Jeremy Appleton, ND
Healthnotes Newswire —An exceptionally well-designed clinical trial,1 published in Saturday’s British Medical Journal, has again validated the effectiveness of homeopathy. Using dilutions of natural substances so extreme that not a single molecule of the original substance remained, researchers from the Royal Glasgow Infirmary’s Department of Medicine were able to produce significant objective improvements in nasal airflow in people suffering from inflammation of the nasal passages due to year-round allergies (perennial allergic rhinitis).
Fifty-one adults with a diagnosis of perennial allergic rhinitis, confirmed by skin-prick testing, completed the study. Each received a single portion, divided into three evenly spaced doses over one day, of either a homeopathic preparation of the substance to which they were allergic (e.g., dust mites, cat dander, grass pollens) or a matching placebo. All participants had been taught to use a special flow meter that provided an objective, sensitive, and reliable indication of nasal obstruction. Over three to four weeks, the homeopathic remedies emerged as the clear winners over placebo. Patients in the homeopathy group had an overall improvement of nasal obstruction averaging 21%, compared with only 2% in the placebo group. The effect observed for the homeopathic remedies was similar to that found with topical steroids in other trials.2
Despite clear evidence of increased airflow in the group given homeopathic remedies, both the treatment and placebo groups reported a similar degree of symptom relief. To gain a broader perspective on the effect of homeopathy on symptom relief, the authors of this trial pooled their results with those of three previous trials they had conducted in people with asthma3 and hay fever.4 5 The combined results of the four trials showed a more positive picture: homeopathic remedies produced a reduction in symptoms of 28%, compared with only 3% reduction from placebo.
The form of homeopathy used in this trial, known as isopathy (eye-SAH-puh-thee), is not considered “true” or “classical” homeopathy by many homeopathic practitioners. In the practice of classical homeopathy as pioneered in the nineteenth century by the German physician Samuel Hahnemann, a remedy is selected solely on the basis of extensive interviewing and evaluation of a patient’s symptoms and observable signs of illness (e.g., skin rashes, body odor, pallor), not on laboratory tests as used in the current trial. The classical homeopathic remedy is one capable of producing symptoms and signs in a healthy person similar to those seen in the sick person. This “similar” remedy is given in an extremely diluted form and is thought to have a therapeutic action.
The results of this and several other clinical trials strike at the core our understanding of science. If a remedy is so dilute that not one molecule is present, then scientists believe nothing is present. Therefore, administering such a remedy could only produce a placebo effect. However, using sound scientific methods, these researchers have shown that such dilute remedies are better than placebo.
These results defy scientific explanation and create a dilemma: if they are correct, then the scientific paradigm in which such results are considered impossible must be rejected,6 or at least revised. The mechanism by which homeopathic remedies work cannot be explained using current biological principles, and this presents a great intellectual challenge, if not a complete impasse for many scientists.7 But while a divide is growing between hard evidence supporting the efficacy of homeopathy and what scientists have believed is possible, more and more researchers are attempting to cross the chasm and shine the light of modern scientific research on the enigmatic science of the infinitesimal dose.
Detractors contend that the clinical effects of homeopathy are simply due to the “placebo effect.” However, a growing number of trials, including this most recent one, have found that homeopathic dilutions have a greater effect than placebo. To date, about 180 controlled trials of homeopathy have been conducted. A 1997 meta-analysis of 89 trials found that homeopathy was about twice as effective as placebo.8 Seventy-three percent of these trials reported homeopathy as being more effective than placebo.
Critics say that it is not enough for bigger and better trials to continue to demonstrate effectiveness; a plausible mechanism must be put forth to explain the “impossible” results.9 Dr. Hahnemann scorned similar attitudes over 150 years ago, stating that a doctor’s highest and only mission is to restore the sick to health, not to “construct so-called systems, by interweaving empty speculations and hypotheses concerning the internal essential nature of the vital processes.”10
References1. Taylor MA, Reilly D, Llewellyn-Jones RH, et al. Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series. BMJ 2000;321:471–6.
2. Malmberg H, Holopainen E, Simola M, et al. A comparison between intranasal budesonide aerosol and budesonide dry powder in the treatment of hay fever symptoms. Rhinology 1991;29:137–41.
3. Reilly DT, Taylor MA, Beattie NGM, et al. Is evidence for homeopathy reproducible? Lancet 1994;344:1601–6.
4. Reilly DT, Taylor MA, McSharry C, Aitchison T. Is homeopathy a placebo response? Controlled trial of homeopathic potency, with pollen in hay fever as model. Lancet 1986;ii881–6.
5. Reilly DT, Taylor MA. Potent placebo or potency? A proposed study model with initial findings using homeopathically prepared pollens in hay fever. Br Homeopathic J 1985;74:65–75.
6. Spira J. Applause for a study well done. bmj.com eLetter for Taylor et al., 321(7259)471–6. http://www.bmj.com/cgi/eletters/321/7259/471. (Accessed 8/21/00).
7. Vickers A, Zollman C. ABC of complementary medicine: homoeopathy. BMJ 1999;319:1115–8.
8. Linde K, Clausius N, Ramirez G, et al. Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials. Lancet 1997;350:834–43.
9. Fisken RA. The science of homoeopathy. bmj.com eLetter for Taylor et al., 321(7259)471–6. http://www.bmj.com/cgi/eletters/321/7259/471. (Accessed 8/21/00).
10. Hahnemann S. Organon of Medicine, 6th ed. Translated by Boericke W. B. India: Jain Publishers. Jeremy Appleton, ND, is a licensed naturopathic physician, writer, and educator in the field of evidence-based complementary and alternative medicine. Dr. Appleton is Chair of Nutrition at the National College of Naturopathic Medicine and Senior Science Editor at Healthnotes.