For many people, homeopathy is an alternative to medicine that uses natural products to cure common illnesses. This is not unlike the public’s perception of Scientology before the 1990s. People who had heard of Scientology (and even most who were part of it) thought it was merely a system to help you get rid of your stress and unwanted emotions. Then the lid blew and it all came spewing out: Galactic confederacies, tyrannical aliens, genocide by volcano, extraterrestrial possessions. The difference with homeopathy is that the truth about its belief system is out there for anyone to find, but most people don’t pay too much attention to what it really is and simplify it to just “herbal remedies”.

Homeopathy is not about natural products. It is a system built on antiquated beliefs that fly in the face of science and common sense. Let’s list its claims first:

1. Like cures like. Homeopathy claims that a substance which causes symptom A in a healthy person will cure an ill patient with symptom A.

2. The more dilute a substance, the more potent it is. Homeopathy claims that a substance diluted in 100 parts water has a greater power to heal than the undiluted substance.

3. While the ultradilutions required to generate homeopathic remedies mean there is no molecule of the active ingredient left in the solution, the water in which the ingredient has been diluted retains the “memory” of the ingredient. Homeopathy admits the ingredient is no longer there but that, somehow, a ghost image of it is left in the water, and it is this ghost image which triggers the patient’s body to start fighting the illness.

This is the part of the essay where most people reach for the gin and tonic. If your common sense has not completely deserted you yet, you have intuitively realized that the claims of homeopathy do not gel with the way the world works. We know that poisons do not cure envenomed patients. We know that a substance’s potency decreases as one dilutes it. And something just doesn’t sound right about water retaining the “memory” of a substance with which it came into contact.

If you are already convinced that homeopathy is hokum, congratulations. You can stop reading now.

If you still have an open mind, let’s delve into the facts.

Homeopathy, like any pseudoscience, is mainly concerned with two things: money and legitimacy. Since it is not recognized in the canon of medicine, homeopathy strives to evoke an aura of legitimacy any way it can. It is not uncommon to find websites from associations of homeopaths which define homeopathy as “a system of medicine”¹ or “a scientific method of treatment”². This is factually wrong: homeopathy is neither medicine nor science, but to the common reader, credence has been asserted.

The principle of “like cures like” (often rendered in its original Latin, similia similibus curentur, for maximal credential impact) is further explained on the website of the Society for Homeopathy, a British organization: “[…] you can treat ‘like with like’, that is, a substance which causes symptoms when taken in large doses, can be used in small amounts to treat those same symptoms”¹. Even though this notion is blatantly counterintuitive, the website goes on to use an example from the medical literature: Ritalin. The claim by the Society for Homeopathy is that, even though Ritalin is a stimulant and patients with attention deficit/hyperactivity disorder (ADHD) are overstimulated, Ritalin is often prescribed for these patients in low doses. Like cures like, right?

Not so fast, homeopathy. Ritalin’s function as a stimulant does not magically reverse at a certain dose, turning the drug into the equivalent of a cup of chamomile tea.

A common problem in patients with ADHD is a deficiency in a particular neurotransmitter. Neurotransmitters are the molecules that transmit information from neuron to neuron. Dopamine and norepinephrine are two neurotransmitters which are present in lower-than-normal levels in some patients with ADHD. Thus, even though the patient may look overstimulated, it is false to assume there is too much of “something” in the brain; rather, it is a deficiency that needs to be addressed. We know that ADHD drugs like Ritalin increase the levels of these neurotransmitters in a part of the brain known as the prefrontal cortex³. Far from calming the prefrontal cortex, stimulants like Ritalin do indeed stimulate this area of the brain, which leads to increased concentration. Ritalin does not work on the principle that a stimulant will cure a patient suffering from overstimulation; it works because neurotransmitters are “under-stimulated” and Ritalin stimulates them until focus can be restored.

There is no scientific evidence for the “like cures like” meme. This does not stop homeopaths from regurgitating it blindly on ill-informed patients.

