Deconstructing Homeopathy: An Indian perspective

In January this year, sceptics from many cities in the UK, Australia, New Zealand, Canada and the USstaged a stunt where 300 people took large overdoses of homeopathic remedies. Their aim was to demonstrate that homeopathic remedies are nothing but sugar pills and as expected, no volunteer was killed or injured. As 62% of all Indians believe in homeopathy and with that number growing, it is high time that the country begins to understand the science behind homeopathy and the dangers of blindly believing in its claims.

Let’s consider how a homeopathic remedy to treat common cold is made. Homeopaths follow the ‘like cures like’ principle, according to which one must find something that causes the symptoms of common cold like running nose and watery eyes. It is known that onion juice can. So a drop of onion juice is taken and diluted 100 times by adding 100 drops of water. It is then shaken. But that dilution is not enough because homeopaths believe in another principle: ‘the higher the dilution, the higher the potency’, thus one drop of that solution is taken and another 100 drops of water are added to it, followed by more shaking. This is repeated at least 30 times to give the final remedy. At this level of dilution, the chance of finding Barack Obama sitting in your living room is higher than the chance of finding a single molecule of onion juice in that homeopathic remedy. (See BBC documentary to know more)

There have been serious concerns about the validity of homeopathic principles in the mainstream medical community. They lack any scientific evidence and are in complete contrast to the body of knowledge that is traditional medicine. Such highly diluted solutions, which don’t contain even a single molecule of the active ingredient, also make it possible for homeopaths to claim that their remedies have no side effects. Also according to the ‘like cures like’ principle, as stated before, the same homeopathic remedy used to treat stress can simply be used to treat a brain tumour. After all, both conditions cause a headache and the homeopathic remedy for both would simply consist of a highly diluted solution of something that causes a headache.

Many patients who receive homeopathic treatment say that it works for them and it would be wrong to claim that they are lying. Positive effects of homeopathy are merely caused by something called the ‘placebo effect’. A placebo is a medication with no active ingredients in it. The best examples of the placebo effect are observed when two dummy treatments are compared with each other. If one sham treatment works better than the other then it must be simply because people are expecting it to work. For example, a study showed that four sugar pills a day are better at reducing pain than two but more invasive treatment, like a salt-water injection, is even better. In another study patients reported that a red pill was better at treating pain than a white one, even though both were inert.

Homeopathy ‘works’ because of the placebo effect. It doesn’t matter if you are a sceptic, a baby or an animal – if people around you expect the treatment to work, it is more likely to. Sometimes ignorance of important symptoms which need timely attention can give homeopathy credence. This ignorance often makes people wait to see the doctor until their illness is at its worst. At this point a homeopathic remedy is prescribed to the patient. Once the worst is over, the immune system becomes capable of combating the disease and healing begins. But unfortunately, the natural process of healing is often then attributed to homeopathy.

When a homeopathic treatment does not lead to a cure, people tend to blame either their condition or their fate, but still continue to rely blindly on homeopathy. The belief in homeopathy is also perpetuated by India’s unregulated pharmaceutical market which makes it easy to buy medicines across the counter without a physician’s prescription. As a result, people often take the wrong medication and blame the ineffectiveness on mainstream medicine. This tendency generates an undesirable bias towards homeopathy.

One might question that if homoeopathic remedies work (by placebo effect or by self-healing) then surely there is nothing “wrong” in prescribing them? Ethically speaking, it is not wrong to use homeopathic remedies to treat minor illnesses such as common cold or a headache. But it can be exceedingly dangerous, as WHO warned recently, when homeopathy claims to be able to treat serious medical conditions such ascancerswine fluAIDS, TB, or malaria.

Furthermore, there can be serious consequences when homeopathy becomes enshrined in mainstream medical policy. In Punjab, for instance a state-wide program is being implemented that uses homeopathic treatment to ‘cure’ pregnant mothers of the need for a C-section during child birth. Incidences like these makes one wonder how many mothers will die and if they do, whether the homeopaths will ever be held to account.

The scientific community has, for decades, systematically refuted every claim that homeopathy makes and yet millions of people in India still believe in it. Government funds itministers support itmore colleges are built and more homeopaths walk amongst us year on year. Some say this broad public support for homeopathy remains because the scientific community is unable to communicate this to the people or it comes from a general disdain for “western” medicine.

Further Information:
  1. BBC Horizon documentary
  2. Sense about Homeopathy: A Sense about Science publication
  3. Homeopathic treatment for Ovarian Cysts
  4. Prasad, R. The Lancet, 2007, 370, 1679
  5. Samarasekera, U. The Lancet, 2007, 370, 1677

How a Homeopath tried to understand the science behind Homeopathy

At Café Scientifique, last night, I heard Dr. Stephen Cartwright speak on ‘Homeopathy – Dispelling myths and establishing facts’. I had never been to one of these CafeSci evenings, but going from the description, I was hoping there will be many who will be interested in hard scientific facts and theories. Even then, I took a print of the Sense about Homeopathy poster published by Sense about Science, just in case anyone might be interested in knowing more about it later. But within the first few minutes of the talk, I knew I would not need it.

Dr. Stephen Cartwright, is a molecular biologist who, with support from private donations, started researching homeopathy in 2009. Prior to that he trained and setup his own business as a homeopath in Oxford in 1988. Last night, he began his talk with a story about how he first got into homeopathy, and that is when I neatly folded my Sense about Homeopathy poster and put it in my bag.

In 1984, he visited a homeopath, out of curiosity. After talking to the homeopath, he was prescribed some pills which he happily took; only to develop symptoms of sinus within 24 hours. That intrigued him and he took up the study of homeopathy.

