HOMEOPATHIC REMEDIES

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HOMEOPATHIC REMEDIES

What are some homeopathic rememdies?  What are the origins?

Isopathy is a therapy derived from homeopathy invented by Johann Joseph Wilhelm Lux in the 1830s. Isopathy differs from homeopathy in general in that the remedies, known as “nosodes”, are made up either from things that cause the disease or from products of the disease, such as pus.  Many so-called “homeopathic vaccines” are a form of isopathy.

Flower remedies can be produced by placing flowers in water and exposing them to sunlight. Although the proponents of these remedies share homeopathy’s vitalist world-view and the remedies are claimed to act through the same hypothetical “vital force” as homeopathy, the method of preparation is different. Bach flower remedies are prepared in “gentler” ways such as placing flowers in bowls of sunlit water, and the remedies are not successes.    There is no convincing scientific or clinical evidence for flower remedies being effective.

The low concentration of homeopathic remedies, which often lack even a single molecule of the diluted substance, has been the basis of questions about the effects of the remedies since the 19th century. Modern advocates of homeopathy have proposed a concept of “water memory”, according to which water “remembers” the substances mixed in it, and transmits the effect of those substances when consumed. This concept is inconsistent with the current understanding of matter, and water memory has never been demonstrated to have any detectable effect, biological or otherwise.  Pharmacological research has found instead that stronger effects of an active ingredient come from higher, not lower doses.

Outside of the CAM community, scientists have long regarded homeopathy as a sham or as “supernatural quackery”.  There is an overall absence of sound statistical evidence of therapeutic efficacy, which is consistent with the lack of any biologically plausible pharmacological agent or mechanism. Abstract concepts within theoretical physics have been invoked to suggest explanations of how or why remedies might work, including quantum entanglement, the theory of relativity and chaos theory.  However, the explanations are offered by non-specialists within the field, and often include speculations that are incorrect in their application of the concepts and not supported by actual experiments.   Several of the key concepts of homeopathy conflict with fundamental concepts of physics and chemistry.   For instance, quantum entanglement is not possible as humans and other animals are far too large to be affected by quantum effects, and entanglement is a delicate state which rarely lasts longer than a fraction of a second. In addition, while entanglement may result in certain aspects of individual subatomic particles acquiring each other’s quantum states, this does not mean the particles will mirror or duplicate each other, or cause health-improving transformations.

The proposed mechanisms for homeopathy are precluded from having any effect by the laws of physics and physical chemistry.     The extreme dilutions used in homeopathic preparations often leave none of the original substance in the final product. The modern mechanism proposed by homeopaths, water memory, is considered erroneous since short-range order in water only persists for about 1 picosecond.  Existence of a pharmacological effect in the absence of any true active ingredient is inconsistent with the observed dose-response relationships characteristic of therapeutic drugs (whereas placebo effects are non-specific and unrelated to pharmacological activity). The proposed rationale for these extreme dilutions – that the water contains the “memory” or “vibration” from the diluted ingredient – is counter to the laws of chemistry and physics, such as the law of mass action. 

The extremely high dilutions in homeopathy preclude a biologically plausible mechanism of action. Homeopathic remedies are often diluted to the point where there are no molecules from the original solution left in a dose of the final remedy. Homeopaths contend that the methodical dilution of a substance, beginning with a 10% or lower solution and working downwards, with shaking after each dilution, produces a therapeutically active remedy, in contrast to therapeutically inert water. Since even the longest-lived non-covalent structures in liquid water at room temperature are stable for only a few picoseconds, critics have concluded that any effect that might have been present from the original substance can no longer exist. No evidence of stable clusters of water molecules was found when homeopathic remedies were studied using nuclear magnetic resonance.

Furthermore, since water will have been in contact with millions of different substances throughout its history, critics point out that water is therefore an extreme dilution of almost any conceivable substance. By drinking water one would, according to this interpretation, receive treatment for every imaginable condition.   For comparison, ISO 3696: 1987 defines a standard for water used in laboratory analysis; this allows for a contaminant level of ten parts per billion, 4C in homeopathic notation. This water may not be kept in glass as contaminants will leach out into the water.

