US doctors spark homeopathy row

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  • Published 21.08.14

New Delhi, Aug. 20: A medical paper by two American doctors that denounces clinical trials in homeopathy has evoked an equally sharp response from an Indian government agency that has supported dozens of trials putting homeopathy medicines to test.

In a paper published today in the journal Trends in Molecular Medicine, cancer surgeon David Gorski and neurologist Steven Novella have dubbed clinical trials in homeopathy and reiki as the equivalent of trying to determine whether magic can heal.

The doctors said the two core principles of homeopathy — that symptoms should be treated with compounds that cause the same symptoms in people who are not ill, and the more a remedy is diluted, the stronger its action — have no basis in science.

“These principles have no basis in physics, chemistry, or any science and, in fact, go against much of what we know,” Gorski, the chief of the breast surgery section at the Wayne State University Medical School, told The Telegraph. “On basic science considerations alone, there is no reason to think homeopathy will have any effect in humans above that of placebo.”

Under the placebo effect, patients taking sham medications at times find their symptoms improving.

Gorski and Novella, in their paper, have said clinical trials on treatments such as homeopathy and reiki “degrade the scientific basis of medicine” by portraying formulations whose basis rests on pre-scientific thinking as though they were supported by science.

Reiki involves using hand touches to direct a “healing energy” into a patient. The two doctors said there is no evidence such healing energy even exists.

In homeopathy, the doctors said, remedies are diluted to levels of up to 10 raised to the power of 60, far beyond what chemists call the Avogadro’s constant, making even a single molecule of the remedy virtually undetectable. At such dilution levels, the chance of consuming a single molecule of the remedy is much less than finding a specific tagged grain of sand in a colossal heap of all the grains of sand on Earth.

India’s Central Council for Research in Homeopathy (CCRH) has supported dozens of clinical trials of homeopathy medicines against several illnesses — autism, diabetes, high blood pressure, osteoarthritis, schizophrenia, among other chronic and infectious diseases.

“All of these trials are a complete waste of taxpayer resources,” Gorski said.

But the CCRH says homeopathy remains misunderstood by most modern medicine practitioners. “Science is a progressive phenomenon — as humans understand more and more, that part that is understood is labelled science,” said Raj Kumar Manchanda, the CCRH director general.

Manchanda said all homeopathy medicines do not use dilutions beyond the limit at which molecules become undetectable. “In nearly 80 per cent of homeopathy formulations, the source substances are easily detected,” he said.

The US doctors have said clinical trials on homeopathy, or reiki, breach a major assumption that underlies evidence-based medicine — that by the time an investigational treatment is ready for rigorous clinical trials, it has passed pre-clinical tests, typically based on animal studies.

Virtually all modern drugs are released after animal and human clinical trials.

But CCRH researchers question the concept of standard clinical trials to measure the efficacy of homeopathy drugs. A homeopathic prescription is based not only on the symptoms of disease, but also on a host of factors such as emotional health, personality and eating habits of patients.

“The efficacy of an individualised homeopathic intervention is thus a complex blend of the prescribed medicine together with other facets of in-depth consultation and integrated health advice provided by the practitioner,” Manchanda said.

Gorski and his colleague Novella, an assistant professor of neurology at Yale University, said investigators labour under a “seemingly reasonable delusion” that formulations from such alternative systems of medicine would be abandoned if they don’t show effect in clinical trials.

“Unfortunately, this abandonment never seems to occur,” they wrote in their paper. “Acupuncture and reiki remain widely practised and even embraced at academic institutions, and even homeopathy continued to be practised despite clinical trials that demonstrate effects indistinguishable from placebo effects.”

The CCRH has been conducting trials on homeopathy for over three decades. “In conditions like allergies, upper respiratory tract infections, childhood diarrhoea, influenza, rheumatic diseases and vertigo, outcomes are in favour of homeopathy,” Manchanda said.