Ethical Pharmacy Practice and Homeopathic NO-JET-LAG

Pharmacies are an integral part of the healthcare industry. They provide a valuable decoupling between the doctor you see for an examination and potentially a prescription, and the institution that stands to profit from the medicine you pay for. Without this separation, there’s the potential for a conflict of interest where the physician examining you would profit more from giving you a prescription than they would from telling you that you’re fine and sending you on your way.

I’m not trying to imply that bias has been entirely removed from the healthcare industry, but having independent pharmacies fill prescriptions from doctors does help. You unfortunately don’t generally see this sort of separation of interests in the alternative healthcare industry, where practitioners who claim to know the secret true cause of your “dis-ease” or “lack of wellness” (blocked chi, misaligned chakras, vertebral subluxation complexes etc.) also just so happen to also offer the solution; for a price, of course.

This association between pharmacies and doctors leads pharmacies to be respected and trusted institutions. After all, we expect the person behind the counter – the pharmacist – to not only be able to dispense the correct amount of the correct drug we’ve been prescribed, but also to have a sufficient understanding of how it works so they can advise us on such things as precautions we should take. “Do I need to take this with food?”, “Will this make me drowsy?”, and so on. However, pharmacies also need to be profitable to work as a business, which is why you’ll also be able to find all sorts of non-prescription products for sale such as cosmetics and non-prescription medication. Because of their involvement with the healthcare industry and respected status, it’s important that these other products sold in pharmacies also be reliable, and they should not be stocked without good reason. Essentially, pharmacies should be held to a relatively high ethical standard.

In New Zealand, there is a crown entity known as the Pharmacy Council that is established by the Health Practitioners Competence Assurance Act 2003. The Pharmacy Council is responsible for duties such as registering pharmacists and setting standards of conduct, although in cases where pharmacists require disciplining that is carried out by another crown entity also established by the Health Practitioners Competence Assurance Act: the Health Practitioners Disciplinary Tribunal. In order to ensure that pharmacists are held to an appropriate ethical standard, the Pharmacy Council has developed a Safe Effective Pharmacy Code of Ethics, published in 2011, which is publicly available on their website.

In my opinion, this Code of Ethics is an admirable document, and I’m encouraged by the idea that New Zealand pharmacists might be held to such an appropriate ethical standard. For example, it defines its principles to be the following:

AS A PHARMACIST YOU MUST:

  1. Make the health and well-being of the patient your first priority.
  2. Promote patient self-determination, respect patients’ rights, autonomy and freedom of choice.
  3. Use your professional judgment in the interests of the patients and the public and promote family, whānau and community health.
  4. Show respect for others and exercise your duties with professionalism.
  5. Actively seek and apply contemporary pharmacy knowledge and skills to ensure a high standard of professional competence.
  6. Act in a manner that promotes public trust and confidence in pharmacists and enhances the reputation of the profession.
  7. Practise in a manner that does not compromise your professional independence, judgement or integrity, or that of other pharmacists.

The Code of Ethics goes on to expand on each of its principles in seven sections. I encourage you to read through the document, as it’s interesting to come to a better understanding of the ethical standards to which New Zealand pharmacists should be held. For example, part 2.4 regards the patient’s right to informed consent:

YOU MUST… Explain the options available to patients and the public, to help them make informed decisions. Make sure the information you give them is impartial, relevant, up-to-date and independent of personal commercial considerations.

The section of this Code of Ethics which I found most interesting, as well as most encouraging, is section 6.9 (emphasis mine):

YOU MUST… Only purchase, supply or promote any medicine, complementary therapy, herbal remedy or other healthcare product where there is no reason to doubt its quality or safety and when there is credible evidence of efficacy.

