Does homeopathy work?
A personal view from Ivan
When I told a friend that I was going to write a blogpost addressing that knotty question, he suggested I might want to reconsider.
When I asked why, he told me that, if I went ahead, I should be prepared to lose a substantial section of our subscribers. He explained people have strong views on homeopathy and they don’t like to have them to be challenged.
Now, I may be naïve, but I like to think our readers and subscribers are a pretty intelligent lot.
I’m a simple sort of chap but I know that if facts are presented to me that challenge my beliefs, then, I am happy to examine those facts to the best of my ability and, if they show what I had believed up until that point had been incorrect, I change my belief. Isn’t that, after all, how humans have made progress throughout history – particularly over the last 100 years or so?
I’m guessing, if you’re reading this, you probably adopt a similar approach (even though I’d never dream of describing you as a ‘simple sort of chap’). I hope so. If not, then I’ll be sorry to see you prove my friend right.
Anyway, back to the question at hand – does homeopathy work? And this is where my friend pops up again. He told me a single blogpost was not the way to answer that question. Rather tartly, I told him that he was right – the question could be answered, not in a single blogpost, but in a single word!
I’m not going to do that though – it would hardly be fair and reasonable. So, instead, I may deal with the question over the course of more than one post – whether this spills over into other posts and how many depends upon how steamed up I get about this issue
So, before we go on to examine the question of does homeopathy work, we should perhaps explain what we are not addressing. Many people still see homeopathy and herbal medicine as one and the same thing. They are not. Homeopathy is as far removed from herbal medicine as it is from standard western medicine.
So, how, exactly, is homeopathy supposed to work?
So what is the basic principle on which homeopathy is based? According to the British Homeopathic Association’s website ‘Homeopathy is based on the principle that ‘like cures like’ – in other words, a substance taken in small amounts will cure the same symptoms it causes if it was taken in large amounts. ‘
An interesting assertion, I’m sure you’ll agree. So, what is the basis for that assertion on which all of homeopathy stands? It seems that in the late 18th century, a doctor by the name of Samuel Hahnemann simply dreamt it up. OK, scratch ‘dreamt it up’ and substitute ‘posited the theory’ that this was the case and then set out to prove (using ‘prove’ in it’s modern sense rather than it’s original meaning of ‘test’) the theory.
In fact, while we’re talking about it, ‘proving’ means something very specific to a homeopath and I may well touch on that in a later post.
Back to Hahnemann. What he was saying was that, if a certain substance given to a healthy person caused a particular type of reaction or symptoms, then someone already suffering those symptoms (and note, we’re talking symptoms, not the cause of the symptoms) could be treated with a very dilute solution of the thing that caused those symptoms in the healthy person.
With me so far? So, in simple terms, if a substance caused violent stomach pains and vomiting in a healthy person, then a person who was already suffering violent stomach pains and vomiting could be cured by taking a small amount of that substance.
Ok, the British Homeopathic Association talk of taking the substance in small amounts – exactly how small do we mean?
This is where things start to get really rather interesting. We are talking very, very small indeed. You will often see homeopathic remedies sold at 30C dilution – in other words, diluted at the rate of one part in a hundred, thirty times over.
Now, for the avoidance of any doubt, that is not the same as saying one part in thirty times one hundred, or, in other words, one part in 3,000.
For the sake of this explanation, let us assume that one part equals 1ml. A 30C dilution requires 1ml to be added to 99mls of water. Then 1ml of the resultant solution to be added to 99mls of water. Then 1ml of that resultant solution to be added to 99mls of water… and so on, until that process has been repeated 30 times over.
In other words, we end up with a solution that’s diluted to the point that there is one part of the active ingredient per 1,000,000,000,000,000,000,000,000,000,000,000,000,
000,000,000,000,000,000,000,000 – to save you counting, that’s a 1 with 60 zeros after.
Imagine a sphere of water with a diameter of 150 million kilometres
Now, if you’re anything like me, you’ll look at a massive number like that and just glaze over. That’s why I’m grateful to Ben Goldacre for putting it in terms I can understand in his excellent book Bad Science. Before I go on to quote what Goldacre has to say, please note that, rather than using 1ml as his base unit, he uses 1 molecule (which, even I know, is way, way smaller).
Anyway, here’s what he has to say:
‘For perspective, there are only around 100,000,000,000,000,000,000,
000,000,000,000 molecules of water in an Olympic-sized swimming pool. Imagine a sphere of water with a diameter of 150 million kilometres (the distance from the earth to the sun). It takes light eight minutes to travel that distance. Picture a sphere of water that size, with one molecule of a substance in it: that’s a 30c dilution.*
*For pedants, it’s a 30.89C dilution’
Now, do bear in mind that homeopathic remedies are often sold in much more dilute forms – 200C is not uncommon. Goldacre goes on to point out that, at a dilution of only 55C, 1 molecule of the active ingredient would need sufficient water to fill the entire universe.