Practitioners of homeopathy hold that higher dilutions — described as being of higher potency — produce stronger medicinal effects. This idea is inconsistent with the observed dose-response relationships of conventional drugs, where the effects are dependent on the concentration of the active ingredient in the body. This dose-response relationship has been confirmed in myriad experiments on organisms as diverse as nematodes, rats, and humans.

No individual preparation has been unambiguously shown by research to be different from placebo. The methodological quality of the primary research was generally low, with such problems as weaknesses in study design and reporting, small sample size, and selection bias.  Since better quality trials have become available, the evidence for efficacy of homeopathy preparations has diminished; the highest-quality trials indicate that the remedies themselves exert no intrinsic effect.

The fact that individual randomized controlled trials have given positive results is not in contradiction with an overall lack of statistical evidence of efficacy. A small proportion of randomized controlled trials inevitably provide false-positive outcomes due to the play of chance: a statistically significant positive outcome is commonly adjudicated when the probability of it being due to chance rather than a real effect is no more than 5%—a level at which about 1 in 20 tests can be expected to show a positive result in the absence of any therapeutic effect. Furthermore, trials of low methodological quality (i.e. ones which have been inappropriately designed, conducted or reported) are prone to give misleading results.

 Science offers a variety of explanations for how homeopathy may appear to cure diseases or alleviate symptoms even though the remedies themselves are inert:   The placebo effect — the intensive consultation process and expectations for the homeopathic preparations may cause the effect;  Therapeutic effect of the consultation — the care, concern, and reassurance a patient experiences when opening up to a compassionate caregiver can have a positive effect on the patient’s well-being;  Unassisted natural healing — time and the body’s ability to heal without assistance can eliminate many diseases of their own accord; Unrecognized treatments — an unrelated food, exercise, environmental agent, or treatment for a different ailment, may have occurred;  Regression toward the mean — since many diseases or conditions are cyclical, symptoms vary over time and patients tend to seek care when discomfort is greatest; they may feel better anyway but because of the timing of the visit to the homeopath they attribute improvement to the remedy taken;  Non-homeopathic treatment — patients may also receive standard medical care at the same time as homeopathic treatment, and the former is responsible for improvement;  and Cessation of unpleasant treatment — often homeopaths recommend patients stop getting medical treatment such as surgery or drugs, which can cause unpleasant side-effects; improvements are attributed to homeopathy when the actual cause is the cessation of the treatment causing side-effects in the first place, but the underlying disease remains untreated and still dangerous to the patient.

While some articles have suggested that homeopathic solutions of high dilution can have statistically significant effects on organic processes including the growth of grain, histamine release by leukocytes, and enzyme reactions such evidence is disputed since attempts to replicate them have failed.  Supposedly it was discovered that basophils, a type of white blood cells, released histamine when exposed to a homeopathic dilution of anti-immunoglobulin E antibody. The journal editors, skeptical of the results, requested that the study be replicated in a separate laboratory. Upon replication in four separate laboratories the study was published. Still skeptical of the findings, Nature assembled an independent investigative team to determine the accuracy of the research, consisting of Nature editor and physicist Sir John Maddox, American scientific fraud investigator and chemist Walter Stewart, and sceptic James Randi.  After investigating the findings and methodology of the experiment, the team found that the experiments were “statistically ill-controlled”, “interpretation has been clouded by the exclusion of measurements in conflict with the claim”, and concluded, “We believe that experimental data have been uncritically assessed and their imperfections inadequately reported.”   James Randi stated that he doubted that there had been any conscious fraud, but that the researchers had allowed “wishful thinking” to influence their interpretation of the data.  The provisions of homeopathic remedies have been described as unethical.

Patients who choose to use homeopathy rather than evidence-based medicine risk missing timely diagnosis and effective treatment of serious conditions such as cancer.

