Comment and Analysis

A bittersweet remedy

Leonie Joubert

Alternative medicine: What's the harm in a bit of placebo effect, dressed up as a legitimate remedy?

A necessary evil of moving house is that it forces one to spring clean, whatever the season. I was doing exactly that to the medicine cupboard last weekend when I found, among the bottles of expired cough medicine, travel sickness tablets and melted cough lozenges, a few half-empty vials of homeopathic sugar pills. I can’t remember what they’d been prescribed for—anxiety, maybe, or headaches—but prescribed they were.

I got them many moons ago (2002, actually), during a time when I needed to believe homeopathy worked. And it certainly seemed to. But since then I’ve done a bit of poking about, and now I just feel ripped off.

The practice of homeopathy—a line of alternative medicine that claims to take just about anything in the natural world and use it to treat everything from acne or cancer to bed-wetting and social fears—dates back to the late 1700s when it was developed in Germany and has grown into a massive industry. In spite of our growing understanding of chemistry and physiology making it look increasingly improbable, homeopathic remedies are covered by medical aids, sold in pharmacies, advertised in our media and prescribed by some GPs.

This is the underlying theory: if a natural substance—for the purpose of illustration, let’s say the sap of the crocus plant (Colchicum autumnale)—causes symptoms of nausea and vomiting when a healthy person ingests it then, if you give that substance to a sick person showing those symptoms, it should cure him. Like treats like, apparently.

Similarly, symptoms of mercury poisoning include swelling, peeling skin, sweating, rapid heart rate and high blood pressure—so treat anyone showing those symptoms, regardless of the cause, with mercury. You follow the logic? Source material is anything vegetable, ­mineral or animal. Not all are poisonous, but most are equally bizarre: duck’s liver and heart to treat flu; indigestion—oyster shell; fear—silver nitrate; eczema—crude oil; and so on.

If you shake that substance, the logic goes, you make it more potent. But because some remedies, like the crocus, are deadly, they need to be diluted. A lot.

The “mother tincture” is made by letting the source material sit in solvent so that some molecules dissolve. One part of this solution is then diluted in nine parts water. The more it is diluted, the stronger it becomes, so the dilution process is repeated again and again and again. One or two drops are then added to a vial of sugar pills, and that’s your remedy.

Problem one (again, using the crocus example): nausea and vomiting, in this case, could be in response to a viral infection, food poisoning, heatstroke or half a dozen other conditions. Taking a dose of one poisonous plant isn’t going to be a cure-all.

Problem two: why should shaking a remedy make its constituents more potent?

If you shake a cup of tea (say, one sugar, no milk), after you’ve taken out the teabag, you’re not going to increase the strength of the caffeine or the sweetness of the sugar.

Problem three: a homeopathic remedy mixed to the “potency” of “30C” has been diluted so much that there’s little chance that a single molecule of the mother tincture is left in the final remedy (at this point you’ll be told that water somehow holds on to a “memory” of the source material).

So the methods are questionable (like treats like; shaking and super-dilution increase potency). But could these remedies be working at some deeper and more mysterious level—after all, we can’t possibly know everything about how the world works?

Clinical trials have been done to test its efficacy, but in most cases these have been poorly structured experiments that don’t fully eliminate personal bias or other “noise” that might skew the results. Professor of complementary medicine Edzard Ernst at Exeter University, and author Simon Singh, give an overview of the research in this field in their book Trick or Treatment?: Alterative Medicine on Trial. It’s worth a read.

I’ve taken my share of homeopathic remedies over the years and have given the same assertion that most users do: “I tried it when I had x-y-z and I got better.” Well, maybe the placebo effect was strong, or I was going to get better anyway (after all, illnesses either run their course or kill you). Personal anecdote isn’t evidence of efficacy.

What’s the harm in a bit of placebo effect, dressed up as a legitimate remedy? Britain’s Royal Pharmaceutical Society agrees there’s place for “harmless faith-based ­remedies”. But when a cancer patient abandons chemo or a kid’s eardrum ruptures because the infection didn’t get treated with more than sugar pills, that’s another matter. And my medical aid payments are subsidising another’s sham treatment. That irks.

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