Homeopathy
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[edit] Definition
Homeopathy is best viewed as a number of related forms of sympathetic magic that are also known as "alternative medicine" that derive from the work of Dr. Samuel Hahnemann (1755-1843). Widely accepted principles include "Similia similibus curentur” (let likes be cured by likes), and the "law of infinitesimals."
[edit] Origins
Although homeopathy has clearly been influenced by other people, homeopathy is usually credited to Samuel Hahnemann. The normal story is that Hahnemann formulated the principle of like cures like after testing the effect of Cinchona bark (then used as a treatment for malaria) on himself. His claim was that it should produce the symptoms of malaria if taken by a healthy person. It has been suggested that the results of Hahnemann's experiments were due to him having an allergy to quinine.[1]
[edit] Potencies
There are a number of potencies that are used by homeopaths. X and D mean diluted by a factor of ten each time so 5X and 5D mean diluted by a factor of 100000. C means diluted by a factor of 100 each time so 3C means diluted by a factor of 1000000. LM means diluted by a factor of 50,000 each time so LM2 means diluted by a factor of 2500000000. The situation with LM remedies is further complicated by the practice of using 3C remedies as a starting material rather than the mother tincture.
Finally there are the so called K potencies which are made by repeatedly emptying and refilling the same flask. Homeopaths normally treat these as being broadly equivalent to C potencies.
[edit] Discussion
Despite no evidence for its effectiveness beyond the placebo effect, it is still often used by many practitioners to deceive people (and in the vast majority of cases themselves as well) by promising that it can offer an effective treatment for illnesses.
Because matter isn't infinitely divisible, remedies above a certain potency will have on average less than one atom/molecule per dose. The potencies at which this happens are approximately 24X and 12C.
The calculation for these numbers follows:
- Number of atoms/molecules in initial solution = 6.02214199×1023 assuming 1 litre 1M solution.
- 24X and 12C both mean diluted by a factor of 1024.
The following division 
gives us a value of 0.602.
While the exact value at which a remedy will fall below 1 atom per dose varies, even the strongest starting solution would not require us to go beyond 25X or 13C assuming a massive one litre dose. In practice there is no known chemical that is physiologically active at anything near these dilutions.
If we start with a 1 molar solution then the homeopathic dilutions for various potencies result in:
12C 1 atom per 1 2/3 liters
17C 1 atom per 16 cubic kilometers
34C 1 atom per 49.6 cubic AU (at its most distant pluto is 49.3 AU from the sun)
41C 1 atom per 19.6 cubic lightyears
[edit] Magical Beliefs
The basis of homeopathy is effectively sympathetic magic, the idea that like affects like. In this case the magicality is transmitted by an unerasable taint, whereby something, in this case a solvent, that has been 'touched' by something else bears the mark of that touch permanently. This has been called Contagious Magic. If one lacked any realisation of the atomic theory of matter then it might have been tenable that a solution could be diluted indefinitely without losing evidence of that original touch. However, atomic theory is a well-established fact and contradicts this magical belief.
However, science is not the only enemy of homeopathy. Its own internal contradictions destroy it from within. If the 'touch' of an agent dissolved in a solution can never be removed then there is no way for the solution to 'know' which agent's action to potentise. No solvent is pure and even trivial contaminants in the solvent will rapidly outweigh the supposed influence of the remedy material.
Other homeopathic ideas make the inherently magical nature of homeopathy more explicit. One such idea is "grafting". This is the transfer of remedy power from one previously activated tablet to a set of blank tablets added to the same bottle. Homeopaths have no useful answer to the question of why any homeopathic pharmacy can legitimately stay in business if tablets can be created endlessly given a single one as an initial seed. Grafting is also supposed to be able to influence the contents of adjacent bottles. No explanation is available to explain why a box of homeopathic remedies does not end up as a hopeless jumble.
[edit] Internal Contradictions (or Reductio ad Absurdum)
One of the greatest problems homeopathy has is that if its tenets are taken literally and if the accounts of its practitioners are taken at face value then it falls apart in a mass of logical inconsistencies and conflicting versions. The logical inconsistencies can have the force of a reductio ad absurdum disproof of homeopathy. The conflicts among practitioners cover a number of areas and for many of them the opinions form an incompatible dichotomy so that if one group is correct then the other group absolutely cannot be, though it is more likely given what else we know that neither group is correct.
An example of the "Two Schools of Thought" problem is the belief that airport X-ray scanners inactivate remedies. Yet some homeopaths believe this not to be the case. Both sides continue to claim successful treatment, while never wondering about the veracity of the other.
[edit] The Problem of Evidence
The principle evidence-base of homeopathy is the case records of individual patients. These are interpreted on the basis that all changes in the patient that occur after a remedy has been taken are caused by that remedy. This includes both improvements, deteriorations (called "aggravations"), and changes in the range of symptoms shown. This means that from within the belief system, homeopathy is unfalsifiable. Its tools have been described as a narrative method that accompanies all eventualities with a story to explain those changes in homeopathic terms. Less generously homeopathy has been described as less a system of medicine and more a set of excuses.
