Tuesday, 4 September 2012

How Homeopathy Works

I don't agree with Steve on some things. Forget that, many things. But I agree with him on this. He kindly passed on the link to this Telegraph article, telling us that the new Health Secretary, Jeremy Hunt, supports homeopathy.

The article includes the following paragraph, in a letter he wrote to a worried (and probably quite angry) constituent:
"I understand that it is your view that homeopathy is not effective, and therefore that people should not be encouraged to use it as a treatment. However I am afraid that I have to disagree with you on this issue. Homeopathic care is enormously valued by thousands of people and in an NHS that the Government repeatedly tells us is "patient-led" it ought to be available where a doctor and patient believe that a homeopathic treatment may be of benefit to the patient."
Let's suppose I set up a hospital whose method of treatment was to beat people with sticks to drive the demons out. Let's suppose that by playing the "Respected Religion" card I got the Government to subsidise it. Let's suppose that Steve (wrongly, in my opinion, and intolerantly, of course) wrote to Mr Hunt suggesting that my beating-people-with-sticks treatment didn't work, and it shouldn't be supported by the NHS.  Let's suppose he received the following reply:
"I understand that it is your view that beating people with sticks to drive out the demons is not effective, and therefore that people should not be encouraged to use it as a treatment. However I am afraid that I have to disagree with you on this issue. Flogging-based therapy is enormously valued by thousands of people (although they don't enjoy it much at the time) and in an NHS that the Government repeatedly tells us is "patient-led" it ought to be available where a doctor and patient believe that a good beating with a stick may be of benefit in driving the demons out."
You'd think that was a pretty stupid reply, wouldn't you? The response to the argument that people value a good beating to drive out the demons would not be regarded as equivalent to scientific trials showing clinical effectiveness. Yet homeopathy has absolutely no effect. That's why some people like it - it has no side effects, it isn't gruelling, it doesn't make you feel sick before the good effects really kick in, like real medicine sometimes does. In fact, beating people with sticks has far more effect than homeopathy. I'm not saying they're good effects - but they're definitely effects. And beating people with sticks to drive out the demons is a "traditional" remedy. People have used it for hundreds of years.

Still, if the government wants to make cuts, I suppose giving patients water is going to be a lot cheaper than all those nasty expensive medicines. Or, if they want a really good therapy for driving out demons, they know where to come.


  1. Couldn't agree more, Eileen. So much hinges on the utter scientific 'innocence' of most politicians and opinion-formers.
    The Geek Manifesto has a lot of sensible things to say about this (http://geekmanifesto.wordpress.com.), as does Ben Goldacre's Bad Science (http://www.badscience.net/). And also Simon Singh's Trick or Treatment (http://simonsingh.net/books/trick-or-treatment/).

  2. I am in two minds about this one.
    When my then 11 year old daughter started leukaemia treatment one of the Consultants in the hospital who also offered homeopathy suggested that she might try it to alleviate some of the severity of the side effects.
    I was thinking in terms of a placebo effect that would help her to be less stressed.

    But when we did take her to a homeopath, he eventually gave her some pills without telling her what to expet, he simply said that she should come back and tell him what happened.
    Again, I thought that that was a clever way of admitting that nothing is going to happen!
    Of course, it was also a way of not leading her to imagine certain effects just because she was believing in them.

    I am prepared to admit that the homeopath was as surprised as we were, but the actual immediate physcial and verifiable result was that she more or less stopped being sick, no longer vomited up to 5 times every night and that we were able to cut her anti-sickness medication down from 3 types of drugs daily to 1 occasional one.

    Do I "believe" in homeopathy? I have to side with the scientists who consistently discover that it has no effects.

    Would I use it again? You bet!!

  3. still there is one benefit of homeopathy - at least nobody will die from taking an overdose!

  4. Erika, my granddad smoked 60 cigarettes a day, he died peacefully in his bed aged 98, therefore smoking is perfectly safe... see the problem?

  5. No, Steve, I don't see the problem.
    If someone has been terribly sick for months and is given some medication and then stops being sick, it is not easy to assume that this is just one heck of a coincidence.

    Especially when the sickness returns when the medication is stopped (which we did without her knowing - the number of pills she had to take made sure that she never knew)and disappears again when the medication is resumed.

    Now, granted, this is not a reported benefit of homeopathy for other cancer patients and it is probably an exeriment that could not be replicated in anyone else.
    That it could be replicated in the course of treatment of a desperately ill 12 year old will do for me.

    That you can indulge in dangerous behaviour and get away with it is really a completely different issue.

    I said somewhere before, homeopathy is religion - those who support it will hear nothing against it and for those who don't believe in it it is the medical equivalent to the Flying Spaghetti Monster Christians are accused to believe in.

    I am not engaging in a faith war.
    I just state it as it is.

    I do not "believe" in homeopathy but I will certainly continue to use it when appropriate.