Although it is written here in this code, most people who use a pharmacy in their day to day lives aren’t aware of it. Instead, it is more like an unspoken assumption: if it’s sold in a pharmacy, then surely it’s legitimate, reliable, and effective. And of course, this should be the case – if there is no credible evidence of efficacy then an ethical institution should neither promote nor supply it. The Pharmacy Council has also published Advertising Guidelines, and its General Principle 7 reiterates this point (emphasis mine):

Any medicine, complementary therapy, herbal remedy or other healthcare product associated with the maintenance of health must have credible evidence of efficacy and safety (Code of Ethics 2011: 6.9). Health claims for complementary therapies or herbal remedies must be able to be substantiated and must not breach the Medicines Act with regard to therapeutic purpose.

Unfortunately, it appears many New Zealand pharmacists do not abide by these rules. I was unfortunate enough recently to discover an instore display in an Auckland pharmacy for a product called “NO-JET-LAG”. While I was in the pharmacy, I took a photograph of this display with my phone:

NO-JET-LAG

As you can see, this display makes some strong and explicit claims regarding the effect of the product:

TRY NO-JET-LAG
It Really Works

Effective

Homeopathic Jet Lag Prevention

Hang on a minute… “Homeopathic”… That sounds familiar. I wonder what exactly is in these pills? Luckily, there’s a website listing their ingredients:

The five homeopathic remedies listed below are the active ingredients in No-Jet-Lag.

Arnica Montana 30C (Leopard’s Bane), Bellis Perennis 30C (Daisy), Chamomilla 30C (Wild Chamomile), Ipecacuanha 30C (Ipecac), Lycopodium 30C (Clubmoss)

If you’ve read my post on homeopathic dilutions, you may recall that “30C” means the ingredient has been diluted by 1/100 30 times. That is a mind bogglingly large dilution. If you were to end up with just one single molecule of the original ingredient at the end of that, you’d have to start with 1060 molecules of it.

That’s a hard number to visualise though, and it’s hard to think of things in numbers of molecules, so let’s compare it to something more familiar. The Earth is made up of roughly 1050 atoms, so the amount of ingredient we’d have to start with would be roughly 10,000,000,000 (yes, that’s ten billion) times bigger than the planet. Even the Sun only has around 1057 atoms in it: still 1,000 times fewer than the number we’d need. Needless to say, after the dilution is done there is absolutely no amount of any of these ingredients remaining in any “NO-JET-LAG” pills.

Knowing this, it seems rather implausible that they’d be effective for anything at all, let alone specifically preventing jet lag, but all the same it’s best to look at the evidence. The manufacturer’s website has a Scientific Test page. Now, given that I have spent some time writing up a complaint to the Advertising Standards Authority because I don’t think this evidence even comes close to being enough to substantiate the claims made about these products, I don’t particularly want to write out the same arguments all over again. So I am going to make this complaint public. While the first section specifically regards the instore display I saw in Parnell Pharmacy on the 2nd of July, the other sections are about the evidence regarding “NO-JET-LAG” and the ethical implications of my complaint, and these sections apply to all of the many New Zealand pharmacies that promote and supply this product.

This complaint should be read with the following in mind: Assuming I am correct regarding the evidence for this product, I think the appropriate response of pharmacies stocking it would be to immediately remove it from their stock, and to apologise to the customers they have failed to protect. The Code of Ethics for an industry is the absolute minimum acceptable level of ethical behaviour, and it appears for all the world that many New Zealand pharmacies haven’t even been doing that.

(Note that the original complaint was in plain text but I’ve edited it to add appropriate formatting here)


An instore advertisement for “NO-JET-LAG” in Parnell Pharmacy contains misleading therapeutic claims, in violation of the Therapeutic Products Advertising Code Principle 2. Because these claims are misleading, the advertisement also fails to observe the high standard of social responsibility required of it by the Therapeutic Products Advertising Code Principle 3.

