While wary of the lack of scientific proof behind so-called alternative treatments, my response to patients taking them is a neutral one. I encourage people to tell me what other treatments they are taking, but in the absence of any side effects and on the understanding that they are being used to complement conventional medicine rather than replace it, I’m pretty relaxed about what is ultimately a personal freedom to choose what we put in, or on, our bodies.
Some scientists and doctors, however, become a little steamed up when alternative medicine enters the treatment equation. They will have welcomed the National Health and Medical Research Council (NHMRC) of Australia’s recent demolition of homeopathy.
After an extensive review of 1,800 scientific papers, it found “there are no health conditions for which there is reliable evidence that homeopathy is effective”. It added that homeopathy should not be used to treat health conditions that are chronic, serious, or that could become serious, and warned that people who used the preparations could put their health at risk by rejecting or delaying more effective medicines.
Homeopathy is based on the theories of Samuel Hahnemann, who claimed that “like cures like”, so a substance that causes symptoms can also eradicate them. That process is theoretically achieved using a process of dilution of the substance and subsequent shaking. Homeopaths claim the mixture retains a “memory” that triggers a healing response in the body.
Extensive research
The NHMRC analysis is backed by previous reports from the UK Commons science and technology committee and the Cochrane Collaboration. Cochrane has carried out a series of studies which found no good evidence that homeopathy helps flu, chronic asthma, dementia, irritable bowel syndrome, or labour induction. It kept an open mind on whether it might help skin complaints caused by radiotherapy and chemotherapy for cancer, but said that more extensive research was needed to confirm any benefit.
In his recent book, A Scientist in Wonderland, Edzard Ernst, a former professor of complementary medicine at Exeter University, is highly critical of alternative medicine. "There is no such thing as alternative medicine; there are just treatments that work, and those that don't," he writes. "Those that work will find their way into the standard armamentarium of medicine, while those that don't are destined to remain in the realm of quackery."
Ironically, his first job as a doctor was in a homeopathic hospital in Munich where he learned the “incredible power of the placebo”. But in the book he describes homeopathy as “one of the least plausible treatments in the realm of alternative medicine”. He says: “The clinical evidence . . . does not suggest that homeopathic remedies have effects beyond those of placebos.
“The risks of homeopathy can be considerable,” he writes. “When someone chooses to embrace an ineffective treatment instead of pursuing effective therapy for a serious condition, even seemingly innocent remedies can, by default, turn out to be life-threatening.”
Ernst published a review in 2012 of the harmful effects of homeopathic preparations. Of some 1,160 patients who experienced adverse events, the most common were allergic reactions and intoxications. Some reactions were quite serious and four people died.
Much of the book is about his ousting from his academic post, which he attributes in part to the intervention of Prince Charles, a noted proponent of alternative medicine. Referring to the “inside story” of alternative medicine he says: “ [It] is commonly viewed as a sleepy benign cottage industry where little money is at stake and people are kind and gentle; my story discloses such notions as myths.”
Meanwhile, back at the clinical coalface, homeopathy badly needs some positive scientific studies to help its cause. A Scientist in Wonderland: A Memoir of Searching for Truth and Finding Trouble by Edzard Ernst is published by Imprint Academic (£14.95) mhouston@irishtimes.com muirishouston.com