Where is the Difference? By Catrin (CCH Graduate)

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The two little girls look out of their paintings at something I cannot see.  High up on either side of the fireplace, suspended in the late 1800’s, they are twins, both aged about 6.  Yet within a couple of years, one had died of diphtheria, while the other lived through two World Wars to the time of the Beatles, just missing her ninetieth birthday.  The same genetic inheritance, brought up together in the same family: both nature and nurture the same.  But there was a huge difference somewhere.

Medical science has made tremendous strides in the last two centuries and truly amazing work is performed today – a million miles from the bloodletting, mercury and arsenic, vomiting, laxatives and enemas that were a doctor’s stock-in-trade in the early 1800s.  Yet even today, anyone working in health from a newly qualified nurse to an eminent surgeon will tell you that the there is more to recovery from ill health than can be worked out scientifically or written in any medical notes.  You can call it a person’s drive, the will to live or the strength of their constitution, but there is something beyond conventional scientific explanation that carries some people on, where others can no longer continue.

This is where homeopathy comes in.  Because homeopathy is where the difference is what matters.  And before you drop this article, shaking your head in disbelief at more “bunk”[1], have a look at some facts – as any rational person should do before making a judgement.

[1]Homeopathy is bunk, study says.  The Guardian, 8 April 2014.

  1.  Homeopathy looks at the individual, taking account of their individual characteristics and responses and looking at their organism as a whole, rather than focussing on specific problems in isolation. On the basis of this information, homeopathy can help the individual to get better from what is bothering them and encourage their constitution to strengthen.  Thus the whole person is helped to move to better overall health, and to recoup the energy to live their life as well as they can within their limitations.
  2. Homeopathy has been doing this since 1796 when the modern father of homeopathy, the medical doctor Samuel Hahnemann (1755-1843)[1] first looked for a more helpful approach than that of the medical practices of his time, and began experimenting with a new form of medicine on himself and his family. Hahnemann was regarded as exceptional by those who taught him, and was hugely impressive academically, able to quote verbatim from medical sources in eight languages[2].  Despite the fact that his new form of medicine flew in the face of the accepted practices of the time, towards the end of his life when he had become well-known for his homeopathic healing, there were queues of people waiting to be treated by him, both rich and poor, every day3.
  3. Hahnemann developed Homeopathy on the basis of experimentation and observationthe basis of all science – leaving behind him a huge quantity of information, and a number of important published works, the main one of which, “The Organon of Medicine”, ran to five editions in his lifetime (with a sixth composed before his death) as he constantly improved and updated his work.  This book was complemented by his second great work “The Chronic Diseases”, and together they form the foundation stones of modern homeopathy.  Even today, reading Hahnemann’s books, it is not possible to be unimpressed with the huge volume of work and with meticulously recorded notes of the treatment and progress of his patients over the course of nearly half a century.   His careful extensions of his methods of cure based on observation, deduction, and then application of his ideas followed by more observation, deduction and application are evidence of an exemplary, gifted and incredibly dedicated scientist.
  4. Hahnemann started out by taking a small dose of Cinchona himself, repeated over several days, in order to understand how it worked, because he did was unconvinced by William Cullen’s theory that Cinchona was a specific for malaria due to its tonic action on the stomach3. (Hahnemann was translating Cullen’s Materia Medica at the time – 1790.)  Hahnemann found that he experienced symptoms broadly similar to malaria, including spasms and intermittent fever.  This suggested a medical principle to him – ‘like cures like(‘similia similibus curentur’) and was the start of fifteen years of thinking, study and experiments to record the effects of a number of substances on healthy people – which he called ‘proving’ these substances, or remedies, eventually culiminating in his first major publication.  He matched the symptoms of his patients to the effects of the different remedies when taken by healthy people, gradually reducing the dose of the remedies he gave to minimise any negative effects.
  5. By 1812 the conflict of the Napoleonic Wars had entered Leizpig, where Hahnemann was living at the time, bringing with it typhus[1]. Armed with 26 homeopathic remedies, Hahnemann treated 180 patients of whom only 2 died – a mortality rate of just over 1%, compared with a typical mortality rate of more than 30% according to medical records[2].  This success was replicated in a number of further epidemics over the next century, such as the 1854 cholera epidemic in London, where the death rate for patients treated at the London Homeopathic Hospital, nearest to the source of the outbreak, was 16%, whereas that for those treated conventionally by the nearby Middlesex Hospital was 53%[3], and the Spanish Flu Epidemic, in 1918 when there was a mortality rate of just over 1% for those treated homeopathically, compared with a mortality rate of 28% for those treated conventionally5.
  6. Homeopathy began to spread from Germany to Russia, India, France and the UK from the 1820s onwards, and outwards across the world.  Charles Dickens, Mark Twain and even Charles Darwin himself used homeopathy.  Today over half a billion people around the world use homeopathy, from the poorest in India, to the rich and famous.  Homeopathy is included in the national health systems of Brazil, Chile, India, Mexico, Pakistan, Switzerland and the UK[1]. A brief cross-section of current well-known people who are keen users of homeopathy includes: Usain Bolt, David Beckham, Cindy Crawford, Vidal Sassoon, Paul McCartney, Tony Blair and her Majesty the Queen[2].  In the UK, 400 doctors, and in Germany 3,500 doctors, prescribe homeopathically.  In France 69% of the medical profession considers homeopathy to be an effective treatment.  In Brazil there are 15,000 homeopathic doctors and 9 million people use homeopathy.  Nearly 50% of Pakistan’s doctors regularly prescribe homeopathically and in India 100 million people use homeopathy, which is prescribed by 300,000 homeopathic practitioners[3]