The advertisement contained the following text (also see image attached):

TRY NO-JET-LAG
It Really Works

NO-JET-LAG
Homeopathic Jet Lag Prevention
Natural | Effective | No Side Effects or Drug Interactions

The Perfect Travel Companion

The product packaging, also visible from the front in the attached image, displayed this text:

The Perfect Travel Companion

NO-JET-LAG
Long Haul, for flights longer than 7 hours
Homeopathic Jet Lag Prevention

The strong and absolute therapeutic claims “Homeopathic Jet Lag Prevention”, “Effective”, and “It Really Works” require robust substantiation. Although it may not fall within the ASA’s jurisdiction, it is important to consider the advertisement within therapeutic context implied by its placement on the front desk of a pharmacy and by the prominently displayed name of the product “NO-JET-LAG”.


As far as I can tell, the only substantiation offered by the manufacturer is a small (n=19) pilot study that does not appear to have been published in a peer-reviewed scientific journal. This pilot study can be found on the manufacturer’s website: http://www.jetlag.co.nz/jet-lag6.html

Although it is not stated in the study, the POMS scale on which subjects rated their level of “fatigue-inertia” (the only measured end point reported to have statistically significant differences between control and experimental groups) is measured on a scale from 0-28. In this context, the mean difference between control and experimental groups of 3.84 is less impressive than in the context of a smaller scale that seems a sensible conclusion from reading the study, given that the y-axis of the bar chart only goes from 0-12. The non-significant measure of “vigor-activity” is similarly displayed on a chart with a y-axis from 0-22, whereas the actual scale is from 0-32.

Also, the POMS scale includes 6 measurements, yet there is no mention in the study of having corrected their statistical analysis for multiple measurements. Assuming that no adjustment for this was made, as none is mentioned in the study, this means that although one of the 6 measurements purportedly reached statistical significance it is fairly likely to have been a false positive. From random chance alone, the chance that 1 out of 6 measurements would reach this level of statistical significance is approximately 1/4 (26.5%). A relatively conservative method of correction, the Šidák correction, would alter the required p-value for statistical significance in this case to 0.0085. However, the measurement’s p-value of 0.026 doesn’t even come close to crossing below this threshold and would therefore not normally be considered statistically significant.

The study also brings the effectiveness of its participant blinding measures into question with the following statements:

When asked if they knew whether they had taken the remedy or the placebo, they said that at the time of arrival in Germany the whole party all felt very tired but most were already fairly sure which treatment they had taken.

On the outward journey, of the 19 taking part 13 (68%) correctly guessed whether they had taken the placebo or No-Jet-Lag. Of the others, three did not know and three incorrectly assigned themselves to the wrong group.

On the return journey, two were incorrect, three did not know and 14 (74%) correctly guessed.

Also, one of the study’s authors was the Director of Research at Miers Laboratories, the manufacturer of this product. It is not clear how much influence the manufacturer had over the study design or operation, or to what extent it may have been funded by them.

So, as far as I’ve been able to find, the only evidence that could be used to support the very strong claims made on this advertisement is a small unpublished non-independent pilot study with questionable blinding that does not appear to have reached the threshold for statistical significance. In short, the claims do not appear to have been adequately substantiated, and should therefore be considered to violate the Therapeutic Products Advertising Code Principle 2.


Although it falls outside of the ASA’s jurisdiction, I feel it would be appropriate to briefly discuss the Pharmacy Council’s Safe Effective Pharmacy Practice Code of Ethics 2011. Section 6.9 of this industry code of ethics states that:

YOU MUST… Only purchase, supply or promote any medicine, complementary therapy, herbal remedy or other healthcare product where there is no reason to doubt its quality or safety and when there is credible evidence of efficacy.

I sincerely hope that the manufacturer of this product has high quality rigorous scientific evidence that substantiates the claims made about this product hidden away somewhere and that, despite the fact that the only evidence they publicise on their website is the tiny low quality pilot study I discussed above, they have shared this evidence with every single one of the many New Zealand pharmacies who stock their product. If not, and things really are as they seem, then this would be an appallingly widespread violation of perhaps the most important part of the Pharmacy Council’s Code of Ethics.

