A case of ‘diminishing’ returns

Homeopathy doesn’t work. In fact, you are probably better off without it. This caveat comes from Australia’s National Health and Medicine Research Council (NHMRC), which last month declared homeopathy as utterly useless in treating ailments ranging from the common cold to malaria.

The reviewers didn’t get into the complex and rather futile debate over homeopathy’s slippery theoretical foundations which remain shaky to this day. Instead, they kept it simple by asking whether it really worked by analysing homeopathy in scientific settings. This approach, called evidence-based medicine, is now a popular method of inquiry into the sometimes absurd claims of alternative medicine.

Predictably, the finding has reignited verbal skirmishes between opposing camps. Respected British naysayers like Ben Goldacre and Edzard Ernst took the opportunity to denounce homeopathy as not only unscientific but also a con job pulled on gullible patients and helpless taxpayers alike.

Defenders of homeopathy were quick to slam the review as biased and flawed, arguing that 

randomised controlled trial, the gold standard in Western medicine, treats every human being as the same when it comes to treating any given ailment. This, they argue, contradicts the very individualised nature of homeopathic treatment.

This isn’t the first attempt by science to “expose” homeopathy. In August, 2005, British medical journal The Lancet published a cluster of studies damning homeopathy as no “better than a placebo”. However, the studies were later attacked by homeopathy supporters for being biased and lacking in rigour. Again, in 2010, a study by the British House of Commons rubbished homeopathy as quackery and even recommended that the National Health Scheme (NHS) stop funding it. The government though, decided against it as homeopathy had a large following.

Homeopathy gets under the skin of scientists not just because of its mass appeal but also because it flies in the face of scientific logic. It is founded on the belief that “like cures like” and that the more diluted the medicine (most homeopathic medicines are diluted 10 to the power 60 times in alcohol or distilled water), the more potent and effective it is. Now, this degree of dilution will render the original substance ethereal, leaving behind its “memory” or “essence”. That this ghostly presence cures the body of its many aberrations is pure bunkum, claim critics.

The maths needs to be perhaps further explained in a simple,succinct and lucid enough manner. At best, the “homeopathic remedies” are Placebos.Homeopathic products are made from minerals, botanical substances, and several other sources. If the original substance is soluble, one part is diluted with either nine or ninety-nine parts of distilled water and/or alcohol and shaken vigorously (succussed); if insoluble, it is finely ground and pulverized in similar proportions with powdered lactose (milk sugar). One part of the diluted medicine is then further diluted, and the process is repeated until the desired concentration is reached. Dilutions of 1 to 10 are designated by the Roman numeral X (1X = 1/10, 3X = 1/1,000, 6X = 1/1,000,000). Similarly, dilutions of 1 to 100 are designated by the Roman numeral C (1C = 1/100, 3C = 1/1,000,000, and so on). Most remedies today range from 6X to 30X, but products of 30C or more are marketed.

A 30X dilution means that the original substance has been diluted 1,000,000,000,000,000,000,000,000,000,000 times.  

Patrons of homeopathy do concede that it is counter-intuitive. To make sense of it, they grasp at any proverbial straw, such as nanoparticles, or the sheer complexity of the healing process that can’t be reduced, as modern medicine does, to a linear “A cures B” formula. Nonetheless, what matters is that it works for many. As British novelist Jeanette Winterson wrote in The Guardian, “Where is the scientific sense in saying that because we don’t understand something, even though we can discern its effects, we have to ignore it, scorn it, or suppress it?”

The scientific critique of homeopathy seems a tad tiresome now with both sides recycling the same old arguments. A more fascinating conundrum to mull over is how is it that millions of people put their money in something they believe works for them but which science trashes as bogus. No ready or simple answers there. However, authors of the present review believe that their findings will at least provoke people into thinking about medical evidence, and help them judge better. Wishful thinking, given the growing public disillusionment with modern medicine.

For now, homeopathy seems to be winning. It is reportedly the fastest growing medicine in the world today, and by 2035, its projected worth would be about US $1.1 trillion. In India alone, there are half-a-million registered homeopaths catering to 100 million patients. To paraphrase Mark Twain, reports of homeopathy’s death have been greatly exaggerated.

Time after time, properly conducted scientific studies have proved that homeopathic remedies work no better than simple placebos. So why do so many sensible people swear by them? And why do homeopaths believe they are victims of a smear campaign? DOWN TO EARTH