The Other Medicine: Programme Three

FORD
Placebo aside, what about the treatments themselves? Patients go to practitioners for a specific therapy. So has science got anywhere in understanding them? How might an acupuncture needle reduce your pain? Does the body really contain energy that can heal? And is there a mechanism working within the extreme dilutions of classical homeopathy?

Well, science has barely begun to explore these questions yet. Acupuncture is probably closest. It’s thought that the needles activate the body’s own painkiller - endorphin. This at least gives scientists a site of action and a plausible theory to build on.

Homeopathy is another matter. Whilst clinical trials show patients improving, attempts to repeat the results in the lab have become notorious, and have led to some widely publicised, though bogus results.

Homeopathy is based on the principle "similia similibus curentur" meaning "let like be treated by like". Its inventor was Samuel Hahnemann, an 18th Century orthodox doctor, horrified at the ever-more barbaric practices of his profession. He created a gentler form of medicine which takes as its basis for treatment, the presenting complaint.

ARMITAGE
I’m Katherine Armitage, I work as a homeopath from Health Foods, Fulham Road. I use flower essences and homeopathy as my main therapies. I also work as a healer. A lady from up the road was getting very bad hot flushes and last week she came in and I suggested a remedy to her - apis mel - which is honey bee sting in potency. She’s a very busy lady, always rushing around, not very much time for herself and busy like a busy bee flying around. And apis has helped her enormously with her hot flushes, it’s also a very good remedy for water retention and she’s now going to try and take it for a further week - morning and evening - and she’s going to come back and report her results.

People think that homeopathic remedies, because they have less matter in them, are less strong than something like an orthodox medicine, let’s say Imodium for diarrhoea, Imodium will literally immobilise the system. We might as a homeopathic remedy give arsenicum, which is arsenic in potency, which actually causes diarrhoea but it’s diluted and shaken, diluted and shaken to such a degree that you’re just getting the energy of the arsenic and as homeopathy works with the law of similars you’re giving - you’re matching the energy of the body and you’re giving it a stimulus to say something needs rebalancing here, something needs correcting.

FISHER
My own interest in complementary medicine goes back a long way when I was still a medical student and we went to China, and this was in the summer of 1972, and I can tell you the precise moment at which the scales fell from my eyes - we were standing in the operating theatre of a small Chinese provincial town, there was a woman on the operating table, entire abdomen open, conscious, talking to the anaesthetist with three needles attached to a little electrical box - three needles in her left ear. And I thought this doesn’t happen, they certainly didn’t tell us about this in medical school. So that was I think what opened my eyes to the fact that there is more to medicine than the orthodoxy.

FORD
Dr Peter Fisher is the Head of the Royal London Homeopathic Hospital and Homeopath to her Majesty the Queen. Earlier this year, a respected research journal published the results of several studies that seemed to show that the extreme dilutions of homeopathic remedies could nevertheless have a direct effect on cells in culture. This is, Fisher argues, objective, repeatable evidence that something which science says shouldn’t work, does. And it begs the question: how?

FISHER
There is a surprisingly large number of clinical trials of homeopathy, over 200 clinical trials of homeopathy and everybody who’s looked at them, everybody, you can do something called mesh analysis where you get all the results and pool them using a statistical technique called metanalysis. Everybody who’s done that concludes that the evidence says homeopathy really does work compared to placebo, it is not a placebo effect. And the question is well how on earth, people are sceptical about that because they cannot understand how these very high dilutions could possibly have an effect that isn’t a placebo effect. But again I think even in that area we’re starting to make progress, there is now test tube laboratory research that says these very high dilutions do something, in a model of allergic response in the test tube you can show that very consistently - that there really is an effect. So the next question is - well how is that effect mediated? And I think we don’t have the answers to that, we certainly don’t have all the answers to that. It may be that what we’re talking about is a structural effect in water, that the water is carrying or the water alcohol mixture that homeopathic medicines are made up in is carrying a message. We talk about floppy disks, if you take a homeopathic medicine to an analytical chemist and say what’s in here, they’ll say well water, alcohol and sugar, the medicine’s made up in water and alcohol and then put on sugar pills. But of course if you took that same chemist a floppy disk and said what’s in here, he’ll say vinyl ferric oxide. For all he knows it could have a Shakespeare play or a virus or it might be a blank disk, you simply don’t know what the information content is from the chemical point of view, it’s a physical phenomenon, there is some physical structuring phenomenon going on in the water and that is how it works.

