by Clive Stuart

This article was originally printed in Investigate magazine.

In August 2005 the medical journal “The Lancet” published a study suggesting that any positive effects from Homeopathic treatment were due to a placebo response, in other words a person gets better because they believe in the medication or the practitioner or both. The study was a meta-analysis. This type of study is a comparison of many clinical trials carried out in the past. An editorial in the same journal titled “The end of Homeopathy” advised Doctors to be “bold and honest” with their patients about Homeopathy’s lack of benefit. Strong stuff indeed, especially as the last major meta-analysis of Homeopathy published in the same journal in 1997 concluded that the positive effects of Homeopathy were not down to the placebo effect. Why then the mad rush to declare the end of a system of medicine that has shown it’s efficacy in many high quality studies?

Homeopathy has been around for a couple of hundred years. Widely used in America and Europe in the 1800’s, it has enjoyed a spectacular resurgence in the last twenty to thirty years. In the UK where it is recognised by Act of Parliament there are a total of four Homeopathic hospitals. In India it is practised almost as widely as conventional medicine. Studies have shown it to work equally well for animals with many veterinarian surgeons using it for their patients.

One of the reasons for it’s popularity is that it is a very safe form of treatment. This is due to the fact that the remedies used are highly dilute and thus free of any toxic side effects. It has been postulated that Homeopathic remedies stimulate the body’s homeostatic or self-balancing mechanism. The choice of Homeopathic remedy is based on a totality of the patients symptoms including mental and physical symptoms. The philosophy is very different to the reductionist approach of modern medicine where disease is generally reduced to one dysfunctional organ or system.

Little research has been carried out to explain just how homeopathy works but it’s efficacy is well documented. This is borne out by many high quality studies published in peer reviewed medical journals showing the positive effects of Homeopathy above and beyond those of placebo. Just one month before the negative Lancet paper was published a study appeared in the “European Journal of Paediatrics” giving scientific evidence that Homeopathy was effective in the treatment of ADHD (Attention Deficit Hyperactivity Disorder). Should Doctors not be “bold and honest” with their patients about this fact ? As Homeopaths we see our patients with ADHD respond well to Homeopathic treatment but our anecdotal evidence means nothing to conventional practitioners without scientific fact to back it up. That scientific fact is now available in this latest study. Doctors therefore owe it to their patients to acquaint themselves with the ADHD research and recommend Homeopathy as a safe and effective alternative to amphetamine based drugs such as Ritalin. One month before the ADHD research a German comparative cohort study of 493 people was published in “Complementary Therapies in Medicine”. The aims of this study were to evaluate the effectiveness of Homeopathy versus conventional treatment in routine care. The study concluded that patients on Homeopathic treatment had a better outcome overall compared with patients on conventional treatment. With this in mind why then did the editor of the Lancet Dr. Richard Horton lock on to one negative study among many positive ones to launch a highly vehement attack on Homeopathy? Surely a balanced statement calling for more research into Homeopathy would have been more in keeping with good science.

Horton is well known for his opposition to Homeopathy as is one of the principal authors of the paper Prof. Matthias Egger. Egger stated at the outset that he did not expect to find any difference between Homeopathy and placebo. It now appears that he found what he wanted to find. As scientists from around the world dissected the study more disturbing facts came to light. Only 8 out of the 110 studies on Homeopathy were used. The authors admitted that many of the 110 studies showed positive results for Homeopathy, yet these studies were thrown out after the authors had decided they were “lower quality”. Respected scientists subsequently branded the paper “junk science” saying it was deeply flawed and biased but by now Horton and Eggers hatchet job on Homeopathy was beginning to bear fruit. News media around the world were awash with “Homeopathy no better than dummy pills”, all the while fuelled by journalists of a sceptical bent who were keen to offer misplaced reverence to the Lancet study. Unfortunately the rebuttals and rebukes of the study by those in the scientific community never got the same publicity as the Lancet soundbites. These critiques included letters to the Lancet itself that were rejected for publication. Medical doctors who had objections to the methodology used in the study asked for the identification of the eight trials used in the final analysis but the authors explicitly refused. Added to this was the fact that the journal had recently refused to publish a large UK study which showed high levels of effectiveness for Homeopathy and you have all the transparency of a brick.

