Saturday, April 25, 2015

Homeopathy Under Attack

In the last few years there has been a growing trend to discredit natural healing traditions. Always looking for a controversial subject to cash in on, the media has jumped in on this one with both feet. The primary target that has been in the crosshairs of all of this vitriol is homeopathy. Because the principles of homeopathy can not be explained by modern scientific theory it is an easy target. Although most of the skeptics will be satisfied if homeopathy is thoroughly discredited, the more extreme of the lot are hoping that they will be so successful making homeopathy look incredibly far fetched and ridiculous that it will be easy to extrapolate that sentiment to other systems of healing. In writing this post, I have no interest in debating with the skeptics because it is pointless. I'm putting this out there for those of you who are confused by all of the misinformation that has been propagated in the media. Hopefully it will help you to have a better understanding of the issues.

For my next post I was planning to write the second installment of my series on vaccinations, itself a very controversial subject these days. As we shall see, it is closely related to the homeopathy debate (or lack of it!). I had originally intended to steer clear of homeopathy because I have a limited amount of time for writing and there are other things I want to write about. I was hoping that with time people would just get bored of it and move on to something else. However, instead of fading away this issue has been building momentum and a couple of recent attacks that are relatively close to home grabbed my attention. Firstly, a group of scientists have attacked University of Toronto for proposing some good research on homeopathy. The chief researcher of the study, which is intended to examine homeopathy as a treatment for children with Attention Deficit Hyperactivity Disorder, is Heather Boon of the Department of Pharmacy. In proposing this study her credibility has also come under attack. I met Heather a few times quite awhile ago. I don't know her very well, but I am familiar with some of her work. She is someone who seems to me to be very committed to doing quality research on complementary and alternative medicine (CAM). The essence of the attack on Heather and U of T is that, although the proposed study is well-designed, since we already know that homeopathy doesn't work conducting this study is a waste of time and money.

That happened a few weeks ago. More recently the government of Ontario has come under attack for regulating homeopaths in this province. This has been in process since 2007 when the Homeopathy Act was tabled and finally came to completion a couple of weeks ago when the Act was passed. The provincial government is being condemned for legitimizing homeopathy.

Samuel Hahnemann, the founder of homeopathy.

This story begins at the end of the 18th century when purging, bleeding, high doses of mercury and poor hygiene were typical of the practices of mainstream medicine. At that time there was already a growing divide between the practices of orthodox medicine and more natural healing traditions, although there was a lot of grey in between. Enter Samuel Hahnemann. He was a medical doctor that wasn't happy with the practices of his time. He saw them as counter to the traditional healing principles that date back to Hippocrates and beyond. I'm not going to get into a detailed discussion of the principles of homeopathy because that would require a book, but what's important is that by the end of the 19th century the homeopaths were better organized and had better standards and hospitals throughout Europe and North America than their mainstream counterparts. As a result, they were perceived as a major threat by allopathic medical practitioners who used financial and political influence to gradually discredit or absorb most of the homeopaths. This was easier to do by the early 20th century because mainstream medical science was starting to mature and the public no longer perceived going to a doctor as such a scary prospect.

The influence of homeopathy may have been reduced but it never went away. In some parts of the world, such as India, it continued to flourish. Fast forward to the 1960s and we have the beginning of a renaissance of natural healing traditions that continues to this day. During this time homeopathy has prospered along with herbalism and many other natural healing modalities, and natural health products have become big business.

The growing popularity of natural healing has not been universally appreciated, as is always the case when money, influence and a clash of paradigms occurs. The four major antagonistic sectors are the pharmaceutical industry, medical doctors, pharmacists, medical researchers, and the associations that represent them. Although the growth of the natural health product industry has to some extent been at the expense of the profits of the pharmaceutical industry, the latter has chosen to adapt by diversifying. That primarily translates into buying up successful natural health products manufacturers.

Of course, not everyone who is a member of one of these groups is antagonistic to CAM. But many of them are. In spite of this, medical doctors and pharmacists are mostly too busy to care and pharmacists are happy to reap the profits of natural health product sales whether or not they believe in them. There are, however, a minority of extremists among the doctors and pharmacists who are very antagonistic to CAM.

The recent wave of attacks has to a significant extent been championed by medical researchers, supported by the professional skeptics who are always out their proselytizing. Although there is a definite clash of paradigms at the root of this, a big part of it is about money. In response to its growing popularity, many governments and universities have chosen to devote a small proportion of their research dollars to investigating CAM. For the most part this is a good thing because CAM research in the West is lagging way behind the research that is being done in Eastern countries such as China and India where traditional healing systems have continued to be appreciated.

The result of these changes is that it is now slightly more difficult for researchers who are doing mainstream medical research, many of whom are antagonistic to CAM, to get funding. As they see it, all of the research money rightfully belongs to them and it is being wasted funding research on what they see as pseudoscientific or completely unscientific healing modalities.

