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The Case for Homeopathy

A. THE CLINICAL EFFECTS OF HOMEOPATHY ARE NOT DUE TO PLACEBO

i. Ground-breaking work in Rhinitis and Asthma by Dr. Taylor-Reilly M.R.C.P.
ii. Meta-analyses
iii. Herbert Spencer’s ‘bar against knowledge’
iv. Conclusion

Doctors have traditionally thought that homeopathy ‘only’ has a placebo effect.

The hypothesis that homeopathy has an effect that is no greater than that of placebo has been shown to be ‘null’. That is, it is not valid.

Ground-breaking work in Rhinitis and Asthma by Dr. Taylor-Reilly M.R.C.P.
Dr. Taylor-Reilly performed an elegant series of randomized double-blind prospective studies in rhinitis and asthma1,2,3,4 between 1985 and 2000. He demonstrated that homeopathically-prepared pollens could improve not only symptoms (measured using visual analogue scores), but also objective outcome-measures such as peak flow and nasal air-flow resistance.

Dr. Taylor-Reilly failed to find any evidence in favour of a placebo hypothesis that fully explains the effects of homeopathy. The studies found that homeopathic preparations may show a clinical effect over and above their placebo action. Reilly’s 1994 study, published in the international journal, The Lancet, posed this challenging statement: “…either homeopathy is superior to placebo or the double-blind randomised controlled trial is not the gold standard we believe it to be…”
(The double-blind randomized controlled trial is held to be the ultimate form of scientific testing in medicine).

The results also suggest that homeopathic immuno-therapy may hold potential as a substitute for conventional
desensitisation, which is a restricted practice in the United Kingdom.

Metanalyses
In excess of 200 randomized clinical trials, varying in quality of research, have been published concerning homeopathy. One way of assessing the over-all results of these different trials, is to pool them all together, in what is known as a ‘meta-analysis’, another of conventional medicine’s more acclaimed research tools.

Four meta-analyses confirm that homeopathy’s effect can not be explained by that of placebo.
Professor K. Linde, of the Centre for Complementary Medicine Research, Department of Internal Medicine, Munich University, delivered the following conclusion to his meta-analysis, published in The Lancet in 19975: “the results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homoeopathy are completely due to placebo”.
This meta-analysis showed that 42% of the trials that were pooled together were clearly positive for homeopathy and a further 39% showed a positive trend.

Professor Kleijnen, an epidemiologist in the Department of Health Care Research, University of Limburg, The Netherlands, published the findings of his meta-analysis in the British Medical Journal6, in 1991.
He made the robust statement that the evidence found “would probably be sufficient for establishing homoeopathy as a regular treatment for certain conditions”.
Of 107 trials with interpretable results, 77 were positive for homeopathy. A sub-group of the most rigorous trials discovered that 15 out of 22 found homoeopathy to be superior to placebo.

The European parliament ordered the Homeopathic Medicines Research Advisory Group to give an independent review after Linde’s analysis had been made. They selected 17 comparisons with 2,001 patients deemed suitable for rigorous statistical analysis and gave the following conclusion7:
“it is likely that among the tested homeopathic approaches some had an added effect over nothing or placebo”.

The Homeopathic Medicines Research Advisory Group published their work in 2000 in the European Journal of Clinical Pharmacology8: 16 trials fulfilled the inclusion criteria of the meta-analysis out of a possible 116 randomised trials. One of the conclusions in this review was a forthright “homeopathic treatments are more effective than placebo.”

Another meta-analysis was done in 1998 by Professor Linde on trials that studied individualized homeopathy9: 19 out of a total of 32 trials provided sufficient data for meta-analysis. He concluded that “these trials showed individualized homeopathy to be significantly more effective than placebo.”

Herbert Spencer’s ‘bar against all information’
Despite these serious statistical analyses performed by scientists who are not necessarily homeopaths, which show convincingly that there is a phenomenon in homeopathy that cannot be explained by the placebo effect, many skeptics remain unconvinced. This reminds us of Herbert Spencer’s vignette: ‘There is a principle which is a bar against all information, which is proof against all arguments and which cannot fail to keep a person in everlasting ignorance – that principle is contempt prior to investigation’

Conclusion:
In the 21st century we know that homeopathy has an effect that cannot be explained by that of placebo. Homeopathy has been shown to have specific effects in Randomised Controlled Trials, not merely non-specific effects. In proving the case for homoepathy, we can look at other evidence, such as Outcome Studies and Case Studies, which show overwhelmingly positive outcomes when the effect of homeopathy is measured in patient’s lives.

References:

1. Reilly DT et al: Potent placebo or potency? A proposed study model with initial findings using homeopathically prepared pollens in hay fever Br Hom J 1985; 302: 316-323

2. Reilly DT et al: Is homeopathy a placebo response? Controlled trial of homoeopathic potency, with pollen in hay fever as model. Lancet 1986; ii: 881-886

3. Reilly DT et al: Is evidence for homoeopathy reproducible? Lancet 1994; 344: 1601-06

4. Reilly DT et al: Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series. BMJ 2000; 321: 471 – 476

5. Linde K, Clausius N, Ramirez G, Melchart D, et al. Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo-controlled trials. Lancet 1997 350: 834-843.

6. Kleijnen J, Knipschild P, Ter Riet G. Clinical trials of homeopathy. BMJ 1991 302:316-323.

7. Boissel, J. et al. Overview of data from homoeopathic medicine trials: Report on the efficacy of homoeopathic interventions over no treatment or placebo. Report of the Homoeopathic Medicine Research Group. Brussels: European Commission. 1996.

8. Cucherat M et al.. Evidence of clinical efficacy of homeopathy. A meta-analysis of clinical trials. Eur J Clin Pharmacol 2000 56:27-33

9. Linde, J. and Melchart, D. Controlled trials of Individualized Homeopathy: A State-of-the-Art Review Journal of Alternative and Complementary Medicine 1998 4(4):371-388