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 topicÃ‚Â 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.