Mary Wakefield

Is homeopathy really hogwash?

Mary Wakefield has used homeopathic medicine all her life, but is now beginning to have doubts about its efficacy and is not sure that it should be available on the NHS

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It didn’t occur to me until a few weeks ago to question homeopathy. Of course it worked. I grew up with it; my aunt Liz was and still is a homeopathic practitioner and for us — my mother, father, aunts, uncles, brother, cousins — calling Liz was the natural reaction to the slightest swollen gland. We weren’t loopy: if things got dangerous, a trained doctor would be summoned but as he tapped and tutted, the aunts would hover, a copy of First Aid Homeopathy in Accidents and Ailments by Dr D.M. Gibson to hand. My childhood memories are full of the taste of little sugary pills — ‘There, open wide, let it dissolve on your tongue’ — and the rhythmic clinking of remedies being beaten into water with a hundred stirs of a silver spoon. The sound of science.

None of us would ever have questioned the efficacy of homeopathy because, over the years, we saw it work. Not in a conventional way, with a gentle alleviation of symptoms followed by full recovery, but in the manner of potions class at Hogwarts. My brother Jack, for instance, suffered from eczema for the first three years of his life, the insides of his elbows and knees unbearably red and itchy. A Dr Somper prescribed the usual course of tasty pills and one morning a shriek came from Jack’s room. He’d been found lying in bed, swollen up like a puffer fish. Mum called Dr Somper in a panic. ‘Very merry, very merry indeed,’ he said, with a chuckle, ‘he’s cured!’ And so, when he deflated, he was.

A few years later, mother took a remedy designed to help her get over her fear of flying. A nasty rash appeared almost instantly all over her back, but shortly after she was found, happily and entirely unselfconsciously, booking aeroplane tickets over the phone. When this was pointed out to her, however, she took fright. The thought that she might find herself cured and on a plane was so alarming that she refused any more pills.

There were downsides: the great disappointment of waiting for a dramatic bruise only to find that arnica had put paid to it. But basically we were and still are a happy homeopathic family, calendula on tap and every bathroom cabinet crammed full of tiny vials with mediaeval-sounding labels: hepar sulph, nat mur, lachesis, lycopodium.

Then, in late August this year, a medical journal, the Lancet, published ‘proof’ that homeopathy was fraudulent. It reported the findings of a group of Swiss scientists from Berne university who had compared the results of 110 trials of homeopathic medicine with 110 trials of conventional medicine and found homeopathy to have no more than a placebo effect. ‘We acknowledge that to prove a negative is impossible,’ said Dr Egger, a member of the Berne team, ‘but we have shown that the effects seen in placebo-controlled trials of homeopathy are compatible with the placebo hypothesis.’ In the same issue the Lancet ran an editorial full of angry jubilance. It’s hardly surprising that homeopathy does badly compared with conventional medicine, it said. ‘Of greater interest is the fact that the debate continues despite 150 years of unfavourable findings. The more dilute the evidence for homeopathy becomes, the greater seems its popularity....For too long a politically correct, laissez-faire attitude has existed towards homeopathy. Now doctors need to be bold and honest with their patients about its lack of benefit.’

Blimey! Really? I was amazed, and the more I thought about it, the more alarmed I became. Had I grown up with a lie? Was it conceivable that members of my family were just prone to nasty rashes and collective delusions? That not one of those millions of pills had had any effect? Perhaps most people would find it uncontentious to suggest that homeopathy is hogwash. I found it horrifying, and talk of ‘the placebo hypothesis’ no comfort.

Most sceptics, once confident that they’ve destroyed the credibility of a treatment, will suggest, as a sop, that it acts as a placebo; that even though there are no effective ingredients, sometimes just the act of giving a pill can be a help. In the case of homeopathy they say that the practice of listening carefully and asking questions is what does the trick.

Of course there is such a thing as a placebo effect: it’s been proven many times that large pills work better than small ones, bright colours better than white; doctors dolled up in white coats and stethoscopes are more effective than dressed-down GPs because the trappings of professionalism give people faith, and faith heals.

In the case of homeopathy, however, the placebo effect isn’t good enough for me. Though a born fence-sitter, keen on cop-outs, this time there’s too much at stake. My mother’s hips for instance. Although she finds it difficult to walk and has to sit down on walls halfway to Waitrose to do grisly, bone-grinding exercises, she’s currently refusing to have her arthritic hips replaced with two new bionic ones because she’s so sure that taking a tiny homeopathic dose of volcanic lava is going to see her right. There’s the rest of the world to think of as well. A man called Bob de Vaatt told his story in the Daily Mail the other day. His wife, Julia, was diagnosed with breast cancer. She turned down a lumpectomy and chemotherapy in favour of homeopathic treatment and grew so obsessive about it that her marriage broke down. She died in July last year. There must be thousands of critically ill men and women across the world all, like Julia de Vaatt, hoping that homeopathy can work miracles.