[1] https://www.hri-research.org/resources/homeopathy-the-debate/essentialevidence/use-of-homeopathy-across-the-world/
[2] http://www.lahomeopathicschool.com/testimonials/famous.html
[3] http://braindynamicsclinic.com/about-homeopathy/
[1] https://www.hri-research.org/resources/homeopathy-the-debate/essentialevidence/use-of-homeopathy-across-the-world/
[2] http://www.lahomeopathicschool.com/testimonials/famous.html
[3] http://braindynamicsclinic.com/about-homeopathy/
[1]https://books.google.co.uk/books?id=tzRwRmb09rgC&pg=PA145&lpg=PA145&dq=deaths+from+1812+typhus+epidemic+leipzig&source=bl&ots=hQ8U2p1czU&sig=tBQvoXZ-i8b-4GpUrL2gbk-dd6M&hl=en&sa=X&ved=0ahUKEwjty73M8ZXUAhWFDcAKHaBQD6AQ6AEIKTAA#v=onepage&q=deaths%20from%201812%20typhus%20epidemic%20leipzig&f=false
[2] http://www.drmasiello.com/homeopathy/history-of-homeopathy/
[3] https://www.uclh.nhs.uk/OurServices/OurHospitals/RLHIM/Pages/historyofrlhim.aspx

  1. There is also a vast amount of homeopathic literature. There are nearly 40,000 homeopathic books in libraries in Germany, France and the UK alone.  The UK has libraries in London and Glasgow totalling nearly 14,000 homeopathic books, in France there are libraries in Lyons and Paris with nearly 6000 homeopathic books between them, and in Germany there are libraries in Bensheim, Essen, Hamburg, Karlsruhe, München and Stuttgart with more than 18,000 homeopathic books between them[1].  This does not even begin to count the case notes, papers and theses on homeopathy.

So, if we look at the facts so far, we have a medical approach which is:
1. based on 200+ years of carefully documented experimentation and observation.
2. backed up by a vast amount of literature.
3. used all over the world by millions and millions of people, the majority of whom vote with their feet by paying for homeopathic medical attention.

[1] http://homeopathyeurope.org/media/publications/documentation-resources/
[1] http://www.homeoint.org/books4/bradford/chapter24.htm
[2] http://www.homeoint.org/morrell/articles/biohahnemann.htm
[1] https://www.hri-research.org/resources/homeopathy-the-debate/essentialevidence/use-of-homeopathy-across-the-world/
[1] http://www.lahomeopathicschool.com/testimonials/famous.html
[1] http://braindynamicsclinic.com/about-homeopathy/
[1] http://homeopathyeurope.org/media/publications/documentation-resources/

But how can anything as dilute as homeopathic remedies have any effect at all, I hear you ask?

The first thing to note is that homeopathic remedies are not merely diluted, they are succussed at each stage of the dilution in a specific process called potentisation.  This means that for every dilution, the mixture is shaken vigorously and banged firmly against a resilient surface, and this process is repeated about 40 times.  This succession is crucial for the resulting solution to be homeopathically effective.  This is the part of homeopathy that makes no sense to conventionally trained scientists.  However, there is beginning to be scientific evidence that there is something different about homeopathically diluted solutions[1],[2],[3],[4],[5], as compared with straightforward dilutions without succession.

