Friday 03 July 2009
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Funding Charlatans

With the recent announcement that a fifth of NHS hospitals trusts have reduced or cancelled funding for homeopathy, Chris Williams explains why he's so happy

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An aunt who has never quite got over the passing of 1969 into 1970 recently told me that she was planning to take Charaka as prophylaxis for malaria on a trip to Botswana. Having picked the drug up in Switzerland from her homeopath, she wondered what I thought about it.

As with all homeopathic drugs, Charaka aims to aggravate the immune system into producing more of the same symptoms that the patient is already suffering. This, so the theory goes, will cure them of their disease. The "like cures like" premise was first established by Dr. Samuel Hahnemann in the late eighteenth century but Hahnemann also noticed that it wasn't such a good thing to have patients suffering twice as much as they were in the first place. To solve the problem he thought he would dilute his preparations. Dilution, he said, when done in the right way with the right amount of vigorous shaking at the right times would create a "memory" of the active molecule in the water molecules around it that would let the body know what it should do without inducing most of the actual symptoms themselves. Hahnemann recommended diluting active compounds 30 times at a ratio of one part of the tincture to 100 parts water each time.

To put this in context, if you start with 1ml of concentrated drug and put that whole volume through this dilution, you'll end up with enough finished product to fill a cube 1,000,000,000,000,000,000 metres per side. In other words, over 1 million light years cubed. Needless to say, in most homeopathic tinctures, not a single molecule of the original active ingredient remains.

In a report in The Guardian last week, it was revealed that over one fifth of NHS Hospital Trusts have cut or reduced funding to homeopathic services in the past two years. Such a change marks the first success for a campaign waged by many eminent scientists to end the practice altogether.

Why the NHS ever thought it necessary or acceptable to fund such a ridiculous practice is beyond many people. Whilst leeches, blood letting and popping arsenic have fallen by the wayside of their contemporary, the theory of homeopathy, has prevailed. What seems to sustain homeopathy today are three major factors. Firstly homeopathy does no harm – no one ever died from taking a little bit of water. It was just this ideal that Hahnemann was working towards when formulating his new type of treatment that would avoid the hideous side-effects of the medicines of his day. Side-effects still play an unfortunate role in today's medicine and many people want to ensure that they suffer from none of them – water is a very effective drug when a lack of side effects constitutes your measuring stick.

Perhaps the principal reason why reasonable people are not up in arms about homeopathy is the complete lack of appreciation amongst many members of the public for the difference between this sham and herbalism. Such a simple misunderstanding often allows homeopathy to escape scrutiny scot-free. Homeopathy is a pseudoscience based on the principles described above; herbalism is the use of traditional herbs such as St. John's Wort and Echinacea to treat common ailments. Whilst herbal pharmacies are not recommended by doctors as a first port of call for patients owing to the inability of herbal practitioners to assess symptoms in the context of more serious diseases that may be underlying them—the example of constipation as a symptom of bowel cancer is a good one—many herbal remedies have proven effectiveness. Indeed, many of today's drugs are based on the active extracts of these original medications.

The final reason for homeopathy's survival against all the odds is something that most medical practitioners in the twentieth century failed to recognise: it is the very human desire to think that, when all suggested conventional treatments have failed, there must be something else, some "natural" cure left that could solve the problem. This failure to understand patients as people and the consequent treatment of their ailments in isolation – rather than more modern holistic approaches – has been the major contributor to the whirlwind of cynicism and suspicion that is now being reaped by science.

But why come down so harshly on homeopathy? If alternative medicine is a human need, why not let it be? This is a common argument that often comes backed up with the assertion: "My aunt was really stressed and she took a homeopathic remedy and now she's fine." But whilst many complementary therapies are well placed to treat stress—massage, group therapy, reflexology, counselling, acupuncture, gym membership and many more—homeopathy is not. Because although your aunt might find that taking that ampoule of water to treat her stress removes the worst of the problem, she might then consult her pseudoscientific homeopath when she's planning a once-in-a-lifetime trip to Botswana.

She wouldn't go back to her acupuncture specialist for advice on malaria; she wouldn't refuse vaccines for her children based on what her gym manager told her and she wouldn't seek treatment from her group therapist for that constipation that has been bothering her for a while but which could actually be a sign of cancer.

For as many anecdotes that there are describing a homeopathic success story, there is another, more tragic tale of a young woman refusing surgery to remove an easily operable breast cancer, a cancer that would go on to kill her. This true story is told by Professor Michael Baum, Emeritus Professor of Surgery at University College, London and is one of the factors that led him to start his much needed campaign against what he calls the "hocus-pocus" of homeopathy. As Professor Baum points out, £5 million a year is spent on homeopathy by his NHS hospital trust alone, funding the Royal London Homeopathic Hospital. This would be more than enough to cover the cost of herceptin for the trust's breast cancer patients for example – a drug proven to be effective but which the NHS cannot currently afford to provide in all cases.