  6. My experience with homeopathy has been similar to Erika's. But for asthma and hay fever, not cancer.

    Also, there can be a 'feeling sicker before you get better' effect in homeopathy, known as a healing crisis. And I have experienced this too.

    I accept that it cannot be proven, but I would definitely use it again.

  7. The NHS still has some colossal blindspots, e.g. diet based cures, and some alternative medicine can be useful in reminding mainstream medicine to be more holistic. We tend to reduce medicine to pharmacy and invasive surgery, and there's more to it than that. However, just 'feeling that it might work' is no argument for offering something on the NHS.

    The acid test will be, if we dilute Jeremy Hunt to 1 part in a billion, will he be more effective?

  8. I agree that the criteria for offering something on the NHS have to be tighter than the evidence there is for homeopathy.
    On the other hand, what they saved in anti-sickess medication for my daughter would have funded the homeopathic treatment of dozens of people. There again, it probably did fund the conventional treatment of others, and as I paid for the homeopath, the NHS won out anyway.

    I am not qualified to make a scientific case either for or against it. But I am puzzled by the number of conventional doctors who also use homeopathy. If it was definitely proven to be like snake oil, they wouldn't. Would they?

    My own childhood GP wasn't shy with the amount of antibiotics and other conventional drugs she prescribed, but she did also use accupuncture and homeopathy when she felt it to be more helpful. Accupunture was as decried then as homeopathy is now and science "knew" that it didn't work.

    But look at it from my point of view.

    If there is something that, in my own experience, works surprisingly well, and if everyone agrees that it can do no harm and cannot negatively interact with other medication etc., then the only rational thing to do is to keep using it.

  9. Homoeopathy is snake oil but of course snake oil can be beneficial to snakes and homoeopathy can be particularly beneficial to people who are either not ill or believe that it is going to help.

    Beating people with sticks, on the other hand, has a demonstrable effect, not least because the beatee often wants it to stop. How well I recall those school days thrashings where we were expected to chant in rhythm with the stocks "Spank out the bad, spank in the good, spank with leather, spank with wood."

    And I never did it again, whatever it was, so clearly there was a benefit. For someone.

  10. "homoeopathy can be particularly beneficial to people who are either not ill or believe that it is going to help."

    And a 12 year old cancer patient who does not know when she is given homeopatic treatment and can therefore have no expectations of it fits that definition?

    It's not a religion! You don't have to be fervently in favour or fervently against!

    You can just sit lightly to it, try it out and if it doesn't work, drop it again but if it does work, keep using it.

    Provided you're not stupid enough to use it instead of conventional medicine but in conjunction with it - what's the big deal? Why does everyone get so worked up about it?

  11. I suspect that most of us are suspicious of some of the claims made by Homoepathy, but in ancient times, this or brutal surgery was the only option.

    I've seen for myself the results of Acupuncture when my spouse went to a clinic in York, with tooth pain, when we were there on a long weekend and miles from our own dentist and dentists were closed in York. After taking a medical history they gave her a short course of pins being placed strategically at different points of her skull and it worked. She had pain relief for long enough to come home and visit her dentist on the next working day.

    I believe that it's a mindset thing. If we are convinced enough of it's benefits, we may well benefit from it. If we are doubtful, than we are unlikely to draw any benefit from it.

    I believe that medical science doesn't know everything. And you read all of the time of the discovery of the medicinal properties of common plants, being rediscovered. Knowledge that the Ancients had, but was lost through time and people who practised it being accused of witchcraft.

    If I were suffering from a serious illness, I would resort to medical science first, because that's what we are conditioned to do. But, I would also ask the question are there any natural remedies that might help? No doubt I'd be told NO! But sometimes there are doctors who actually think that some benefit might be accrued through using a different solution the the chemical cosh that most modern medications contain.

    And, in a age of patient choice in the NHS, surely the patient has the freedom to opt in or out of homoeopathy if they wish to.

  12. I was agnostic verging on doubtful about homeopathy until it relieved my severe hay fever. In those days the only medication available made you completely dopey for hours on end and unwise to drive. Not good when looking after a baby.

    So I don't think my state of mind influenced the outcome.

  13. OK, so good to know you've all been getting along while I was fighting those daleks.

    If anything, I'd call "placebo". Which is why I'm opening a big new "Placebo Chemist's Shop". I am a quantum Chemist by education, so as long as I don't explain what kind of chemist I am I'm well within the Trade Descriptions Act.

    There's an interesting article where the Guardian describes a study where the placebo effect works even if you know it's a placebo. Which goes to show there's more things in heaven and earth, Horation...

    And yes, you can get an overdose of homeopathy. Or, drowning, as it's better known.

  14. Isn't the whole point of placebo that you know you're taking it and it helps because you believe it will?

    So what if someone doesn't know they're taking it and it still helps?
    That appears to be stretching the definition of placebo a little.