Homeopathy and Anecdotes

In the Herald today, a letter to the editor from a Mr Barry Davis was published regarding an article about a recent scientific report on the evidence regarding homeopathy published by the Australian National Health and Medical Research Council: Effectiveness of Homeopathy for Clinical Conditions: Evaluation of the Evidence

The report evaluated the evidence regarding homeopathic treatment of several conditions, and drew the following conclusion:

The available evidence is not compelling and fails to demonstrate that homeopathy is an effective treatment for any of the reported clinical conditions in humans.

This letter to the editor, given the title “Homeopathic treatment”, mostly took the form of an anecdote. As far as I am aware letters to the editor are not published online, so here it is in its entirety:

I strongly disagree with your Saturday article on homeopathy. After having open-heart surgery for a faulty valve, I had a series of transient ischaemic attacks (mini strokes).

This resulted in seven visits to hospitals, totalling 42 days, numerous tests and scans, and two outpatient visits. The doctors told me they had no idea what was causing the strokes.

If the cause is not found, and treated, it could lead to a full stroke.

A relative, who has a PhD in chemistry and a diploma in homeopathy, took an interest in the problem. She recommended a homeopathic treatment, and in the last year, whenever I have felt an attack coming on, I have taken two of her pills and sat down, and the attack has stopped.

The only time in the last year that I have had an attack is when I twice failed to carry the pills.

Five years ago, I had a problem with recurring sore throats and congestion – this was also cured by homeopathic treatment.

I do not criticise the doctors or the hospitals – they tried and could not find the solution – but I firmly believe the medical profession and alternative medical practitioners should work in parallel, and each recognise the other.

Citing anecdotes seems to be a common way to defend modalities such as homeopathy, which are not supported by rigorous evidence. Unfortunately, personal stories can often be much more convincing than they should be. I am sending a letter of my own to the editor of the Herald in response to this one.

As I can’t be sure if it will be published, or if sections will be removed (although I’ve tried to keep it brief), I will publish it fully here as a rebuttal to the strategy of attempting to defend homeopathy against this report by citing personal experience.


There was once a time when medicine was based on personal anecdotes such as that of your correspondent Barry Davis. This philosophy gave rise to such false ideas as the four humours and ineffective and harmful treatments like bloodletting, for which there was no shortage of anecdotes.

It is only with the advent of medical science, particularly the randomised clinical trial, that we have become able to truly test medical interventions. Isolated cases such as Mr Davis’ still have a place in medical science, but they are considered the lowest form of evidence and best used in deciding where to allocate resources for testing treatments. There is good reason why our own Medicines Act prohibits their use in medical advertisements.

In order to provide safe and effective healthcare, doctors need to be able to accurately predict the outcomes of a treatment. Relying on poor evidence, like anecdotes, is likely to lead to inaccurate predictions and lower quality healthcare.

It is only by assessing high quality evidence, like in the recent report from the Australian National Health and Medical Research Council that looked at the best evidence regarding homeopathy, that we are able to reliably provide high quality healthcare.

If you really care about the truth then evidence trumps personal experience, not the other way around. If you really care about whether or not homeopathy is effective, then you need to follow the evidence where it leads, even if it does not line up with personal experience. Currently, as the aforementioned report concludes, that means:
“The available evidence is not compelling and fails to demonstrate that homeopathy is an effective treatment for any of the reported clinical conditions in humans.”


Update 2014/04/24 8:38 a.m.

My letter to the editor was published in the Herald this morning. It looks like it was kept pretty much intact, the only difference I noticed is that the very end was edited to appear as though the conclusion I quoted from the report was in my own words.

The Miasm Theory of Disease

Living in Denial

In 1828, Hahnemann published his book The Chronic Diseases, in which he described his theory of miasms as the origin of disease. The three “miasms” described in this book “are held to be responsible for all disease of a chronic nature and to form the foundation or basis for all disease in general”1. Miasms are supposedly ways in which a person’s “vital force” can be tainted, and homeopaths maintain that they are heritable2.