The other problem that conventionally trained scientists have with homeopathy is whether or not there is any proof that it works.  The answer to this is three-fold.

[1] Boyd, W.E. (1954) “Biochemical and biological evidence of the activity of high potencies.” British Homeopathic Journal, vol 44, Issue 1, pp7-16.
[2] Rey, L. (2003) “Thermo-luminescence of ultra-high dilutions of lithium chloride and sodium chloride.”  Physica A: Statistical Mechanics and its Applications, vol. 323, 15 May, pp67-74.
[3] Mallick,P. et al. (2003) “Ameliorating effect of microdoses of a potentised homeopathic drub, Arsenicum Album, on arsenic-induced toxicity in mice.”  BMC Complementary and Alternative Medicine (vol 3, p 7).
[4] Witt, C.M. et al. (2007). The in vitro evidence for an effect of high homeopathic potencies–a systematic review of the literature. Complement Ther Med., 15(2): 128-38.
[5] Betti, L. et al. (2013).  Effectiveness of ultra high diluted arsenic is a function of succussion number as evidenced by wheat germination test and droplet evaporation method. Int J High Dilution Res, 12 (44): 127–128

Firstly, there is definitely a proof of homeopathy’s effectiveness in the form of formal research[1],[2],[3],[4],[5],[6], as well as the evidence of the millions of patients who consistently return to homeopathy.  However, this formal proof has not been broadcast by the mainstream media[7].  Despite there being thousands of medically trained doctors who are also homeopaths, the fact that there is no conventional scientific explanation for how homeopathy works makes it difficult for many scientists and medics to believe that it does, and this has meant that positive results are hard to accept and tend to be suppressed.  There are meta-analyses (analyses of a number of different research papers which draw conclusions about the group of papers considered as a whole) which have concluded that homeopathy works[8],[9],[10] ; indeed, one characterised homeopathy as “a valuable addition to the conventional medical landscape”[11].  However, the results of these analyses are not well known.  In comparison, two meta-analyses which concluded that homeopathy does not work hit the press headlines in a major way.  Yet when you look closely at how these analyses were conducted, they seem to have been almost designed with the goal of finding that homeopathy does not work.  Two examples illustrate the point very clearly:

[1] Sinha, M.N. et al. (2012)  Randomized controlled pilot study to compare Homeopathy and Conventional therapy in Acute Otitis Media. Homeopat. J. Fac. Homeopat., 101: 5–12
[2] Vickers, A. and Smith, C (2006).. Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes. Cochrane Database of Systematic Reviews: Issue 3. Art. No.: CD001957. DOI: 10.1002/14651858.CD001957
[3] Frass, M. et al. (2005) . Adjunctive homeopathic treatment in patients with severe sepsis: a randomized, double-blind, placebo-controlled trial in an intensive care unit. Homeopathy :94;75-80.
[4] Frass, M. et al. (2005).  Influence of potassium dichromate on tracheal secretions in critically ill patients. Chest: 127:936-941. (This journal is considered the most respected journal in respiratory medicine.)
[5] Jacobs, J. et al. (2003). Homeopathy for childhood diarrhea: combined results and metaanalysis from three randomized, controlled clinical trials. Pediatr. Infect. Dis. J.,22:229–234
[6] Chapman, E.H. et al. (1999).  Homeopathic treatment of mild traumatic brain injury: A randomized, double-blind, placebo-controlled clinical trial.  J Head Trauma Rehabil. Dec;14(6):521-42
[7] Frei, H. et al. (2005)“Homeopathic treatment of children with attention deficit disorder: a randomized, double blind, placebo-controlled crossover trial.”  Eur J Pediatr. 164: 758-767.  Results of this paper are presented in a German documentary viewable with English subtitles at https://www.youtube.com/watch?v=uwwdpnh7Uq4
[8] Hahn, R.G. (2013) Homeopathy: Meta-Analyses of Pooled Clinical Data. Forsch Komplementmed., 20:000–000.  Published online: October 17, 2013 DOI: 10.1159/000355916
[9] Mathie, R.T., et al. (2013).  Randomised controlled trials of homeopathy in humans: characterising the research journal literature for systematic review. Homeopat. J. Fac. Homeopat.,  102:3–24
[10] Mathie, R.T. et al. (2014).  Randomised placebo-controlled trials of individualised homeopathic treatment: systematic review and meta-analysis. Systematic Reviews, 3: 142
[11]  Bornhöft, G. and Matthiessen, P.F. (eds) (2011)  Homeopathy in Healthcare: Effectiveness, Appropriateness, Safety, Costs ISBN 978-3-642-20637-5.  A short summary of the report was published: Bornhöft G, et al. (2006. Effectiveness, safety and cost-effectiveness of homeopathy in general practice – summarized health technology assessment. Forsch Komplementmed.,13(Suppl 2):19-29

