Several years ago, during a lecture on Science-Based Medicine, I noted that if there were one medical pseudoscience that was vulnerable to extinction it was homeopathy. Homeopathy is perhaps the most obviously absurd medical pseudoscience. It is also widely studied, and has been clearly shown to not work. Further, there is a huge gap in the public understanding of what homeopathy is; it therefore seems plausible that the popularity of homeopathy can take a huge hit just by telling the public what it actually is.
Further, homeopathy is in a precarious regulatory position. Homeopathic products are presented and regulated as drugs, but clearly they are not, and they are also not supplements, herbal drugs, nutrition-based, or natural products. They are simply fraudulent drugs riding a wave of ignorance.
In the last few years homeopathy has had a rough time. While the industry is still growing, there are signs of clear trouble on the horizon. Let’s review:
Homeopathy is a 200 year old pre-scientific system of medicine based upon magical thinking. It is mostly based on two notions, the first of which is that like cures like. In other words, a substance that causes a symptom can cure that symptom in extremely low doses. There is no scientific basis for this, despite the desperate attempts by homeopaths to invoke vaccine-like analogies, or their new favorite, hormesis.
The second notion is that you make a remedy more powerful by diluting it to extreme degrees. People have fun making comparisons, such as the need to drink a solar-system’s worth of water to have a 50% chance of getting a single molecule of active ingredient. No problem, say the homeopaths, homeopathic potions contain the magical “essence” of what was previously diluted in them. It’s turtles all the way down.
I intensely dislike all forms of medical quackery. Of course, my passionate, full-throated, defense of the scientific consensus on the safety and effectiveness of vaccines is fairly obvious. There are literally mountains of evidence that support my skepticism of the antivaccine beliefs.
But there’s more junk medicine out there than the pseudoscience pushers running around the vaccine world. One of my favorite ones is homeopathy. It is a scam that tries to convince people that a vial of nothing more than water (and sometimes ethanol) has some magical medical properties. And it’s expensive water, much more expensive than some bottled water that claims it’s bottled at the source of some glacier in the Alps.
What is homeopathy?
But let’s back up a bit, and explain the “science” of homeopathy, because a lot of people, mostly Americans, conflate homeopathy with natural medicine, like herbal medicine. It isn’t. Basically, homeopathy, known as the “law of similars”, relies on belief that “let like be cured by like”, and is a term coined by Samuel Hahnemann, a German physician who was appalled by the state of medicine at the time, the late 1700’s. And frankly, the state of medicine at that time was pretty bad, so any new idea might have been worthy of trying. However, when Hanneman was alive, basic scientific knowledge was missing. Cell theory and germ theory were a few decades from even a basic understanding.
Homeopathic potions are prepared by serially diluting the original substance (could be anything from diseased tissue to arsenic to snake venom plus mercury) with shaking and forceful striking on an elastic body, which they term succussion. Each dilution followed by succussion is assumed to increase the effectiveness. Homeopaths call this process potentization. So far, it’s just merely diluting and shaking, so nothing much there. But the level of dilution is such that there is only a tiny possibility of any molecule of the original substance showing up in solution.
The dilution is precisely described by Hahnemann. The first dilution is one part to 99 parts water. Then, one part of that first dilution is then diluted in another 99 parts water. Each of these dilutions is called 1C, so two dilutions would be called 2C, with one part of the original similar diluted in approximately 10,000 parts water.
But it doesn’t stop there. Homeopathy uses >30C dilutions, which means that the final dilution is simply water with an almost 0% probability of including even 1 molecule of the original similar.