Homeopathic remedies: safe, inexpensive … and they seem to work

Homeopathic remedies have enjoyed renewed interest in the last 20 years. They're safe, relatively inexpensive, and as accessible as the nearest health food store. But do they work? Three Dutch physicians took this question seriously enough to conduct a comprehensive assessment of 107 published studies, many of which compared people given homeopathic remedies with those given a placebo (dummy pill). Their findings, published recently in the British Medical Journal (9 February 1991), indicate that "there is a legitimate case for further evaluation of hemeopathy." The homeopathic remedies were shown to be more effective than placebo in the treatment of a variety of common problems, including migraine headaches, dry cough, and ankle sprains.

Homeopathy was developed at the end of the 18th century by a German physician, Samuel Hahnemann, who became disillusioned with standard allopathic medicine. At the time, most medical practices were ineffective and/or downright lethal. Doctors attempted to rid the body of disease with purging, bloodletting, or highly toxic substances like mercury. While allopathic physicians are primarily concerned with the suppression of symptoms, homeopaths view them as something to be encouraged because they are a sign of the body's natural capacity for self-healing.

Homeopathic remedies, usually in the form of tiny white pills, are extremely diluted animal, plant, or mineral extracts. The guiding principle in the selection of homeopathic treatment is like cures like. The remedies consist of a minute dose of a substance that would produce in a health person symptoms similar to those of the disease. For example, a person suffering from malaria might be given a microscopic dose of quinine so chosen because a large dose of quinine would produce in a healthy person the symptoms of malaria.

In the U.S., homeopathy was strong enough up to the turn of the century to rival allopathic medicine, but eventually it lost ground to the rising strength of the pharmaceutical industry and a Rockefeller-funded AMA evaluation of the nation's medical schools which led to the closing of all homeopathic medical schools and hospitals. Homeopathy's "renaissance" in this country has been attributed to the rise of the holistic health, consumer, and women's movements. A common thread that runs throughout all three movements is a dissatisfaction with overly toxic medical treatments. In other countries, particularly, Germany, England, France, The Netherlands, and India, homeopathic medicine has always enjoyued a far higher level of acceptance among physicians and the lay public.

Makes No Sense

To many people, homeopathy makes no sense, especially when they hear how homeopathic remedies are produced. The extract is combined with water or water and alcohol in a one to ten dilution. It is vigorously shaken and then diluted again in the same proportion. The process is repeated many times. According to homeopathic theory, the curative properties of even high toxic substances are released at these high dilutions. The more extract is diluted, the higher its potency.

In the introduction to their newly published assessment of homeopathy trials, the Dutch physicians, Jos Kleijnen, M.D. and colleagues at the University of Limburg, addressed the two major areas of skepticism among their fellow physicians. "...many doctors do not believe that homeopathy is an efficacious treatment as it is highly implausible that infinitesimally diluted substances retain their biological effects. It is also often stated that homeopathy has not been evaluated using modern method--that is, controlled trials. The first argument may be true but the second is certainly not true."

The University of Limberg investigators, who are all epidemiologists, conducted an exhaustive search of the published medical literature to find evidence of homeopathy's efficacy regardless of implausibility. They found an astonishing 107 controlled studies. Many of them compared a homeopathic remedy with a placebo. While some studies were well designed, the investigators found that the methods used in the majority left much to be desired. But their findings were favorable enough toward homeopathy to suggest further evaluation: "Of the better studies, 15 trials showed positive results whereas in seven trials no positive effect could be detected (in one trial only homeopathic treatments were compared with each other)."

They used strict criteria for the selection of the best trials. Highest marks went to the studies with these characteristics: a large numbe of participants, double blinding (neither physicians nor participants know who is receiving the homeopathic remedy), a placebo that was described as indistinguished from the homeopathic remedy, and random assignment of participants to a treatment group.

The study that topped the list of the 15 "better studies with positive results" involved a flu remedy called oscillococcinum, which has become a popular seller at most health food stores and many pharmacies in the U.S. The recovery rate within 48 hours was 17% of the participants taking oscillococcinum and 10% of those on the placebo (British Journal of Clinical Pharmacology, 27:329-335, 1989).