Views & Reviews From the Frontline

Good medicine: homeopathy

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e6184 (Published 14 September 2012) Cite this as: BMJ 2012;345:e6184

Re: Good medicine: homeopathy

It is truly remarkable the level of ignorance involved in this debate, with critics of homeopathy showing their true love of mediocrity, conformism and brain-dead enforcement of orthodoxy (dogma) – with enthusiasm that would make an Inquisitor blush.

Would be defenders of science and so-called ‘evidence-based medicine’ seem to have no problem whatsoever issuing criticisms of homeopathy which are completely and totally at variance with the actual data.

Somehow they don’t see the irony in calling homeopathy ‘unscientific’ even though the criticism is itself not based on any hard evidence. As Dr. Spense has rightfully pointed out, this is a very safe and conventional position – ‘everyone’ knows homeopathy is ‘just water’ and ‘just placebo’. The critics see no problem substituting conventional wisdom for facts – which is why if you peruse Dr. Spense’s article and the subsequent commentary, you will find almost no mention of material facts, just schoolyard slander.

The fact is, the weight of the evidence strongly favors homeopathic remedies being biological active agents.

Nearly all physico-chemical research – conducted by scientists of the very highest skill on earth, such as Rustum Roy and Jayesh Bellare – demonstrates physical properties of homeopathic remedies which are distinct from those of plain water or succussed/diluted water controls. None of the research is completely beyond reproach, but it is nevertheless quite strong and viewed as a whole becomes stronger.

http://www.ncbi.nlm.nih.gov/pubmed/17678814

http://www.ncbi.nlm.nih.gov/pubmed/20970092

http://www.ncbi.nlm.nih.gov/pubmed/17678812

The in vitro evidence is similarly strong – with a recent review finding that over 2/3 of all high quality studies demonstrate biological activity of homeopathic remedies. The same is true for nearly 3/4 of all replications.

http://www.ncbi.nlm.nih.gov/pubmed/17544864

The clinical evidence is less consistent, but this is because of the enormous heterogeneity of the literature – with many different types of homeopathy being studied, often by people who know nothing of homeopathy or lack the skills specific to the performance of homeopathic trials. Viewed as a whole, 41% of all RTC’s come to positive conclusions, while 52% are inconclusive; 7% are actually negative. These numbers correlate almost precisely with RCT’s of conventional medical therapies.

http://www.facultyofhomeopathy.org/research/

Systematic reviews have come to positive conclusions for, so far, the following conditions: allergies and upper respiratory infections, childhood diarrhea, influenza treatment, post-operative ileus, rheumatic diseases, seasonal allergic rhinitis, vertigo and most recently, fibromyalgia and chronic fatigue syndrome

http://www.facultyofhomeopathy.org/research/systematic_reviews/

http://www.ncbi.nlm.nih.gov/pubmed/21733480

Homeopathic critics, if they cite any evidence, seem to universally cite only one study – the Shang, et al meta-analysis (Lancet, 2005). They may as well have referenced no data at all, since Shang is an abomination of science – failing nearly every conventional norm for high quality research (e.g. failing to meet multiple QUOROM criteria for systematic reviews) – and basing its conclusions on 8 out of 110 cherry picked trials. No sensitivity analysis was performed, but in subsequent independent assessment, literally every single other manner of assessing the data comes up positive for homeopathy. The 8 selected trials fail the ‘leave one out’ cross-validation test – take out the study looking at use of Arnica for soreness in marathon runners (a completely irrelevant research question with zero external validity) and the conclusions reverse dramatically (in favor of homeopathy). In other words, Shang is a sham. But clearly for critics it represents the pinnacle of research science since it supposedly ‘debunks’ homeopathy. No mention is ever made of all the other meta-analyses - which come to positive ends and are of far higher quality than Shang.

http://www.ncbi.nlm.nih.gov/pubmed/18834714

http://www.ncbi.nlm.nih.gov/pubmed/19371564

The homeopathic literature is not without deficiencies, but to say homeopathy is nothing but placebo requires turning a blind eye to a large amount of data which, though not completely conclusive, certainly suggests otherwise. It is clear that those who issue boilerplate criticisms of homeopathy have not bothered to consider the entirety of the data. Intelligent people and true scientists should be embarrassed by this and most ‘discussions’ taking place about homeopathy in the British medical community – they are an affront to scientific principles of rationality and objectivity.

Competing interests: No competing interests
06 October 2012
Christopher M Johnson
Naturopathic Doctor
Private Practice
4910 31st St S Suite A Arlington, VA 22206 USA
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