Update April 2010 Homeopathy a systematic review finds no evidence that homeopathy has effects beyond placebo. Dr. Steven Barnett's article, Homeopathy: The Ultimate Fake reviews the status of homeopathy in the United States. Homeopathy lists the critiques published of homeopathy in April, 2010. homeopathyThere's Nothing In It, the 10:23 campaign.
Why It Is Hard to Think About Homeopathy And Why It Is Health Fraud part 2
The Background to Homeopathy
Homeopathy's founder is considered to be Samuel Hahnemann (1755-1843), a German physician, who began formulating homeopathy's basic principles in the late 1700s. We should honor Hahnemann for what he he accomplished in his milieu, as we honor other great medical thinkers such as Lister or Pastuer. Hahnemann worked before the germ theory of disease was well established, before the mechanisms of infections disease were well understood. before the understanding of public health, and before the scientific method and more advanced testing of hypothoses, such as double-blind testing were established. Hahneman, as a physician, noticed that the common treatments of the day, such as bloodletting, leeching, purging, and the administration of toxic remedies, did far more harm than good. As a good healer, and scientist, he went in search of remedies and theories.
Hahnemann and his successors hypothesized that diseases represent a disturbance in the body's ability to heal itself and that only a small stimulus is needed to begin the healing process. Hahnemann thought that chronic diseases were manifestations of a suppressed itch (psora), a kind of miasma or evil spirit. He then hypothosized that every symptom induced by a toxic dose of a substance in a healthy person can be cured by a remedy prepared from that same substance--in Hahnemann's own famous words: similia similibus curentur ("Let like cure likes.") He further hypothosized that each naturally occurring element, plant, and mineral compound will, when ingested or applied, result in certain symptoms.
Hahnemann and his early followers conducted "provings" in which they administered herbs, minerals, and other substances to healthy people, including themselves, and kept detailed records of what they observed. One of his followers, Constantine Hering, expanded the ideas to include remedies compounded from diseased tissue and healthy tissue--"nosodes" and " sarcodes"-- between 1827 and 1833 . To put this into historical context, Jenner first published his success using cowpox to as a preventative to smallpox; vaccination wasn't universal until 1853. As Hahnemann and his followers carried on experiments, the records were compiled into lengthy reference books called materia medica, or the pharmacopeia, which are used to match a patient's symptoms with a "corresponding" treatment.
Does The FDA Really Endorse Homeopathy?
Here comes another opportunity for modern-day confusion. The United States Food and Drug Association does indeed recognize the entire contents of Homeopathic Pharmacopeia as drugs, and as safe and effective. However, as we saw above, that happened as a result of lawmaking, not as a result of double-blind, many-subject testing that conventional Western medicine medications must pass to be approved. The opportunity for confusion is that we have come to regard FDA approval as synonomous with rigorous testing. The chain of thought is that homeopathy must be safe and effective because it is FDA approved. This is not the case, and the homeopathic establishment knows it is not the case, even though homeopaths routine misrepresent what the FDA's position is.
Personality and Homeopathy
Many homeopaths maintain that certain people have a special affinity to a particular remedy (their "constitutional remedy") and will respond to it for a variety of ailments. For example:
This is referred to in homeopathy as "constitutional type" syndrome. A special detailed picture is taken of the person's likes and dislikes, emotional upsets, feelings, things a person is sensitive to, genetic history and complete health history. There is a special emphasis on looking at the complete emotional, physical and mental details of a person's life. The constitutional remedy is a comprehensive view of these systems and from this one specific choice of remedy can be found.
If a person is experiencing acute illness it may first be appropriate to give a remedy to alleviate the symptoms. After there is a recovery, a constitutional remedy can be given.
Each constitutional type is named after a specific remedy, and addresses the various physical, emotional, and mental problems that it clears.
Here is a list of various constitutional remedies and the types they best serve.
Arsenicum Album The remedy picture portrays a person who is meticulously devoted to details Everything has to be perfect, and everything has to be in order, and organized. They are constantly obsessed with being clean and having their homes tidy. They are very tense and restless types. Their obsession with being so neat is to convince themselves that everything is under control. They set very high standards for themselves, sometimes standards that are beyond their grasp and then they feel guilty about not achieving their goals.