In laying out this background, what is not apparent is why the skeptics are particularly focusing on homeopathy. Basically it is this: in accordance with the principles of homeopathy, homeopathic remedies are subjected to a "potentization" process that involves diluting them in fixed ratios and shaking each dilution vigorously before diluting them again. Remedies are used at a variety of different dilutions, but they can potentially be diluted to the point where few, if any, of the molecules of the substance from which the remedy is derived are present. According to homeopathic theory and practice, the more times a remedy is subjected to this potentization process the more potent it becomes, even if on a chemical level it is becoming more dilute.

No one knows with absolute certainty how homeopathic remedies work.

From the perspective of the modern reductionistic, materialistic paradigm, this is absolute nonsense! How can something that has no molecular basis be more potent or have any therapeutic value at all? According to Hahnemann, the potentization process separates and intensifies the "vital force" or life force of the substance and it is this vital force that is primarily responsible for the therapeutic action of the remedy. More recently homeopaths, in an attempt to explain the actions of these remedies in more modern terms, have postulated mechanisms such as the transfer of this life force energy into the water in a way that alters the bonding angle or the electromagnetic field of water molecules, or possibly that they act within the realm of quantum mechanics. These are just hypotheses. The bottom line is that if homeopathic remedies work they operate in a way that can not currently be explained by the known laws of chemistry or physics. This is the crux of the matter.

The attack on homeopathy is fear-based. One of the unfortunate characteristics of human nature, at least how it is expressed in the modern world, is that when people invest a lot of energy into a belief system they (consciously or unconsciously) are afraid of alternative beliefs. Some people can just agree to disagree, but others are more zealous. Human history is full of examples of groups of people acting with violence against other groups of people who held different religious, political or other beliefs. Although scientists like to believe that they are beyond this and act on the basis of reason, the history of science says otherwise. The majority of scientists are dogmatists to varying degrees who do not question the reigning scientific paradigm of their era.

As anyone who has read a few of my posts knows, I'm actually a fan of science! However, for any field of inquiry to be useful we must recognize its limitations. Science, when practiced appropriately, is a very useful way to explore the world that we live in. However, it is only one of a number of different ways to explore the world. Each is legitimate within its field of reference and each has its strengths and limitations. Each also affects how we perceive the world. If we approach the world in a rationalistic, reductionistic, materialistic way, the world will appear to us as a rationalistic, reductionistic, materialistic place. This is one of the major mistakes that most scientists make. Objectivity is an illusion. The world will tend to appear in ways that conform to how we look at it. Even when it doesn't, we tend ignore, misinterpret or deny experiences that don't conform to our world view.

When science is done properly it is a beautiful thing. We approach the world as the big, beautiful, mysterious place that it is. We are humbled by it, knowing that it is infinitely bigger and more complex than we can every hope to comprehend with our rational mind. As soon as we fall into the trap that we have things figured out we are no longer doing science because our beliefs affect the kinds of questions that we ask and how we perceive and interpret the results. Our beliefs can even cause us to see things in the results that aren't there or to manipulate the results so that they conform to our expectations.

The mystery of Nature: the source of all healing!

Getting back to homeopathy, if we want to truly investigate it in a scientific way the first thing we need to do is separate the effect from the explanation of the effect. The most important thing to investigate is whether or not homeopathic remedies work. If we focus on the explanation, we risk throwing out the baby with the bathwater because if the explanation turns out to be false there is a tendency to assume that the effect is also false. As a healer, I subscribe to a particular paradigm because it is what best conforms to my experience and produces the best results. However, my goal is to heal. Healing is a beautiful and mysterious thing. It doesn't matter to me if my understanding of why what I do works is accurate. What matters most is that it helps people. Similarly, demonstrating whether or not homeopathic remedies work is the most important thing. If it turns out that they do, the appropriate response is not to reject the results because they don't conform to our theories, it is to re-examine our theories because clearly they are inadequate to explain our observations.

One of the major arguments against homeopathy is that it is not supported by research. In fact, one of the reasons that the attack on homeopathy has recently ramped up so intensely is because the Australian National Health and Medical Research Council (NHMRC) recently conducted a "review" of the available research on homeopathy and concluded that the research overwhelmingly demonstrates that homeopathic remedies do not work any better than a placebo. Although it is true that there aren't many good studies on homeopathy, this conclusion is not accurate for a number of reasons. Firstly, good quality human clinical studies are very expensive to conduct and, in general, it's difficult to get funding for studies on homeopathy. Consequently, there aren't very many studies out there on homeopathy and most of them aren't very good. Another issue is that homeopaths are not part of the mainstream research community. If they attempt to do studies, it is difficult for them to get sufficient funding and they, as a rule, don't have a lot of experience doing research. Conversely, most experienced researchers aren't interested in doing research on homeopathy, and even if they are, they don't understand homeopathy. This means that their research is likely to be conducted from a modern medical paradigm and is not accurately testing homeopathy the way it is actually practiced. Finally, many of the people who have done studies on homeopathy are really trying to disprove it. Thus their studies are significantly biased. The Australian NHMRC itself was also trying to disprove homeopathy, so their analysis is extremely suspect.