    1. Not entirely. A significant placebo effect can be often observed simply because people feel that they are being taken seriously and are being cared for.

    2. Also she was given something, by somebody with a clinical manner, and you had taken her there and may have had your own expectations. So a placebo effect is plausible.

      In order to counter placebo effects, it's a standard process to ensure the people giving out medicines in trials know which is real and which is a placebo (double blind trials) - thus preventing their ideas of what might happen being passed subconsciously to the trial volunteers.

      The human mind is a wonderful and surprising thing.

  15. I think you're misunderstanding the situation of a cancer patient, especially a child.
    They are being taken extremely seriously, they are given extraordinary amounts of attention and they are given an extraordinary amount of drugs to take at home between in-patient chemo. Some of those drugs are chemotherapy, some are to alleviate the various side effects of the various chemotherapy drugs some are steroids, some are... they are legion!
    And the cocktail changes daily depending on what chemo is being given and on what side effects that chemo has. Treatment goes on for 3 years.

    The general expectation is that the drugs make you feel worse. Because most do. The ones that make you feel better are obvious - tramadol, cocodamol, the kind of drugs you take in response to extreme pain. Others, you know will make you feel worse. Tired, weak, sick, suicidal, give you pain.

    If your mother gives you a handful of tablets to take in the morning, another small handful in afternoon and yet another handful in the evening, you have no particular expectation of any of them. You take them because you know that you will die if you don’t, and then you hope for the best for that day.

    If you can swallow because the ulcers in your mouth have healed a little for once, you take a glass of juice and just drink it all down, while your mother is hoping you won't be sick again before they've gone through your system.

    This is far removed from a patient with one complaint having a caring hour long consultation in some private posh room and being given drugs for one that.

    As I said earlier – for me, it’s not a religion. I have no particular horse in this race. But I do find it astonishing that people have such firm views – on both sides – that they will try to explain away anything that doesn’t fit their belief.

    I shall continue to sit light to it all.
    And I shall continue to believe that it is more rational to take something that you know helps on occasion and has not side effects, than it would be not to take it, thereby missing out on any possible benefit.
    After all, even if placebo is all it was (and as I explained, I don’t think it always is), your placebo effect is a huge benefit too. And if it can be bought at the price of a sugar pill, why fight so much against it?

  16. Cor, this thread's lively!

    Erika, I can completely empathise, confirmation bias is a very powerful thing, but I think as others have pointed out the meat of this debate is not about what people believe (or not), it's about what our tax money is spent on and what methods we use to determine the efficacy of so called alternative medicines, i.e. science or anecdote?

    My view is that we should use an evidence based approach simply because it's the one that works best and the one that's the least subjective when it comes down to insisting that people put their hands into their pockets!

    If people wish to follow their own path then good luck to them, just don't use public money to do it :)

    For those that are interested there's a fairly recent book called "Evolutionary Medicine" which outlines a very plausible (scientific) explanation for placebo which is to do with the evolutionary advantages of balancing the expending precious energy for survival purposes vs. expending energy to overcome disease, it's an interesting perspective on this subject.

  17. Steve, I couldn't agree more! I would not want tax money to be spent on homeopathy, not until the NHS is so flush that it can afford to spend it on unscientific medication. Or, more to the point, on medication that is more predictably and more reliably effective for more people.

    But the general argument that boils down to: "in some people and in some cases harmless small pressed sugar pills can evoke a powerful placebo effect that is so strong that it can alleviate or heal debilitating symptons other medication has not been able to alleviate or heal. We must therefore abolish small pressed sugar pills" does not appear to be entirely rational.

  18. Oooh, Erika, I do admire you. I don't have the energy or the intellect for this sort of thing anymore. I am in the cloud cheering you on from the sidelines.

  19. I think that the Arch Druid started this contentious thread because she has one eye on the Christian New Media Awards and Conference #CNMAC12 in October, in the hope that someone will nominate her blog.

    As most of the stuff here is very tongue in cheek with an underlying morality somewhere (you have to dig very deep to find it), so as humour is Christian, she must be eligible.

  20. I think she was just having a bad pointy hat day and got carried away with her own charism of invective production.

    Anyway, is a Beaker blog eligible for the Christian Media Awards? Is there an ecumenical category?

  21. Oddly enough, as to the use of homeopathy I think I agree with both Erika and Steve, in thati f people want to use it at their own expense, that is up to them. If they want to use it instead of real medicine, I'd really recommend they don't, but it's a free country. And if we manage to turn the placebo effect to real, predictable benefit it will be superb.

  22. The only proviso I would add is that it is foolish to use homeopathy instead of real medicine. It can be used alongside real medicine or when real medicine apears to have failed. I have not a shred of understanding for people who reject proper treatment even for serious illness and rely on alternative medicines.

    Now to serious topics - can we nominate the blog for the Christian Media Award?


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