No matter. In fact, homeopaths contend that the more dilute the solution, the more potent the remedy – more of that later.
Now, even the most basic understanding of chemistry will tell you that, way before we approach the 30C dilution, there is none of the active ingredient left. Only water.
So, all that a homeopathic remedy is is water, dropped onto a sugar pill? Not according to the homeopaths.
You see, what I haven’t told you is that the dilution is done following very strict rules, which, it seems, makes all the difference.
Between each dilution, the substance is subjected to succussion. ‘Su-who?’ I didn’t know what it was either, until I looked it up.
Succussion is a process whereby, with each dilution, the container holding the solution is tapped ten times against a firm surface.
Thank heavens for succussion! Otherwise I’d have had to conclude that the 1.5billion Euros market (source: Homeopathy World Community website ) was founded on conning people into buying things that contained absolutely none of what it said on the pack. (Sorry, I let my mask of impartiality slip there momentarily)
So, back to this succussion. It seems that by following this particular process, something amazing happens to the water. It is actually able to compensate for the fact that there is no longer a single molecule of the active ingredient by ‘remembering’ its effect. That’s right – the water develops a memory.
Now, let’s be clear here – and I am again indebted to Ben Goldacre for his valiant attempt to bridge some of the canyon-like gaps in my knowledge. It seems physicists have discovered that
‘water molecules will form structures around a molecule dissolved in them at room temperature, the everyday random motion of water molecules means that these structures are very short-lived, with lifetimes measured in picoseconds, or even less.’
In other words, water has a memory even worse than mine. And, as a side note, shouldn’t we all be grateful for that. Water, after all, has had lots of other stuff floating about in it before it reached the homeopath’s bench – a lot of it nowhere near as palatable as the supposed active ingredient.
So, having diluted and succussed, diluted and succussed and so on, 30 times over, what then happens? Well, I’ve already alluded to it. A drop of the ‘solution’ (I put ‘solution’ in inverted commas as, by now, it’s just water) is placed on a sugar pill, whence, no doubt, it evaporates.
So let’s just go over that again. The more dilute the solution, the more potent; the solution works because the water has a memory of the molecules it no longer contains; the water with the memory evaporates from the sugar pill.
You know, the more I look at it, the more I’m amazed there’s a controversy here.
Now, I may have been a little unfair in singling Hahnemann out as a quack. In all probability he meant well and it also seems highly likely that he killed far fewer of his patients than his contemporary colleagues – being given a harmless sugar pill as opposed to being subjected to blood-letting with dirty instruments would surely have led to him having a higher patient survival rate.
But that does not mean his methods work. The human body is an evolutionary miracle, and has a most wondrous ability to recover from an incredible variety of illness and injury, given time (and protected from the heavy and, most likely, infectious hand of the 18th century surgeon) and that, coupled with the placebo effect, is in all probability, what happened. Fortunately for Hahnemann’s patients, there have been very few deaths caused by a sugar pill.
But here we get to the really serious stuff. If this were just about some misguided wealthy westerners with more money than sense deciding to toddle off to hand loads of cash over to their homeopath for something that contains precisely none of what they’re paying for because they feel a ‘bit out of sorts’, then my collar would not be feeling quite as tight as it is right now.
But we have real people, suffering real and life threatening illnesses, for which standard medicine has proper, thoroughly tested treatments that work, being advised by homeopaths to eschew that life-saving treatment until it is too late. They will even claim that the patient’s symptoms worsening is evidence of the treatment working.
Worse, some are even attempting to introduce homeopathy to third world countries where disease, including HIV AIDS, is rife. There really can be no excuse for that. Let them waste their own money, by all means, but it is not for well-meaning but ill-informed wealthy westerners to deny proper treatment to those who really need it and offer sugar pills instead.
It seems both I and my friend were right. On the one hand, I could have answered the question, ‘does homeopathy work?’ with one word; on the other, it’s too big a question for just one blog post.
We haven’t even begun to consider the placebo effect, ‘proving’, or the need for proper trials (or, indeed, the spurious evidence often cited). Perhaps, if we still have any readers and subscribers left, I’ll deal with that in another post.
In the meantime, in an attempt to lighten the mood, the arch skeptic and debunker of myths, James Randi ended a talk recently with an announcement of the sad news of a homeopathic patient who had died of an overdose. It seems he forgot to take his pill!
The final word – for now
It seems only fair, though, to let a homeopath have the final word, so here’s a video from Dr Charlene Werner. You’ll notice it’s categorized under Science and Technology and you’ll see in the footnote to the video that a chemistry background is helpful. I’m going to stick my neck out here and say, if you’ve come this far with me, you’re going to be just fine.
We’ll be back soon,