However, viewed from outside, homeopathy is most certainly falsifiable by the application of properly controlled trial methods. Homeopaths try to defend their art from this scrutiny by claiming it is outside the scope of objective methods, but their defence usually invokes a straw-man of bad trial design. In reality, all the supposedly special features of homeopathy can be accommodated in a controlled trial with great ease. The main criterion is that remedy selection should be individualised. This can be allowed for, but rather calls into question the tendency of homeopaths to prescribe from a very narrow range of remedies for many common problems. It is unreasonable to claim the need for individualisation invalidates a number of earlier trials while at the same time continuing to prescribe the same remedy time and again for common problems, e.g. Arnica for acute injury.
[edit] "Provings"
Related to the problem of evidence in its therapeutic use is the coundrum of the homeopathic "proving". This is the basic tool by which a homeopathic remedy has its range of effect defined. In a proving, a remedy in its over-diluted form is given to healthy volunteers. They then record every physical feeling and every change in mental state that they have the time and energy to enumerate. These are regarded axiomatically as being entirely the responsibility of the remedy. The "Master prover" collates the symptoms according to a scheme they have previously decided upon. Placebos are included in provings, but they are not employed in the strict way that a properly controlled trial would require. The volunteers may or may not be aware of what they are taking. The Master Prover is certainly not blinded and can pick and choose symptoms to ascribe to the remedy according to their whim. No properly controlled proving has ever reported positive results for a remedy versus placebo.
[edit] Testing
There have been a number of tests on homeopathy over the years
Recently there has been a number of tests involving basophils (a kind of blood cell involved in allergic reactions). this was triggered by the work of Benveniste who reported that that the basophils became more effective when diluted beyond the point where there should have been any reaction.
In 1988, Benveniste went to the journal Nature to publish his results. Nature agreed, as long as they could come inspect Benveniste's lab. Benveniste agreed, and his results were published in one of the most prestigious science magazines in the world. The news spread far and wide, and Benveniste became a celebrity.
But when Nature examined his lab, things went sour for Benveniste. John Maddox, then editor of Nature, arrived to observe the testing, bringing with him Walter Stewart and James Randi. Benveniste's people repeated the experiment, and Maddox and Randi saw the positive results with their own eyes. But Maddox noticed that the experiment wasn't double-blinded; the experimenters knew which tubes had the dilution and which were just plain water.
Maddox and Randi came up with a secret code with which to label the tubes, which they had sealed inside an envelope and stuck to the ceiling of the laboratory before the basophil runs were done. This ensured that none of the experimenters running the basophil tests knew which was the homeopathic solution and which was distilled water. It also ensured that no-one could change the coding between the beginning of the experiment and the analysis of the results.
When the experiment was complete, it was time to open the envelope and examine the results. Benveniste and his team were very confident that the results would confirm their findings, but when the results were compared to which tubes were which, the distribution was exactly what one would expect by random chance. Maddox and Randi wrote a report accusing Benveniste of doing bad science and calling homeopathy a "delusion."
[edit] U.S. product labelling requirements
There are other kinds of ingestible products, such as herbal remedies, which have not passed the rigorous FDA trials required for true pharmaceuticals but which nevertheless purport to affect the ingestor's health. A 1994 U.S. law called DSHEA requires these products to carry the following warning on their packaging:
- These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.
Homeopathic remedies, however, are exempt from this FDA labelling requirements. So, while zinc lozenges claiming to alleviate the common cold must carry the above warning label, the same amount of zinc sold as "Zincum 1X" need carry no such warning label. Caveat emptor.
[edit] Quotations
- "According to Complementary Healthcare: A Guide for Patients, published by the Prince of Wales Foundation for Integrated Health, 'the basic principle of homeopathy is "like cures like"'. Perhaps any homeopaths out there needing treatment for gunshot wounds would like me to test that particular theory.
- Hang on, though. The guide says homeopathy is used to treat conditions like asthma, eczema, arthritis, ME, migraine, menstrual problems, IBS, allergies, depression and anxiety - so it must be good. The fact that it's so useful in managing pathologies characterised by spontaneous remission and a high placebo response is obviously just a coincidence.
- Frankly, I'll only come over all integrated when it's shown to be effective for infarcts, cataracts or atrial fibrillation.
- For those who persist in claiming 'there must be something in it', I have some bad news. There isn't. It's just water. It might start as a tincture of gingko biloba, but it goes through so many dilutions that the final remedy has no active ingredients other than some mystical 'echo' of the original recipe.
- I don't know what's more infuriating: the fact that apparently sentient beings can buy into this shamanism, or that homeopaths have perfected the miracle of turning water in to money."
- Dr Tony Copperfield, Doctor Magazine (UK), 12th July 2005
- "It has been established beyond doubt and accepted by many researchers, that the placebo-controlled randomised controlled trial is not a fitting research tool with which to test homeopathy"
- A spokeswoman from the Society of Homeopaths responding to a report in The Lancet that homeopathy is no better than a placebo[2]
[edit] Related Topics
[edit] Links and references
- BBC Horizon episode on Homeopathy - Link includes Q&A, an interview with James Randi, and a transcript of the episode.
- Homeopathic practices risk lives - BBC report.
[edit] Comments
For all contributors:
- Try to keep the "Definition" as straight and encyclopaedic in style as possible. Use the "Discussion" section for editorialising
- Use the references section for footnotes to books and other sources