  • The recent meta-analysis produced by the Australian National Health and Medical Research Council (NHMRC)[1] in March 2015, which triggered headline news around the world suggesting that NHMRC had found that homeopathy does not work for any condition, has been accused of serious procedural and scientific misconduct including bias and misreporting, and a complaint has been issued to the Commonwealth Ombudsman[2]. If you look at the details of how the NHMRC analysis was conducted, you will see that it was done on the basis of five trails alone, not the 1800 studies that NHMRC said they had based their results on.  If you read the analysis you can see that the NHMRC also disregarded evidence about how well drugs were tolerated when comparing homeopathic remedies with conventional medicines which had serious side effects, and when there was no other reason to discount the results of a positive homeopathic trial, the report concluded the results were not valid because there was no other paper with the same results[3].

A meta-analysis published in The Lancet in  2005 by Shang et al [4] was reported as having compared 110 similar trials on homeopathy and conventional medicine.  It reached the conclusion that homeopathy was no better than a placebo (a tablet looking like a drug, which the patient believes is a drug, but which contains no active ingredient).  This was accompanied by an editorial entitled “The end of homeopathy”[5].  However, the conclusions were actually based on only 8 out of the 110 trials, none of which involved usual homeopathic care.  Furthermore, if you switch just one of the trials chosen from the 110 for a different one, the results are reversed and homeopathy is shown to work much better than a placebo[6], and a German study which increased the number to 40 out of 110 studies also found homeopathy was effective[7].  Despite evidence that the findings of the study are

[1] NHMRC Information Paper: Evidence on the effectiveness of homeopathy for treating health conditions [March 2015]
[2] https://www.hri-research.org/wp-content/uploads/2017/04/Executive-Summary-to-Ombudsman-Complaint-re-NHMRC-Homeopathy-Review-FINAL.pdf
[3] I have looked at the results of this report myself, and this comment is mine.  However, the Homeopathy Research Institute has published a comprehensive review of this report which can be seen at https://www.hri-research.org/resources/homeopathy-the-debate/the-australian-report-on-homeopathy/
[4] Shang, A. et al.(2005)  Are the clinical effects of homeopathy placebo effects? Comparative study of placebo-controlled trials of homeopathy and allopathy. Lancet  366: 726–732
[5] Editorial. The end of homeopathy. Lancet., 2005; 366:690
[6] https://www.hri-research.org/resources/homeopathy-the-debate/the-lancet-paper-by-shang-et-al/
[7] https://www.youtube.com/watch?v=uwwdpnh7Uq4

  • completely unreliable, the Lancet study continues to be quoted as a benchmark in the ‘proof’ that homeopathy does not work.

When you realise what lies behind the sweeping conclusions these reports have made, and consider that they have generated wholly inaccurate worldwide headlines stating that homeopathy does not work, it’s hard not to conclude that this looks more like a witch-hunt than scientific analysis.

Secondly, there is not much money available for research into homeopathy.  Because the remedies homeopaths use are relatively cheap to make, and not patented, there is not the same potential for them to make money for pharmaceutical companies.  Proper drug trials are very expensive to run, and without a potential profit at the end to fund this, it is difficult to find funding for homeopathic trials[1].

Thirdly the way in which clinical trials are conducted is designed to test the effectiveness of a certain drug in dealing with a specific problem.  This is usually done by randomly giving half of a sample of people suffering from the problem in question the drug to be tested, and the other half a pill which looks identical but has no drug in it (a placebo), and then comparing the difference in outcomes for the two groups.  However, homeopathy treats people, not problems: it works by considering the individual and their specific symptoms.  So five people suffering from arthritis, for example, might need five completely different remedies.  This makes it much harder to design trials which the conventional scientific community finds acceptable, because if you use the conventional clinical trial format for homeopathy, you have defeated the purpose before you start.

