Homeopathy: Curing with kindness

Numerous studies have shown that homeopathic remedies don't work. Why, then, do millions of patients swear that they do? The answer, says Professor Edzard Ernst, should be a lesson to all doctors

The British Medical Association recently called homeopathy "witchcraft", and a parliamentary committee recommended stopping all NHS funding for it. Yet many people, not least members of the Royal Family, swear by it.

So, what are the facts? Why is there still so much uncertainty? And why are emotions flying so high? British homeopaths are this week celebrating their annual Homeopathy Awareness Week – a good occasion to try and find some answers.

Homeopathy was developed almost single-handedly by a German physician, Samuel Hahnemann. About 200 years ago he found that when, as a healthy person, he took the anti-malaria drug quinine, he experienced some of the symptoms associated with malaria. He eventually concluded that "like cures like": any substance that provokes a symptom in a healthy person can be used to treat that same symptom when it occurs in a patient. You cut an onion and your eyes start watering; so a homeopathic preparation made from onions can be used to cure hay fever, a condition characterised by watering eyes.

But homeopaths do not use simple extracts of onions or other substances. Hahnemann also believed he had found that diluting an extract repeatedly in a special way – homeopaths call this "potentisation" – would make the remedy not less but more powerful. How on earth can this possibly work? Therefore, homeopathic remedies are so diluted that typically they no longer contain a single molecule of the onion. The theory of the "memory of water" provides the answer, according to homeopaths. It postulates that, during the dilution process, some mystical "energy" is transferred from the onion to the water. And that "energy" then triggers a healing response in our body.

This is all wishful thinking and romantic fantasy, scientists insist. The war of words is as old as homeopathy itself, but somehow misses the most important point. If homeopathic remedies make patients healthy, the debate is academic.

The proof of the pudding is in the eating. So do homeopathic remedies really have any effect on patients? To find out, we need clinical trials. Today we have about 150 clinical trials of homeopathy. Typically they test the effectiveness of homeopathy by treating one group of patients with homeopathy, while a comparable, second group receives placebos, i.e. sugar pills that only look like the real thing.

These trials have generated vastly different results: some suggest homeopathy works, others fail to do so. It can thus be tempting to cherry-pick and select those data that suit our arguments. This sort of thing has fuelled more and more emotional debates. But that approach is, of course, fundamentally misguided. To get to the truth, we must firstly avoid cherry-picking and look at the totality of the studies, and secondly we have to consider the issue of their reliability. Some trials are biased, but others are not. If we do all this systematically, we are bound to arrive at rather sobering conclusions.

Many researchers across the world have reviewed the evidence and concluded that homeopathic remedies are pure placebos. Five years ago, The Lancet even announced "The Death of Homeopathy". But homeo- pathy did not die. In fact, it continues to thrive and now boasts many supporters, who say, "We are not stupid, we have experienced benefits and therefore know it works."

Homeopaths ignite the debate further by claiming that the clinical trials are artificial, inadequate research tools. They show us "real-life" studies where patients are monitored over time but are not compared to a placebo group. These observations invariably demonstrate impressive success rates after homeopathic treatments. So, we seem to be confronted with a perplexing contradiction: homeopathic remedies are placebos with no specific effects, but in "real life" they seem to work.

The solution to the conundrum is quite simple, however: the remedy does nothing and the homeopath does everything.

If you see a homeopath, you are typically asked many very detailed questions. The homeopath is interested, empathetic and you feel warmly understood. The whole encounter lasts for about an hour, and at the end you receive a prescription. The remedy is a placebo but, never mind, the consultation and the expectations it raises have important effects. This is true particularly if you are suffering from conditions such as insomnia, depression or eczema that respond well to this type of reassuring "mini-psychotherapy". No contradiction at all then. But one nagging question does remain. Does it matter what helps the patient? If it is a placebo so be it, some would say. Regardless of the negative scientific verdict, homeopathy is good for you. What really counts is that it works. Essentially this line of argument implies that, regardless of the negative scientific verdict, homeopathy is good for you.

For a whole host of reasons, I disagree with this line of argument. Honesty is one of them. If the remedy is a placebo, we cannot truthfully pretend it isn't. Such lies may be benign, but they are also unethical.

And it is essential to realise that we don't need a placebo to generate placebo-effects. If a doctor prescribes for patients suffering from insomnia, depression, eczema etc a treatment that works beyond a placebo and, if this is done in a kind and empathetic way with time and understanding, the patient will profit from the specific effects of the prescription and also the non-specific effects of the encounter, which we often call placebo-effects.

