Quacks to the left of me, dogmatists to the right of me

When walking around Holborn a few months ago, I stumbled across the Royal London Homeopathic Hospital. At first, I assumed it was some kind of comedy quack money-fleecing outfit. Then I noticed the NHS signs on the door, and decided that it had probably been founded by Victorian herbalists and subsequently turned into a proper hospital while keeping the name for historic reasons.

So I was quite surprised, in the context of a Comment Is Free debate on the merits [cough] of homeopathy, to discover that it actually is a NHS homeopathic hospital. Yup, despite the fact that time and time again, double-blind trials have shown homeopathy has no effect beyond placebo, we’re forking out millions of quid to give people diluted potions. This is silly.

However, the reaction of many commentators on the ‘evidence-based medicine’ side has been a bit silly too, as exemplified by this article on the topic from the normally sensible, right and good Shuggy: “some kind of testable hypothesis would be nice, maybe an explanation of how the principle of dilution works“.

That might sound like a reasonable request, but it actually shows as much of a misunderstanding of the drug development process as the homeopaths have, simply because nearly all of the most demonstrably effective pharmaceutical drugs have brought massive benefit to people despite their creators having no understanding at all of the mechanisms by which they work.

It’s only in the last 10 years, following the deciphering of the human genome and the explosion in biotechnology, that the drug industry has been able to create molecules that are aimed at targeting specific diseases. Throughout the rest of its history, and indeed still ongoing, drug development has been based on creating purer and more effective versions of compounds that we (or our ancestors, or tribal shamans) fortuitously discovered were able to make people better.

A good recent example is the use of lithium to treat depression (and subsequently, the use of chemically similar SSRIs). It’s been in use for 40 years and clearly works, but only now are neurologists starting to understand the mechanism by which this takes place. But pretty much every pre-biotech drug has been the same – its mechanism of action was discovered long after its efficacy was demonstrated.

So according to established medical principles, the only hypothesis we need from homeopaths is “this drug will make people better”. The only test we need is a double-blind clinical trial. If such a trial demonstrated clinical efficacy, this would have massive and surprising implications for physics and medicine as fields and create huge amounts of follow-on work – but there would be no issues at all with prescribing homeopathic remedies before this work was complete.

In the case of other ‘alternative’ treatments, such as acupuncture and reiki, there is more evidence that they can be effective – although obviously these can’t be double-blinded in the same way as drugs. But speaking as a rationalist, not an ‘open-minded’ hippy: if it can be demonstrated that it is cost-effective and clinically effective to use such techniques, even if we can’t explain the mechanisms by which they work, it would be folly on the level of the homeopaths and quack-doctors not to use them.

  1. DuncanRDW said:

    John B

    Never heard of the hospital in question, so I followed your link.

    Very interesting.

    However I didn’t see much reference to homoeopathy, other than in the hospitals name (…….. while keeping the name for historic reasons….as you noted) and in one department, the Pharmacy.
    I agree that in general the case for homoeopathy ( a method of treating disease with small amounts of remedies that, in large amounts in healthy people, produce symptoms similar to those being treated.) has not been proven.

    Although there are established treatments based on similar principles.

    The other ten departments in the hospital, appear to practise well established holistic and alternative procedures.

    I like you am wary of quack remedies, particularly when their practitioners prey on the vulnerable. I think it less likely to occur in an establishment like this than in some back street clinic.

    It seems that, this hospital is providing valid treatment, to many people, many of whom, had not received it from the mainstream system.

    I am not technical, so I take your word for it, that modern science, the pharmaceutical companies and medical academics, are set to make untold advances in medical therapies and treatments. That is of course if we can afford the price!

    Personally I like to keep my options open. I like diverse thinking and alternatives.
    For a country as wealthy as ours, the price tag on this hospital is as nothing compared to millions paid out by the health service on over priced pharmaceuticals.

    Just this one hospital….. let it be, who knows you might need it one day!

  2. john b said:

    actually, i’d vaguely intended in the close of the post to get back to the non-homeopathic things that the hospital does, in the context of ‘alt therapies’ that do appear to work.

    but I forgot, and i’m a non-stealth-editing purist, so your comment will have to serve as the correction…


  3. Phil E said:

    Duncan – homoeopathy isn’t a method of treating disease with small amounts of remedies that, in large amounts in healthy people, produce symptoms similar to those being treated. (That’s vaccination.) It’s a method of treating disease with chemicals in vanishingly tiny amounts – “add a teaspoonful of the remedy to the Atlantic Ocean and stir well”, in the words of Martin Gardner. (You don’t need a poisons licence to sell homeopathic arsenic.)