Isn't the homeopathic doctrine of "constitutional remedies" just like the revolution that is sweeping conventional western medicine, in which medications and treatments are tailored to an individual? No, not at all. The doctrine of constitutional remedies has two parts: diagnosis and treatment. The diagnosis is entirely subjective: what the homeopath perceives about the patient. In the example above, the homeopath The treatment is equally subjective: the patient is somehow "like" arsenic; therefore give them dilute arsenic, and their character will change and/or their health will improve.
Wait a minute. Arsenicum album is white arsenic, a deadly poison. How can a homeopathic remedy be safely administered? The answer is homeopathy's doctrine of dilution.
How Homeopathic "remedies" are prepared.
Homeopathic "remedies" are concocted from minerals, botanical substances, and several other sources. Let us take for example BELLADONNA, or Deadly Nightshade, which is recommended to be given at 1X to 30X, and SILICEA TERRA Silica. Pure Flint, which is recommended at 6Xto 30X. If the original substance is soluble, one part is diluted with either nine or ninety-nine parts of distilled water and/or alcohol and shaken vigorously (succussed); if insoluble, it is finely ground and pulverized in similar proportions with powdered lactose (milk sugar). One part of the diluted medicine is then further diluted, and the process is repeated until the desired concentration is reached. Dilutions of 1 to 10 are designated by the Roman numeral X (1X = 1/10, 3X = 1/1,000, 6X = 1/1,000,000). Similarly, dilutions of 1 to 100 are designated by the Roman numeral C (1C = 1/100, 3C = 1/1,000,000, and so on). Most remedies today range from 6X to 30X, but products of 30C or more are marketed.
The Mother Tincture
Products which are soluble in water or alcohol are prepared using what is called a "mother tincture." Mother tinctures of plant, vegetable or animal substances are prepared by the maceration of the fresh material in different strengths of alcohol at room temperature. After aging (anywhere from one hour to one month), the suspension is filtered by gravity or compression. Final alcohol strengths may be 33 1/3%, 50% or 80 to 90% (volume/volume), depending on the water content of the starting material. Succulent, fresh plants yield between 350 ml per 700 ml of unfiltered succus (or juice) per kilogram of plant material. The succus is mixed with one half of its volume of 95 % pure alcohol, producing mother tinctures of approximately 33 1/3 % (volume/volume) alcohol content. Fresh plant material yielding less than 350 ml per kilogram of succus is repeatedly macerated with alcohol/water mixtures, producing mother tinctures of approximately 80 to 87 % (volume/volume) alcohol content.
Dilution and succussion
"Decimal" solutions are labeled by the letter X or D. Each successive dilution is one part of substance to nine parts of alcohol. "Centesmisals" are labeled by the letter C or CH (or they carry no notation). Each succesive dilution is one part of substance to 99 parts of alcohol.
Succussion is a word made up by Hahneman to denote the process of violent shaking with impact which follows each step of the sequential dilution, which homeopaths believe completes the potentization procedure. Hahnemann achieved this by holding the vial firmly in his hand and using his forearm to strike a leather bound book. The procedure was repeated at least ten times. Today, machines usually provide the force. One such mechanical device causes a glass vial, attached to the end of a motor driven rocking arm, to impinge on a rubber pad on each downward stroke. While succussion certainly insures a thorough mixing of the ingredients, homeopaths believe it also energizes the potency. In other words, the energy expended in shaking and striking is somehow stored in the "remedy", to be subsequently released as kinetic energy in the healing process.
Trituration for Preparations such as Silica
This process is used to pulverize insoluble minerals and chemicals to a very fine form. One part (say, one gram) of the substance in question is ground in a mortar and pestle, while 99 parts of lactose (milk sugar) are slowly added. This process goes on for a least an hour. The resultant finely divided powder represents the first centesimal triturated potency. The entire process is repeated, using one part of the first centesimal trituration and a further 99 parts of pure lactose to produce the second centesimal triturated potency, and so on. For each insoluble mineral or element, a certain potency level is reached, whereby it is sufficiently diluted to be within its solubility limit in the alcohol / water. At this stage, higher potencies can be prepared in the liquid form in the usual manner.
