Homeopathy: A Pseudoscience?

ABSTRACT Founded by Samuel Hahnemann more than two hundred years ago, homeopathy is based on principles that substances capable of producing the disease symptoms in the healthy will cure an illness when administered in minute quantities, and that extreme dilution increases potency. Although increasingly popular with the public, homeopathy fails to gain recognition within scientific and medical establishments, with many claiming the practice is pseudoscientific. By evaluating key supporting and opposing arguments for both the mechanism and efficacy of homeopathy, it was determined whether the practice of homeopathy was indeed pseudoscientific. On comparison of the evidence of mechanisms and efficacy from both supporters and opponents of homeopathy, it is clear that the practice has strong identifying features of being pseudoscientific. As with other pseudosciences, homeopathy is rooted in ancient practice and ritual, demonstrates a lack of progression, is far removed from the scientific norm and does not comply with the scientific method, and exhibits flawed methodologies. As highlighted, the majority of randomised controlled trials report no efficacy beyond the placebo effect. And, although positive outcomes above placebo were demonstrated in some trials, it was suggested that reduced methodological quality and biased reporting may have impacted on this. The mechanism behind the Law of Similars and Infinitesimals is still controversial, with supporters researching areas such as 'The Memory of Water' and Macroscopic Quantum Entanglement. However, the mechanism leaves many ambiguities, said to defy solid principles of physics and chemistry. Such validated science has fewer mysteries and critics suggest is easier to accept. Therefore until otherwise, there is strong evidence suggesting homeopathy is pseudoscientific. Despite evidence against the practice, homeopathy may have a place in health care. Offering strong patient centred care and lengthy empathetic consultations, homeopathy may provide patients with support and hope for the future, even if the medicine is merely a sugar pill.

Introduction Since its introduction more than two hundred years ago, homeopathy has grown to become one of the most popular complementary and alternative medicines, with sales in the UK increasing by nearly 25% from 2002 to 2007 (Cohen, 2009). Having been available on the NHS for the past 60 years, millions of people use the service in the UK every year (Ng, 2011, Thomas et al., 2001). Homeopathy is considered to be a 'holistic' therapy, treating health'. from the perspective that humans . function as complete, integrated units rather than as aggregates of separate parts' (MeSH, 2013). In fact, these therapies stress the importance of the patient as a whole, and offer extensive compassionate consultations, whereby a practitioner aims to identify with the patient and their medical history and life events (Williamson and Rankin-Box, 2009). This humanistic approach is plausibly the keystone to homeopathy's success. Some seeking complementary therapies describe the approach more compatible with their values and beliefs, and others report dissatisfaction with conventional medicine, for example poor patient care or lack of effective treatment, the driving force for an alternative health model (Astin, 1998, Furnham and Forey, 1994, Ernst, 2000).

This essay aims to define homeopathy, the nature of genuine science and pseudosciences and through evaluation of key literature aims to appraise the practice of homeopathy. Using Ockham's Razor ('entia non sunt multi- plicanda praeter necessitate' - entities should not be multiplied beyond necessity), a principle expressing that the simplest explanation with the least mysteries tends to be best, identify whether homeopathy is indeed a pseudoscience, and if it has a place in healthcare today (Sehon and Stanley, 2010, Rodriguez-Fernández, 1999).

What is homeopathy? Homeopathy, founded 200 years ago by Samuel Hahnemann, is based upon the Law of Similars where 'like cures like'. Substances capable of producing symptoms in the healthy is said to cure disease when administered in minute doses to the ill. The dilutions in homeopathic remedies are extreme, with an initial 1:100 solution being weakened to more than 30C (10-60) (Gold et al., 2008). The ritual of dilution and shaking (succession) are said to transfer information and potentiate the solution. The Law of Infinitesimals describes the escalation in potency through infinite dilutions (Chaplin, 2007). To many, this defies the known laws of chemistry and physics, but supporters of homeopathy have suggested that the remedy may act as a catalyst or restore imbalance for self-healing, initiate an antigenic style response or liberate the body through 'dynamisation' (Bernal, 1995). Supporters claim homeopathy is beyond the paradigm of 'western science', suggest theories and mechanisms of action, or outline trials with positive outcomes and submit mechanisms are unnecessary (Rutten et al., 2012, Sehon and Stanley, 2010, Chatfield, 2011).

The Nature of the Scientific Method and Pseudosciences Despite its popularity with the public, homeopathy fails to gain recognition within scientific and medical establishments (Relton et al., 2008, Samarasekera, 2007). Critics claim homeopathy is not a 'genuine science', rather a pseudoscience. As history identifies, the distinction between science and pseudoscience is complex, as celebrated scientists such as Copernicus (De Revolutionibus Orbium Caelestium) and Mendel and their theories were once considered pseudoscientific, with theories unproven from facts (Lakatos and Feyerabend, 1999). Even presently discrimination is problematic. However, the backbone of genuine science, and much of the success and authenticity of science is due to the 'Scientific Method', developed by philosophers such as Descartes, Popper, Kuhn and Bacon (Carroll, 2009). Due to the legitimacy of this model, it is taught to schoolchildren worldwide.

Although difficult to define the scientific method, it is known for following a particular sequence:

(1) Conjectures (hypotheses) based on observations, that must be capable of refutation or falsification (2) Carefully devised and controlled experimentation (often randomised and blinded to limit bias) (3) Confirmation or rejection of the initial hypothesis (4) Explanation and reasoning (5) Reproducibility of results

(Carroll 2009, Popper, 2002, Bragg, 2012) Through observation and experimentation, the scientific method has lead to a systemised and consensual body of knowledge defining the material processes governing the universe (Beyerstein, 1996, Bunge, 2011, Ziman, 1996).

Contrary to this, pseudosciences tend to be rooted in ancient practice and go beyond the realms of 'normal'. They are reported to contradict genuine science, and show little sign of progress. In line with this, they are commonly isolated from the scientific community and rarely welcome debate or criticism. Whilst outwardly scientific, pseudosciences are notorious for failing to follow the scientific method, performing experiments with flawed methodologies. Examples of pseudosciences include 'Polywater', 'N-Rays' and 'Astrology' (Beyerstein, 1996, Bunge, 2011).

Exploring Mechanisms and the Science Behind Homeopathy Despite research into the therapy, little more is known about the mechanisms behind this treatment than when it was founded more than 200 years ago, and homeopathy is surrounded by mystery. It is unknown why the Law of Infinitesimals and Law of Similars are limited to homeopathic remedies, and why impurities in water are not potentiated (Sehon and Stanley, 2010). Critics suggest the lack of progression, and unsolved mechanism supports the belief homeopathy is pseudoscientific.

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