Tuesday, November 13, 2007

Homeopathy: there’s nothing in it

Jeanette Winterson has a (possibly) peer-reviewed article in today’s Guardian, arguing in favour of homeopathy. She begins with an anecdote of a time when she was ill:

My desperate publisher suggests I call Hilary Fairclough, a homeopath who has practices in London and Penzance. She sends round a remedy called Lachesis, made from snake venom. Four hours later I have no symptoms whatsoever.
Dramatic stuff, and enough to convince me that while it might use snake venom, homeopathy is no snake oil designed for gullible hypochrondriacs.

A neat turn of phrase, but actually very apt. Given the massive dilution that homeopathic ‘remedies’ use, I’m sure there was absolutely no snake oil (or any other snake product) at all in the bottle that Winterson had.

She says: “I admit it is hard to talk about what it is that homeopathy actually does, or why it works.”

No, it’s easy. What’s hard is to argue that it does anything more than deploy a placebo effect. The official story, of course, is that homeopathy “follows the ‘like by like’ premise - that tiny dilutions of the ‘problem’ can prompt the body to effect its own cure”.

This sounds a little bit like the principle by which vaccination infection works, but in the latter case there’s a coherent and superbly documented mechanism: the immune system can successfully deal with a weak – but real – dose of a disease’s causative agent, in the process producing the antibodies that make it easier to fight any future infection. It’s essentially preventative. Homeopathy isn’t. And of course, the quantities of infectious agent used in a vaccine are non-imaginary.

Objections to homeopathy begin with what are viewed as the impossible dilutions of the remedies, so that only nano amounts of the original active substance remain, and in some cases are only an imprint, or memory. Yet our recent discoveries in the world of the very small point to a whole new set of rules for the behaviour of nano-quantities.

“Imprint”. “Memory”. The bottle of homeopathic remedy one takes home may well have precisely zero molecules of the supposed active agent, but despite being diluted into annihilation, what remains is somehow held to ‘remember’ this ingredient.

There’s no scientific evidence that this happens, or known physical mechanism by which this could happen (Winterson’s subsequent hand-waving about nanoparticles notwithstanding – like the intelligent design mob, homeopaths pounce on anything not currently completely understood and try to erect an altar there to their god of the available gaps).

Furthermore, any homeopathic remedy will have had quantities of many other substances polluting it at some stage, and yet the ‘memory’ of these is supposed to be forgotten.

On top of this, the effect that the alleged active ingredient (or more accurately ‘egredient’, given that it’s been diluted away) has is something operating not at the physical/chemical level but, supposedly, at the level of any of a number of malaises experienced by the patient. This means that an apparently undetectable microphysical phenomenon responds directly to the intentions of the people preparing and prescribing the remedy – perilously close to a belief in psychic powers.

In reality, though, homeopathy works via the intentions and hopes of the patient. In fairness, I must note that Winterson addresses the ‘just a placebo’ charge head-on, citing almost one published study:

I am sure that there is a placebo effect in homeopathy, but it is a fact that many of the people who end up visiting a homeopath do so as a last resort, when nothing else is working. That such people often see an improvement suggests that the remedies themselves are contributing to the wellness of the individual.

Rubbish: desperation breeds faith. And you really don’t need a lorryload of pseudoscientific mumbo-jumbo to explain the placebo effect. However, such specious blather can be very handy in actually bringing the effect about.

4 comments:

LiberalHammer said...

Tom,

I read that article and thought it was utter tosh. Whilst Winterson did address, in part, some of the criticisms of homeopathy she is utterly unable to demonstrate that it works in anything other than an anecdotal sense. But it was typical of the Grauniad to use a literary writer rather than a science journalist to address what is ultimately a scientific issue.

LiberalHammer said...

Tom,

I read that article and thought it was utter tosh. Whilst Winterson did address, in part, some of the criticisms of homeopathy she is utterly unable to demonstrate that it works in anything other than an anecdotal sense. But it was typical of the Grauniad to use a literary writer rather than a science journalist to address what is ultimately a scientific issue.

Tom Freeman said...

A very good point. It's all about constructing a narrative - which is precisely what homeopathic practitioners do so very well to maximise their placebo effect. Indeed, she said that her own personal experience was "enough to convince me" that it works for real. No need to even consider any studies in that case...

The article's not so much an argument in favour of hopmeopathy as a celebrity endorsement.

Dr. Nancy Malik said...

Homeopathy is evidence based modern medicine for the 21st century