Now that we have covered the history of homeopathy and how homeopathic "remedies" are prepared, we can address the likelihood that homeopathy can have any effect upon the body, whether positive or negative
Review: Homeopathy is a belief system with the following features:
- The Vital Force Homeopaths believe that the essential nature of a living being is not to be found in the physical tissues and organs of the body.
- Like cures Like (Law of Similars) Curing is achieved by stimulating the body with substances that in large doses cause the sypmtoms in question.
- Law of InfinitesimalsExtreme dilution enhances the curative properties of a substance.
- Succussion The action of succussion makes the remedy more powerful.
- Whole Person Prescribing Example: two persons exhibiting the same flu-like symptoms may get two different medications from the homeopath based on the appraisal of the mind/body constitution
- The Constitutional Remedy Homeopaths believe that one specific remedy can cure all the ills of a particular "constitional type"
- The Use of Natural Materials There are several classes of remedies: those based on plants; those based on elements; those based on chemical compounds; those based on the effluvia of disease (nosodes); those based on preparations from healthy organs and tissues (sarcodes)
Critique of Homeopathic Principles: The Vital Force
This is essentially a metaphysical or spiritual belief, and thus is not susceptible to scientific proof or evidence. It also suggests that homeopathy is not a scientific system, but a spiritual one. Many of the homeopathic principles rest on spiritual beliefs, as we explain below.
Critique of Homeopathic Principles: Law of InfinitesimalsWe should address this in several parts.
- What is the proof that a remedy becomes stronger through dilution? (I have not been able to find any evidence, other than repeated assertions that this is so)
- What is the generally-recognized physical or chemical law that allows potency to grow through dilution? That is to say, that allows one molecule of a substance to have more effect in the body than 10, or 100, or 1000? (The answer is, there is none)
- what about Avogadro's limit of dilution?
The Scientific Impossibility of Homeopathic Dilution: The Avogadro limit
We now know (as Hahnemann probably did not) that there is a finite number of molecules in a given volumn of a substance (Avogadro's number). Usually, this is expressed as a "mole." A mole of a substance is the molecular weight of a substance expressed in grams. Water, H2O has a molecular weight of: 2 + 16 = 18. A mole of water is therefore 18 grams. Avogadro's number tells us that there are 6.022 x 1023 water molecules in 18 grams of water. Relative to the dilutions common to homeopathy, Avogadro's number expresses an extreme limit of dilution: one molecule of "substance" (homeopathical mother tincture) per one mole of dilutant. Homeopathic potencies greater than 24X or 12C exceed the limit expressed. At any time you ingest a remedy with potency greater than 24X or 12C, you hare ingesting only the dilutant.
Homeopaths don't usually have to worry about exposing their patients to poisons or noxious substances. The notation 30X means the 1:10 dilution, followed by succussion, is repeated thirty times. That results in one part in 1030, or 1 followed by thirty zeroes. Suppose a homeopath prescribed you a 30X preparation of Arsenicum Albium to treat your problem with compulsive behavior. You would need to ingest some two billion drops to get even one molecule of the Arsenicum. Some homeopaths provide dilutions of up to 200C, which works out to one molecule of the active substance to 1400 molecules of the diluting agent. But the total number of atoms in the entire universe is estimated to be about one googol, which is 1100, one followed by a mere one hundred zeroes.
Critique of Homeopathic Principles: SuccussionThis is what homeopaths believe:
Succussion and trituration release the healing essence of the substance (derived from an animal, botanical or mineral source) and concentrate it, while the dilution removes the physical presence of the substance itself...Succussion releases dynamic forces from the diluents which are preserved and intensified with subsequent dilutions. (Potentization)
Critique of Homeopathic Principles: Succussion
Dr. Hahnemann prepared the remedy by succussing it-repeatedly shaking it vigorously and banging it down on a hard surface. Succussing the remedy is said to release the energy in the drug.
In fact, it is more than a simple dilution process by which the homeopathic remedies are made. One part of the original form of the substance is first diluted in ninety-nine drops of water and/or alcohol. Then it is shaken vigorously. The shaking is called succussion and the entire procedure is termed "potentization"; the remedy is made potent by the process. ... Clearly, the action of a homeopathic remedy goes beyond chemical reactions and physical substance as we commonly understand it.