    John’s right to say that all this would be moot if clinical trials showed that homeopathy worked. I only mention it because the idea that homeopathy has some vague family resemblance to conventional medicine seems quite widespread, and it’s really not the case.

  4. Merrick said:

    it had probably been founded by Victorian herbalists

    That would be rather unlikely, as herbalism is quite different to homeopathy.

    One difference, to keep with your theme, is that herbalism has proven efficacy whereas homeopathy does not.

  5. Not Bald Now said:

    In my early twenties I went to my GP because my hair was literally falling out in clumps. After briefly enquiring whether I was likely to have been poisoned at work by heavy metals, he diagnosed it as stress-related and said there was nothing else he could do.

    In my desperation, I turned to a homeopath who lived nearby. But before she could ‘prescribe” anything she said she needed to talk to me in order to understand my problem. During this hour long session of question and answer, I broke down and years worth of emotional vomit came out. My hair stopped falling out almost immediately, and within days had started to grow back. I never went back for the second session where I was to receive my dilute potion.

    I think my point is this; a doctor can be surrounded by fantastic drugs and technology but if (s)he doesn’t have the time or inclination to use them with care, then give me a new age quack who’s prepared to listen every time.

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  7. ziz said:

    I recently attended a lecture by an NHS pysiotherapist who was a qualified to perform acupuncture as part of standard treatments, principally for joint and muscular conditions.

    IT was extremely difficult to obtain any evidence that the treatment was beneficial or effectively replaced other satisfactory treatments.

    2 members of the audience had received such treatment and expressed no satisfaction at all.

    I had been led to understand that the vogue for homoeopathy was as a result of the Royal family having a great belief in it in the 20th Century and it became thereby quite fashionable.

    The first to be treated by this means was Queen Adelaide (Queen consort of William IV) in 1835.

    The interest continued into the twentieth century: Sir John Weir, a royal physician, is reported to have prescribed homeopathic remedies for three Kings and four Queens attending the funeral of King George V in 1936.

    King George VI, also a subscriber to homeopathy, even named one of his racehorses Hypericum (St John’s Wort) after a homeopathic remedy. He also granted the use of the title Royal to the London Homeopathic Hospital, of which The Queen is now Patron.

    Today, The Duke of Gloucester is Patron of the Homeopathic Trust for Research and Education and The Prince of Wales is well known for his championship of complementary medicine.

    The Homœopathic Trust for Research and Education
    (linked to the Faculty of Homeopathy, Royal London Homoeopathic Hospital)
    2 Powis Place
    London WC1N 3HT (U.K.)
    +44 (0)171 837 9469 Fax +44 (0)171 278 7900

    It is quackery of the worst kind.

  8. merrick said:

    Once again I feel the need to draw distinction between various ‘alternative’ therapies.

    Ziz, whilst homeopathy may well be quackery, that doesn’t mean all ‘alternative’ medicines are. The efficacy of St John’s Wort (used in herbalism rather than homeopathy) is proven.

    Regarding acupuncture, just because you found two people who report no benefit doesn’t prove anything. I know two people who get no effect off Ecstasy, but I’m sure we can agree that it is nonetheless a real drug.

    it’s quite some time since studies showed it is effective for certain conditions. Hence the BMA – hardly a bunch of leftfield quacks – calling for it to be more widely available on the NHS

    I know a GP who uses it quite a lot. She says around 10% of patients find it useless, about 10% find it amazing, around 80% find it some use.

    She uses it frequently as it is cheap, less of a sledgehammer than most pharmaceuticals, and works on causes in areas (such as chronic pain) where other medicines treat only the symptom.

  9. DuncanRDW said:

    Being at a bit of a block head I took the definition for ‘homoeopathy’ from The Sage’s English Dictionary and Thesaurus – cut and paste.


    However, as I believe I intimated, I’m of the view that a little investment in alternative’s, in whatever field, is a wise move. Progress depends on people pushing the boundaries of our knowledge. All pushing in the same direction, no matter how popular, does not necessarily mean we produce the most successful evolution.
    I suspect that in years to come ‘alternative’ therapies and the ‘Holistic’ view will become more intertwined into the social fabric of our culture. More focus on the causes rather than expensive remedies.

    Ooops I feel a rant coming on, so I’ll sign off!