This idea of Hahnemann’s both predates and opposes the modern established science of germ theory, stating that all contagious diseases are caused by microorganisms3, which is a fundamental part of modern medical science. Basically, Hahnemann’s opposing theory has been disproven.

However, Hahnemann’s 19th century theory of miasms as the origin of chronic disease is alive and well in the practice of homeopathy, where it is “now generally accepted by most homeopaths without question”1. While actual medical doctors recognise that infectious diseases such as influenza are caused by microorganisms and are able to effectively treat them as such, homeopaths that subscribe to Hahnemann’s outdated miasm theory of disease are still claiming that the predominant cause of all chronic disease is the miasma known as Psora, or “itch”.

Essentially, these homeopaths are living in denial – trying to practise medicine as though germ theory has never even occurred to anyone. Trying to practise medicine, essentially, as though it were still prior to the 1860s.

It is worth noting, however, that at the time of its inception homeopathy appeared to be effective. The reason for this is that contemporary medicine, consisting of practices based on the misguided idea of the four humours (such as bloodletting), tended to do more harm than good.

In contrast, homeopathy had no active effect on its patients, although it would elicit a similar placebo response (a phenomenon unheard of in those times) to the harmful treatments, without the same detrimental effects. As a result, those treated by contemporary medicine would tend to do worse than those left untreated, who would again tend to do worse than those treated with homeopathy. Even though the homeopathy itself had no effect, it seemed to be effective.

Today, however, we know better. When compared against a similarly administered placebo, the effect of homeopathy is shown again and again to be no stronger. While there may be some statistical flukes in which the result is in the favour of one or the other (if you test something enough, occasionally you’ll get a strange result simply by chance) the overall body of scientific evidence points overwhelmingly toward the conclusion that homeopathy is nothing more than a placebo.

References

  1. Morrell, Peter. Hahnemann’s Miasm Theory and Miasm Remedies. Homéopathe International [updated 24 December 2004; cited 04 April 2012]. Available from: http://homeoint.org/morrell/articles/pm_miasm.htm
  2. Modern Homoeopathy. [cited 14 April 2012]. Available from http://www.modernhomoeopathy.com/miasms.htm
  3. WordNet Search. Princeton University [cited 04 April 2012]. Available from http://wordnetweb.princeton.edu/perl/webwn?s=germ+theory

Homeopathic Dilutions

Much Ado About Nothing

After realising that giving sick people substances that caused the very symptoms he was trying to cure, Hahnemann realised that something needed to change. Instead of deciding that his principle of “like cures like” was perhaps wrong, Hahnemann decided that instead what he needed to do was dilute his remedies.

Hahnemann went further than simple dilution, however. His idea involved serial dilutions, with each step punctuated by a vigorous shaking of the dilution container. According to Hahnemann this shaking, known as “succussion”, would activate the “vital energy” of the substance1. It is here that homeopathy essentially became magic.

According to homeopathy, this process of serial dilution and succussion would prevent a substance from causing the symptoms that it could be expected to cause when given to a healthy person but still allow it to cure those symptoms via the (incorrect) principle of “like cures like”.

The claim becomes even more scandalous when you realise just how far homeopathic remedies are diluted. Each step of a serial dilution is generally a dilution of 1 in 10 or 1 in 100. The number of steps, size of each step and sometimes the method used are labelled on the remedy. The number of steps comes first, followed by the size of each step represented by a roman numeral. For example, a dilution of 30C (a common homeopathic dilution) consists of 30 steps of a 1 in 100 dilution.

Let me say that again. A common homeopathic dilution involves diluting the original substance by 1 in 100 30 times. As an example, let’s imagine a homeopathic dilution of gold (which was one of the common remedies listed on ABC Homeopathy – listed as “Aurum Metallicum”), starting with an enormous but simple amount of one mole. From Avogadro’s constant, which was unknown during homeopathy’s inception, we know the number of atoms or molecules in one mole. For gold, this amount would weigh about 200g; if it were a cube would be just over 2cm across.

