17 Apr 2015
The SCI Cambridge and Great Eastern Group organised a lecture on 19 March as part of the Cambridge Science Festival. The lecture, on the subject of Homeopathy – science fact or science fiction? was delivered by Prof Jayne Lawrence (Institute of Pharmaceutical Science, King's College London).
The event was a huge success: it attracted a very good attendance and was superbly delivered. Prof Jayne Lawrence was informative, clear, accurate, diplomatic and empathic on this potentially controversial topic, where strong opinions are often strongly expressed and, consequently, people do not listen. An overview of the lecture is given below.
Many homeopaths trace the origins of homeopathy to around 400 BC when Hippocrates attempted to treat mania by administering a small dose of the mandrake root which, in large doses, was known to cause mania. Yet, it was only in the late 1790s that the German, Samuel Hahnemann, proposed the idea of treating an illness with low doses of a material that – in a healthy individual – would produce symptoms similar to those of the disease being treated. Hahnemann coined the term homeopathy and the word first appeared in print in 1807. The practice of homeopathy subsequently proved so popular that by the time Hahnemann died in 1843, he was a millionaire!
Despite its popularity, however, homeopathy was controversial even back in the early 1800s. An early clinical trial, performed in 1835, under conditions approximating a double-blind, randomized controlled study (similar to that used today) showed that as a method of treatment homeopathy was wholly ineffective.
Homeopathy nevertheless continued to prove popular, and to appreciate why this was so, one must remember that in the 18th Century, Western medicine made great use of toe curling practices such as bloodletting and purging, as well as administering complex mixtures, such as Venice treacle – a concoction of 64 substances including opium, myrrh, and viper flesh. Such treatments frequently worsened a patient's symptoms, sometimes proving fatal, so it is easy to see why homeopathy and its use of ultralow doses of the treatment material became popular.
Development, testing and production of homeopathic medicines follow very specific procedures, different from those required for more conventional drugs. The marketing and sales of homeopathic remedies are also subject to different practise: homeopathic pharmacies having an elegant appearance. Homeopathic preparations are generally diluted, via a repetition of very specific procedures, by 1030 (i.e. much lower than Avogadro’s number) and so should surely do no harm! Homeopaths propose that water memory is responsible for maintaining activity, even when the chances are that no active component is present. Finding evidence of water memory has so far proved elusive, after all dilutions are high and water molecule dynamics are typically sub-nanosecond. Nevertheless, homeopathy has a high reputation amongst the British public (39% think it works, 26% feel it should be available on the NHS) and this support arises for a range of reasons, from celebrity users (Royalty, pop stars) to distrust of “big pharma”.
The talk explored the scientific and medical evidence proposed by modern homeopaths to support homeopathy, and whether homeopathic practice has anything to offer modern medicine. The methods and results were compared in detail to the more modern clinical trials of conventional medicines. Prof Lawrence concluded that the body of scientific knowledge which we now possess, taken together with the findings from more modern clinical trials performed to assess the efficacy of homeopathic materials only serve to support the conclusion reached in the first clinical trial, that homeopathy is ineffective, with no effect beyond that of a placebo (i.e., no effect beyond that of a preparation containing no active drug).
The final topic of discussion was indeed the placebo effect – undoubtedly a real phenomenon, which can work even when the patient is aware that it is a placebo being taken! No doubt on grounds of cost, any future Health Minister would welcome learning of the success of placebo formulations that had been diluted to homeopathic concentration, and preferably by a large-scale, low-cost process!
Since 2007, Prof Lawrence has been on a 50% secondment at the Royal Pharmaceutical Society (RPS) as their Chief Scientist. At the RPS Prof Lawrence is responsible for science and research, performing a variety of roles including working with other scientific organisations and the media and ensuring that the RPS and its membership is up to date with the latest scientific developments in pharmacy.
Andrew Howe
Treasurer of the CaGE committee
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