Why do pharmacists sell homoeopathic remedies?BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d349 (Published 19 January 2011) Cite this as: BMJ 2011;342:d349
- Fred Kavalier, GP, north London
I am a great believer in the ability of the human body to heal itself, and I think it is sensible to stay away from doctors and take as little medicine as possible. This is why I support the homoeopathic practice of not giving any medicine to patients who don’t have much wrong with them. But I like to think that I am more honest than most homoeopaths, so I tell patients that their vague feeling of malaise is likely to sort itself out if they are prepared to wait. Rather than going through the charade of prescribing a few sugar pills to be taken on a clean tongue, it seems simpler to prescribe nothing at all.
But a problem arises when a patient has an illness that won’t get better without treatment. Modern scientific medicine, for all its failings, has a few treatments that really do make a difference.
This came home to me a few years ago when I had a patient who was planning to travel to the Sahara desert to make a documentary film. As his general practitioner I saw him before he set off and gave him some straightforward advice about malaria prevention: insect repellent, bednets, tuck your trousers into your socks, and take the antimalaria pills. And if you develop a fever after you return to the United Kingdom, even months later, remember to tell the doctor that you might have malaria.
A friend suggested that he take a homoeopathic alternative to my antimalarials (no nasty side effects, no toxic chemicals). He followed his friend’s advice (and ignored mine), thinking that the homoeopathic prophylaxis was likely to be just as effective. When he arrived back in London he phoned me to say he had terrible diarrhoea. When I asked him to take his temperature it was 41°C. His blood was teeming with malaria parasites, and he only survived thanks to the strenuous efforts of the Hospital for Tropical Diseases.
It was a memorable case for me, because inner London GPs don’t see many patients with malaria, and it brought back traumatic memories of the many patients with malaria I saw when I visited Uganda in the 1990s.
I tracked down my patient recently, after I was contacted by the BBC’s science correspondent, who was preparing a film for Newsnight on homoeopathic malaria prophylaxis. The item was going to be broadcast because it was thought that the General Pharmaceutical Council (the pharmacists’ equivalent of the GMC) was about to discipline some pharmacists who were accused of advising patients to use homoeopathic malaria prophylaxis as an alternative to the real stuff.
I’m saddened to discover that the case against the pharmacists has been dropped, on the grounds that the pharmacists in question have apparently mended their ways and no longer peddle homoeopathic malaria prophylaxis (see News, BMJ 2011;342:d338, doi:10.1136/bmj.d338).
For 10 years I wrote a weekly medical advice column in the Independent. Only once did I make the mistake of mentioning homoeopathy in my column. Over the next few weeks I was subjected to a torrent of abuse from both sides. The homoeopaths didn’t like the tone of my article—too flippant and dismissive. The scientists were appalled that a doctor should even mention the word homoeopathy in a column that prided itself on promoting evidence based medicine. I humbly apologised to the scientists in a subsequent column, and I vowed never even to mention the H word in print again.
Last week I visited a large central London pharmacy to have a look at its homoeopathic range. To give the staff their credit they didn’t have anything that claimed to prevent malaria. But I was given a copy of Nelsons Homeopathy Factfile, which told me that Rhus Tox 6c “relieves chronic rheumatic and arthritic pain, stiff joints and tendons” and that Gelsemium 30c “relieves flu-like symptoms including shivering, headaches, runny nose, muscle pain, and sneezing.”
I don’t really understand why chemists and the companies that make homoeopathic remedies are allowed to make false claims for the efficacy of their sugar pills. I’m sending a copy of Nelson’s Homeopathy Factfile to the General Pharmaceutical Council and the Advertising Standards Authority. I don’t expect that the spineless council will do much. We’ll see if the ASA thinks that these claims are “legal, decent, honest, and truthful.”
I think pharmacists who sell homoeopathic products need to do a little soul searching. I know we all have to earn our crust, but it shocks me that a little box of “sucrose/lactose pillules” can be passed off as a “medicinal product.”
Perhaps it’s not much worse than flogging ineffective cough medicines. I love overhearing the sales assistants in pharmacies asking customers if it’s a “tickly cough” or a “dry cough.” During my visit to the pharmacy I checked on the active ingredients of tickly and dry cough medicines. One contains glycerin and the other contains glycerol. According to my pharmaceutical textbook, glycerin and glycerol are the same. Perhaps they would work even better if they were diluted a few trillion times.
(For an excellent tutorial on homoeopathy I recommend Mitchell and Webb’s Homeopathic A&E: www.youtube.com/watch?v=HMGIbOGu8q0.)
Cite this as: BMJ 2011;342:d349
Provenance and peer review: Commissioned; not externally peer reviewed.