One lump or two? 'High potency' homeopathic pillules are nothing but sugar

The 10:23 campaign seems to be stirring up a wasps nest amongst homeopaths – fortunately these wasps have a venom so dilute that they are incapable of doing much more than make an angry buzz. I would feel sorry for them if they weren’t so adamant that their flimsy belief system is capable of treating serious illnesses like type I diabetes, gangrene, appendicitis, AIDS, malaria, etc. (you don’t believe that they make such claims? check out Nancy Malik’s twitter account: http://twitter.com/DrNancyMalik).

Of course, some homeopaths have taken up the #ten23 hashtag and are fighting a spirited (and sometimes spiritual) battle against the arrayed forces of science, scepticism and general doubt (as is their right). Needless to say their response does tend to rely heavily on bombast, unfounded statements from anecdote and links to videodotes or webpages promoting homeopathy, although seldom to anything resembling rigorous, peer-reviewed scientific studies (the odd basket of carefully picked cherries does turn up). But of course, science is clearly lagging behind – in the words of one homeopath twitterer (@HomHeals):

Homeopathy – Waiting for Science to Catch Up!

Scary science is gonna get you! DISCLAIMER This is in no way meant to represent a threat of physical violence

But of course, it’s not like that. There is no dichotomy between science and homeopathy. Science is a process whereby evidence is assessed in a systematic, repeatable way and ideas are accepted or rejected on the basis of the outcome, whilst homeopathy is a set of beliefs based on a defining principles established by Samuel Hahnemann 200 year ago. These principles as a set have simply failed to stand up to scientific testing, so homeopathy finds no support from science. This means that for homeopaths to continue doing their thing, they need to reject the principles of the scientific method (i.e. reliance on evidence), rather than change their ideas about homeopathy. In response to the rhetorical question posed by John Maynard Keynes:

When the facts change, I change my mind. What do you do, sir?

A homeopath would probably respond by saying:

“I ignore the facts – they’re not my facts anyway, they’re facts made up by people who are colluding to besmirch the name of homeopathy and I have anecdotal evidence that is far more convincing than your double-blind, randomised, placebo controlled trial anyway. And your facts are just made up by big pharma, which doesn’t work and it kills people. You’re just a bunch of allopaths who don’t recognise the true faith of homeopathy. So there.”

What is particularly vexing about debate with homeopaths is their inevitable retreat into logical fallacies and long outdated arguments. They make statements about homeopathy being better than allopathy, when allopathy was a phrase coined by Hahnemann 200 years ago for the Hippocratic, Galenic etc. schools of medicine, long since made defunct by Germ Theory in the 1880s and the rise of modern evidence-based medicine, which has been around for less than 40 years.

In effect, modern medicine has successfully overhauled the established medical opinion of Hahnemann’s time by virtue of being more effective. If homeopathy was as effective as homeopaths make out, it’s surprising that it isn’t the method that has been adopted as the best form of treatment available – after all it has been around longer and it’s cheaper to produce because it doesn’t require all that pesky testing. Moreover, it sells in huge amounts – but popularity is not a robust indicator of efficacy by any means, as I’m sure any homeopath could tell you… if they weren’t so obsessed with popularity.

Before this post turns into a huge rant or a serial refutation of the nonsensical arguments used by homeopaths, I will try to make my point. 10:23 is about what is in a ‘high potency’ homeopathic preparation (of 30C or more). These products are marked as having active ingredients, but the dilution of whatever ingredients might have been in the solution at the outset is so great as to go far beyond the Avogadro constant – in short there is less than a single molecule weight of the ingredient in the solution. This solution is then dropped on sugar and allowed to evaporate. So should it be marked as being an active ingredient? It’s rather like a bag of sugar listing Tyrannosaurus rex as one of its ingredients, because there is a possibility that one molecule of water that dried on one grain of sugar was once in contact with a T. rex (see here for a clear summary of the homeopathic process).

I have no evidence before me to suggest that they are efficacious, and we look very much for the evidence to support that…

(Paul Bennett, Professional Standards Director of Boots speaking at the Science & Technology Committee Homeopathy inquiry 25th Nov 2009 – full transcript here)

This seems wrong. It seems as though a trusted company is betraying people’s trust – falling back on caveat emptor (let the buyer beware) rather than maintaining the standards of what they sell. Imagine if Boots started selling travel sickness pills that contained no active ingredient, just sugar. This would be a placebo and it would be unethical (and probably illegal) for Boots to sell the product. Which may explain why Boots don’t indicate what the homeopathic pillules they sell are for. In effect, they do sell travel sickness pills that contain no active ingredient, just sugar (it’s called Aconite 30C) but they get around the ethical and legal problems using the disclaimer:

Boots Aconite 30c is a homeopathic medicinal product without approved therapeautic indications.

Contains ingredients:

Active Ingredients: 30c Aconitum napellus

Also contains: Sucrose & lactose

(taken from Boots website)

It would be interesting to see if the listed ingredients would actually stand up in a court of law, given the lack of any molecules of Aconitum napellus in the product – it’s rather like an apple pie with no apple.

The 10:23 campaign is intended to make this point in the public eye, to raise awareness of what super high dilution homeopathic pillules actually consist of – nothing but sugar. That’s why I will be taking part in the London leg of the homeopathic overdose at 10:23 this Saturday. Perhaps it will make the point publicly enough to persuade Boots that they shouldn’t be misleading the public by stocking homepathic remedies that are not shown to work and are listed as having active ingredients, yet they contain nothing but sugar.

“One lump or two?” Not for me thanks – I’m cutting down on woo.