An Idea Whose Time Has Gone

Pearl Street is home to one of New Haven’s lesser known academic institutions – the School of Homeopathy. Homeopathy is a 200 year old system of medicine invented by German physician Samuel Hahnemann, who believed that toxic substances, if given in extremely diluted amounts, would cure the same symptoms they cause in more substantial doses. It turns out that homeopathic remedies are even more of a scam than bottled water – both are indistinguishable from tap water, but homeopathic remedies come with health claims.

But isn’t homeopathy generally accepted as a real and effective form a medicine? Well, no. The scientific community knows it’s bunk, and in a perfect world it would have vanished over a century ago, gone the way of phrenology (divining personality from the bumps on one’s head) and leaching. Homeopathy, however, found its way into the fringes of healthcare and has managed to eek out a survival there (<3.5% of the public use homeopathy according to a National Institutes of Health survey). 

There are several reasons for homeopathy’s frustrating persistence. It is partly due to the fact that homeopathy has been allowed to cover itself in the trappings of real science and respectable professionalism. New Haven’s School of Homeopathy hands out real degrees. When the FDA was formed, through political pressure existing homeopathic remedies were grandfathered in – without ever having to meet any standard of evidence.

Another reason that homeopathy has managed to survive despite utter scientific failure, is that proponents of homeopathy are deceptive about their actual claims. The common perception is that homeopathic remedies contain small amounts of active ingredient, because that’s what homeopaths say. The National Center for Homeopathy website characterizes a homeopathic remedy as having a “minute dose.” In reality, most homeopathic dilutions leave behind no active ingredient – not a single molecule. This may seem subtle, but from a scientific (hey, from a common sense) point of view, there is a big difference between a small amount and nothing at all. Nothing is, well…nothing. It turns out Hahnemann’s “law of infinitesimals” is a “law on non-existence.”

How can this be? Well, when Samuel Christian Hahnemann thought up the idea of homeopathy two centuries ago, chemists still did not understand that substances were made of molecules, and that molecules could not be diluted or divided. A single molecule is the smallest amount of something you can have. At the time Hahnemann devised using extreme dilutions he falsely believed that substances could be diluted infinitely.  Subsequent advances in chemistry and physics should have relegated Hahnemann’s ideas to the museum of quaint early scientific notions. Perhaps they could have been placed on the shelf somewhere between the ether (the mysterious substance once believed to permeate the universe) and the miasma theory of infectious disease.

Hahnemann’s ideas persisted partly because believers continued to pretend that science had not progressed around them, that you could dilute a substance beyond the point where even a single molecule would be left. Recently, with the faddish attention being paid to anything with the label “alternative,” homeopaths have tried to don more modern scientific robes. When pushed they acknowledge (how could they not) that no active ingredient is left behind in their preparations, but, they claim, the water retains the “memory” of the substance that was diluted in it.

Hmmm…I bet you didn’t know water was that smart.

This is, of course, a non-explanation. Water is a simple molecule and there is no known or plausible mechanism by which it can “remember” any information about substances that had been diluted in it in the past. Homeopaths might as well say it works by “magic.”

Another curious aspect of homeopathy is the so-called “law of similars.” Homeopathy proponents claim that substances which cause a symptom will in fact cure that very same symptom if taken in extremely diluted (i.e. non-existent) doses. Homeopaths pretend this is a scientific law, but it is nothing of the sort. This is also a simplistic notion not unusual in the prescientific era. But there is no biological reason to suspect that caffeine in small enough doses is a sedative, or that extract of onion will cure runny eyes from a cold because onions make your eyes water. This is magical thinking.

Some homeopaths claim that the law of similars works the same way as allergy shots, which involve getting injections of small amounts of a substance in order to cure allergies to that substance. Nothing could be farther from the truth. Allergy shots involve real and increasing doses of the offending substance, with progressively greater stimulation of the immune system to form blocking antibodies. These blocking antibodies bind the offending substance and prevent allergy causing antibodies (a different kind of antibody) from causing an allergic reaction. Allergy shots involve real doses, and a known, specific, and tangible mechanism – not water fairies.

So if homeopathy is as demonstrably wrong as the earth-centered universe, why do so many people believe in it? The answer is partly that homeopathy – unlike the ether, say, deals in the realm of sickness and health. When the ether was finally disproved and discarded, no one protested that the ether had cured them of their migraines. Healthcare is an especially emotional area, and our symptoms are subject to a host of confusing variables, including the placebo effect. These factors conspire together to make it seem as if almost any bizarre and counterintuitive treatment could work for any symptom or illness.

This is why, over the last 100 years or so, we have come to rely upon careful observation, where variables are controlled and bias is minimized. So what does such careful research say about homeopathy?  Proponents are quick to claim that research supports homeopathy, but the scientific community agrees that the body of research into homeopathy clearly shows that it does not work. Even the National Center for Complimentary and Alternative Medicine, which is highly predisposed to being favorable to alternative methods such as homeopathy, gives this wishy-washy summary:

“Research studies on homeopathy have been contradictory in their findings. Some analyses have concluded that there is no strong evidence supporting homeopathy as effective for any clinical condition. However, others have found positive effects from homeopathy. The positive effects are not readily explained in scientific terms.” 

There are many hopelessly flawed studies with “contradictory” results. However, the more carefully designed and executed studies are negative. This pattern is well known to scientists, it means there is no real effect at work. There is no there, there.

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