Therapy On Trial: Talk the Talk

Updated Thursday, 8th September 2005
How to sound like an expert. You could do with knowing some key words, phrases and pieces of information. Just so you can cut throught the alternative therapy jargon and make your points with panache

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To really speak the language of homeopathy, you would need to be fully comfortable with the Latin names of the remedies and understand which ones are prescribed for what ailments, and why. However, group discussions among lay people tend to be much more common and fiery along the lines of:

"You should try homeopathy.."
"What, that load of old mumbo-jumbo?"
"Plenty of scientific evidence around - and me, I’m living proof!"
"Nah, power of the mind, mate. You can’t underestimate it …"
"Yeah but: homeopathy works on small kids and animals too …"
"Er… didn’t know that. Still don’t believe in it though."

So, that’s the basic shape of many discussions. When you’ve read around the subject (see links for some starting points), you’ll know where you stand on the matter.

THE BASICS First, the spelling. It is now officially HOMEOPATHY… but it used to be HOMOEOPATHY… and in fact it used to be HOMŒOPATHY. Worth knowing when if you’re using a search engine on the internet.

Homeopathy is often confused in people’s minds with herbal treatments, Chinese medicine, acupuncture, naturopathy and ’alternative therapy’ in general. But it’s a unique system of treatment, with a theoretical basis which is all its own. And although it may be trendy, it’s not new. It was developed in the 1800s, and has been with us in the UK since the 1830s.

THE THEORY
The idea behind homeopathy is that ’like cures like’. The word "homeopathy" derives from the Latin version of the phrase. The central principle is that substances which harm the body in large doses, can in fact stimulate the body to cure itself if given in miniscule amounts. Think of how cutting onions makes your eyes water. The substance that causes that effect is used in minute doses by homeopathists to treat patients who have problems with streaming eyes …

This is another key principle in homeopathy: the more dilute a substance is … the more powerful the effect. The dilution of remedies is designated by the roman numeral ’C’, for one hundred dilutions. At 12 C the remedies become so dilute that none of the original solution is left … and homeopathists use remedies up to 200C and higher. Not surprisingly, the principle of dilution is controversial with mainstream chemists, but homeopathists insist that if the remedy is created properly this is the case….

"Allopathic" treatment is the converse of homeopathic treatment, and is what most of us are more used to with conventional medicine. Allopathic treatment is far less focused on prevention of illness, but is powerful in managing disease conditions, such as bacterial infections by use of scientifically developed drugs and regimes.

But is it really feasible that water can hold a memory of molecules that used to be in there, but aren’t any longer? Again, it’s controversial to say the least, but if you’re in a debate about it, remember it’s a bit lame just to say: "that’s not possible", especially if you haven’t checked it out practically yourself, as most of us haven’t … After all, people told Gallileo his theory "wasn’t possible" and more recently Stanley Prusiner was laughed out of court for suggesting there were things around called ’prions’ - Stanley Prusiner who subsequently won the 1997 Nobel Prize for Medicine for his discovery, that is…

Homeopaths put their case like this: you can have a blank floppy disk, onto which you then download the works of Shakespeare. An analytical chemist will say the disk is identical in terms of constituents in each case… but we all know that what is crucially different, is that the disk now contains information. Same principle, they say … And we have to add that the Nobel Prizewinning Physicist Brian Josephson who was interviewed for our programme has a lot of time for this theory … So - it’s an interesting one.

CLINICAL TRIALS
The only way to try for a definitive answer to the question "does X work?" is to conduct stringent clinical trials. This doesn’t just apply to alternative therapies but to conventional drugs as well. Clinical trials are basically controlled experiments in which patients are assessed before and after treatments of various sorts - but if you thought you had to jump through hoops to pass your driving test, you should try setting up a clinical trial that meets with everyone’s approval… It’s just not as easy as it sounds.

The concept of "the placebo effect" is critical to drug trialling. This is the well-documented phenomenon whereby a person can be given a ’dummy’ pill, i.e. something that definitely does nothing to the body physically, but because the patient believes it will help them, they subsequently feel all the better for it. Belief is a powerful instrument (related experiments have also, for example, shown that you can ’get people drunk’ by telling them their orange juice has shots of vodka in it… ) but it does mean that a treatment that is seemingly effective could be a case of ’all in the mind’ … For this reason treatments being evaluated are usually assessed against the power of a placebo drug, with half the patients assigned to each type.

Bad luck if you experience ’the nocebo effect’. This has been described as the ’evil twin’ of the placebo effect… Patients on dummy pills instead of feeling good on them, convince themselves they’re having a bad effect. In one experiment, patients were given harmless sugar water and told it would make them throw up … 80% of them subsequently did!

In the context of clinical trials, "double-blind" is good, if not essential. What it means is that neither the patient nor the doctor knows whether the patient is being given the real treatment or the placebo. That way neither the patient nor the doctor’s beliefs about the drug can bias the results.

For trials to be properly randomised, a large population of subjects is required, so that a truly random cross section of people will be given both the drug and the placebo. Factors to control for include: age, social class, sex, previous history etc.

THE JURY IS STILL OUT
Homeopathists claim there have been convincing trials conducted supporting homeopathy… and medical researchers who evaluate clinical trials for a living say there have not. Or hardly any, anyway. So, the safest though possibly most boring position to take is to sit right on the fence. Strangely though, even if you do that, you’ll find others still disagree with you!

 

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