The treatment of disease should be evidence-based and not done by faith-healing, writes Donald Cairns
Homeopathy is promoted as a centuries old form of medical treatment based on the principles that “like cures like”.
In this form of faith-healing, a tiny dose of an agent which causes a disease in a healthy person is believed to be beneficial for treatment of that condition when the person becomes ill.
Another related homeopathic belief is that, the more a preparation is diluted, the more ‘potent’ it becomes.
This belief, unsupported by any scientific principles or evidence, encourages adherents of homeopathy to prepare and administer preparations which, it can be shown, no longer contain a trace of the prescribed preparation.
An Italian chemist called Avogadro showed in 1811 that the volume of a gas, at constant temperature and pressure, was proportional to the number of atoms or molecules present, and that this relationship was true regardless of the composition of the gas. The number of atoms or molecules present can be calculated and this total is now known as the Avogadro number.
Armed with this knowledge, it can easily be shown that a homeopathic preparation diluted beyond this number will on average contain not a single molecule of any of the original ingredients.
If homeopathy existed as an historical anachronism, a passing footnote in the history of medicine, the situation would be bad enough.
But homeopathy is available on the NHS and we all pay for it through our taxes and National Insurance. The treatment of disease should be ‘evidence based’ and founded on strict principles of therapeutic benefit to the patient versus risk to the patient of completing the treatment. This is particularly true when the funding available for these treatments is finite.
The disciplines of modern pharmacology and therapeutics are built on results from carefully controlled clinical trials, where prospective treatments are compared for efficacy, in healthy volunteers and in carefully selected patients.
Only when a trial has been completed and compared to others undertaken elsewhere, is a potential treatment approved for use.
Generally, the larger the trial, the more robust the evidence gathered, and this may lead to huge trials taking place across many centres, where data are pooled to provide accurate and reliable information for practitioners and scientists.
Homeopathic ‘treatments’ also undergo clinical trials, and are consistently shown to be ‘no better than placebo’. A recent study concluded that homeopathy was effective in zero out of 68 conditions studied.
The phrase ‘no better than placebo’ is also important here. The placebo effect is a well-recognised phenomenon in medicine, where a ‘fake’ or ‘dummy’ treatment, containing no active agent whatsoever, is effective in improving a patient’s symptoms.
The effect is believed to be psychological, whereby the patient’s expectation of getting better is so powerful that their condition improves, even though they have received no active treatment. This is the explanation for any treatment successes held up by supporters of homeopathy.
There are people who believe in homeopathy, just as there are people who believe the earth is flat, or that the Apollo moon landings were faked, but that doesn’t mean it has a role in modern healthcare.
A final thought on homeopathy is more personal for me. I have been a pharmacist for nearly 35 years and in that time, I have taught science to many hundreds of students of pharmacy and chemistry. It therefore saddens me to see homeopathic preparations sold in community pharmacies up and down the country.
Why should this be? Is it due to simple greed? It cannot be due to ignorance, because every pharmacist is trained in the scientific basis of their professional practice.
Students are told that homeopathic preparations are no better than placebo and their continued use is scientifically unsound. The only conclusion I can reach is that pharmacists who supply homeopathic preparations are doing so in the knowledge that the product they supply is useless and are therefore deceiving the customer. This conclusion does not reflect well on my profession and, in fact, shames all of us.
• Professor Donald Cairns is the Head of the School of Pharmacy and Life Sciences at Robert Gordon University, Aberdeen.