BALL
You can find throughout history the idea that water has miraculous properties and miraculous properties that will somehow be to our benefit, that will somehow act as a saviour, that it will provide a fuel or that it will provide a marvellous medicine or that it will purify and cleanse - this is a cultural - a very strong cultural myth.

FORD
Phillip Ball is a science writer by profession, but was educated as a chemist and later as a physicist. He’s taken a keen interest in efforts by others to discover a mechanism for homeopathy. In his book H₂0: a Biography of Water he examined the most commonly held belief, that homeopathic dilutions, with no active molecules of the medicine left in them, might be working through something called "the memory of water".

BALL
It’s an idea that is supposed to convey the suggestion that water can retain, if you like, an imprint of molecules that have been in it and then have been effectively taken out by diluting the water. So the idea is that somehow once the water has been exposed to these substances it is able to mimic their behaviour, it’s able to remember their - perhaps their shape or their function. It’s never really made very clear how people think this memory is being retained, whether it simply is the sort of template effect or whether it’s something else, that’s never really specified. Water - liquid water is a bit like a crowd of people who are holding hands, okay, because the molecules are bound to each other by these weak bonds between molecules, called hydrogen bonds, and those are constantly forming and reforming all the time, so this crowd they’re holding hands but they’re always letting go and then joining up with a new partner. And that happens, on average, a hydrogen bond lasts for just a billionth of a second before it breaks and then the molecule reforms one to another molecule. So there’s this constant making and breaking of this so-called hydrogen bonded network throughout the liquid and that’s something that makes water different from just about every other liquid that we know about, the fact that it has this continuous three dimensional network of hydrogen bonds.

I don’t think you can simply sweep away the question of how this could be working when the phenomenon seems so strongly to contradict fundamental properties of matter - fundamental principles of science. I think it’s kind of incumbent on any serious scientist to, in that situation to be thinking well how on earth can I explain this, or perhaps to be thinking well what have I done wrong. And to continue asking that question until you can’t ask it anymore, it’s not clear that that’s really the approach that’s been taken. So I think if people were seriously interested in explaining what was going on then they would start to think about these sorts of experiments of how you can simplify this, how you can - if you think that it’s happening because of this phenomenon how can you test that in a much more direct way?

REILLY
Surely we have to realise that when we look back three hundred years from now back to now we will see ourselves in the dark ages to a measure, just as much as we see those of three or four hundred years ago. I certainly don’t hold a world model that we’ve somehow cracked it and have an understanding of the forces of nature, never mind of healing, which is even more complicated at one level because it involves a whole living organism to some level. We were dealing with everyday phenomenon like gravity, like light, like magnetism - all the basic forces of nature - and then the scientific inquiry, long before we had any inkling whatsoever of the mechanism. So I personally find that a naïve critique.

FORD
Whether or not we think it’s of value to explore the mechanisms underlying complementary medicine, there’s little doubt many mechanisms will eventually be understood. Some practitioners might one day have to face up to irrefutable evidence that their therapies are solely based on belief and placebo. Or the scientific community might have to accept that water has a memory. Meanwhile perhaps for the time being, what really lies at the heart of this debate is the simple question of whether or not patients get better, rather than why. For Dylan Evans as for others, like George Lewith, the arguments about mechanism point to a need to explore and understand a new way of healing, that may reflect as much about our minds as about our bodies.

EVANS
The existence of the placebo effect could lead to a much more sophisticated understanding of the body’s own abilities and a respect for the body’s own abilities to manage its own healing system because one thing that medicine - Western medicine - has been guilty of in the last 30, 40 years is to assume that it’s always best to aggressively intervene and treat things and in fact the body turns out to be a lot wiser than we were previously aware of.

LEWITH
I think it will ask questions about the way we practise medicine, as both practitioners and patients and I think those questions are very important. There’s a very big spirit to human beings and it overcomes lots of difficulties and lots of things. I mean people survived terrible hardships on the D-Day beaches in the war in Central Europe, in the camps, in all sorts of situations and they survived when they really shouldn’t have survived because of what was going on in the head.

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