Trick or Treatment—The Undeniable Facts about Alternative Medicine (Electronic book text)

When scientists dismiss such human cases as partly or wholly due to the placebo effect, homeopaths often cite cases of animal healing, because they believe that animals are immune to the placebo effect. It is true that many pet owners and farmers feel that homeopathy helps their animals, and it is also true that these creatures are oblivious to what a pill is supposed to do, but the value of these anecdotes collapses under closer scrutiny.

For instance, the animal is unaware of which treatment it is receiving or how it is supposed to respond, yet the fact remains that the person monitoring the animal is fully aware. In other words, the animal is effectively blinded to what is happening, but the person reporting the events is unblinded and is therefore unreliable. For instance, an anxious pet owner who has faith in homeopathy might focus on any sign of improvement based on expectation and hope, while ignoring symptoms that have deteriorated. Even if the animal has definitely improved beyond the placebo effect, then this could be due to a variety of factors other than the homeopathic pill, such as the extra care and attention being provided by a caring and concerned owner.

In short, the medical establishment will not accept anecdotal evidence — based on either human or animal patients — as reliable enough to support homeopathy or any other treatment. No amount of anecdote can stand in place of firm evidence, or, as scientists like to say, ‘The plural of anecdote is not data.’

Medical scientists place an emphasis on data because the best way to analyse the impact of any therapy is to look at the results from rigorous scientific investigations, particularly clinical trials. By way of a quick recap, you will recall that Chapter 1 revealed the uncanny ability of the randomized clinical trial to show which therapies work and which do not. Chapter 2 then built on that foundation to show how this technique could be used to test the claims of acupuncturists. So what happens when homeopathy is submitted to the same scientific scrutiny?

In theory it should be much easier to test homeopathy than acupuncture, because it is much more obvious how to take into account the placebo effect. A homeopathic trial would require the random assignment of patients into two groups, namely a group treated homeopathically and a placebo control group. The patients would not be told to which group they had been assigned. Both groups would receive an empathic encounter with a homoeopath, who would also be blinded, inasmuch as he or she would not know which patients belonged to which group. Researchers would then create two batches of pills that were identical, except that one batch would have been treated with a drop of homeopathic solution and the other batch would remain plain. The treatment group would receive the homeopathic pill and the control group would receive the plain pill. Patients in both groups should experience some improvement, simply due to the placebo effect. The critical question is this: does the treatment group on average show significant improvements over and above the control group? If the answer is ‘yes’, then this would clearly indicate that homeopathy is genuinely effective. If, however, the answer is ‘no’ and each group shows a similar response, then homeopathy would be exposed as having nothing more than a placebo effect.

Before looking at the trials conducted with humans, it is interesting to note that there have been some randomized placebo-controlled trials of homeopathy’s impact on animals. The overall conclusion of the major studies is that homeopathy offers no benefit to animals. For example, in 2003 the National Veterinary Institute in Sweden conducted a double-blind trial of the homeopathic remedy Podophyllum as a cure for diarrhoea in calves, and it found no evidence for the efficacy of homeopathy. More recently, a Cambridge University research group conducted a double-blind trial to compare homeopathy against a placebo as a treatment for mastitis for 250 cows. An objective way of checking for any improvement in inflammation of the udder is to count the number of white blood cells in the cow’s milk, and the conclusion was that homeopathy was no more effective than the placebo.

When scientists looked at the evidence in terms of human patients, the picture was more complicated. The good news was that by the mid 1990s there had been well over 100 published trials seeking to decide the therapeutic value of homeopathy. The bad news was that this mountain of research consisted largely of poorly conducted trials, often with inadequate randomization, or with no proper control group, or with insufficient numbers of patients. None of these trials was able to give a definitive answer to whether or not homeopathy benefited patients beyond the placebo effect.