Likewise, their claim that diluting a substance increases its potency is laughable, perhaps the most absurd of all three. A number of jokes have been made about this statement, showing quite humorously its nonsensical nature when followed to its logical end. If your headache is particularly bad, take half an Aspirin instead of two. If you really want to get hammered, make sure to dilute your beer in water a few times in a row. And, best of all, if taking as little of something yields the best cure, one should stay away from homeopathy altogether. There’s no duck liver more dilute than no duck liver at all.

So how dilute are those homeopathic remedies? Well, one can’t harangue homeopaths for not going the extra mile. Indeed, homeopathic dilutions are so extreme, there often is no single molecule left of the active ingredient in the final product. How can they dilute something this much? Homeopaths use a basic laboratory process known as “serial dilutions”.

Imagine you are in the kitchen and want to dilute soy sauce in water. You add one teaspoon of soy sauce and nine teaspoons of water to a bowl. There is now one teaspoon of soy sauce in a total volume of ten teaspoons of liquid. You have now accomplished a one-in-ten (1:10) dilution, known in homeopathy as a 1X (“X” being the Roman numeral for 10). You mix the solution with a spoon until it is homogenous, and then take one teaspoon of it and put it in a second bowl that contains nine teaspoons of water. The total dilution factor now is 1:100, or 2X. That soy sauce is becoming very dilute already.

Imagine doing this process thirty times.

This is the number of serial dilutions that a good number of homeopathic remedies undergo before they are mixed with lactose to form a pill ready for market. How many times has that ingredient been diluted? I’ll let Dr. Stephen Barrett guide you through the mental calculation:

“A 30X dilution means that the original substance has been diluted 1,000,000,000,000,000,000,000,000,000,000 times. Assuming that a cubic centimeter of water contains 15 drops, this number is greater than the number of drops of water that would fill a container more than 50 times the size of the Earth.”⁴

What this means is that, if one were to dilute one drop of this ingredient in the volume of water required to reach 30X right away, without doing serial dilutions, one would have to put that drop in a container of water the size of 50 planet Earths.

This ultradilution already boggles the mind, but homeopathy does not stop at incredulity; it plows on straight into the field of absurdity. If you have ever walked into a drugstore during the winter season, you have probably noticed boxes of Oscillococcinum, a homeopathic product claimed to act “effectively within 48 hours to reduce the duration of flu-like symptoms”⁵. The active ingredient in Oscillococcinum is a preparation of duck liver and heart. Its dilution factor?

200C.

If “X”s represented 1:10 dilutions (one part ingredient in ten parts total volume), the “C”s represent 1:100 dilutions (one part ingredient in 100 parts total volume). Each drop of duck offal is diluted in 99 drops of solvent, and this process is repeated serially 199 times.

Once again, I will let Dr. Barrett lead us through the logic:

“If a single molecule of the duck’s heart or liver were to survive the dilution, its concentration would be 1 in 100²⁰⁰. This huge number, which has 400 zeroes, is vastly greater than the estimated number of molecules in the universe (about one googol, which is a 1 followed by 100 zeroes). In its February 17, 1997, issue, U.S. News & World Report noted that only one duck per year is needed to manufacture the product, which had total sales of $20 million in 1996. The magazine dubbed that unlucky bird ‘the $20-million duck’.”⁴

So how can a solution that clearly contains no molecule of its supposed active ingredient cure patients of their ills? Not even homeopaths deny the fact that these solutions are devoid of their original ingredient; rather, they now claim water has memory and remembers what the ingredient was.

The Society for Homeopathy’s website puts it thusly:

“One theory is that during the production of a homeopathic medicine, the dilution and agitation processes cause an interaction between the original material (e.g. a plant such as Belladonna) and the water and alcohol it is mixed with. This creates tiny new structures (nanostructures) which are the ‘active ingredient’ and remain present even when the sample has been diluted many, many times.”¹

The Montreal Classical Homeopathy Institute goes a bit further, appropriating more scientific terms to lend credence to their explanation:

“Water molecules vibrate at a specific frequency as well, but this frequency can be modified in a laboratory process called ‘potentization’ or ‘dynamization’, in which the waveform frequency of a remedy source is imprinted onto the base frequency of water molecules.”⁷

If water has memory, then it should have memory of everything it has encountered: soap, dead skin cells, urine, feces, blood, soil, vomit, plastic, metal, asphalt, bacteria, viruses. Of course, homeopaths will claim that this “imprinting” only happens when the water is shaken in a very specific way, a process known as potentization, dynamization, or succussion.  Let’s watch the procession in action, shall we?