Some homeopathic remedies involve poisons such as Belladonna, arsenic, and poison ivy which are highly diluted in the homeopathic remedy, only in rare cases are the original ingredients present at detectable levels. This may be due to improper preparation or intentional low dilution. Serious adverse effects such as seizures and death have been reported or associated with some homeopathic remedies.   Instances of arsenic poisoning have occurred after use of arsenic-containing homeopathic preparations. Zicam Cold remedy Nasal Gel, which contains 2X (1:100) zinc gluconate, reportedly caused a small percentage of users to lose their sense of smell; 340 cases were settled out of court in 2006 for 12 million U.S. dollars. 

Beyond ethical issues and the integrity of the doctor-patient relationship, prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS.

Homeopathy is a controversial topic in complementary medicine research. A number of the key concepts of homeopathy are not consistent with fundamental concepts of chemistry and physics. For example, it is not possible to explain in scientific terms how a remedy containing little or no active ingredient can have any effect. This, in turn, creates major challenges to rigorous clinical investigation of homeopathic remedies. For example, one cannot confirm that an extremely dilute remedy contains what is listed on the label, or develop objective measures that show effects of extremely dilute remedies in the human body.

On clinical grounds, patients who choose to use homeopathy in preference to normal medicine risk missing timely diagnosis and effective treatment, thereby worsening the outcomes of serious conditions.   Critics of homeopathy have cited individual cases of patients of homeopathy failing to receive proper treatment for diseases that could have been easily diagnosed and managed with conventional medicine and who have died as a result and the “marketing practice” of criticizing and downplaying the effectiveness of mainstream medicine.   Homeopaths claim that use of conventional medicines will “push the disease deeper” and cause more serious conditions, a process referred to as “suppression”.  Some homeopaths (particularly those who are non-physicians) advise their patients against immunization.  Some homeopaths suggest that vaccines be replaced with homeopathic “nosodes”, created from biological materials such as pus, diseased tissue, bacilli from sputum or (in the case of “bowel nosodes”) feces.

Homeopathy is fairly common in some countries while being uncommon in others; is highly regulated in some countries and mostly unregulated in others. It is practiced worldwide and professional qualifications and licenses are needed in most countries.   Regulations vary in Europe depending on the country. In some countries, there are no specific legal regulations concerning the use of homeopathy, while in others, licenses or degrees in conventional medicine from accredited universities are required. In Germany, to become a homeopathic physician, one must attend a three-year training program, while France, Austria and Denmark mandate licenses to diagnose any illness or dispense of any product whose purpose is to treat any illness.   Some homeopathic treatment is covered by the public health service of several European countries, including France, the United Kingdom, Denmark, and Luxembourg.   In other countries, such as Belgium, homeopathy is not covered. In Austria, the public health service requires scientific proof of effectiveness in order to reimburse medical treatments and homeopathy is listed as not reimbursable, but exceptions can be made; private health insurance policies sometimes include homeopathic treatment.   The Swiss government, after a 5-year trial, withdrew homeopathy and four other complementary treatments in 2005, stating that they did not meet efficacy and cost-effectiveness criteria, but following a referendum in 2009 the five therapies are to be reinstated for a further 6-year trial period from 2012.

The Indian Government recognizes homeopathy as one of its national systems of medicine, it has established AYUSH or the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy under the Ministry of Health and Health and Family Welfare The Central Council of Homeopathy was established in 1973 to monitor higher education in Homeopathy, and National Institute of Homeopathy in 1975.   A minimum of a recognized diploma in homeopathy and registration on a state register or the Central Register of Homoeopathy is required to practice homeopathy in India.

 In the United Kingdom, MPs inquired into homeopathy to assess the Government’s policy on the issue, including funding of homeopathy under the National Health Service and government policy for licensing homeopathic products. The decision by the House of Commons Science and Technology Committee follows a written explanation from the Government in which it told the select committee that the licensing regime was not formulated on the basis of scientific evidence. “The three elements of the licensing regime (for homeopathic products) probably lie outside the scope of the … select committee inquiry, because government consideration of scientific evidence was not the basis for their establishment,” the Committee said. The inquiry sought written evidence and submissions from concerned parties.

Beyond ethical issues and the integrity of the doctor-patient relationship, prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS.

Kathy Kiefer

One thought on “HOMEOPATHIC REMEDIES

    Alessandro Sicuro Comunication responded:
    February 24, 2014 at 7:01 pm

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