June 2010|Vol 7|Issue 6

June 2010 | Volume 7 | Issue 6

 

Article
 
Homoeopathy is scientific & evidence based: a rejoinder to the Critics
 



 


Prof. (Dr.) Chaturbhuja Nayak
Director General,
Central Council for Research in Homoeopathy
Dept. of AYUSH Ministry of Health & Family Welfare, Govt. of India
Co-Authored by - Dr. Debadatta Nayak


       A group of junior doctors of British Medical Association have recently passed a resolution denouncing the practice of Homeopathy. They have gone to the extent of equating Homeopathy with witchcraft and urged for stopping state funding to the homoeopathic hospitals. Such types of heinous attacks are not new to Homoeopathy. The Lancet journal in August 2005, declared ‘Homoeopathy as placebo’ [1]. However, the conclusion drawn in this paper on Homoeopathy being a mere placebo was questioned by a group that re-analyzed the data in the study and found that Homeopathy had a significant effect beyond placebo [2]. Prof. Gustav Born, Emeritus Professor of Pharmacology at King’s College, Prof. Michael Baum, and Emeritus Professor of Surgery, University College, London and eminent physicians / scientists of UK launched a campaign against funding of National Health Service (NHS) for promotion of Homoeopathy in UK. A widely publicized debate was made in University of Connecticut Health Center, Farmington, Connecticut, USA on 25 October 2007, “Is Homoeopathy Pure Quackery or Perhaps the Future of Medicine?” Participating in the debate, 3 scientists spoke in favour, one against Homoeopathy and two argued for further evaluation of Homoeopathy [3].

    On 20 Aug. 2009, BBC telecast news item ‘Homeopathy not a cure, says WHO’. Some of the medics from the UK and Africa, under the banner of ‘Voice of Young Science Network’ which is a part of charity “Sense about Science” approached WHO to issue instruction for not promoting Homoeopathy for treating TB, infant diarrhoea, influenza, malaria and HIV[4].

    Another campaign named as ‘1023 homeopathy there is nothing in it’, wherein a group of protesters from the Merseyside Skeptics Society of UK, the so called non-profit organization for the promotion of scientific skepticism, swallowed the contents of entire bottles of homoeopathic pills (Arsenic alb.) on 31.01.2010 at 10.23 am to illustrate their claims that such remedies are nothing but sugar pills [5].

    Most recently the Science and Technology Committee of UK, House of Commons, constituting MPs reported that the National Health Service (NHS) should cease funding Homoeopathy as they found a mismatch between the government policies and there is no evidence that Homoeopathy works beyond placebo effect. Just 4 out of the 14 members of the Science and Technology Committee voted on this report: one for, three against Homoeopathy [6]. But, on 23.02.2010, 70 members of British Parliament, have moved through Early Day Motion, denouncing the report of the Committee and have pleaded in support of Homoeopathy [7].

    Many such attempts to prove Homoeopathy as unscientific have been made in the past and many more could be in the pipeline, for we have no dearth of skeptics of Homoeopathy.

    Evidence base of Homoeopathy
    An argument put forth by the critics of Homoeopathy that, as no medicinal molecule is present in higher dilutions of homoeopathic medicines, so they are placebos. Several systematic reviews have been made regarding the effect of homoeopathic potencies in in-vitro model. It was concluded that homoeopathic potencies have certain biological effect when tested in in-vitro model [8, 9, and 10]. Claudia Witt et al evaluated the quality and results of in-vitro biological experiments with ultra-molecular stepwise agitated dilutions. 75 publications were found of which 33% were replications; 73% showed an effect with ultra-molecular dilutions including 68% of high quality experiments. 73% of replication experiments were also positive [8].

    Four out of five comprehensive systematic reviews of RCTs in Homeopathy have drawn the conclusion that Homeopathy effects are beyond placebo [11, 12, 13, and 14]. The fifth systematic review concluded that “finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects”[1], but the methodology of that review and its conclusions have been challenged [2].