Personally, I can not speak to the quality of the studies on homeopathy out there because most of the people who are writing about them are biased one way or the other and I simply don't have time to review the actual studies myself. However, I am familiar with one study which illustrates my point. In the late 80s a French researcher, Jacques Benveniste, did a study which seemed to demonstrate the effectiveness of homeopathy. He submitted a paper to Nature magazine. Not surprisingly, they were skeptical of his findings. They told him that in order to publish it he would have to incorporate some additional controls in the study and also have it replicated at other labs. He made the suggested changes and his study was replicated by researchers at University of Toronto, University of Milano and Hebrew University. When he resubmitted the paper, Nature begrudgingly published it because they said that they would, but in an uncharacteristic move they also published an editorial attacking the study. They then sent a team of "experts" to examine Benveniste's methodology. This is completely unprecedented! They would never do this with researchers whose research conforms with the mainstream medical paradigm, even if the research was of a much poorer quality. In addition, none of the "experts" were actual researchers and only one of them was a scientist, but from a completely different field of study. Their sole intent was to discredit Benveniste. They had him repeatedly redo his experiment under more extreme controls even though the results remained consistent, until finally they got the results that they wanted and this is what was reported. From their perspective, that of Nature, and most of the scientific skeptics in the world, Benveniste's results were disproved and the positive results that he did get were due to some flaw in the design of the study that they were not able to determine. Benveniste later conducted even better designed studies and got consistent results but Nature refused to publish them. Shortly after, the French Institute of Health and Medical Research cut his funding after a routine evaluation of his lab. Although they acknowledged that his lab exceeded their standards, they cut his funding because he refused to stop doing research on microdoses.

Needless to say, the whole Benveniste affair has very little to do with real science and all of the characteristics of a witch hunt. Even some scientists who are skeptical of homeopathy have criticized the way it all went down.

When evaluating healing systems that are outside of the mainstream, "not supported by scientific evidence" is one of the common criticisms. What is interesting to me is how skeptics like to apply strict criteria to the evaluation of things that they don't believe in, but are willing to accept far lower standards for things that they support. For instance, many of the practices of modern medicine have little to no research backing them up and medical practitioners often continue to practice them even when the research clearly demonstrates that they are ineffective [see: http://www.scientificamerican.com/article/demand-better-health-care-book/ and http://well.blogs.nytimes.com/2009/04/02/the-ideology-of-health-care/?_r=0]. It is also quite common that things that initially seem to be backed up by research turn out to be false [see: http://www.huffingtonpost.com/alison-rose-levy/what-statins-transfats-and-gmos-tell-us-about-scientific-controversies_b_4385741.html and http://www.newyorker.com/magazine/2010/12/13/the-truth-wears-off]. To a large extent this is because of the biases of researchers, whether ideological or because the people conducting and funding the research have a vested interested in the results of the study [see: http://www.scientificamerican.com/article/trial-sans-error-how-pharma-funded-research-cherry-picks-positive-results/ and http://www.sciencedaily.com/releases/2015/04/150403073439.htm and http://www.sciencedaily.com/releases/2014/10/141021141746.htm and http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124].

Although there are many medical practitioners that genuinely want to find ways to help people who are sick or suffering, sadly, even those who are coming from a good place are largely barking up the wrong tree. Although mainstream medicine has made great progress when it comes to emergency interventions, it is largely unsuccessful when it comes to the treatment of chronic health conditions. In fact, it has actually contributed to the growing epidemic of chronic degenerative diseases, both as a result of its toxicity and side-effects [see my previous post The Vaccination Controversy, Part 1] and by promising magical cures that don't really work. This is because modern medicine is not really about healing. It is about palliative care - suppressing or neutralizing symptoms rather than understanding and addressing the underlying condition. A good example is the so-called "war on cancer". In spite of the billions of dollars that have been spent funding the cancer industry, with the exception of childhood leukemia a person's prognosis if they are diagnosed with some form of cancer is no better today than it was 60 years ago [see: http://blogs.scientificamerican.com/cross-check/2014/05/21/sorry-but-so-far-war-on-cancer-has-been-a-bust/]! Lots of new drugs have been developed and profits made, but the actual results speak for themselves.

