One of my patients used to run a health food shop which sold various herbal, homeopathic and assorted alternative remedies. One of the most annoying questions people asked her was “Does it work?” She likened it to a pharmacist being asked if paracetamol works. ‘Well, it does work for some people and some conditions, but it doesn’t work for everyone or every condition. It might work a bit, it might work really well, it might not work at all.’ The difference is that for a pharmaceutical drug to be sold we presume that it must have been shown, absolutely beyond doubt, to work for at least some people. If it doesn’t work for us, well, we just accept that. We don’t think the drug was somehow totally ineffective full stop. But the pills and potions sold alongside the hemp and nettle bath salts are different. We guess that they haven’t been subjected to numerous randomized controlled trials. We think they are probably safe, or they couldn’t be on sale, but they probably haven’t had to show that they “work”. So let’s consider one of these sets of pills: homeopathy.
Now homeopathy is currently an extremely controversial treatment. Lots of people can’t understand how it can possibly work. It would have to defy basic scientific laws. It is funded by the NHS in some instances, even though a 2010 House of Commons report said that homeopathic remedies perform no better than placebos. Here’s the full Science and Technology Committee’s Report and here is the page explaining why, at the time, Homeopathy Remains on the NHS: not because it was thought to be efficacious, but to provide choice. At one end of the opinion spectrum we have sceptics. They have no doubt that homeopathy is a load of rubbish: a waste of everyone’s time and money, peddled mostly by well meaning practitioners who lack critical thinking skills and who mistake the placebo effect for true efficacy. Accusations of charlatanism are creeping in, though. The Good Thinking Society estimate that the NHS has been spending between 3 and 5 million pounds a year on homeopathy; the lion’s share going to Bristol’s and Glasgow’s homeopathic hospitals, the rest in tiny pockets of the country. They actively campaign and they have had a successful judicial review contesting NHS Liverpool Clinical Commission Group’s (CCG’s) decision to spend £40 000 a year on homeopathic remedies. They also happily report that Dorset and Halton’s CCGs and even the aforementioned Bristol’s Homeopathic Hospital will stop providing remedies. Homeopathy has also appeared as a standard target of panel-show comedians, along with Greggs, Nando’s and Stephen Hawkings. This Mitchell and Webb sketch – Homeopathic A and E shows you how homeopathy is mocked as being useful only for those with “a vague sense of unease, a touch of nerves, or just more money than sense” i.e. the weak and the stupid.
At the other end of the spectrum are homeopaths and their loyal clients, some of whom I meet as they are well represented in the osteopathic world. I have always envied those osteopaths who have an unshakable belief in homeopathy. That certainty must feel lovely. Some of them seem to think that homeopathy is a cure for almost anything. If I mention that my son never slept as a baby, or I have a nasty cold, or my husband is a workaholic, the response will be to assure me that homeopathy would help sort that out. I am not one of those people. But those people stop me dismissing homeopathy out of hand. Because contrary to the opinions of the anti-homeopathy brigade, they are not weak or stupid. Some do have a tendency to think anything natural is better than anything pharmacological, and some are prone to the variant of hypochondria that makes you rush to a medical encyclopedia at the first sign of a sneeze or a minor twinge. But not all of them. They are not (all) the stereotypical air-headed tree-huggers that homeopathy’s critics would have you believe.
As for myself, it’s a bit more complicated than that. I can’t unreservedly give it my wholehearted recommendation; neither can I dismiss it.