    About 142 RCTs have been conducted in Homoeopathy in different clinical conditions out of which 120 RCTs (85%) were placebo controlled. The other 22 RCTs (15%) were controlled by other than placebo. Of the 142 trials, the finding was positive in 44%, (n=63), negative in 8% (n=11), and statistically non-conclusive in 48% (n=68) of cases [6].

    A 6-year long study conducted in the Bristol Homoeopathic Hospital showed overall relief in 70% of the patients as an outcome of homoeopathic treatment [15].

    In recent years, it is established that homoeopathic potencies have properties other than alcohol, which is used for their preparation. Similarly, biological plausibility of homoeopathic medicines is also established. Rao et al studied the structure of two medicine used in homoeopathy viz. Nat. mur. and Nux vom. in three different potencies (6C, 12C, 30C) with the help of UV-VIS spectroscopy and Raman spectroscopy. They observed that there are differences in spectra of the two medicines (Nat. mur. and Nux vom.). Similarly difference in the spectra was observed between the various potencies of the same medicine. The authors concluded that an ultradilute sol (potencies) is indeed structurally different from the pure liquid solvent phase. The data on the ultradilute sols prepared with succussion, show clear differences between the differently treated samples (different potencies) [16].

    Contribution of CCRH
    Central Council for Research in Homoeopathy (CCRH) under the Dept. of AYUSH, Ministry of Health & Family Welfare, Govt. of India is working towards understanding the scientific basis of homeopathic medicines. The Council conducted a randomized double blind, placebo-controlled trial on Chikungunya during its outbreak in 2007 in Kerala. The preventive trial done on 38, 499 healthy volunteers revealed that the homoeopathic medicine Bryonia alba had a significant protective effect in comparison to placebo [17]. A double-blind placebo-controlled trial of homoeopathic medicines in HIV/AIDS conducted by the Council confirmed a positive role of homoeopathic medicines in improving immune status (CD4+ count) of HIV/AIDS patients, as compared to placebo [18]. The Council also collaborates with various Institutes of Excellence to perform advanced researches. In a study conducted in collaboration with the School of Tropical Medicine, Kolkata (WB), it was found that the homoeopathic medicine Belladonna diminished the infection of Japanese Encephalitis virus on chorioallantoic membrane (CAM) of chick embryo. In another ongoing in-vivo study on chicken at High Security Animal Diseases Laboratory, Bhopal to evaluate the effects of homoeopathic medicines against Avian Influenza virus (H5N1), it has been found that mean death time in the medicine group is significantly less than the placebo group. At Central Institute of Medicinal and Aromatic Plants, Lucknow, the scientists working on plant model have found that the homoeopathic medicine Zincum sulph., in various potencies, has different effects, as compared to placebo.

    An exploratory scientific trial on homoeopathic medicines was conducted by CCRH at Regional Research Institute for Homoeopathy, Mumbai using Medical Analyzer developed by Bhabha Atomic Research Centre, Trombay, on 77 healthy volunteers. The variability spectra of heart rate (HRV) and peripheral blood flow (BFV) were recorded after the administration of Aconitum napellus (6C, 30C, 200C, 1M, 10M), Sulphur (200C, 1M), Gelsemium sempervirens (200C, 1M), Pulsatilla nigricans (200C), Arsenic album (200C, 1M) and Phosphorus (200C, 1M) with a placebo control. Specific changes on the heart rate variability (HRV) and blood flow variability (BFV) were observed following homoeopathic medication [19].

    Associating Homoeopathy with witchcraft or placebo is quite unbecoming on the part of the critics. It also amounts to insulting the choice of the countless people, who opt for homoeopathic treatment. Let the people have freedom of choosing their therapeutic intervention, not the critics and skeptics.

    References
    1. Aijing Shang, Karin Huwiler-Müntener, Linda Nartey, Peter Jüni, Stephan Dörig, et al. Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homeopathy and allopathy. The Lancet. 2005; 366 (9487) 726-732.

