Are curative effects of homoeopathy due to placebo?

Professor Atta-ur-Rahman has written about homoeopathy in his column “The Wondrous World of Science” of March 6, 2011. Quoting reports and statements, he has tried to show that homoeopathy lacks scientific proof of its effectiveness and that any benefits of homoeopathy are due to the placebo effect or the natural tendency of the body to heal itself over time.

On the face of it, his claims sound forceful and convincing but a deeper analysis in the light of recent scientific developments does not support them and unmistakably shows, they are unsubstantiated and based on flawed information.

The mainstay of his arguments is the purported inability of homoeopathy to show positive results in randomized clinical trials (RCTs) which, according to him, “have proved over and over again that it has no more benefit than that which can be attributed to the placebo effect.”

RCTs may be the best way to evaluate conventional medicine (allopathy) but they are totally useless to assess homoeopathic effectiveness in any given disease because conditions necessary for homoeopathic treatment are not taken care of in RCTs. RCTs measure a single drug substance to see its effectiveness for a specific medical condition whereas in homoeopathic clinical practice, a medicine is prescribed based on the totality of signs and symptoms with particular attention to the personal characteristics and individuality of each patient and the circumstances under which he experiences these symptoms. It is not possible to consider this totality while conducting RCTs as all the participants (subjects) have to be given the same substance whether their symptoms correspond to that medicine or not.

It should not, therefore, be difficult to understand, why a homoeopathic remedy fails to fare better than a placebo in RCTs while in all other clinical trials meeting the requirements of homoeopathic prescribing, the results are quite satisfactory. A recent book “The Trials of Homeopathy” by Michael Emmans Dean, which is based on his PhD thesis, gives a systematic review of all clinical trials of homoeopathy from its beginning to the 21st century and shows that homoeopathy has a long history of scientifically conducted trials with positive results.

Professor Atta-ur-Rahman also quotes a report from The National Center for Complementary and Alternative Medicine of the National Institute of Health, USA, as stating, “Its key concepts are not consistent with established laws of science (particularly chemistry and physics).” He does not identify the “inconsistent key concepts” but a reading of the report available on the NCCAM website suggests, he is referring to the laws of Similars and Minimum Dose in homoeopathy. In simple words, he means that since homoeopathic medicines are diluted to such a degree that they do not contain a single molecule of the original substance, it is not possible for these dilutions to have any effect.

In this context, one also should not ignore the statement of Professor Luc Montagnier, who won the Nobel Prize for Medicine in 2008 and currently heads the World Foundation for AIDS Research and Prevention under the auspices of UNESCO. In an interview published in the prestigious Science Magazine of December 24, 2010, he stated, “I can’t say that homoeopathy is right in everything. What I can say now is that the high dilutions (used in homoeopathy) are right. High dilutions of something are not nothing. They are water structures which mimic the original molecules.” (Italics are mine).

Professor Atta-ur-Rahman also quotes health organizations of the USA and the UK to have issued definitive statements that there is no convincing scientific evidence to support the use of homoeopathic treatments in medicine. He particularly mentions the American Medical Association (AMA) and the UK’s National Health Service (NHS).

The AMA represents and safeguards the interests of allopathic physicians of the USA. Not many people know today that it was formed in 1847 in reaction to the growing popularity of homoeopathy in the USA and has a long history of professional conflict with homoeopathy. Therefore statements like the one cited by Professor Atta-ur-Rahman should not surprise anyone. As for the UK’s National Health Service, it has always resisted the demand by the UK allopaths to stop funding homoeopathy because of “lack of scientific evidence about its effectiveness.” The NHS provides financial grants to four big homoeopathic hospitals, one each in Bristol, Glasgow, Liverpool and London. The statement attributed to it by Professor Atta-ur-Rahman might be the result of some misunderstanding. It appears, he has mistaken a feature report posted on the NHS website for the statement of NHS! The feature report is there to meet legal obligations and, needless to say, does not represent the views of NHS.

The conclusion that homoeopathic effects are due to placebo is scientifically untenable. Epidemiological studies in recent years as well as the results in a very large-scale study against Leptospirosis in a dangerous epidemic situation in three provinces of Cuba in 2007 speak otherwise. According to the abstract (PMID: 20674839) of the study available with the National Center for Biotechnology Information, U.S. National Library of Medicine, USA , the results of the study show that an annual outbreak of the epidemic was successfully prevented using homoeopathic prophylactic formulation in a population of 2.5 million in a high risk region affected by the epidemic.

When one analyzes all available literature, it is almost impossible to claim that homoeopathy is nothing more than a placebo effect. Even for the sake of argument, if we accept the contention that homoeopathic action is nothing but a placebo effect, then how can one explain its action on animals and babies? Homoeopathic medicines work as well on animals as on humans and likewise, babies respond particularly well to homoeopathic treatment. Is it even possible to explain to them that the homoeopathic remedy alleviated their symptoms, much less that the psychological effect of taking it brought about the cure?

Ahmad Fakir Muhammad, April 11, 2011