Then there’s the cash. We currently have five NHS-funded homeopathic hospitals and the largest, the Royal London Homeopathic Hospital, has just had a £20 million facelift. The market value of the remedies is £32 million and growing year by year; and the NHS is in the middle of a big debate as to whether to make homeopathic medicines available to any NHS patient who demands them. It’s not enough for homeopathy to be a harmless conduit for the power of positive thinking. It’s either effective or it should not be funded by the taxpayer.

Last week the homeopaths fought back against the Lancet. Peter Hain said his baby Sam had, like my brother, been cured by homeopathy of eczema. The next day Prince Charles released the results of his own report which found that patients treated with homeopathic remedies had fewer consultations with GPs, and took half as many drugs.

But the Prince came too late for me. My doubts had already taken root. I felt confused, torn between the Lancet and the aunts. It was time to find out what homeopathy actually is.

The man responsible, Samuel Hahnemann, was born in Germany in 1755. His parents were poor but eager for young Samuel to improve himself; they set him logic problems and encouraged him to learn languages. By the time he was 13 he was teaching his buddies Hebrew and by 20 he spoke eight languages. At 30 Samuel Hahnemann was a successful and talked-about doctor, author and chemist, but he was already disillusioned. He had no faith in the medical practices of his day — bleeding by venesection, cupping and leeches — so he took to translating instead. And here’s where Hahnemann had his revelation. He was working on a German version of William Cullen’s Materia Medica when he found himself in disagreement with Cullen on the subject of quinine (cinchona bark), and decided to test the drug on himself. He took a small dose and found to his surprise that taking it produced the exact symptoms of the malarial fever it was supposed to cure. This was to Hahnemann what the falling apple was to Newton and the swinging lamp to Galileo. Like cures like, he said to himself, similia similibus curantur. He went on to test a further 60 different substances on his friends and family, and homeopathy was born.

Hahnemann’s homeopathy had three main tenets. The first is that a tiny amount of a substance will, if taken by a healthy person, induce a set of symptoms. If these match the symptoms of a patient, then it will have a curative effect on him. Like cures like. In other words, what was true of quinine is also true of many thousands of other substances, from salt to snake venom.

The second part of Hahnemann’s philosophy is to do with how you prepare the substances to best turn them into medicine. And though it seems irrational, in fact the more dilute the remedy is, the more its power increases. Sometimes the dilutions are so extreme that it’s unlikely that even a single molecule of the original substance remains but, said Hahnemann, this is no barrier to the remedy’s efficacy. Why? Because the water has been shaken or ‘succussed’ with the curative substance, and this imprints the water with an energy blueprint which then passes on to the patient’s body.

The third of Hahnemann’s ideas is the oddest. It’s that all of our ailments stem from the suppression of various key diseases or ‘miasms’. Seven eighths of all ills, he thought, had their root in suppressed skin complaints which he called the ‘psoric miasm’.

Finally, it’s crucial to realise that for Hahnemann and his 21st-century followers homeopathy isn’t just an alternative, it’s a better form of medicine with its own venerable history. Hippocrates acknowledged the truth of the principle of similars in the 4th century bc, they say, but in the 2nd century ad medicine was derailed by Galen, the father of modern, allopathic treatment, whose cures contained substances unrelated to the disease.

Knowing more about what Hahnemann thought, however, didn’t make it any easier to ignore the Lancet. Not only are the three tenets contentious, but as I read on I discovered that over the last 250 years they have failed in controlled tests time and time again.

In 1835, for instance, a public challenge was offered to the best-known homeopathic physician in Paris. He was to select the ten substances he felt had the most striking effects, dilute them himself and choose one at random. He was then to try it upon himself, feel the effects and guess the substance. The challenge was never taken up.

In 2000 an illusionist and sceptic who calls himself the Incredible Randi offered £1 million to anyone who could provide convincing evidence that homeopathy works. In 2002 the television programme Horizon set out to win Randi’s million and conducted their own experiment on camera. But none of their scientists could tell the difference between the homeopathic solutions and plain water, so Randi kept his cash.

The physician and poet Oliver Wendell Holmes had a more general complaint against homeopathy: ‘The three great asserted discoveries of Hahnemann are entirely unconnected with and independent of each other,’ he said in 1845. ‘Were there any natural relation between them it would seem probable enough that the discovery of the first would have led to that of the others. But assuming it to be a fact that diseases are cured by remedies capable of producing symptoms like their own, no manifest relation exists between this fact and the next assertion, namely the power of infinitesimal doses. And allowing both these to be true, neither has the remotest affinity to the third new doctrine, that which declares seven eighths of a chronic disease to be owing to psora.’