Sigh. So, we are led to believe that during this process of banging the bottle on a leather pad, only the ingredient that has been willingly put into the water knows to imprint itself on the water—through a mechanism that disagrees with the physical laws as we know them—whereas all other contaminants (dust particles, pollen particles, dead skin cells) know not to imprint themselves. This is not science; this is wishful thinking.

The defence of homeopathic societies like the British Society is to point to scientific articles that seem to prove the existence of water memory. One paper in particular is a pyrite for homeopaths: it shines quite brightly and can easily be mistaken for gold. Indeed, the first author on this paper is none other than Luc Montagnier, winner of the 2008 Nobel Prize in Physiology or Medicine for his discovery of HIV, the human immunodeficiency virus. What is Montagnier’s claim? That his team observed in the lab that DNA could “clone” itself in electromagnetic form (meaning waves, such as radio waves and visible light) and that this ghostly image of the DNA could be replicated by the DNA replication machinery just like the actual molecule. Thus, water does have memory, and diluting a substance to the point where no molecule is left can result in an effective remedy, since the “ghost” of the molecule is still present in the water. Montagnier allegedly denied his results supported homeopathy on a Canadian program, but then later changed his mind when he decided to move to China to pursue his radical ideas⁷. It is worth noting that the journal in which he published his controversial study was brand-new, was edited by him, and looks to have undergone no peer-review process judging by the dates.

Dr. Harriet Hall, a physician and skeptic, was one of many who critically evaluated the paper and concluded it did not prove homeopathy and its science was quite possibly shaky. Her analysis is available here. Here’s a summary of her points against the Montagnier paper:

• Montagnier’s team, while trying to figure out why they were getting a contaminating bacterium in their cell cultures suddenly, and with no apparent logic, decided to look at electromagnetic emissions. This leap is never justified in the paper and makes no scientific sense.
• Their measuring system was devised by Jacques Benveniste, the infamous physician who claimed to have proven that water has memory using ultradilutions of an antibody. Benveniste’s controversial results could not be reproduced by a follow-up group with whom Benveniste’s own lab cooperated, nor by subsequent teams.
• The paper does not use the ultra-high dilutions of homeopathy, as DNA molecules are still detected in the solutions.
• The effect disappears at high dilutions and is only present in more concentrated solutions, the exact opposite of homeopathy’s second claim.
• The measured effect lasts fewer than 48 hours, while  “most homeopathic medicines have a five-year expiration date”⁸.
• Finally, the measured effect was found in pathogenic bacteria (i.e. bacteria which cause disease), but not in probiotic bacteria. Hence, water not only has memory, but it seems to be smart, too.

(To this, I will add another point which I noticed while reading the first few paragraphs of Montagnier’s paper. This entire discovery started when they were investigating means of filtering out a particularly troublesome contaminant in cell cultures, Mycoplasma bacteria. They claim that certain filtrating processes were successful in filtering out the Mycoplasma, but that the bacteria were “regenerated” after incubation with normal cells⁹. What? Are we led to believe that a bacterium is indeed fully filtered out of a solution, only to magically reappear ex nihilo? Having worked with cells in culture, I can personally attest to the fact that Mycoplasma are the bane of the cell biologist. They are difficult to detect and are easily spread from one culture to another. Montagnier’s problem was not that his Mycoplasma magically reappeared, but that it had never been filtered out to begin with and its levels post-filtration were too low for detection. Bad science.)