This waste of limited NHS resources is bad enough, but what is far worse is that for every day that passes with NHS funding seemingly substantiating the fraud of homeopathy, another person, confused by the complexity of conventional medicine or lacking the proper complementary care they need, may be heading to an early grave by sincerely seeking answers from charlatans.
Chris Williams is Comment Editor at The Journal and is a third year medical student at the University of Edinburgh

8 comments

Stavros Isaiadis
Fri 15 Feb 2008

I (along with many other rational people) have been ranting about homeopathy (here) and one of the main reasons for my rants was that we pay taxes to fund such unproven techniques! It is absolutely criminal to reduce funds from where they are needed to favor homeopathy! Prove that it works and then we will give you funds.

Very, very well said Chris.

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David
Fri 15 Feb 2008

I would like to offer a dissenting opinion as a working homeopath.

I agree that homeopaths shouldn't be offering alternative medical advice about vaccinations when travelling to a third-world country. Undeniably there are incompetent, irresponsible homeopaths out there. But this criticism applies likewise to conventional medicine.

Homeopathy has survived because unlike leeching it is proving effective in a 21st century context, despite its admitted implausibility. The trouble is that whatever research showing positive results that does exist is systematically ignored by skeptics, who at the same time refuse to spend the necessary time in direct clinical observation of homeopathic practice.

It is unfortunate that a system which is cost-effective (even if its effectiveness is due to placebo) is taken out of the choice of therapies despite clear public demand.

I author a homeopathic blog where I've written a couple of relevant articles to this topic:

Is Homeopathic Medicine the "Enemy of Reason"? and another one on skepticism about homeopathy.

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laughingmysocksoff
Sat 16 Feb 2008

Chris Williams misses the crucial point here -- patient choice. If a woman chooses to treat her breast cancer with homeopathy, that's her choice. Not Professor Baum's.

Given the number of fatalities -- hundreds of thousands worldwide every year -- from iatrogenic causes, many people would far rather take their chances with homeopathy. And we ALL pay our National Insurance contributions. Why should someone who would rather have homeopathic treatment be forced to have their contributions diverted to subsidise vastly more expensive conventional treatments and have homeopathic treatment denied them?

Homeopathy is not without evidence of efficacy, despite the vigorous campaigns of sceptics to deny any such thing. Check the science behind the headlines and soundbites and you'll find a rather different story.

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Doughnut
Sun 17 Feb 2008

A great article Chris. I really don't understand how homeopathy continues to be funded under the NHS. I assume its a consequence of the genius of our great leader the Prince of Wales.

laughingmysocksoff - you suggest that people should get whatever treatment they want. Well there are two problems with that. The first is that there is a very limited amount of money in the NHS. We can't all get exactly what we want (and if we could I would like a holiday in Florida to beat the 'winter blues'.

Its also plainly stupid to give some a treatment for cancer unless it has been proven to work. If a women with cancer decides to use homeopathy rather than proper medicine then she is very likely to go to an early grave. Encouraging someone to do so is completely irresponsible.

With the right treatment people with cancer can be cured. That's never going to happen if they just take water or sugar pills.

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Tim Farley
Mon 18 Feb 2008

For more tragic tales of the harm that homeopathy can cause, look here:

http://whatstheharm.net/homeopathy.html

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Mrs IM Rabid
Mon 18 Feb 2008

I won't use anything but homeopathy because these so-called "scientists" but stuff in pills to keep us ill. And vaccines - don't get me started on vaccines. My mother died 25 years after her smallpox jab - my friend Rosemary says she got monkey virus genes into the third strand of her DNA. At least you can put homeopathy in your tea to sweeten it - you can't do that with Prozac, can you? HAHA! Take that, scientists and know-nothing "doctors"!

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Stavros Isaiadis
Tue 19 Feb 2008

David:

This is the case currently: since there is absolutely no plausibility regarding the mechanics of homeopathy there is no concrete theory behind it. It goes against science at this point.

So the only way to really test it is by the results. And here is the science behind this bit: no systematically correct, double blind placebo controlled trial is ignored. Out of the large number of such trials a small minority indeed show that it has some small advantage over placebo. And this is exactly what one can expect if it IS placebo! So they are not ignored, they are just a very small minority. And because homeopathy is such implausible it will take more (much more) than just a few studies that show it is slightly better than placebo.

laughingmysocksoff:

We do pay our contributions towards things that we know they work -and homeopathy is not one of them. We cannot pay contributions for something because "the public wants it"!!!

Of course I cannot reply to Mrs IM Rabid because her comment is simply ridiculous...

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Phil
Fri 14 Mar 2008

Aah our bright young medical student Chris is having a rant and rave at Homeopathy. Well, Chris, give it a few years and the truth of your profession will hit home... treat many, cure few. I was an eager medical student too, many years ago. But years of disillusionment forced me to investigate alternate means of helping people. That is what you want to do after all isn't it, Chris? Help people?
Today I can go to bed an honest man. I have helped thousands of ill people, not just made them better but CURED them. A powerful word that, CURE.
So, before you try to relegate Homeopathy to the ranks of primitive and best-forgotten 'therapies', go out there and read, study and try to understand Homeopathy. We have come under attack before, many many times. And we will endure, as we always have done.
Or you can just turn a blind eye, head out for your golf session every Wednesday with the rest of your cronies and enjoy the kick-backs of the drug-companies who want to keep humanity ill. And enjoy the slow collapse of the NHS as it shuns a very effective treatment modality and makes yet another mistake.
The choice is yours.

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