So why did I end up trekking to Cricklewood in North London to give the honorary secretary of the Society of Homeopaths a chance to explain himself? Three reasons. First, and most important, the endless claims of cures culminating in Peter Hain’s last Thursday. It seemed unfair to rule against 250 years of normal people in favour of the Incredible Randi. Second, Hahnemann himself. The more I learnt about him, the more sensible he seemed. Unlike his medical contemporaries, Hahnemann was sickened by bloodletting, keen on hygiene and nutrition and nice to mad people. ‘I never allow any insane person to be punished by blows or any other painful corporeal inflictions,’ he wrote, after taking charge of an asylum in Georgenthal. The third reason was his theory of miasms. It sounds barking, but it stuck in my mind. If the vast majority of all ailments are the result of a suppression of psora, it might explain why my family breaks out in rashes every time they’re given a little white pill.

Francis Treuherz, the honorary secretary of the Society of Homeopaths and practising homeopath for the last 20 years, sees patients in a large Victorian house. His study walls are lined with books and bottles, and Hahnemann’s famous dish-faced profile stares sternly to the right on postcards propped up around the room. Sitting with tea and a biscuit, I asked him why homeopathy seemed unable to prove itself in medical trials. ‘It’s not homeopathy’s fault, it’s the trials that are wrong!’ said Treuherz excitedly. I looked sceptical. He explained: ‘In the Lancet trials, for instance, they gave the same remedy to each patient, but the whole point of homeopathy is to focus on the individual. Even if two people have the same disease, it’s unlikely they’ll get the same remedy. Listen.’ He leaned forward in a grandfatherly fashion. ‘Imagine a woman walking in here with osteoarthritis. Imagine that she seems to be fussy, chilly, thin, ambitious and without much appetite, I’d give her arsenicum — arsenic. Now imagine another woman with osteoarthritis. But instead of being tidy and chilly, she’s messy and often hot. The pain in her knees is a burning pain and she likes her food. I’d give her sulphur. Same condition, different remedies. See?’ Sort of. One of his socks was green with a white clover pattern, one white with green clovers.

‘Look,’ said Treuherz, sensing my doubt, ‘let me show you the effect homeopathy has had in the past.’ He leapt around his study, pulling down old books, laying them open in front of me. ‘Here! These are the records of Joseph Kidd, a doctor from Limerick who studied homeopathy in London. When the famine struck Ireland he returned home to treat people with Hahnemann’s remedies. I have his figures here and his patients did dramatically better than those in the regular hospital.’ Perhaps he gave them more food, I suggested, feeling childish. ‘Kidd didn’t have any more food than anyone else,’ said Treuherz, ‘but he treated his patients with homeopathic medicine for malnourishment and dysentery. Here’s another one. In the 19th century, during the cholera epidemic, the mortality rate of local hospitals was about 60 per cent. At the homeopathic hospital it was 16 per cent. Even if I didn’t believe in the principles of homeopathy, I know where I’d go if I had cholera!’ Difficult to disagree.

‘People are scared of homeopathy because they don’t understand it,’ says Treuherz, ‘and because homeopathic remedies can produce unpredictable reactions. Sometimes, for instance, patients react to a constitutional remedy by weeping, because we treat the whole patient not just the visible symptoms. Homeopathy brings what’s inside out.’ As Treuherz bustled around the room, looking for another book, I went a little quiet. Last year, after taking a remedy given me by a homeopath in Shepherd’s Bush, I put down my bike on the grass by Admiralty Arch and, for no reason I could think of, sobbed fit to bust. Ten minutes later, right as rain, I was back on my bike. Weird but true. But did that mean Francis Treuherz was right about why little white pills failed to perform in front of scientists? Did it mean that my mother’s osteoarthritis would f ade away under the influence of the imprint of a lava molecule on water? Who knows? When I tuned back in, he was speaking with some urgency. ‘People try to write homeopathy out of history, but we’re talking about two paradigms of science here and they’re heading for a collision.’

I left Dr Treuherz’s surgery with a bag-ful of pamphlets proving homeopathy’s influence throughout the ages, quite convinced that it does have more than a placebo effect, but why and to what extent I was less sure. Nor was I sure, on the current evidence, that homeopathic medicine should be available on the NHS. Patients themselves may long for little white pills, but how could a doctors advise them without knowing how homeopathy works? There’s no guarantee that busy hospital staff would have the time to find exactly the right remedy to suit patients’ symptoms and, as Treuherz says, the wrong remedy is utterly useless. The NHS has limited funds and until homeopathy proves itself properly, it seems wrong to take money away from hip replacements.

A few hours later my mother called. She had just returned from a hip X-ray at the hospital. ‘Well, darling, the X-rays don’t show any sign of improvement, but I still think the remedy’s working. I can walk at least twice as far as I used to be able to. I know I can, whatever the doctors say.’