Does homeopathy really work or not?

There are two questions here, one being whether homeopathic medicines and treatments produce clinical benefits for patients, but the other being whether patients feel better after having been treated by such medicines and treatments. This may sound like two ways of saying the same thing, but it is not. I am quite prepared to give a “No” answer to the first question but a “Yes” answer to the second.

What is homeopathy?

If we examine the clinical claims of homeopathy, they do indeed sound extraordinary. Working on the “hair of the dog” principle (that to cure a hangover you need to drink a small quantity of what it was that made you drunk in the first place), homeopathic medicines consist of highly diluted doses of the substance that may have caused your disease.

The principle is known by homeopaths as “like cures like”. In itself, this sounds highly unlikely, but the degree of dilution is so extreme that it becomes very hard to believe that the substance in question can have any effect on the body at all. Indeed, some of the claims of dilution would require a single molecule of a substance to be surrounded by more atoms than exist in the entire Universe!

On the face of it, this sounds to be nothing short of absurd. How could a treatment prepared on this basis (if it were indeed possible to create such a medicine, which is clearly not the case) have any effect at all? But that is not the whole story. What turns a dilution into a homeopathic remedy is another principle of homeopathy, namely that “water remembers”. The fact that the water you ingest has been in contact with the active substance is what gives rise to the cure. This is an enormous claim, especially when you consider that water gets around a lot, and the water that comprises my cup of coffee has been drunk and excreted countless times before, and been in contact with any number of substances, both benign and not. Just which of those millions of memories is supposed to effect my cure?

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It gets even more ridiculous than that!

We must not forget “succussion” either. A homeopathic medicine only acquires its power if it undergoes a process that involves the vessel containing the remedy being struck ten times against “a hard but elastic object”. This practice goes back to the founder of homeopathy, the 18th century German doctor Samuel Hahnemann, and is still at the heart of homeopathy today. Without the ten strikes, the remedy does not work.

So, if you ask yourself how homeopathy can work, in purely clinical terms, the answer must surely be that it cannot. Nothing is being done to the body that can possibly have any effect on it whatsoever.

If it works, what is going on?

Countless people claim to have had their illnesses cured by homeopathy, and it would be perverse to claim that they must all be either lying or deceiving themselves. I am quite prepared to accept what they say. However, I do not believe that it is the physical nature of the treatment that is doing the trick as much as the psychological effect of actually being treated.

The psychology of “mind over matter” takes many different forms. Many fascinating studies have been performed over the years into the “placebo effect”, namely how a patient’s condition is improved when they believe that they are being treated with real medicine when it is in fact only a harmless sugar pill (or equivalent) that they are being given. It has also been shown, for example, that when the same pills are packed in plain boxes and in colourful ones with brand names all over them, the latter produce better results.

Proper clinical trials, carried out with all necessary precautions by independent scientific institutes, have shown consistently that homeopathic remedies perform no better than placebos, but that is not the same as saying that they are entirely useless, because placebos often work remarkably well.

Don’t discount placebos

Medical practitioners have always known that a patient with a positive attitude towards their condition will often do better than someone who is pessimistic, whatever treatment is offered. Doctors know that the time spent talking with a patient and discussing their illness is frequently more effective than any medicine that is prescribed. They also know that when a patient insists on leaving with a prescription in their hands, it is usually better to give in to their demand, because if someone really believes that a medicine is what they need, then even a box of sugar pills will be better than nothing.

One problem with the health system, at least in the United Kingdom, is that regular medical practitioners cannot give as much time to their patients as they would like, with seven minutes being the average time of a consultation. However, people working in alternative medicine, such as homeopaths, are free to give as much time as they want to discussing a patient’s needs, going into their family background, social circumstances, medical history, and much more besides. All this focused attention on the patient is far more effective, psychologically, than any pill that is prescribed.

Another factor, hinted at above, is the self-belief of the patient. Very often, a patient goes to a homeopath after having been, as they see it, let down by conventional medicine. The homeopath is not seen as the last hope, but as a beacon of hope. The patient wants the treatment to work; they are, after all, paying good money for this consultation, and most people do not throw good money after bad by spending it on causes that are lost from the start. Many first visits to a homeopath come after a recommendation by a friend who reports good results; this again is likely to inspire hope and a positive attitude.

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(Some people are in no doubt about the issue!)

Can homeopathy always be trusted?

Homeopathy does not always work, and I would personally be very reluctant to trust a serious condition to homeopathic treatment. Although “miracle cures” are sometimes reported, it must be remembered that “miracles” do sometimes happen and, by definition, the cause of a miracle cannot be determined with certainty. I am referring here to the statistical evidence of the 1% of terminal cancer patients who are still alive five years after 99% have died; there is no single factor that distinguishes the survivors from the deceased.

We should not be swayed by the claims for potentially miraculous cures due to homeopathy, because there is no way of knowing that it was the homeopathy that did the trick. We must beware of falling into the logical trap of “post hoc ergo propter hoc”, meaning that because A happened after B, then B must be the cause of A.

It is disturbing to read of patients being persuaded by homeopathic practitioners to abandon conventional treatments for such conditions as advanced heart disease and cancer, and dying much sooner than they should have done. Having faith in a treatment can only take you so far, and, in such circumstances, I would prefer on balance to favour science against irrational belief.