Another comment that is interesting to me is that homeopathic remedies are "just placebos". They speak about placebos as if they are something to be written off, but the placebo effect is one of the most interesting things ever demonstrated by medical science. It is a demonstration of the healing power of the human mind! If anything, we should be doing a lot more research on the placebo effect. For one thing, so called "placebo controlled" studies aren't even properly designed to determine the magnitude of the placebo effect [see: http://www.sciencedaily.com/releases/2015/04/150413140906.htm]. Secondly, the placebo effect is a very powerful and important part of the healing process. It should be cultivated, not written off, because the beneficial affects of ALL treatments, conventional and natural, are partly due to the placebo effect [see: http://blogs.scientificamerican.com/cross-check/2013/03/12/psychiatrists-instead-of-being-embarrassed-by-placebo-effect-should-embrace-it-author-says/]. This is why it is a very dangerous thing to attempt to convince someone with a serious illness that they shouldn't follow a treatment that they really believe in. What this does is instill doubt and fear in people and it can significantly hinder the outcome of their treatment. Similarly, there is also a negative placebo effect. Just as a person's belief in the benefits of a treatment can significantly improve the effectiveness of the treatment, their disbelief in the benefits of a treatment can significantly hinder the effectiveness of the treatment. This is one of the reasons why there is usually no point attempting to convince someone to undergo a treatment that they don't believe in (the other reason is that they are less likely to properly follow instructions or continue the treatment long enough for it to be effective). As a practitioner, the best thing we can do is attempt to educate a person in as unbiased a way possible about the potential benefits and limitations of their treatment options and allow them to choose what they feel is best for them.

St. Johnswort (Hypericum perforatum) is an amazing herb for the treatment of nerve trauma and inflammation. For this purpose it works
both in crude form and in homeopathic potencies, but it works best when both are used concurrently.

Getting back to homeopathy, regardless of how difficult it is to understand from a scientific perspective, it is completely unrealistic to assume that the tens of thousands of practitioners that have prescribed homeopathic remedies and the millions of people who have used them over the last couple of centuries are completely deluded. I have used homeopathy for myself, my family and pets. Although it is not my primary modality, I sometimes recommend homeopathic remedies to my clients as well. I can say with absolute certainty that they work. Interestingly, they work even better for animals than humans because animals don't have any negative beliefs about them. Because of their lack of beliefs, when animals demonstrate positive results from homeopathic remedies it can not be attributed to the placebo effect.

It certainly wouldn't hurt to fund some good quality, unbiased human clinical studies that investigate homeopathy in the context of how it is actually used to put this issue to rest once and for all. Unfortunately, this is unlikely to convince most of the skeptics. They are too attached to their theories. How the world really works is secondary. If such studies were to be done, I have confidence that the results will be positive. Once it is clear that homeopathy does work, then we can attempt to figure out why. It may be that we do not have the right technology to figure that out at the moment, or that we will never be able to with absolute certainty. As far as I am concerned, that doesn't matter. What matters is that homeopathic remedies when used correctly have a tremendous potential to help people. Positive healing outcomes are the most important thing. Good theories and explanations are useful, but not necessary.

For those who have been patiently waiting, I will continue my series on vaccinations in my next post.


4 comments:

  1. Michael, thank you for this brilliant post! Natural healing will grow stronger because of people like you.
    Maybe you should consider submitting this post to the Vitality magazine. I am sure it would benefit many people who are confused about homeopathy.
    I also think that the Wikipedia entry on homeopathy needs to be revised as it is really biased. Why do allopathic, skeptic researchers seem to be controlling all Wikipedia entries on alternative healing? I cannot help but feel aggravated when I look through the entries on natural healing on Wikipedia. Every entry seems to exist solely to discredit alternative healing.
    We need to educate our children that not everything mainstream science says is true or false should be trusted. Mainstream science likes to say something is pseudoscientific or false just because it does not possess the capability of understanding it. Homeopathy is one example, and more ridiculous example is the way of thinking that life only exists on Earth just because it has not been proven otherwise. And there are 1,000,000,000,000,000,000,000,000 in the observable universe. Little bit off topic but it illustrates my point.

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    1. There is a definite bias against natural healing traditions in Wikipedia. I've heard that the founder is very anti CAM. I'm not sure if it is true, but the entries on natural medicine are clearly written by people who have a strong reductionistic, materialistic orientation. This is unfortunate because a lot of people are relying on Wikipedia as a major source of information these days. That being said, a lot of the pro natural healing information on the Internet is being propagated by people who are selling products. Unfortunately, for the most part (there are exceptions) the Internet is not a very good source of reliable information on natural healing.

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  2. Wow, you actually just succeeded in opening my mind on this subject. Hmm.

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  3. Even though I have seen many articles on the reason for the organized attack against the system of Homeopathy,I have not seen such a comprehensive one..Well studied and well explained. I am from India where everyday at least a million people are taking homeopathy treatment..But now there is an organized outcry against the system..It is well funded by the modern medicine lobby..

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