The take-home lesson from all this? Scientists, no matter how famous or how important their contribution to their field, can end up believing in nonsense. See Linus Pauling (contribution: understanding the chemical bond; quackery: megadoses of vitamins can cure cancer). See Charles Richet (contribution: important work on anaphylaxis, a sometimes deadly allergic reaction; quackery: belief in paranormal phenomena and a supposed sixth sense). See Brian Josephson (contribution: prediction of a phenomenon of supercurrent that bears his name; quackery: belief in parapsychology, including telepathy). For a fun detour into the mind-boggling phenomenon of the Nobel disease, and its accompanying MD disease, check out the Skeptic’s dictionary entry on it.

Still, it might be worth playing the Devil’s advocate for a minute. Just because a proposed mechanism has not been proven to exist does not mean that a) it is wrong or b) the pill does not cure patients. Fine, there is no valid scientific proof that water carries a selective memory of an ingredient “succussed” into it. Moreover, the laws of chemistry clearly demonstrate there can be no active ingredient left in the solution, meaning that homeopathic remedies can only consist of the solvent used (a mixture of water and alcohol) and the material used to make the pill (sugars like lactose). But does it work? Does taking a sugar pill work better than taking a placebo, which is… another sugar pill?

At this point, even the Devil’s given up, but not the homeopaths, who claim that studies demonstrate that, indeed, regardless of how homeopathy works, it does work.

Our succussing friends in Great Britain claim that “75% of in vitro experiments have found that substances as dilute as homeopathic medicines have specific effects”¹⁰. The number comes from a meta-analysis by Witt et al. published in 2007 in the journal Complementary Therapies in Medicine¹¹. This article, which looks at a number of previous publications in order to summarize what we know and what we don’t know (a sort of State of the Union address), does indeed claim that 75% of studies using ultradiluted solutions on cells (not looking at human patients, but work performed in vitro or “test tube experiments”) show an effect.

Unfortunately, this analysis, and others of its kind, has been refuted. The British Medical Journal issued such a rebuttal¹². Recurring problems are dilutions which are actually much less than those of homeopathy and a lack of independent replication. Even the Witt study, which homeopaths quote with radiant smiles, admits that “no positive result was stable enough to be reproduced by all investigators”¹¹. If it can’t be reproduced, it was probably badly done in the first place.

***

After all is said and done, we are left with a system of beliefs whose claims are unsubstantiated and thoroughly debunked. Regardless, homeopathy survives, mutating in subtle ways to prolong its appeal and longevity.

While some homeopaths have chosen the road of “scientific validation” to give credibility to homeopathy and to bring it closer to medicine, others, like the Montreal Institute of Classical Homeopathy, are instead trying to appeal to more spiritually minded individuals:

“Classical Homeopathy is, and always was, a holistic therapy, considering the body, mind and soul as a whole, rather than treating a disease and its symptoms.”¹³

They go on to claim that a homeopath “must be very conscious of his/her nature or ‘soul’ before being able to perceive and guide others to the depth where homeopathic healing occurs”, and they throw around malappropriated words like ‘quantum’ to make their esoteric nonsense sound simultaneously more scientific and more new-agey.

This duality in trying to cater to both the more scientifically minded and the more spiritually inclined has extended to the methods of distribution of these products. On the one hand, a homeopath like André Saine, the Dean of the Canadian Academy of Homeopathy, claims that he must know everything about the patient—“his feelings, sensations, sensitivity, psyche, and all that concerns his organism in terms of energy, sleep, hunger, digestion, etc.”—in order to find the right homeopathic treatment for him². The treatment is then given once, and the patient is seen again two to six weeks later. André Saine clarifies the objective by writing, “Strange but true, in homeopathy we do not treat diseases, but the person who is sick”. On the other hand, homeopathic remedies are sold over the counter in drugstores all over Canada. No psyche exam is necessary for those. They are tailored to the disease not the patient (Got the flu? Take Oscillococcinum!). So which is it? Of course, it is both. Homeopaths want to have their cake and eat it in the most profitable way possible.

It has been shown that the basic tenets of homeopathy—that like cures like, that dilutions increase potency, that water has memory—are scientifically unsound and false. Homeopathy does not even work in patients when studied in properly designed, randomized controlled trials.

