Is it right to vilify homoeopathy? Sometimes. Often, perhaps. But not always.

In a brilliant article for the Guardian Tim Lott decried the intolerance of people on the left of politics. He complained that people, like him, who raised questions about gender discrimination, Islamism, feeling English or complaining about political correctness, risk unleashing intolerant invective from the “liberal” left.  He was speaking as a Labour loyalist – but I recognise the same issue in the Liberal Democrats. Now let me make my politically incorrect contribution to the genre. It’s about homoeopathy.

Homoeopathy is a branch of alternative medicine developed in the 19th Century. Its theoretical grounding might fairly be called mumbo-jumbo. But it has retained a degree of popularity, and has been available under Britain’s NHS, which supports placebo therapies in some circumstances. It is, however, a popular subject of ridicule, particularly from the liberal left. They condemn its availability on the NHS, and want it to be driven off the face of the earth. This article by Edzard Ernst in today’s Guardian is one of the more temperate ones. It follows some publicity from a recent Australian study showing that there was no scientific foundation for its claims.

Let’s clear the decks a bit. I have no doubt that homoeopathy provides cover for charlatans. And practising homoeopaths are their own worst enemies. They persist in using their outdated mumbo-jumbo explanations. According to Dr Ernst they also cite scientific evidence that is spurious. That goes for David Tredinnick, the Conservative MP who is a public supporter. People that suggest that homoeopathy is an equivalent discipline to modern conventional medicine deserve the ridicule that is heaped on them.

But there is another side to this story. Arguments over the discipline’s scientific basis miss a point that should be understood by everybody. Scientific evidence will only ever get our understanding of the world around us so far. Much knowledge is simply beyond its reach. Homoeopathy may not be an alternative to modern medicine, but it may enter space that modern medicine cannot go.

Conventional medicine it is bound up with the idea that people suffer a series of different ailments, and medicine’s job is to find and test therapies for each of these ailments in turn. These ailments are further described in turns of measurable chemical or biological imbalances. The therapies are likewise usually chemical or biological agents – though other therapies may be admitted so long as they are standardised and repeatable. This line of approach (which I like to call the “magic potion” method of medicine) is extremely powerful. It goes alongside a system of evidence gathering  that allows you to place a tick or cross against each therapy. The standard is whether or not the symptoms are alleviated against an alternative “placebo” treatment which uses chemically inert substances. Through this approach medicine has developed a formidable inventory of magic potions over two centuries and prolonged many, many lives.

But it will take you only so far. Now take two places where homoeopathy might help to provide patients with relief. The first is what might be called “mind over matter”. It has been demonstrated countless times that mental outlook can affect symptoms. This phenomenon accounts for the placebo effect.  Scientists do everything they can to eliminate its effects from their evidence. So if homoeopathy is an effective placebo, the scientific studies wouldn’t show it. This is something Dr Ernst’s article is quite careful to state (“no effect beyond placebo”).  Of course there is danger if a patient is persuaded to use a placebo when something else is more appropriate – but not to treat a patient with a placebo when this might be effective also poses an ethical problem. Or it should. Conventional doctors often use antibiotics to treat viral infections; this is surely a much more questionable practice.

The second way homoeopathy might work is holism. Homoeopathic practitioners should (even if many don’t) look at the patient’s complete circumstances – from  the complete range medical symptoms to anxieties and outlook on life, before selecting a therapy that is individual to that patient. This is another place that scientific method cannot go. It cannot produce the sort of repeatable results that science requires – because everybody is a bit different. That still leaves therapies depending on placebo effects, but it could give that effect extra oomph. One of the causes of disillusion with modern medicine is that patients are treated as disconnected symptoms parcelled out to different specialists, with  obvious things (like what the patient eats in hospital) often neglected. Puzzling symptoms are overlooked to focus on ones more within practitioners’ comfort zones. There is much talk of patient-centred medicine, but remarkably little practice. That may be because building up an appropriate evidence base is impossible.

To my mind that leaves space for an ethical homoeopathist who is no simply trying to peddle expensive but inert magic potions. Modern medicine can’t be beaten in the magic potion business. But when it comes to treating mind and body as part of the same human being and looking more widely on how to advance that human beings health and wellbeing – modern medicine does not look so hot.

 

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3 thoughts on “Is it right to vilify homoeopathy? Sometimes. Often, perhaps. But not always.”

  1. Matthew
    Good article. Dear Dr Evan, late MP for Oxford, shot himself and the LibDems in the foot just before the last elections by making an ass of himself in an anti-homeopathy demo. Classic extreme secularist, sensing (Myers Briggs) intolerant ridicule that offended many people, including those for whom homeopathy is not a medicine they take.
    It just reinforces the JS Mill point I made in my comment about the middle ground.

  2. Thank you for this. Three cheers for the open-minded!

    Western medicine is not stranger to the use of placebos, and noone really knows how much this contributes to the recovery of their patients. Ironically it might be precisely that they claim to eliminate the placebo effect in drug testing, that makes the drugs effective placebos – people believe they “really work”.

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