    2. R. Lüdtke, A.L.B. Rutten. The conclusions on the effectiveness of homeopathy highly depend on the set of analyzed trials. Journal of Clinical Epidemiology. 2008; 61(12) 1197-1204.

    3. Peter W. Gold, S. Novella, R. Roy, D. Marcus, I. Bell, N. Davidovitch, A. Saine. Homeopathy—quackery or a key to the future of medicine? Homeopathy. 2008; 97(1)28-33.

    4. BBC News. Homeopathy not a cure, says WHO. Accessed on 9.3.2010 url: http://news.bbc.co.uk/2/hi/health/8211925.stm.

    5. Homeopathy: There’s nothing in it. Accessed on 9.3.2010 url:http://www.1023.org.uk/

    6. Evidence Check 2: Homeopathy - Science and Technology Committee. Accessed on 9.3.2010. url:http://www.publications. parliament.uk/pa/cm200910/cmselect/cmsctech/45/4502.htm

    7. UK Parliament - Early Day Motions-23.02.2010. Accessed on 2.4.2010. url:http://edmi.parliament.uk/EDMi/EDMDetails.aspx?EDMID=40517

    8. Witt CM, BluthM, Albrecht H,Weißhuhn T, Baumgartner S,Willich S N. The in vitro evidence for an effect of high homeopathic potencies - A systematic review of the literature. Compl Therap Med .2007; 15, 128–138.

    9. Leoni Villano Bonamin, Peter Christian Endler. Animal models for studying homeopathy and high dilutions: Conceptual critical review. Homeopathy; 2010; 99(1):37-50

    10. Fred Wiegant, Roeland Van Wijk. The similia principle: Results obtained in a cellular model system. Homeopathy; 2010; 99 (1):3-14.

    11. Kleijnen J, Knipschild P, ter Riet G. Clinical trials of homoeopathy. British Medical Journal. 1991; 302: 316–323.

    12. Boissel JP, Cucherat M, Haugh M, Gauthier E (1996). Critical literature review on the e effectiveness of homoeopathy: overview of data from homoeopathic medicine trials. In: Homoeopathic Medicine Research Group, Report of the Commission of the European Communities, Directorate-General XII—Science, Research and Development, Directorate E—RTD Actions: Life Sciences and Technologies—Medical Research, Brussels, Belgium.

    13. Cucherat M, Haugh MC, Gooch M, Boissel JP. Evidence of clinical efficacy of homeopathy— A meta-analysis of clinical trials. European Journal of Clinical Pharmacology. 2000; 56: 27–33.

    14. Linde K, Clausius N, Ramirez G, et al (1997). Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo-controlled trials. The Lancet. 1997; 350: 834–843.

    15. Spence D S, Thompson E A, Barron S J. Homeopathic treatment for chronic disease: a 6-year university-hospital outpatient observational study. Journal of Alternative and Complementary Medicine. 2005; 11:793–798.

    16. Rao M., Roy R., Bell I. Characterization of the structure of ultra dilute sols with remarkable biological properties. Materials Letters. 2008; 62: 1487–1490.

    17. Nair J, Gopinadhan S, Kurup t, Kumar BSJ, Aggarwal A, Roja v, Nayak D et al. Homoeopathic genus epidemicus ‘Bryonia alba’ as a prophylactic during an outbreak of Viral Fever / Chikungunya in India - A cluster andomized double blind placebo controlled trial. (submitted for Publication)

    18. Rastogi DP, Singh VP, Singh V, Dey SK, Rao K. Homeopathy in HIV infection: a trial report of double-blind placebo controlled study. British Homoeopathic Journal. 1999; 88 (2): 49-57.

    19. Muraleedharan KC, Mishra N, Paranjpe AS, Devendra KM, Singh H, Nayak C. BARC’s Medical Analyzer System for Fundamental Research in Homoeopathy. Souvenir for National Symposium on Nuclear Instrumentation 2010. 531-535.