Physicist
Robert L. Park, former executive director of the
American Physical Society, is quoted as saying,
"since the least amount of a substance in a solution is one molecule,
a 30C solution would have to have at least one molecule of the original substance dissolved in a minimum of 1,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000 [or 10 to the power of 60] molecules of water.
This would require a container more than 30,000,000,000 times the size of the Earth."
Park is also quoted as saying that, "to expect to
get even one molecule of the 'medicinal' substance allegedly present in 30X pills, it would be
necessary to take some two billion of them, which would total about a
thousand tons of lactose plus whatever impurities the lactose contained
Critics and advocates of homeopathy alike commonly attempt to illustrate the dilutions involved in homeopathy with analogies.
Hahnemann is reported to have joked that
a suitable procedure to deal with an epidemic would be to
empty a bottle of poison into Lake Geneva, if it could be succussed 60 times. Another example given by a critic of homeopathy states that
a 12C solution is equivalent to a "pinch of salt in both the North and South Atlantic Oceans", which is approximately correct.
One-third of a drop of some original substance diluted into all the water on earth would produce a remedy with a concentration of about 13C. A popular homeopathic treatment for the
flu is a 200C dilution of duck liver, marketed under the name
Oscillococcinum. As there are only about
10 to the power of 80 atoms in the entire observable universe, a dilution of one molecule in the observable universe would be about 40C.
Oscillococcinum would thus require 10 to the power of 320 more universes to simply have one molecule in the final substance. The high dilutions characteristically used are often considered to be the most controversial and implausible aspect of homeopathy.
The low concentration of homeopathic remedies, which often lack even a single
molecule of the diluted substance, has been the basis of questions about the effects of the remedies since the 19th century. Modern advocates of homeopathy have proposed a
concept of "water memory", according to
which water "remembers" the substances mixed in it, and transmits the effect of those substances when consumed. This
concept is inconsistent with the current understanding of matter, and water memory has never been demonstrated to have any detectable effect, biological or otherwise.
Outside of the
alternative medicine community,
scientists have long considered homeopathy a sham or a pseudoscience, and the mainstream medical community regards it as quackery. There is an overall absence of sound statistical evidence of therapeutic efficacy, which is consistent with the lack of any
biologically plausible pharmacological
agent or mechanism.
The proposed
mechanisms for homeopathy are precluded from having any effect by the laws of physics and physical chemistry. The extreme dilutions used in homeopathic preparations usually leave none of the original substance in the final product.
No individual preparation has been unambiguously shown by research
to be different from placebo. The
methodological quality of the
primary research was generally low, with such problems as weaknesses in
study design and reporting, small
sample size, and
selection bias. Since better quality trials have become available, the evidence for efficacy of homeopathy preparations has diminished; the highest-quality trials indicate that the remedies themselves
exert no intrinsic effect. A review conducted in 2010 of all the pertinent studies of "best evidence" produced by the
Cochrane Collaboration concluded that "the most reliable evidence – that produced by Cochrane reviews –
fails to demonstrate that homeopathic medicines have effects beyond placebo.
The Australian National Health and Medical Research Council completed a comprehensive review of the effectiveness of homeopathic remedies in 2015, in which it concluded that "
there were no health conditions for which there was reliable evidence that homeopathy was effective. No good-quality, well-designed studies with enough participants for a meaningful result reported either that homeopathy caused greater health improvements than placebo, or caused health improvements equal to those of another treatment."
Science offers a variety of explanations for how homeopathy may appear to cure diseases or alleviate symptoms even though
the remedies themselves are inert:
- The placebo effect — the intensive consultation process and expectations for the homeopathic preparations may cause the effect.
- Therapeutic effect of the consultation — the care, concern, and reassurance a patient experiences when opening up to a compassionate caregiver can have a positive effect on the patient's well-being.[203]
- Unassisted natural healing — time and the body's ability to heal without assistance can eliminate many diseases of their own accord.
- Unrecognized treatments — an unrelated food, exercise, environmental agent, or treatment for a different ailment, may have occurred.
- Regression toward the mean — since many diseases or conditions are cyclical, symptoms vary over time and patients tend to seek care when discomfort is greatest; they may feel better anyway but because of the timing of the visit to the homeopath they attribute improvement to the remedy taken.
- Non-homeopathic treatment — patients may also receive standard medical care at the same time as homeopathic treatment, and the former is responsible for improvement.
- Cessation of unpleasant treatment — often homeopaths recommend patients stop getting medical treatment such as surgery or drugs, which can cause unpleasant side-effects; improvements are attributed to homeopathy when the actual cause is the cessation of the treatment causing side-effects in the first place, but the underlying disease remains untreated and still dangerous to the patient.
