Is Homoeopathy Effective and Safe?

If you rely on the personal experience of patients, there are a large number of people who will claim homoeopathy is effective, usually with great certainty, that they had been cured or at least helped by homoeopathy when orthodox medicine had failed. One can see why. The system is easy to understand and seems safe.

The long consultation is, per se, therapeutic, although it is seldom realized that a succession of shorter consultations with an orthodox and sympathetic general practitioner can soon add up to an hour, with the added advantage that the series of consultations allows observation of the development or disappearance of a disease over time. This is especially important since many of the diseases treated by homoeopaths are either transient and disappear spontaneously, or they are cyclical, consisting of a series of attacks followed by spontaneous remissions. If a visit to a homoeopath happens to be followed by remission or the total disappearance of a disease, homoeopathic medicine gets the credit.

Is homeopath effective?
Is homoeopath effective?

If there was ever a medical system which cried out for a careful scientific trial it is homoeopathy astonishing because it was very close to a double-blind, randomized controlled trial, undertaken with great care long before the mid-twentieth century when most of us believed that such randomized trials were first devised and carried out. It showed, incidentally, that homoeopathy was ineffective. This was followed by such a long series of clinical trials and systematic reviews, all of them would take up more space than the whole of this paper, but a useful account of clinical trials of homoeopathy in the nineteenth century was published very recently.

REPL Pharma Homeopath
REPL Pharma Homoeopath

Some homoeopathic practitioners argue that carrying out randomized controlled trials is an appropriate activity for orthodox medicine but inappropriate for homoeopathy, where effectiveness should only be judged by patient satisfaction. Where clinical trials and systematic reviews have been carried out, however, the results remain uncertain. A few seemed to show that homoeopathy was effective, but only slightly; a majority showed that homoeopathy had no therapeutic effect. Unfortunately, many of the trials included in systematic reviews were less than perfect in design, application or sample size.

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A recent authoritative paper concluded that ‘the evidence of the effectiveness of homoeopathy for specific clinical conditions is scant, is of uneven quality, and is generally of poorer quality than research done in allopathic (mainstream) medicine.’ Nevertheless ‘when only high-quality studies have been selected… a surprising number show positive results’ although ‘even the best systematic reviews cannot disentangle components of bias in small trials.’ These authors conclude that ‘more and better research is needed, unobstructed by belief or disbelief in the system.

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When one recalls the underlying beliefs of the homoeopathic system, such as the process of extreme dilution with the transformation of a drug into a ‘dematerialized spiritual force’, a totally neutral and ‘unobstructed’ attitude may be impossible. We can, however, be reasonably certain that in the context of the total provision of medical care, homoeopathy has played and still plays a large part, judged by the number of patients who believe, rightly or wrongly, that homoeopathy has helped them.

The late Sir Douglas Black should have the last word. In a very balanced article on complementary medicine, he wrote:

‘Although mainstream medical intervention is critical in only a minority of episodes of illness, in those particular episodes it is critical indeed; and I would plead that at least in acute illness, and possibly in any illness, “complementary” medicine should also be subsequent to an assessment of the clinical situation by competent “orthodox” means. ‘Although mainstream medical intervention is critical in only a minority of episodes of illness, in those particular episodes it is critical indeed; and I would plead that at least in acute illness, and possibly in any illness, “complementary” medicine should also’ be subsequent to an assessment of the clinical situation by competent “orthodox” means.

References

Published in Journal of the Royal Society of Medicine

J R Soc Med. 2006 Dec;99(12):607-610.

PMCID: PMC1676328

DOI: 10.1258/jrsm.9912.607

PMID: 17139061

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