Complementary and alternative medicine Medicine Quackery

Homeopathic remedies as a “catalyst”

I sometimes feel a bit guilty beating up on homeopathy. It just seems like beating up on a blind man. The feeling passes quickly, of course, but it’s at least somewhat understandable. Homeopathy is so patently ridiculous from a scientific standpoint that watching homeopaths try to justify and defend a therapy that consists of substances that are usually so diluted that there is not a single molecule remaining by invoking the “memory” of water or even quantum theory is, in a perverse way, entertaining to a skeptic like me. I’m always waiting to see what sort of strange analogy or explanation that they’ll come up with next, given the extreme biological and physical implausibility of the concepts behind homeopathy and the utter lack of basic scientific evidence that homeopathy can work and clinical evidence that it does work more than a placebo.

Sometimes, however, I wonder what it is that homeopaths think they are doing. Clearly, many of them are motivated by the same sorts of things that motivate “conventional” physicians (like me): To help people, to cure disease. The difference is that, in most cases, scientific and clinical evidence supports the therapies we use. In most cases of homeopathy and other so-called complementary and alternative medicine modalities, anecdotes are all that can be marshaled to support them. Sometimes, I come across the writings of homeopaths trying to explain what it is that they do, in this case the Basics of the Homeopathic Prescription. First, you must understand the concept of potency:

Potency basically refers to the strength and depth of effect of a homeopathic remedy. Potency is expressed in terms of the number of times the remedy has undergone the process of dilution and succussion (as described in The How and What of Homeopathic Remedies), and the factor of each dilution (1:10, 1:100, or 1:50,000).

Higher potencies stronger-acting than lower ones, even though they are apparently more diluted (remember that the effect of the homeopathic remedy is not chemical, so the concentration of the original substance is unimportant to the potency). This counterintuitive fact is proven as valid in everyday clinical practice.

Uh, no. It isn’t. I’m sorry, but it’s just not true. There’s no scientific evidence to suggest that diluting a remedy will make it stronger, with or without succussion. There is, however, evidence that not a single molecule of a homeopathic remedy remains in many solutions, such as the 20C or 30C dilution, two of the most commonly used homeopathic dilutions. What I found more interesting was the claim that the homeopathic remedy is “not chemical.” If that’s the case, then what is it? Humans (and, indeed, all life) is driven by chemical reactions. The actions of pharmaceuticals all depend on chemistry, as drugs interact with receptors or other molecular targets and cause chemical reactions that influence cellular and organ function. Even herbal remedies used by CAM practitioners work through lowly chemical interactions and reactions. Yet homeopathy seems to claim that it doesn’t need this basic mechanism of life. So the question remains: If homeopathy doesn’t work through chemistry, how does it work? I remind homeopaths that even arguments about the “memory” of water are arguments of chemistry. True, they’re arguments of woo chemistry, but they are based in chemistry that claims that somehow water retains structural “memory” of substances that have come in contact with it and then can somehow transmit that “memory” to cells.

Our intrepid homeopath has an answer:

The action of the homeopathic remedy is thus like that of a catalyst. Catalysts are used in chemistry to stimulate reactions to progress at a much faster rate than otherwise. Many chemical reactions that take place within seconds with the help of a catalyst would take many thousands of years to occur naturally. Similarly, the homeopathic remedy accelerates the body’s self-healing capacities . This is why a single dose of a remedy could, under the right circumstances, produce a long-lasting reaction from the organism. This reaction often persists for several weeks to several months before before further dosing is required.

No, no, no. A catalyst is actually present in detectable amounts in a chemical reaction. Homepathic remedies are not present in any such detectable quantity. Indeed, no homeopath has ever been able to differentiate water from a homeopathic remedy diluted much beyond Avagaddro’s number. These remedies are nothing more than water. I realize that this is an analogy, but it’s a poor one. After all, one characteristic of a catalyst is that it decreases the activation energy of a reaction, allowing it to proceed faster, while not being consumed in the reaction itself. If a homepathic remedy is truly a catalyst, it wouldn’t be consumed. Would it accumulate in the body? Who knows? If it had any activity at all,that would be a concern.

Given the lack of science behind homeopathy, I really have to wonder at some of the statements here:

In the case of acute illnesses, homeopathic remedies are in a frequency proportional to the severity of the condition. For example, a stroke victim will receive a remedy once every minute or two to begin, then once every few minutes, and several times daily in the few days which follow. On the other hand, treating the common cold might require one to three doses per day.

And we know this through…what evidence? None, as far as I can tell. Here’s another bold claim:

The homeopathic remedy can be dispensed either in liquid form or in tablet form. The liquid form is based on a water-and-alcohol mixture, whereas the tablet form is made of sucrose or lactose suffused with the homeopathic remedy.

The choice of format is based sometimes on personal patient considerations, and sometimes on therapeutic considerations. For example, those averse even to the small amount of alcohol found in a daily homeopathic dose can opt for tablets; children can be give the sweet tablets to encourage intake, or conversely the liquid form to avoid sugar intake; those who are lactose intolerant can opt for sucrose tablets or the liquid form; and so on. In addition, there are subtle differences between the effect of these two formats of the homeopathic remedy that might also dictate the choice between the two.

What are these “subtle” differences? What is the experimental evidence? Remember, anecdotes are very problematic and can easily lead to the impression that a remedy that is no more than a placebo appears to work. That’s all homepathy is, an elaborate placebo.

It’s rather depressing to see articles like this. They are, no doubt intentionally, written in an authoritative tone, as though there is a great deal of evidence to support the recommendations and practices described. It’s all a charade. if you ask a homeopath what the evidence supporting the claims that certain dosages or dosing frequencies are most effective, most likely you’ll get a response that “clinical experience” supports it. That may have been enough 25 years ago, even for “conventional” medicine, but no more. “Conventional” medicine has steadily been actively trying to become more and more science- and evidence-based. If the use of anecdotes is no longer enough for “conventional” medicine, it’s not enough for homeopathy or any other so-called CAM either.

And that’s why my guilt over beating up on homeopathy as a concept rapidly passes.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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