The Current State of Homeopathy

I have been friendly with and received referrals from homeopaths. and taken care of patients who have sung the praises of that art.  Since I am known to most folks as an “alternative physician,” this is understandable.  All homeopaths have been gentle folks, and I supposed that they were doing people good, in some way, be it placebo or something else.  I had no reason to fight them. I cannot remember ever actually referring someone to a homeopath.  Some people have told me it did not work for them.  And even though I use alternative methods,  I do things that are scientifically proven to my satisfaction.

I have never told anyone to stop seeing a homeopath who was helpful to them.  I decide on the basis of safety and efficacy for every treatment, as best I can.  Even if I sometimes have wondered about efficacy, I will admit. But for safety, homeopathy is off the charts.  I know of no down-side. I remember looking at the “dilution” level of the remedies.  In general, they are so dilute that they could not possibly have any of the “substance” that was used to make them, not even a molecule.

To me, that just means they can’t possibly interact with any drugs.  This is rare in my world, for drugs can interact with other drugs of prescription, over-the-counter drugs and foods.  Drugs can interact with themselves and change their own metabolism and have colorful side effects in the human body. Dealing with homeopathics has got to be basically, taking water.  I am used to saying “Take all the homeopathic remedies you want,” and nobody has ever gotten in trouble.

So I found out, from a news article about government intervention that the FDA and FTC (Federal Trade Commission) are mandating a disclaimer for homeopathic products. It will basically say “There is no scientific evidence that the product works,” and  “The product’s claims are based only on theories of homeopathy from the 1700s that are not accepted by most modern medical experts.” At least one caring and patient homeopath took the time to explain to me “provings” and the development of remedies, it was admittedly like nothing I ever had learned, but it didn’t sound like Black Magic, either, and there are LOTS of reports of efficacy from patients. The scariest thing is that it says “not accepted by most modern medical experts,”  and I am pretty darned expert as standards go. The best thing is it only says “most,”  so I dug back into over 300 years of medical literature and I will make an attempt to summarize what hit me the most.

The writer of this history of homeopathy (who has a degree in public health) does a good job of writing a historical chronicle. He never approaches the notion of “scientific proof,” staying more at the level of popularity. It definitely makes some folks feel better. The author posits political and economic reasons it has fallen from favor.  These factors certainly do exist even now, for American medicine, with the assistance of various corporate entities has indeed endorsed “allopathic” or mainstream prescription-based medicine at the expense of “alternative” entities which I know work perfectly well as I do alternative treatments as a part of my livelihood.

Still, as the public has become increasingly aware of the problems associated with prescription drugs, it is claimed in this history that the number of people being treated by homeopathy has doubled since 1970. Sure, I remember reading in the Lancet (a wonderful British medical journal) a bunch of articles that suggested the results of homeopathy were better than what would be expected for a “placebo effect” alone. I do not see any studies that seem to have been controlled for the large amounts of time a wildly personable and charming homeopath spends with a patient.  Most patients in traditional medical care who can expect to spend only about seven minutes in a routine visit from a family practice doc. More often, such a patient won’t even see a medical doctor, as most primary care now is handled by “doctor extenders” — nursing level, physician assistant or similar clinical staff. In fact, in our “anything to cut costs” atmosphere, many states are eliminating a requirement for a doctor to even rubber-stamp a signature on whatever prescription or treatment a patient receives.  Insurance companies are happy to process a larger of volume of patients and clinics need to churn out the patient visits to make expenses since payments are continually being reduced.

I don’t know any science to prove why this modality should work.  Anyone who is honest would admit that the results of scientific research are at least a bit influenced by “confirmation bias” (what somebody believes and how they look for it) and sometimes, even who is funding the research. Magician James Randi, well known skeptic, has offered one million dollars to anyone who can prove scientifically that homeopathy works.  The million has remained unclaimed.  That is not pocket change, and would expected to induce someone to do (or at least to plan) a little science. There is an entity called “water memory,” often cited by endorsers of homeopathy to explain why it works.  These folks claim that even if a water solution of a substance has been so greatly diluted as to have none of the substance, the water has somehow been “changed” by the presence of the substance. I probably should add that the choice of the substance to be used is a function of the clinical effects of the illness to be treated.  An excellent example given in the London Daily Mail is that a cold, which generally produces teary eyes and a runny nose, would be treated with a remedy made from onions, as they produce teary eyes and a runny nose.

