Homeopathy - there’s nothing in it

Chrys Stevenson

It’s a scorching hot Saturday morning in Brisbane and I’m standing outside the Treasury Casino with a handful of sleeping pills in one hand and a bottle of water in the other. I keep a close eye on my watch. This has to be done at precisely the right time. As the minute hand ticks over to exactly twenty-three minutes past the hour, I down the pills. But have I taken enough? I decide not. I punch some more from the silver foil card and take those too.

A small, eccentrically dressed, elderly woman notices my strange behaviour and shuffles over.

“What are you doing?” she asks - more puzzled, than concerned.

“I’m overdosing on homeopathic sleeping tablets,” I reply as I continue popping pills into my mouth like Tic Tacs.

“Why?”

Now I have to explain why I, the twelve people standing with me, plus more than a thousand other participants across the world, have chosen 10:23am on Saturday, 5 February 2011 to swallow ridiculous amounts of medication purchased from main street pharmacies - and why we’re all still standing.

In 2010, Paul Bennett, the professional standards director of Boots Pharmacy, conceded that homeopathy has no therapeutic value (beyond placebo) but confirmed that Boots continued to manufacture and sell these worthless products because of customer demand. Outraged, the Merseyside Skeptics organised a nation-wide protest outside Boots’ stores. They decided on a homeopathic ‘mass overdose’ to graphically demonstrate their slogan: Homeopathy - There’s Nothing in It.

Today, along with protestors throughout Australia, New Zealand, Europe and the UK, the United States and Canada, South America, Israel, the Philippines and South Africa, we’re joining in this global demonstration against homeopathy.

But why? What does it matter if people want to take homeopathic sugar pills? Surely we’re only proving that, even if homeopathy doesn’t work, it does no harm. So, what’s the big deal?

They’re valid questions and, despite the upbeat, even jovial, atmosphere among my companions, there is a deadly serious answer. While homeopathic preparations may be harmless in themselves, homeopathy can be lethal when used as a substitute for scientifically proven medicines and treatments.

In Perth, in 2005, Penelope Dingle died an agonizing death from metastatic renal cancer after repeatedly refusing anything but homeopathic treatments. The Coroner’s Report on Dingle’s death says, in part:

[T]he homeopath had assured the deceased that she could cure rectal cancer using homeopathic methods alone and that the deceased would not require surgery, chemotherapy or radiation treatment. It was suggested that it was on the basis of this advice that the deceased had not pursued a surgical option … in spite of her increasing pain levels the homeopath repeatedly assured her that the treatment was effective (curative) and encouraged her to persist with homeopathic treatment.

Even when Dingle was rushed to hospital with a complete bowel obstruction, the homeopath tried to dissuade her from allowing the doctors from performing life-saving surgery. The surgeon described Mrs Dingle’s condition as follows:

…she looked almost dead. She was down to 35kgs, cachectic [wasted from the cancer], suffering from severe weight loss, sunken eyes, grossly distended abdomen, in severe pain and incredibly unwell.

At length, Dingle agreed to the operation but, tragically, by this time, her cancer was so far advanced only palliative care could be offered. Reviewing her history, the treating doctor said that, had Mrs Dingle followed the conventional treatment course recommended after her initial diagnosis, she would have had a good chance of survival.

If homeopathy were simply being touted as a cure for minor ailments like headaches, insomnia and morning sickness perhaps there would be no need for grand gestures like public mass overdoses. But homeopathy is also being promoted, especially in third-world countries, as an alternative treatment for potentially deadly, but manageable, diseases such as HIV/AIDS, malaria, tuberculosis, diarrhea and influenza. Let me be clear here, after more than a century of research, hundreds of studies and at least two, major meta-analyses (studies of studies), the science shows that homeopathy has no therapeutic effect greater than placebo. (See Ernst (2010), Medical Journal of Australia; Singh and Ernst (2008) Trick or Treatment)

It’s horrifying to think that scientifically trained pharmacists give shelf space to homeopathic medicines, not because they work, but because they sell. This gives the products an imprimatur of credibility that is simply not deserved and potentially dangerous.