So why did it work for your aunt? Pseudoscientific quackery can seem to work anecdotally for the following reasons. Illnesses naturally ran their course. The body’s immunity kicked in, as it would have without the homeopathy. The disease was misdiagnosed in the first place and seemed to vanish upon reexamination, while it was never there to begin with. A common phenomenon termed “regression to the mean” consists of the simple observation that sick people tend to consult doctors or alternative medicine peddlers when their illness is at its worst. The illness naturally regresses to its mean in the following days, but improvement is attributed to the pill. And sometimes, even major ailments like cancer resorb themselves on their own, for reasons still unknown to medicine. The homeopathic pill did nothing in any of these cases. It can’t do anything: it’s a sugar pill.

We may wish for treatments that carry no side effects and which are amazingly effective. In fact, that is why homeopathy was developed in the first place, because medicine in the 1700s used crude techniques like bloodletting in an attempt to save patients from their illnesses. The great thing about medicine, though, is that it evolves in the face of evidence. It becomes better. Pseudoscience like homeopathy doesn’t; all it can do is to squirm around to find new ways of justifying and legitimizing its magical notions and to cling to ill-advised people whose wishful thinking muffles their reason.

Feature picture by Dirk HR Spennemann

1. The Society of Homeopaths. “What is homeopathy?” Accessed September 6, 2013. http://www.homeopathy-soh.org/about-homeopathy/what-is-homeopathy/.

2. André Saine for the Canadian Academy of Homeopathy. “What is Homeopathy?” Accessed September 6, 2013. http://www.homeopathy.ca/articles_det01.shtml.

3. Berridge CW, Devilbiss DM, Andrzejewski ME, Arnsten AF, Kelley AE, Schmeichel B, Hamilton C, Spencer RC. 2006. “Methylphenidate preferentially increases catecholamine neurotransmission within the prefrontal cortex at low doses that enhance cognitive function.” Biol Psychiatry 60 (10):1111-20.

4. Stephen Barrett for Quackwatch. “Homeopathy: The Ultimate Fake” Accessed September 7, 2013. http://www.quackwatch.org/01QuackeryRelatedTopics/homeo.html.

5. Boiron Canada. “Oscillococcinum” Accessed September 9, 2013. http://boiron.ca/en/products/flu/oscillococcinum/.

6. Montreal Institute of Classical Homeopathy. “What’s in a Homeopathic Remedy?” Accessed September 6, 2013. http://m-i-c-h.com/remedy.html.

7. Enserink M. 2010. “French Nobelist Escapes ‘Intellectual Terror’ to Pursue Radical Ideas in China.” Science 330 (6012):1732. Available online at http://www.sciencemag.org/content/330/6012/1732 (warning: pay wall). Quotes from article are available on Luc Montagnier’s Wikipedia page.

8. Boiron Canada. “Frequently Asked Questions” Accessed September 9, 2013. http://boironusahcp.com/homeopathy/faq.php#17.

9. Montagnier L, Aissa J, Ferris S, Montagnier J-L, Lavallee C. 2009. “Electromagnetic Signals Are Produced by Aqueous Nanostructures Derived from Bacterial DNA Sequences.” Interdiscip Sci Comput Life Sci 1:81-90.

10. The Society of Homeopaths. “Basic science” Accessed September 6, 2013. http://www.homeopathy-soh.org/research/evidence-base-for-homeopathy-2/basic-science/.

11. Witt CM, Bluth M, Albrecht H, et al. 2007. “The in vitro evidence for an effect of high homeopathic potencies – a systematic review of the literature”. Complement Ther Med 15: 128–138.

12. Bewley S. 2011. “The evidence for homeopathy is not positive”. Br Med J. Available at http://www.bmj.com/rapid-response/2011/11/03/evidence-homeopathy-not-positive.

13. Montreal Institute of Classical Homeopathy. “About Homeopathy” Accessed September 6, 2013. http://m-i-c-h.com/aboutHomeopathy.html.