Many years ago when I was suffering poor health and constant pain, related to emotional issues and an unhealthy student lifestyle, I tried homeopathy. I didn’t mind the aspect that bothers scientists – that it is heavily diluted to the point that it can’t be active – I think there is plenty still in the world to discover, some of which now seems impossible to imagine or believe. But in practice I found it to be a complicated and confusing system. I dabbled in self-prescription. There were lots of different lists of remedies with various physical and emotional symptoms. The reference books, and the symptoms they described, were like something out of a Jane Austen novel: they talked of seaside complaints, nervous, needy dispositions, desiring breeze, better for having someone someone else in the house but to be alone, worse for getting chilled after being hot, disliking consolation, capricious, childish, clumsy, excitable, melancholic. There was a dizzying list of characteristics of pains and sensations and bodily fluids. Was my catarrh stringy? or prune-tasting? Salty? Frothy? Metallic? Clear? Like egg-white? Were my pains burning, cramping, drawing, pressing, pulling, tearing, better in Summer?, worse around 2am? It was endless. I couldn’t make sense of it. I never totally fitted one particular remedy. Lots of them seemed half-right. But I wasn’t sure which reference book to trust (these were thankfully the days before the internet or I could have driven myself quite demented). These were current, recently published books, but they never seemed to talk in current, up-to-date language. They varied enormously in their descriptions, and contradicted each other. I wondered if I needed a few remedies. I ended up with at least 10 of those little pill bottles, bought in a state of keen confusion, which I took at random when I felt that I fitted most closely their particular description. They came in different doses which I found hard to understand. You couldn’t touch them with your skin. I performed a ritualistic jerky maneuvre to propel them into my mouth because contact with a fingertip would render them useless. You couldn’t drink coffee, or brush your teeth around the time you took them. And after all that, nothing ever happened. At a time when Bach flower remedies and tissue salts felt of huge immediate benefit, I never thought I felt any sort of an effect at all from a single one of these homeopathic remedies. Supposedly if you don’t need them they will “prove”, which means they will cause the symptoms they are supposed to alleviate, but suggestible as I am I didn’t notice this happening either. I obviously should have consulted a real homeopath, but it didn’t seem like I would do myself any harm if I got the wrong remedy.
When I became an osteopath, I discovered that homeopathy was quite popular with some patients. However I also treated a couple of trainee homeopaths. They were Mums whose kids were now at school, and homeopathy seemed as much a hobby as a career interest for them. They also seemed to have some chronic health problem: maybe digestive or gynaecological, or skin, that they were seeing their own homeopath for. It seemed to me that this chronic problem hadn’t cleared up, and the reason was that they didn’t think their homeopath had found the right remedy yet. I got the impression homeopathy was a bit hit and miss, if it was even effective at all.
But funnily enough when I became a mother I did use it for my babies when they were teething. Trendily packaged as “Teetha”, looking reassuringly like any over-the-counter minor pharmaceutical treatment, chamomila was available everywhere and was in common usage in the Nappy Valley where I lived. We had a sliding scale of treatment for teething for our children. We started with giving them something to chew on, escalated to teething rings coated with bonjela, then came trusty Teetha which could extinguish a growing teething jag instantly, mid-crescendo, like dipping a lit match in water. Nearly everyone said “It’s the sugar”. Well, it wasn’t, because I tried it. Icing sugar dropped in the mouth, just like we administered teetha, had no effect at all. NOTHING ELSE had that dramatic and instant effect, and believe me, we tried lots of things. When teetha didn’t “work” we turned to calpol, and nurofen. By that stage, nothing was really “working” but we liked to think the painkillers took the edge off and helped the children (and us) get to sleep.
I then found myself in a situation where I had an upcoming wedding, low level chronic cystitis, and had had four lots of antibiotics for urinary tract infections in a year. I was getting fed up with this, and I really didn’t want to spend my wedding night drinking cranberry juice and watching Match of the Day. My mother-in-law exhorted me to “go back to the doctor”. Well I had. About six times in a year. What was the point? The GP was very sympathetic, “Oh dear, not another one”, but had nothing else to offer and didn’t even see me in person any more, just left a prescription at reception. I spoke to a friend who told me homeopathy always “worked” for cystitis for her. I was willing to risk £50 on the off-chance it might “work”, and I took myself to the local holistic health centre for an appointment.