After 10 dilutions of 1 in 100, we would expect to have just over 6000 atoms remaining. After 12 dilutions, we’re almost just as likely to have a single atom left as we are to have none at all. After all 30 dilutions, the probability that there is even a single atom remaining is astronomically low. So low, in fact, that for all intents and purposes it should be considered to be 0.

Now, let’s take another approach to our thought experiment. We know that the total number of atoms in the visible universe is likely to be somewhere between 1078 and 1082. Taking the liberal estimate of 1082, we can estimate the same dilution of 30 serial dilutions of 1 in 100 on the entire known universe. At the end, we would expect to have around 1022 atoms left, which is about 1/60th of 1 mol – the number of molecules in 0.3 mL of water. And that’s from the entire universe! Homeopathic dilutions that go so far as 200C are far from unheard of, either.

The idea that homeopathic remedies supposedly become stronger as they become more diluted (when dilution is accompanied by succussion) goes directly against the dose-response relationship. There has never been a plausible mechanism put forth by which shaking a solution can impart any properties of the diluted substance to the diluent. What’s more, the claim that such a phenomenon exists at all has not held up to rigorous scientific testing.

However, the fact that homeopathic remedies rarely contain any of the original active ingredient likely won’t bother many homeopaths. The reason for this is that, supposedly, the act of succussion at each dilution step “releases and concentrates the spirit-like, healing essence of the substance derived from its animal, botanical or mineral source”1. Basically, this process of “Dynamization” removes all material trace of the original medicinal substance and leaves behind only its “spirit-like, healing essence”. To quote Hahnemann himself2:

The homœopathic healing art develops for its purposes the immaterial (dynamic) virtues of medicinal substances

It isn’t usually marketed this way, but homeopathy can be placed squarely in the pseudoscientific category of so-called “energy healing”.

References

  1. Glossary of Homeopathic Terms. Omaha: Creighton University School of Medicine [updated 03 August 2009; cited 04 April 2012]. Available from: http://altmed.creighton.edu/Homeopathy/Glossary.htm
  2. Hahnemann, Samuel “§ 11”, “§ 270” Samuel Hahnemann’s Organon of Homœopathic Medicine. New York: William Radde, 1849. 99, 217. Google Books. Web. 04 April 2012.

Homeopathic Provings

Dreams of Robbers

Experiments such as Hahnemann’s with conchina bark, during which a healthy person is dosed with a substance and all subsequent experiences are recorded, became known as “provings” and have since been the method by which homeopaths determine which symptoms a particular substance is supposedly appropriate to treat. The main reference of this information is the Homeopathic Materia Medica, an online version of which is available – Homœopathic Materia Medica.

Of course, because no distinction is made between reactions to the substance being “proved” and unrelated experiences, these tests are incredibly lacking in scientific rigour. To demonstrate this, here are some examples from the entry on “Natrium Muriaticum”1:

Wants to be alone to cry

Aches as if a thousand little hammers were knocking on the brain

Pain in eyes when looking down.

Vesicles and burning on tongue, as if there were a hair on it

Sweats while eating

Craving for salt

Dreams of robbers

Keep in mind that “A proving is the testing of a potentized substance to find out which symptoms that substance is capable of producing, and hence curing.”2, so apparently a homeopathic remedy of this “Natrium Muriaticum” is capable of curing these symptoms, amongst others listed in the Materia Medica.

Homeopaths seem to love using latin names for the substances used to create homeopathic remedies, presumably because it makes them sound scientific yet natural, as latin scientific names generally refer to plants and animals. It also has the convenient side effect of preventing the vast majority of people from having any idea what the substance actually is. This “Natrium Muriaticum” is most commonly known as table salt.

To demonstrate this point, I used Google to search for “Homeopathic Remedies” and found ABC Homeopathy to be the top result. On its home page, 36 homeopathic remedies are listed as the “Top Homeopathic Remedies”, each of which are “widely used in homeopathy”3.