At any rate, back to “water memory,” which even the most astute of physical chemists could not directly prove at this time with current technology: well, I remember when I told a scientist friend about this, she pretty much shouted “pseudoscience” in my face. In 1988 a French (hooray for our side) scientist named Jacques Benveniste published an article in the prestigious journal Nature that endorsed the idea that “water memory” was real.  The editor John Maddox told readers to “suspend judgement” until the experiment was reproduced. Benveniste, an immunologist, made it clear he was free from the influences of homeopathy.  He was working for INSERM.   This is the French equivalent of our National Institute of Health and they are above reproach.  While a student in French medical school I worked to translate some of their research into English for publication in American journals. At any rate, this immunologist and his team diluted a solution of human antibodies so much that it was pretty certain no antibodies were left in the solution.  They reported that human basophils responded to the solution as if they had encountered the antibody.  This is part of an allergic reaction.  This happened only when the solution was shaken violently. Benveniste offered no explanation of what was coming down. Some reporter later called it “water memory.” It still doesn’t explain why onions should help a cold. They won’t let me access the original article unless I pay a lot — something like a pound of flesh and my firstborn child.  How about the Wikipedia article on “water memory?” Which is as good a synopsis as any I can find, and all you need to follow this argument. Let’s just say our intrepid immunologist went to considerable lengths to do followup experiments, which did not impress James Randi who, as far as I know, sill has his million dollars.

James Randi did discover that two of the folks on the team were at least partially paid by Boron, a french company that makes homeopathic remedies.  The conduct of the experiment seems to have been above reproach.  I can see someone whose job skill is making homeopathic remedies as doing whatever it takes to pick up a couple extra bucks (or francs).  The journal seems to have gotten tired of publishing letters about the controversy of what this means, at least according to Wikipedia. Oh, those lovable Brits.  It seems like yesterday they were doing a documentary about how the BBC physician who does documentaries decided to reverse his own diabetes.  That led to my hearing about Prof. Mark Matson, who had been researchiing the (highly salutary) effects of intermittent fasting at our (U.S.A.) National Institute of Health (on my tax dollar, mind you) and it is really good stuff. Now, according to British media, they have set out to prove that homeopathy does not work.

I have to commend them on their depiction of science and medicine in the media.  They’ve really got a free press.  I would rather see this on TV than drug company ads for prescription drugs (which aren’t legal in most other countries, anyway).  According to our friends at the Guardian, Professor Madeline Ennis, specialist in pharmacology at the Queen’s University in Belfast performed, and repeated, an experiment similar to one performed by Benveniste and his gang. Dr. Ennis used basophil cells, and put them with a solution of histamine so diluted its pretty sure it had no histamine.  (You know about histamine.  You’ve taken “anti-histamines to curb you reaction to pollen for years) and the cell reacted just as if it had been exposed to a lot of real histamine.  She seems as shocked as anybody; a serious scientist who seems to have been skeptical of things like homeopathy. Our Brits will follow up on this with a documentary, soon. Until her, as far as I can figure, nobody other than Benvenista seems to have tried to replicate his experiments, and I can’t find anyone else who looked at this process scientifically.

Me, I am not as uncomfortable as everyone else, because this is where I live.  I use all the “real” science I can find to endorse a treatment before I give it to a patient.  It is in the final analysis, a decision looking at advantages and risks.The bottom line is that homeopathy is not proven nor disproven, has minimal risks, and has potentially enormous advantages if it can actually make folks feel better. Whatever else I am, I spend a LOT of energy trying to be scientific, to be objective, to find the “truth.” It would be more accurate to say : There is no significant evidence that this product works with current levels of scientific technology. The jury is still out on homeopathy. I say give it to anyone who wants to buy it.  There are lots of people who hate science and will want something “non-scientific.”  I always have to bite my lip to avoid talking back when a patient says (as they have) that they like me but not science. OY! All the two paltry experiments have proven is that extreme dilutions seem to work in the context of a couple of immune system related reactions.  I don’t know what it means any more than anyone else does. They can leave the one about not being accepted by most medical experts.  I don’t accept most medical experts at all.

If I am trying something new or different on a patient who needs to trust me,  I always ask them what they think keeps the world together.  I take all answers from “I only believe in what I see” to “I am a devout (fill in the blank).” Then I ask them if they think that a healing force can work through a crazy old lady Jewish psychiatrist who really wants to make them well.  It seems most forces can. Then I tell them that force will make them well.  I quote my grandmother of blessed memory (who did not seem to know at the time she was pretty much quoting George Bernard Shaw) God (or whatever or whoever) makes people well — doctors just collect the money.” Or try Proverbs 23:23.

Get the truth and don’t give up on it.  The homeopathic question should not be tucked away and forgotten.  We need to develop better treatments than we’ve got, and put humanity in medicine, and do a lot of things.  Being a doctor is not yet what it could or should be, and I remain, “never give up — never surrender.”

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