One has to wonder if there was some agenda behind all of this. Could pharmaceutical companies have had some influence ? It would hardly be a surprise as these companies are losing huge chunks of market share to Homeopathy and Complementary medicine in general. Then again it could just be actions borne out of sheer frustration at the success of Homeopathy, frustration that will no doubt be enhanced by the recent 6 year study from the Bristol Homeopathic Hospital in the UK. This was the study that the Lancet would not publish. 6,500 patients took part in the study which was published in the peer reviewed JACM (Journal of Alternative and Complementary medicine). 70% of patients with chronic diseases such as arthritis, asthma, chronic fatigue syndrome and severe eczema reported that Homeopathy had a positive effect on their symptoms. This figure rose to 89% for young asthma patients who experienced an improvement in their symptoms. Overall 75% of patients reported feeling “better” or “much better”. Although this was an observational study and not a double blind trial it is of great importance in showing the effectiveness of Homeopathy. It can also be said that conventional medicine would be greatly pleased with outcomes similar to these.

Sceptics have always used the argument that Homeopathy can only work by placebo because the remedies are too dilute to have any physical effect. If there was any credence to that argument then the patients in the Bristol study must have been on “extra strength” placebo because of the sheer volume of positive results. Certainly ultra-dilutions have been a major stumbling block for Homeopathy being accepted by conventional scientists despite there being research suggesting the contrary. One such scientist was Prof. Madeline Ennis, a pharmacologist at Queen’s University Belfast and an avowed sceptic of Homeopathy. She published a paper that was based on a high quality and groundbreaking study that tested ultra-dilute solutions of histamine and it’s effects on certain types of white blood cells called basophils. When the histamine was diluted to homeopathic levels and past the point where any molecules of histamine could remain, the ultra-dilutions still had an effect on the basophils. The results were replicated in 3 other laboratories across Europe and published in the respected “Inflammation Research”(vol 53, p181). Ennis would have to concede that she had failed to disprove Homeopathy. She said in her paper “We are unable to explain our findings and are reporting them to encourage others to investigate this phenomenon”. Ennis is to be commended for her integrity in publishing findings that were difficult for both her and science to accept and explain. Others in the same field could learn from her example and remove themselves from the comfort zone of accepted scientific fact to embrace new possibilities.

As stated previously the bulk of clinical research shows the placebo argument to be an erroneous one. To the research can be added the fact that Homeopathy has been shown to be effective for babies and animals. Here the chances for “power of suggestion” would seem remote. For animals to be susceptible to the placebo effect, their vets would need to develop the same powers of communication as Doctor Doolittle. As Homeopaths we see many patients who have come to us after not having had improvement from other medical treatments. If these people were susceptible to the placebo effect, why then did it not happen with the other treatments ? I have been a Registered Homeopath in full time practice for 10 years in the UK and New Zealand. Nearly all of my work comes from referrals. This is because people recommend what has worked for them personally. If the opposite were true, Homeopathy would have died a death a long time ago.

The public needs to be made aware when bias and selective research are fed to them under the guise of medical science. Homeopathy does not fear scientific scrutiny and evaluation as long as it is carried out on a level playing field with truth and integrity. I have much respect for modern medicine but it is by no means the only way to restore the sick to health. We all need to work together for the good of the patient. Doctors, Osteopaths, Homeopaths, Acupuncturists etc. all have their place and need to work with each other as parts of a cohesive whole. Divisiveness and one-upmanship have no place in healthcare.

Clive Stuart is a Registered Homoeopath in Tauranga, New Zealand