DR. MOHLER: Homeopathy — success through the placebo effect
Homeopathy is more than 200 years old; it is the medical care system of choice of English queens and movie stars; scores of its remedies grace the shelves of our local pharmacies and health food stores; homeopathy is alive and well in the Grand Valley.
The basic concepts of homeopathy are:
1) “Like cures like.” A substance which causes symptoms of a disease in a healthy person will cure similar symptoms in a sick person.
2) The substances are diluted repeatedly to make them “safe” and “effective.” The more dilute the substance, the more potent it is felt to be and the greater its effects.
3) The homeopathic caregiver listens to the patient’s story and prescribes the remedy.
A popular homeopathic remedy for the flu is a million million dilutions of duck liver. This would create a solution with one drop of the substance in the water in 20 swimming pools! It is unlikely that most patients receiving this remedy would receive even one molecule of the substance. Homeopathic caregivers acknowledge this fact and call on the concept of “water memory,” which postulates that the water remembers the substance and transmits its effect to the patient.
What makes homeopathy scientifically impossible?
1) The “water memory” claim contradicts modern physical chemistry principles. Physicists tell us that short-range order (the effect of a substance on water) in water lasts only one trillionth of a second.
2) The idea that a diluted substance is more potent than a concentrated one flies in the face of established pharmaceutical principle of dose-response. Bigger doses have greater responses in the body than smaller doses and certainly more than no dose at all.
So why has homeopathy worked so well for Queen Elizabeth II, Catherine Zeta-Jones and your next door neighbor? First and foremost, homeopathy has a potent placebo effect. The placebo effect is enhanced by the considerable time and attention that homeopathic caregivers give their patients. Second, the natural history of many illnesses is that they get well on their own. I rely on this fact every day and I frequently tell patients: “You are going to get well in spite of me, not because of me.”
In 2010, after reviewing the science, the Cochrane Collaborative (the group of scientists whom I frequently quote for their excellence in research) concluded: “Homeopathy fails to demonstrate any effect beyond the placebo effect.”
The concern with homeopathy is that when it is utilized to the exclusion of mainstream medicine in a more serious illness, diagnosis and treatment may be delayed. In an 18-month-old child, it is sometimes difficult to sort out whether his fever of 101.5 is part of the obvious upper respiratory infection or the early sign of a more serious illness like pneumonia or meningitis.
The use of homeopathic medicine in children is not defensible. In adults, it is not wise.
Dr. Mohler has practiced family medicine in Grand Junction for 38 years. He has a particular interest in pharmaceutical education. Phil works part-time for both Primary Care Partners and Rocky Mountain Health Plans. Email him at firstname.lastname@example.org.
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