The Homeopathic Explaination Of Potentization
The idea is two-fold. One half is that energy or potency is somehow added by dilution, the other half is that the energy expended in shaking or grinding the remedy is somehow captured by the product being shaken. Hahnemann propounded the idea that the method used to prepare homeopathic medicines was not a mere dilution but involved dynamization or trituration, which released astonishing powers; active substances were made more active and hitherto inactive ones, such as quartz sand, were found to have unsuspected latent properties.
Here is what current homeopaths have to say on the subject
Homeopathic remedies are not mere dilutions. The trituration and succussion process is intended to somehow "strip away" the material aspect of the substance while intensifying its "energy signature". It is this "energy" which is thought to somehow stimulate the patient's vital force.
Despite over 200 years of clinical efficacy, the nature of how these remedies work is still a mystery. We do not yet possess the technology or the methodology necessary to unlock homeopathy's secrets and each generation of homeopaths has its favorite theory. The answers must await future generations of scientists to uncover.
During provings, the people knew which substance they were taking. This is a problem because one might anticipate a certain reaction or exaggerate some symptom.
Today, in modern science, we try to prevent this bias by not letting the person know what he or she is taking -- a "test-blind" procedure. When evaluating symptoms, it is also important that the researcher does not know which remedy is being tested (a double-blind procedure) because the researcher can also be biased.
Here is a critique of thechain of weak links
The so-called "active ingredient" must somehow be active (a tautology, perhaps, but I insist!). Gold, or aurum, for example, is a substance where effectiveness is doubtful. According to mainstream science, gold is rather inactive chemically (guess why it's good for jewellery, it lasts!). As for the like-cures-like hypothesis, what symptoms does gold cause when concentrations are high? Virtually none. The same question is valid in the case of occillococcinum. Does duck liver cause symptoms of a cold or a flu? I believe not. (A good foie gras may cure hunger and bad humor, but only in high concentrations.) The principle of simila similibus curantur seems to be conveniently abandoned here.
* The properties of the active ingredient must be transferred to the medium in which it is succussed. Also, these properties must not be stored transiently; they have to be remembered for a long time. According to homeopathy, these memories are stored indefinitely. The medicines have infinite shelf lives, in other words.
* The dilution process must intensify the memory. Enough said!
* The memory has to be transferred to yet another substance, e.g. lactose in pill making. How do the molecules know in which direction the transfer shall take place: from the water to the sugar, or from the sugar to the water? Do different memories have different priorities, and if so, why would water's memories be superior to sugar's dittos? Furthermore, do memories overwrite or overlay one another? Is there an upper limit for storage capacity? And what happens when the water evaporates after the memory transfer--are the memories kept in the water? If so, how large quantities of gaseous medicines can the manufacturer inhale before side-effects show up? Lots of questions, as you can see, but no answers...
* Once the medicine is taken, the reverse memory transfer must occur once again. This leads to the question about memory priorities anew. Why doesn't the blood--or the water in the blood--transfer its memories to the sugar, instead of the opposite, or do they exchange memories? Or are the memories transferred directly from the dissolved sugar molecules to the white blood corpuscles?
* The body must be able to detect as well as to interpret the memory. Why is the memory of a substance better at healing than the substance itself? Is the body able to differ between a substance and its memory?
* Assuming the above conditions fulfilled, the amount of medicine ingested must contain enough of the healing memories to be effective. I honestly hope that homeopathists are wise enough not to claim that the lesser the exposure to healing memories, the more efficient the remedy; then the best way to get healed would be to stay away from homeopathists at all!
* When the body has interpreted the healing memory, the measure taken must be palpable enough for the patient to notice improvement.
What remains of homeopathy if any one of the above conditions is not fulfilled? Not much, that's for sure. Perhaps the law of infinitesimals applies here; the less there is of homeopathy the better!
Since most of the homeopathic beliefs are spiritual in nature, perhaps the homeopathic establishment in the United States should take a leaf from the book of Scientology, a cult/business that's intimidated the IRS into granting tax-exempt status. (By the way, that means that means you and I are supporting this cult).