Good medicine should always employ specific therapeutic effects (which homeopathic remedies do not possess), as well as the non-specific effects of the therapeutic encounter, i.e. time, understanding, empathy and human warmth, which homeopaths have lots of. Using only one or the other is quite simply not good medicine.

So, when we celebrate Homeopathy Awareness Week, we should honour Samuel Hahnemann – not for inventing homeopathy but for reminding us how important those non-specific elements of the therapeutic encounter really are.



Professor Edzard Ernst is the professor of complementary medicine at Peninsula Medical School, University of Exeter

Voices
voices
News
general electionThis quiz matches undecided voters with the best party for them
Arts and Entertainment
Keira Knightley and Matthew Macfadyen starred in the big screen adaptation of Austen's novel in 2005
tvStar says studios are forcing actors to get buff for period roles
News
Prince William and his wife Catherine, Duchess of Cambridge show their newly-born daughter, their second child, to the media outside the Lindo Wing at St Mary's Hospital in central London, on 2 May 2015.
news
Life and Style
ebookNow available in paperback
ebooks
ebookPart of The Independent’s new eBook series The Great Composers
  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Ashdown Group: Trainee Consultant - Surrey/ South West London

    £22000 per annum + pension,bonus,career progression: Ashdown Group: An establi...

    Ashdown Group: Trainee Consultant - Surrey / South West London

    £22000 per annum + pension,bonus,career progression: Ashdown Group: An establi...

    Ashdown Group: Recruitment Consultant / Account Manager - Surrey / SW London

    £40000 per annum + realistic targets: Ashdown Group: A thriving recruitment co...

    Ashdown Group: Part-time Payroll Officer - Yorkshire - Professional Services

    £25000 per annum: Ashdown Group: A successful professional services firm is lo...

    Day In a Page

    Fishing for votes with Nigel Farage: The Ukip leader shows how he can work an audience as he casts his line to the disaffected of Grimsby

    Fishing is on Nigel Farage's mind

    Ukip leader casts a line to the disaffected
    Who is bombing whom in the Middle East? It's amazing they don't all hit each other

    Who is bombing whom in the Middle East?

    Robert Fisk untangles the countries and factions
    China's influence on fashion: At the top of the game both creatively and commercially

    China's influence on fashion

    At the top of the game both creatively and commercially
    Lord O’Donnell: Former cabinet secretary on the election and life away from the levers of power

    The man known as GOD has a reputation for getting the job done

    Lord O'Donnell's three principles of rule
    Rainbow shades: It's all bright on the night

    Rainbow shades

    It's all bright on the night
    'It was first time I had ever tasted chocolate. I kept a piece, and when Amsterdam was liberated, I gave it to the first Allied soldier I saw'

    Bread from heaven

    Dutch survivors thank RAF for World War II drop that saved millions
    Britain will be 'run for the wealthy and powerful' if Tories retain power - Labour

    How 'the Axe' helped Labour

    UK will be 'run for the wealthy and powerful' if Tories retain power
    Rare and exclusive video shows the horrific price paid by activists for challenging the rule of jihadist extremists in Syria

    The price to be paid for challenging the rule of extremists

    A revolution now 'consuming its own children'
    Welcome to the world of Megagames

    Welcome to the world of Megagames

    300 players take part in Watch the Skies! board game in London
    'Nymphomaniac' actress reveals what it was really like to star in one of the most explicit films ever

    Charlotte Gainsbourg on 'Nymphomaniac'

    Starring in one of the most explicit films ever
    Robert Fisk in Abu Dhabi: The Emirates' out-of-sight migrant workers helping to build the dream projects of its rulers

    Robert Fisk in Abu Dhabi

    The Emirates' out-of-sight migrant workers helping to build the dream projects of its rulers
    Vince Cable interview: Charging fees for employment tribunals was 'a very bad move'

    Vince Cable exclusive interview

    Charging fees for employment tribunals was 'a very bad move'
    Iwan Rheon interview: Game of Thrones star returns to his Welsh roots to record debut album

    Iwan Rheon is returning to his Welsh roots

    Rheon is best known for his role as the Bastard of Bolton. It's gruelling playing a sadistic torturer, he tells Craig McLean, but it hasn't stopped him recording an album of Welsh psychedelia
    Morne Hardenberg interview: Cameraman for BBC's upcoming show Shark on filming the ocean's most dangerous predator

    It's time for my close-up

    Meet the man who films great whites for a living
    Increasing numbers of homeless people in America keep their mobile phones on the streets

    Homeless people keep mobile phones

    A homeless person with a smartphone is a common sight in the US. And that's creating a network where the 'hobo' community can share information - and fight stigma - like never before