Opponents of homeopathy have demanded that it should no longer be available on the NHS.  This will not only sacrifice patient choice, it will almost certainly prove to be costly.  An article in the British Medical Journal in 2007 found that only 13% of commonly used NHS

[1] In the UK, 0.0085% of the total medical research budget is spent on Complementary and Alternative Medicine, of which homeopathy is only one example.  [https://www.hri-research.org/resources/homeopathy-faqs/there-is-no-scientific-evidence-homeopathy-works/]

treatments are known to be beneficial[1].  So clearly not all conventional drugs prescribed are effective – and many have unwanted side effects.  The NHS budget for drugs alone  was £10.2 billion in 2010, of which £2 billion – nearly 20% – was spent on drugs to counteract the side effects of other drugs[2].  Compare this with the fact that the NHS currently spends a tiny fraction of its budget (0.004% in 2016) on homeopathy in total counting the running of hospitals, the cost of paying practitioners and that of purchasing the remedies[3].  This provides about 400,000 homeopathic prescriptions a year to patients who would otherwise have had to be treated with more expensive conventional drugs[4].  Furthermore, patient satisfaction with homeopathic treatment is generally high[5].

No-one would want to be without modern pharmaceutical drugs, but surely making more provision for homeopathy, which is safe, gentle, effective and without side effects has the potential to save the NHS significant amounts of money which could then be spent where it is most needed?

It seems to me that there is far too much carefully recorded information, far too much detail and consistency of observation and recording about homeopathic treatment for any scientist worthy of the name to be able to refute it all in one throwaway statement.  It is true that we don’t understand by what mechanism homeopathy works yet, but to jump from this to categorical statements that it just doesn’t work is not even bad science – it is not science at all.

As a trained chemist I have to agree that on the face of it the degree of dilution used in preparing homeopathic remedies is so high that there should be nothing left.  But as a practitioner who uses homeopathy successfully with my patients, and as a patient who has experienced it herself, and observed close-hand how effective it can be with both family and friends, I cannot continue to refute the evidence in front of me.  As a scientist observing cause and effect, I feel that it is not possible to keep inventing other reasons for people getting better with homeopathy where they outstandingly failed to without it – to do so would be to abandon integrity for hyperbole.

“Many years ago my two-year-old son suffered from allergic asthma. The conventional answer then was aggressive steroid treatment which carried some risks so my wife suggested the alternative of homeopathy. She was far from convinced and I was frankly sceptical but we found a local NHS doctor who also practised as a homeopath and he prescribed a dose of something very dilute. The result was astounding. The blue, wheezing toddler turned pink within minutes, became able to breath and would usually drop into peaceful sleep. The effect was, in scientific terms, decisive, observable and entirely repeatable. Placebo effects, in this case, are as unconvincing an explanation as anything else I have read in 25 years. Like Prof Harvey Rutt I find the ideas of water memory and enormous dilution apparently risible – but the corollary of this is to find a better explanation, not to damn homeopathy as impossible. As Lavoisier, Pasteur and so many others understood, good science always fits the hypothesis to the evidence. History is littered with tales of the arrogant and the foolish who have preferred the easier route of reversing that logic or who have denied that something happens simply because they can’t explain why it does.”
Chris Woolfe, from Liskeard, Cornwall[1][1] http://www.theguardian.com/notesandqueries/query/0,,-9542,00.html

If you still feel totally sceptical, consider where your information is coming from.  How much do you really know about homeopathy?  If your opinions are founded on UK mainstream journalism lambasting homeopathy, then you may not be on reliable ground.  Look a little further, find out about homeopathy from someone who understands it, don’t just listen to the ranting from those who don’t.  Start to read the testimonies from those who use homeopathy, look the literature that exists, and consider: are all these millions of people, including thousands of trained doctors and many gifted scientists really deluded?  Or is there actually something of real value here, even if we don’t understand the mechanism by which it works yet?

We need a different approach.  We need to stop demonising homeopathy.  We need conventional medical science and homeopathy to work together with their different strengths in order to help patients to the best health they can achieve in a cost-effective way.

So next time you have a niggling health problem that just does not seem to want to go away – whether it is a chronic asthma, an overwhelming grief, or a constant anxiety about being burgled – think about giving homeopathy a try.  Homeopathy will consider your whole person, and all the things that go to make you who you are.  And it will treat the whole person, so the health of you as a whole improves, rather than focusing on improving one section of the plumbing whilst the header tank in the attic is quietly overflowing.

Who knows, if those twins had had access to a homeopathic doctor in the 1800’s it’s possible that they would have been able to listen to the Beatles together.

And if at the end of the day, you are still vehemently against homeopathy, it does rather beg the question: Why?  There is a lot of evidence that it works, and if it works, why should people not use it?  Why should conventional medicine and homeopathy not work together?

What have we got to lose – apart from our preconceptions?

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