‘After 20 years of practising homeopathy, I really wanted to understand the chemistry behind these remedies and that’s why I have put a lot of thought and came up with some experiments to gain some insight. He continued, ‘I will have to delve into some chemistry, please forgive the jargon.’ He goes onto explain his experiments. ‘It is well known’, he says, ‘that homeopathic potencies are affected by sunlight and magnets’ and thus of all the analytical techniques that man has invented to understand the chemistry of atoms he could only use was visible light spectroscopy.

Some definitions before we proceed; succussion means vigorous shaking of a diluted homeopathic preparation in order to activate the medicinal substance; potency is the dilution factor and in homeopathy, a solution that is more dilute has a higher potency.

Panacea? (Image: The Guardian)

Process: In a special cuvette, he mixes a drop of his potencies with 90% ethanol and measures absorption against a control. Control that he uses is non-succussed water, because homeopaths accept that water that has not been methodically shaken does not have any homeopathic remedy in it. The potencies which could be of various dilutions contain a poly substituted phenol. ‘More details cannot be divulged as it is a patentable finding’, he says.

Observations: With an increase in potency (increase in dilution) he sees increase in the absorbance. Different remedies give different absolute absorbance but same trend. The trend is not linear and because he hasn’t done enough experiments he is unable to calculate the trend. Also, a similar trend is observed with an increase in the succussion of a particular potency used. ‘Quite strange’, he admits.

Additional experiments: ‘Why’, he thought, ‘is it that all homeopathic remedies are made in ethanol?’ He did the same tests with 30 different alcohols instead of the potency and found that the trend was found to be exactly same in case 2,4-pentane diol. What does that mean? Now he goes a step further on his claims and makes another theory to explain this phenomenon, ‘2,4 pentane diol is like two ethanol molecules back to back, thus the potencies might be in some way ordering the ethanol molecules to arrange themselves to form something like 2,4-pentane diol.’

Wow! A Nobel Prize deserving discovery, why hasn’t he published it? Oh wait, there is a problem.

Problem: Results are not reproducible because too many factors affect his experiments, factors like time of the day, place in the lab, how many times was the potency shaken, etc. He also observed that when very rarely he has managed to have all the factors in control, he found that on somedays he got the result and on somedays he did not. So how to explain another strange pheonomenon? Of course, another theory. He hypothesises that there is an oscillation in the potency. On somedays it shows effects and on somedays it does not.

On clinical trials he says, ‘These oscillations are the reason why clinical trials fail. Homeopathic remedies behave in strange ways and these clinical trials don’t take that into consideration. Obviously, the results will never be as predicted.’

On expiry date he says, ‘Homeopathic remedies have no expiry date. On occasions, I have found 20 year old medicines are as active as one’s made today.’

Alternative medicine (Image: Chicagoland Homeopathy)

On future scope he says, ‘Homeopathy has been here for over 200 years. 40% of all prescriptions in India are homeopathic prescriptions. There is huge market for homeopathy but because it behaves in these strange ways we need new assays to test these remedies. The demand for these assays is urgent and the inventor will make a lot of money.’

At the end he quotes Sir Arthur Conan Doyle, who he claims based the character of Sherlock Holmes on a homeopath, “Once you eliminate the impossible, whatever remains, no matter how improbable, must be the truth.”

Enough of the talk, let’s move on to question answers. I’ll enlist the ones I remember.

Q: When you went to the homeopath in 1984, what problem did you have?

A: Nothing, I was quite healthy. Huh? Then why were you prescribed pills? Oh that! You see in talking to him for over an hour, I realised there were so many things that were wrong with me.

Q: What are your thoughts about the claim that water has memory?

A: Perhaps, I don’t know, there has to be some way to explain this strange phenomenon. May be it is true.

Q: Were the oscillations random or regular like a sinusoidal wave?

A: As far as I know, they were regular. Doesn’t that mean that you can then time clinical trials on the days you know the remedy will have a cure!!

Q: Considering that the potency is shaken in 90% ethanol and your claim that with more shaking you observe more absorbance. Is it possible that ethanol is simply dissolving glass or some impurities that are present in glass?

A: I am not aware of it. We take care that the glass used is clean. Of course you do. Did we doubt that? We were talking about dissolving glass or the impurities that get embedded in glass during the manufacturing process.

Q: If homeopathy is so widely used, why hasn’t homeopathy come up with new potencies?

A: Of course we have, you will be able to find potencies of tetracyclines. But te

tracyclines are compounds made to combat disease. Making potencies that way is against the homeopathic principles, right? Homeopaths make potencies of things that cause the disease, right? Oh yes, we make potencies of tetracyclines to combat the side-effects produce by this drug.

Q: This room has many chemists today, including myself and we would to know if you would be willing to share your spectral data with us to let us analyse them?

A: Yes, I’d be willing to that. I am happy to collaborate. Surely, it will be better if you do this before you face the peer-review process.

Q: You have said that you have not published any of this research. But clearly these results have use for homeopaths, have you shared the information with them yet?

A: Not yet. I believe in coming up with a working hypothesis before I do that.

Q: Have you presented your results at a conference?

A: No I do not have money to do that. It is very difficult to find funding because of the fickle nature of the results I’ve obtained. But I will some day. That’s why I give talks at places like these. I came here hoping to be asked intelligent questions, of which there were none, so that I am able to hone my skills of defending my case of homeopathy.

It surprised me that in the many questions asked, no one ever brought the placebo effect into the conversation. It may be because even without that weapon he wasn’t able to come up with convincing answers for the audience. The last question he was asked is the best conclusion I could have asked for to conclude my blog post.

Q for the audience: Will people who have changed their minds about homeopathy after today’s talk, for the better or worse, please raise their hands?

3 out of about 30 raise their hands. The old man who asked this question says, ‘There, Dr. Cartwright, that was a predictable and I dare say, reproducible result.’