsense?" Skeptoid Podcast. Skeptoid Media,
22 Mar 2007. Web.
8 Feb 2016. <http://skeptoid.com/episodes/4034>
References & Further Reading
BBC. "Homoeopathy's benefit questioned." BBC News. BBC, 26 Aug. 2005. Web. 20 Mar. 2007. <http://news.bbc.co.uk/2/hi/health/4183916.stm>
Kleijnen J, Knipschild P. "Clinical trials of homoeopathy." British Medical Journal. 9 Feb. 1991, 302(6772): 316-23.
NCAHF. "NCAHF Position Paper on Homeopathy." National Council Against Health Fraud. The National Council Against Health Fraud, Inc., 1 Feb. 1994. Web. 22 Mar. 2007. <http://www.ncahf.org/pp/homeop.html>
Shang, A., Huwiler-Müntener, K., Nartley, L. "Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy." The Lancet. 27 Aug. 2005, Volume 366, Issue 9487: 726-732.
Singh S., Ernst E. Trick or treatment: the undeniable facts about alternative medicine. New York: W. W. Norton & Company, 2008. 91-144.