Well, a high quality patient-practitioner relationship it wasn’t! My homeopath was part-time. Her other part-time job was cabin crew. She had just gone on strike. She spent quite a lot of the appointment ranting about wanting to punch the Chief Executive of her airline in the nose. She made me drink a large glass of dissolved vitamins. She told me to stop doing pelvic floor exercises and take up trampolining. Then she seemed to cast about randomly for clues to my symptoms and emotional and mental makeup, assuming various personal attributes or characteristics which bore no relation to me. I could hardly get a word in. She finally latched onto something when I admitted I was getting stressed about things being not-in-the-right-place at home. Ahh…,I was a control freak. Seems I needed Arsenic. (Arsenicum Album, to be precise). Well, at least it sounded potent. We had just moved house, were getting ready for a wedding, had a baby who didn’t sleep and a 2 year old who was toilet training. Half our life was in boxes and the other half had not been sorted out. I was uncertain that my frustration with not being able to locate a pack of wet wipes when the baby was screaming and the toddler was running around the house trailing dirty pants was actually pathological, or even an abnormal response to the situation. I didn’t have high hopes for this remedy. She told me she’d drop the three pills through my letterbox later in the day (on the way to a barbecue), along with a couple of other remedies she’d identified (one for general “dryness”, to take whenever I wanted and one for “feeling invaded” by medical procedures. In the event she forgot one of these, but I honestly couldn’t be bothered to follow it up.)
I took the first tablet of Ars. Alb. Nothing happened. I think the next one was a week later. About two days after I took it, out of the blue, I felt a strange sensation pervade my entire body. It was as if the blood in my body had turned to the consistency of a McDonald’s thickshake. I’ve never felt anything like it before or since. It was definite, painless, unheralded and lasted a short time (4 seconds,? 2 minutes?, I have no idea). It made me stop and take note in a kind of temporary existential paralysis, and it departed as neatly and unobtrusively as it had arrived. That moment, or sensation, is laughably easy to dismiss as being of dubious origin and of no significance whatsoever, but somehow I can’t forget it. And then, I noticed straightaway, my level of stress had gone down a significant notch. It didn’t decrease slowly; it was like a switch had been turned down. I could feel it. There had been a change. For no evident reason. I wasn’t so uptight about the mess at home. But, and it’s a fairly big but, I got another urinary tract infection later that month, took those precious antibiotics again, and then…, well, that seemed to be the end of the cycle. No more cystitis or UTIs for a year or more.
Did the homeopathy “work”? Well, any scientist would say no, probably with a sneer and a laugh, and cast me as a suggestible idiot. Look at the evidence; indeed the evidence against homeopathy. I got another UTI almost immediately after taking the three tablets, for goodness sake. As for the reduction in house chaos-related stress, it was just one of the vagaries of life. The sensation? So vague as to be not worth reporting. The chamomila for teething? Hardly conclusive. Much as I can see how my experience would rather support the case against, rather than for, homeopathy, I felt that that visit to the homeopath was absolutely and unquestionably pivotal in ending that cycle of recurrent UTIs. For whatever reason. I know it sounds crazy, and doesn’t stand up to even the most superficial scientific examination. But I think it’s more complicated than that. I still can’t endorse homeopathy, but I don’t want remedies to disappear from the shelves. I’m not sure if the NHS should be funding it; I’m not even sure if I’d call it medicine; I didn’t think the homeopath was particularly great, and I didn’t enjoy the consultation. I don’t know if I would go to a homeopath again with the same condition. I know, it all makes no sense. It could have been the placebo effect, but I had tried other things which had not triggered the placebo effect. But to this day I attribute my cystitis-free year to that intervention. I am very grateful to that homeopath, and in the narrative of my life I feel she played a minor but memorable role. Something changed that day I went to see her, that I don’t believe would have changed had I not been to see her, but I’m not sure if it means homeopathy works. In fact I’m in the process of chucking out a handful of old remedies from my medicine cabinet, because I don’t “believe” in their potency. But I can see a situation where I would use homeopathy again. The placebo effect maybe is not always easy to find, and that might be where it happens for me. Sorry I can’t be more conclusive. Things aren’t always that simple.