I’ve listed some examples from that list here, first as they are listed on the site and then by a more common name, along with a few examples of the symptoms they’re supposed to treat*. Keep in mind that these symptoms were ascertained via a homeopathic proving, wherein a healthy individual is dosed with the substance in order to find out what symptoms it causes2. Reading through the lists of symptoms, it’s sometimes hilarious to read everything they thought was caused by the substance, and often sickening to read a report of the aftermath of a poisoning. Remember, by the tenets of homeopathy, the symptoms listed for each substance are those that can be cured by a homeopathic remedy of the substance.

  • #6. Pulsatilla Nigricans (A highly toxic flower once used by Blackfoot Indians to induce abortions4)
    • Fears in evening to be alone, dark, ghosts
    • Flatulence
    • Numbness around elbow
  • #8. Sepia (Cuttlefish ink)
    • Indifferent to those loved best
    • Hair falls out
    • Pain in teeth from 6 P.M
  • #9. Rhus Toxicodendron (Poison ivy)
    • Thoughts of suicide
    • Jaws crack when chewing
    • Desire for milk
  • #10. Natrum Muriaticum (Table salt, I mentioned earlier some examples of what it supposedly treats)
  • #11. Mercurius Vivus (Mercury, I’ve also seen this listed as a remedy ingredient under the name Mercurius Sol – short for Mercurius Solubilis)
    • Thinks he is losing his reason
    • Sneezing in Sunshine
    • Sweetish metallic taste
  • #12. Belladonna (Deadly nightshade)
    • Patient lives in a world of his own, engrossed by spectres and visions and oblivious to surrounding realities
    • Loss of consciousness
    • Constant moaning
  • #28. Conium Maculatum (Hemlock, a poisonous plant that was historically used as a method of execution, notably for the Greek philosopher Socrates)
    • Photophobia and excessive lachrymation (Fear of light and excessive crying)
    • Painful spasms of the stomach
    • Heavy, weary, paralyzed; trembling; hands unsteady; fingers and toes numb
  • #34. Petroleum (Okay, this name is honest enough, but still worth mentioning. Petrol is one of the top homeopathic remedies?)
    • Loss of eyelashes
    • Strong aversion to fat food, meat; worse, eating cabbage
    • Herpes

Hahnemann eventually realised that giving a sick person a substance that causes the symptoms they already had tended to exacerbate their illness rather than cure it. Instead of deciding that he was wrong, and realising that “fight fire with fire” actually isn’t particularly appropriate in the field of medicine, he came up with a rather odd idea… Homeopathic Dilutions.

* It’s interesting to note that this site has what’s known as a quack Miranda warning. In this case:

This site is for information only and is not a substitute for professional medical advice.
Nothing on this site is a recommendation as to how to treat any particular disease or health-related condition.
Not all conditions will respond to homeopathic treatment.

You’ll see a warning like this quite commonly on sites that sell unproven, untested or even disproven remedies, such as this one. It’s basically their way of covering their tracks in case a customer realises they’ve effectively been conned and decides to become litigious. It’s a good idea to treat a warning such as this one as a big red flag.

References

  1. Boericke, William. Natrium Muriaticum. Homœopathic Materia Medica [updated 23 December 2004; cited 04 April 2012]. Available from: http://homeoint.org/books/boericmm/n/nat-m.htm
  2. What is a Proving. New York School of Homeopathy [updated 27 August 2011; cited 04 April 2012]. Available from: http://www.nyhomeopathy.com/provings.htm
  3. ABC Homeopathy. ABC Homeopathy [cited 04 April 2012]. Available from: http://abchomeopathy.com/
  4. Pulsatilla. Wikipedia, the free encyclopedia [updated 24 January 2012; cited 04 April 2012]. Available from: http://en.wikipedia.org/wiki/Pulsatilla

The Birth of Homeopathy

Similia Similibus Curantur

Homeopathy was invented in the late 18th century by the German physician Samuel Hahnemann1. Hahnemann was very gifted with languages, and at this point in his life he made a living from writing and translating2. In 1790, while he was translating a medical text – Professor William Cullen’s Materia Medica (Vol. 1, Vol. 2) – into his native German he read a claim about the use of the bark of the Cinchona plant (called Peruvian Bark in Cullen’s text) in treating “intermittent fevers” (it was, in particular, used as a treatment for malaria). Cullen claimed that the bark worked in this case due to its effect on the stomach3:

I consider the Peruvian bark… to be a substance in which the qualities of bitter and astringent are conjoined.

