Homeopathy is having a hard time in the United Kingdom.
Sceptic pressure groups such as Sense About Science (SAS)
- sponsored by Glaxo Smith Kline, Pfizer and the Association
of the British Pharmaceutical Industry (ABPI) – are trying to
annihilate homeopathy for the simple reason that it is, from
their point of view, implausible. The UK seems to be back
in the Dark Ages when the Inquisition was seeking out and
prosecuting heretics.
In a debate at the British Medical Association (BMA) junior
doctors’ conference in May motions were passed that specifically
demand that NHS funding for homeopathic remedies and
homeopathic hospitals is banned and that there should be no
homeopathic training posts available in NHS hospitals. It was
claimed that there is no scientific basis to support homeopathy.
On 29 June at the Annual Representative Meeting (ARM), the
BMA’s key policy making forum, the same motions were put
to the vote and passed 3 to 1. Amazingly, there was only 10
minutes debating time without consulting doctors who practise
homeopathy or allowing them to participate in the debate.
One of the sceptics’ arguments was that at a time when the NHS
is struggling for cash we should be focusing on treatments that
have proven benefit. This surely is a noble aspiration. Reality,
however, is that “most decisions about treatments still rest on
the individual judgments of clinicians and patients”, as asserted
by the BMJ Clinical Evidence website. The website shows that
of around 2,500 conventional medical treatments covered,
11% are rated as beneficial, 23% likely to be beneficial, 7%
as trade off between benefits and harms, 5% unlikely to be
beneficial, 3% likely to be ineffective or harmful, and 51%, the
largest proportion, as unknown effectiveness.
Homeopathy research has focused on a total of 80 different
medical conditions, in which there is a total of 142 peerreviewed
RCTs that met a number of key quality criteria.
Findings in 44% of those RCTs reported positive findings,
8% were negative and 48% were non-conclusive. The large
majority of trials have used placebo-controlled design. The
evidence suggests that homeopathy is effective in a number
of specific conditions. The interested reader may want to visit
In a report published 22 February 2010, the Science and Technology
Committee of the United Kingdom House of Commons
concludes that homeopathy is not efficacious (that is, it
does not work beyond the placebo effect), that explanations
for why homeopathy would work are scientifically implausible
and that further clinical trials of homeopathy could not be justified.
Furthermore, it concludes that the NHS should cease
funding homeopathy and that the Medicines and Healthcare
products Regulatory Agency (MHRA) should no longer license
homeopathic medicines. The full report as well as all written
and oral evidence that was submitted to the Committee is
available here.
The British Homeopathic Association and Faculty of Homeopathy
find the Science and Technology Committee report sets out
recommendations that are completely unfounded and reflect
the biased nature of the Committees review of evidence. The
BHA and the Faculty refute the committee’s premise that the
research evidence clearly indicates that the effects of homeopathy
can be primarily attributed to the placebo effect. Evidence
from RCTs and systematic reviews and meta-analyses
of such research do not support such a view. For instance, five
systematic reviews that focused on specific medical conditions
concluded there was positive evidence for homeopathy (childhood
diarrhoea; post-operative ileus; seasonal allergic rhinitis;
vertigo).
The Committee also argued that the notion that ultra-dilutions
can maintain an imprint of substances previously dissolved in
them is scientifically implausible. However, the Committee ignored
the evidence that challenges it. There is a growing and
convergent body of scientific evidence, from methods including
low temperature thermoluminescence, flux calorimetry, conductometry,
Raman and Ultra Violet spectroscopy, and NMR
(Nuclear Magnetic Resonance), that the homeopathic method
of preparation may induce long-lasting structural changes in
water. In addition, there has been replicated high-quality basic
research on intact animals, plants and isolated cells and cell
cultures that demonstrates measurable effects of serially agitated
high dilutions, of histamine on the activation of basophil
leucocytes, of acetosal on bleeding time, platelet aggregation
and coagulation, of thyroxine on the rate of amphibian metamorphosis,
of mercury on the toxic effect of material doses of
mercury on mice, of arsenic on the toxic effect of material doses
of arsenic trioxide on wheat shoot growth.
The BHA and the Faculty conclude that this report and its conclusions
represent a rush to judgment, reflecting the narrow
and cursory nature of the review. It was systematic only in
excluding facts that tend to support homeopathy: it omits or
misrepresents any research evidence, which challenges the
view that patients response to homeopathy is due to placebo.
Its conclusions are unsustainable in the light of scientific
evidence.
The rebuttals are accessible at the BHA website.
But some people just refuse to accept the evidence. They assert
that there is no scientific explanation for its effectiveness, that
ultramolecular homeopathic preparations (beyond Avogadro’s
constant) do not contain any molecules, that molecules are
necessary for effectiveness, and that therefore all positive clinical
evidence for homeopathy must be unreliable. Summarised in
one sentence: “I cannot understand how it could be possible,
so it is not possible.”
What these sceptics do not know is that there is accumulating
evidence in basic research for measurable effects of serially
agitated high dilutions. There is replicated high-quality basic
research in biological experiments on intact animals, plants and
isolated cells and cell cultures, as well as in physical experiments,
that clearly demonstrate that even ultramolecular preparations
have effects.
A recent meta-analysis by Witt et al. (abstract at PubMed)
reviewed 67 in-vitro experiments in 75 publications of research
on homeopathic dilutions. A majority of them reported highpotency
effects. Positive findings were obtained in nearly threequarters
of all replicated studies. Even experiments with a high
methodological standard could demonstrate an effect of high
potencies.
The reader who is interested in existing basic research is
invited to visit the website of the Faculty of Homeopathy,
where an overview of basic research is given that demonstrate
a measurable effect of high potencies. Interestingly, many of
these basic research studies were published in mainstream peerreviewed
journals, including Human & Experimental Toxicology,
Toxicology and Applied Pharmacology, Veterinary and Human
Toxicology, Inflammation Research, Haemostasis, Thrombosis
Research, Pathophysiology of Haemostasis and Thrombosis,
Physica (A), Annals of the New York Academy of Sciences,
Journal of Thermal Analysis and Calorimetry, Journal of Solution
Chemistry, and Materials Research Innovations.
So, even though it is not yet known how homeopathy may
work, it can nevertheless be concluded that the theory that
homeopathy, by its use of ultramolecular preparations, is
implausible or impossible, is simply not correct.
Both in conventional medicine and in homeopathy most
treatments are based on clinical experience, i.e. the perceived
effectiveness in actual practice. If doctors would only be
allowed to provide treatment of which the effectiveness has
been demonstrated by hard scientific evidence, doctors would
lose many tools, both conventional and homeopathic, for their
practical medical work. Patients will certainly not be pleased
with that option.
