Homeopathy: If 'Less Is More,' Is Nothing Best?

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In a randomized controlled trial published in the August 19-26, 2000, issue of the British Medical Journal (BMJ), Morag A. Taylor, David Reilly, and three other university affiliates tested the hypothesis that homeopathic preparations devoid of an active ingredient have no more than a placebo effect. They concluded: "When the results are combined with those of three similar studies, homeopathy is different from placebo on both subjective and objective measures."

Fifty patients completed participation in the study. All reportedly had perennial allergic rhinitis a condition characterized by allergy-induced inflammation of the nasal mucous membranes. Common symptoms of allergic rhinitis include nasal congestion, nasal itchiness or runny nose, and sneezing. Each patient received either a placebo or a homeopathic product prepared according to whichever allergen had been deemed "principal" for the patient. Those subjects who "required" use of drugs for rhinitis during the trial were permitted to use them.

According to the homeopathic principle called "the doctrine of the minimum dose" ("less is more"), peculiarly selected substances trigger healing without side effects when they are applied in quantities that render them nonbioactive or even when they are only seemingly, spiritually applied.

The basis of every standard homeopathic preparation is a serial agitated dilution (SAD) that is, the result of successive admixture and agitation of a substance. A 30C (10030) product would result if, for example, one added 99 drops of a diluent (specifically, alcohol and/or distilled water) to one drop of a "mother tincture" of an allergen (i.e., the filtrate of a strong water or alcohol solution of the allergen), shook this mixture vigorously, and repeated such dilution and shaking 29 times without adding mother tincture.

The university researchers used 30C preparations. A unit of a 30C homeopathic preparation of a substance should contain none of that substance. Hence, according to physical laws, a unit of a standard, genuine 30C preparation of any substance has no intrinsic therapeutic utility. Because in the Taylor-Reilly study both the SAD preparation and the placebo preparation consisted of lactose, sucrose, and the same diluent, one would have expected reasonably that if the homeopathic preparation had any effects, the placebo preparation would have the same effects.

Nevertheless, the researchers said they found a significant "clear objective difference between the effects of placebo and homeopathy on nasal airflow." They also noted that initial worsening of rhinitis symptoms was more frequent with the homeopathic preparation than with the placebo.

If the effects of homeopathic preparations devoid of an active ingredient proved different from the effects of non-homeopathic but otherwise identical preparations, radical revision of axioms of physics would become necessary. But according to published reviews of studies of homeopathy, homeopathy has not proved effective for any single condition, and no set of pro-homeopathy experimental findings has ever been replicated by researchers not involved in the original trial. There is virtually no reason to expect that homeopathic preparations without an active ingredient will prove to have any bodily effect beyond that of a placebo.

The Taylor-Reilly study was short-term, had few subjects, and lacked a control group of subjects receiving neither a hypothetical treatment nor a placebo. Nasal airflow the principal factor in the findings of this study was not measured in three similar studies conducted by the BMJ writers. The focal experimental result in each of these four studies concerned patients' estimations of their symptoms. In the last study, the researchers reported that there was no significant difference based on such estimations between the effects of the homeopathic preparations and those of the placebo. This was not, however, a finding of any of the three previous studies.

ACSH scientific advisor David W. Ramey, D.V.M., notes:

Usually, if one can't find a difference in the primary measure, the study is over. But this is homeopathy. Since the primary measurement showed no difference, they went to a secondary measurement. In this case, they measured nasal peak airflows. There is absolutely no information to indicate that this measurement means anything. In fact, nasal peak flows are simply too unreliable to be of any use as a clinical measurement. The nose is a dynamic structure that can change its characteristics within any given 30-minute period. No one in clinical ENT [ear, nose, and throat] practice uses nasal peak flows any more as a measurement of anything . . . .

In a commentary that accompanied the homeopathy article, Tim Lancaster, of the Institute of Health Sciences in Oxford, England, and Andrew Vickers, of the Memorial Sloan-Kettering Cancer Center, in New York City, stated:

Unlike many medical interventions, [with homeopathy] there are no established animal models, mechanisms of action, or examples of similar treatments of proved benefit. Moreover, homeopathy is biologically implausible because of the use of medicines diluted beyond the Avogadro limit. It is therefore reasonable to ask for a high level of randomised evidence be-fore concluding that homeopathy exerts specific effects.

Jack Raso, M.S., R.D., is the author of three books on alternative medicine.

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Priorities Volume 12 Number 3