As a bitter and astringent conjoined, I consider the bark as a powerful tonic.

It is in no instance, however, more remarkable than in the cure of intermittent fevers. That the bark in this case operates by a tonic power exerted in the stomach…

Hahnemann did not believe this claim, and decided to test it by dosing himself with the bark and recording its effects on his body. He dosed himself with “four good drams of Peruvian bark, twice a day for several days”, and instead of finding that it affected his stomach as Cullen claimed it would, Hahnemann recognised its effects as being very similar to the symptoms of the fevers which are meant to be treated by this bark*. It is from this experience that he thought up the first homeopathic principle: “similia similibus curantur“, most commonly translated as “like cures like”.

It is from this principle that Hahnemann derived the term homœopathy (it is now usually written “homeopathy”, although you may also encounter “homoeopathy”) from the greek homœ-, meaning “similar” and -pathy, meaning “suffering”. In contrast, he also created the term “allopathy”, which he used to refer to forms of medicine that attempted to treat disease via mechanisms that oppose their symptoms (greek allo-, meaning “other”). Considering its origin, this term is generally considered derogatory, and you’ll rarely see it used today except by homeopaths and their sympathisers.

* It’s worth noting that in 1820, 30 years after Hahnemann’s experiment with conchina bark, French chemists Pierre-Joseph Pelletier and Joseph-Bienaime Caventou isolated the chemical quinine in conchina bark4, which was used as a treatment for malaria until the 1940s5.

References

  1. History of Homeopathy. Omaha: Creighton University School of Medicine [updated 03 August 2009; cited 04 April 2012]. Available from: http://altmed.creighton.edu/Homeopathy/history.htm
  2. Grimes, Melanie. Samuel Hahnemann, Founder of Homeopathy. Knol [updated 07 August 2008; cited 04 April 2012]. Available from: http://knol.google.com/k/samuel-hahnemann-founder-of-homeopathy
  3. Cullen, William “Tonics” A treatise of the Materia Medica, Volume 2. Edinburgh: printed for Charles Elliot, and for C. Elliot & T. Kay, London, 1789. 90-91. Google Books. Web. 31 March 2012.
  4. Quinine. Medical Discoveries [cited 04 April 2012]. Available from: http://altmed.creighton.edu/Homeopathy/history.htm
  5. Quinine – a miracle against malaria. Human Touch Of Chemistry [cited 04 April 2012]. Available from: http://www.humantouchofchemistry.com/quinine-a-miracle-against-malaria.htm

World Homeopathy Awareness Week

This week – from April 10* to April 16 – is World Homeopathy Awareness Week, and I’m going to do my part with a series of posts on what homeopathy is and why it’s a problem. This is probably not what the organisers of the event had in mind, I’ll admit, but of course I plan on only telling the truth, and I think this needs to be said.

In my experience, many people have heard of homeopathy, but few know much about it. The fact that it’s a type of “alternative medicine” seems commonly known, but what separates it from other types of “alternative medicine” not so much.

I see this as a problem, so this World Homeopathy Awareness Week I’m going to do my best to raise awareness of homeopathy and what it is. I will do my best not to misrepresent the practice, as I see the truth of homeopathy as being damning enough. Hopefully, after this week, you will feel the same way.

  1. The Birth of Homeopathy
  2. Homeopathic Provings
  3. Homeopathic Dilutions
  4. The Miasm Theory of Disease

* This April 10 marks what would have been the 257th birthday of the inventor of homeopathy, Samuel Hahnemann.