Some homeopathic remedies involve poisons such as Belladonna, arsenic, and poison ivy which are highly diluted in the homeopathic remedy. Only in rare cases are the original ingredients present at detectable levels. This may be due to improper preparation or intentional low dilution.
Serious adverse effects such as seizures and death have been reported or associated with some homeopathic remedies. Instances of
arsenic poisoning have occurred after use of arsenic-containing homeopathic preparations. Zicam Cold remedy Nasal Gel, which contains 2X (1:100)
zinc gluconate, reportedly caused a small percentage of users to
lose their sense of smell; 340 cases were
settled out of court in 2006 for 12 million U.S. dollars. In 2009, the FDA advised consumers to stop using three discontinued cold remedy Zicam products because it could cause permanent damage to users' sense of smell.
On clinical grounds, patients who choose to use homeopathy in preference to normal medicine
risk missing timely diagnosis and effective treatment, thereby worsening the outcomes of serious conditions. Critics of homeopathy have cited individual cases of patients of homeopathy
failing to receive proper treatment for diseases that could have been easily diagnosed and managed with conventional medicine and who have died as a result and the "marketing practice" of criticizing and downplaying the effectiveness of mainstream medicine. Homeopaths claim that use of conventional medicines will "push the disease deeper" and cause more serious conditions, a process referred to as "suppression".
Some homeopaths (particularly those who are non-physicians) advise their patients against immunisation. Some homeopaths suggest that vaccines be replaced with homeopathic "nosodes",
created from biological materials such as pus, diseased tissue, bacilli from sputum or (in the case of "bowel nosodes") feces. While Hahnemann was opposed to such preparations, modern homeopaths often use them although there is no evidence to indicate they have any beneficial effects.
Cases of homeopaths advising against the use of anti-malarial drugs have been identified. This puts visitors to the tropics who take this advice in severe danger, since
homeopathic remedies are completely ineffective against the malaria parasite. Also, in one case in 2004, a homeopath instructed one of her patients to stop taking conventional medication for a heart condition, advising her on 22 June 2004 to "Stop ALL medications including homeopathic", advising her on or around 20 August that she no longer needed to take her heart medication, and adding on 23 August, "She just cannot take ANY drugs – I have suggested some homeopathic remedies ... I feel confident that if she follows the advice she will regain her health."
The patient was admitted to hospital the next day, and died eight days later, the final diagnosis being "acute heart failure due to treatment discontinuation".
In 1978,
Anthony Campbell, then a consultant physician at the Royal London Homeopathic Hospital, criticised statements by
George Vithoulkas claiming that
syphilis, when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the
central nervous system, saying that "The unfortunate layman might well be misled by Vithoulkas' rhetoric into refusing orthodox treatment". Vithoulkas' claims echo the idea that treating a disease with external medication used to treat the symptoms would only drive it deeper into the body and conflict with scientific studies, which indicate that
penicillin treatment produces a complete cure of syphilis in more than 90% of cases.
A 2006 review by W. Steven Pray of the College of Pharmacy at
Southwestern Oklahoma State University recommends that pharmacy colleges include a required course in unproven medications and therapies, that ethical dilemmas inherent in recommending products lacking proven safety and efficacy data be discussed, and that students should be taught where unproven systems such as homeopathy depart from evidence-based medicine.
In an article entitled "Should We Maintain an Open Mind about Homeopathy?" published in the
American Journal of Medicine, Michael Baum and Edzard Ernst – writing to other physicians – wrote that
"Homeopathy is among the worst examples of faith-based medicine... These axioms [of homeopathy] are not only out of line with scientific facts but also directly opposed to them. If homeopathy is correct, much of physics, chemistry, and pharmacology must be incorrect...".
In 2013, Sir
Mark Walport, the new UK
Government Chief Scientific Adviser and head of the
Government Office for Science, had this to say about homeopathy: "
My view scientifically is absolutely clear: homoeopathy is nonsense, it is non-science. My advice to ministers is clear: that there is no science in homoeopathy. The most it can have is a placebo effect – it is then a political decision whether they spend money on it or not." His predecessor, Professor Sir
John Beddington, referring to his views on homeopathy being "fundamentally ignored" by the Government, said: "The only one [view being ignored] I could think of was
homoeopathy, which is mad. It has no underpinning of scientific basis. In fact all the science points to the fact that it is not at all sensible. The clear evidence is saying this is wrong, but homoeopathy is still used on the NHS.
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