Stories like Penelope Dingle’s help me to put aside my reservations about participating in the 10:23 Challenge. Of course I’m concerned this kind of stunt might be seen as trivializing the very real problems of drug abuse and suicide but, ultimately, I’m convinced that the dangers of homeopathy are so significant that any action which draws attention to its lack of efficacy is worthwhile. Yet, frankly, I’m still concerned about my own health.

I’m neither impetuous, nor irrational. Before I committed to take part in the protest, I indulged in a little pre-Challenge googling. I took a close look at the packet of sleeping pills I purchased from my local pharmacy and noted that most of the ingredients sounded innocuous. I wasn’t likely to die from an overdose of caffeine, chamomile or capsicum. But there were some unfamiliar names like humulus lupus which sounded suspiciously like a concoction brewed in the potions class at Hogwarts. I was relieved to discover that humulus lupus is simply the Latin name for hops, and I figured I’d probably downed enough beer to develop an immunity. But some of the ingredients, I discovered, are scarily toxic.

I was alarmed to find that Gelsemium sempervirens can be fatal - even in small doses - and that just 35g of the Hyoscyamus (henbane) contained in the pills I’m planning to take could, theoretically, kill a 70kg adult. I’m not a very brave person and the words ‘toxic’ and ‘kill’ in relation to something I’m about to ingest - let alone overdose on - come back to haunt me as the 10:23am mark draws closer.

“Are we sure this stuff is safe?” I ask my fellow skeptics, only half joking.

Keith, who’s studying for a Bachelor of Health Science and Trent, a law student, draw my attention to the ingredients list on my box of pills, pointing out that each is followed by a number and the letter C. I’ve noticed the figures 4C, 6C, 14C and 30C on the box, but don’t really understand what they mean. I’m not completely clueless; I know that homeopathy works on the principle that cures are affected through highly diluted forms of an active ingredient. This is based on the belief that water has memory. In keeping with the homeopathic maxim ‘like cures like’, the ingredients used to treat symptoms are those which cause the same symptoms.

That explains why coffee has been added to the sleeping pills I’m about to take. But, I’m still hazy on why my box of pills clearly shows a list of ingredients that my friends insist are not contained in the product inside.

Keith and Trent explain that an ingredient with 2C beside it means it has been diluted twice. The first time, the active ingredient is steeped in water at a ratio of 1:99 parts. This forms the mother tincture. (Sometimes alcohol is used instead of water, but let’s keep it simple.) Then, one part of that diluted solution is added to a further 99 parts water. A 30C solution repeats this dilution process 30 times.

The boys reel off a string of numbers, ratios and percentages which I don’t really comprehend. But I listen intently and grasp enough to realise that what’s listed as an ‘ingredient’ on the packet is actually diluted so significantly it’s highly unlikely that any of it ended up in one of my pills - and certainly not in sufficient quantity to do me any harm.

So, I down two cards of homeopathic sleeping pills and, as predicted, I feel no ill-effect or drowsiness whatsoever. I’m still going strong hours later, after a big lunch and a two hour drive home.

At home, I decide to take a closer look at the math that made my head spin earlier in the day. As Keith and Trent suggested, the manufacture of my homeopathic sleeping pills began with 275 micrograms of each of the listed ingredients, but that’s not what went into each pill. The coffee, for instance, was diluted by a factor of 30C.

I’m shocked to read that, after a 30C dilution, only 0.000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 1 per cent of that amount actually remains. If that many numbers makes your head hurt, here’s a simpler way of putting it: at that rate of dilution the chance that even one molecule of coffee is left is one in a billion billion billion.

And the highly toxic and potentially fatal Hyoscyamus? That’s diluted 6 times, each time at a ratio 1:99. So, what is actually added to each pill is 0.000 000 000 1 per cent of 278/1000 of a milligram. By my inexpert calculation, I’d have to take 125 thousand, nine hundred million million pills in order to reach the lethal dose of 35g. That’s not quite no active ingredient, but close enough.

In fact, I read that anything beyond a 12C dilution is generally the point at which one can say, without fear of contradiction, that not a single molecule of the original ingredient remains. This is called the Avogadro limit, or 10 to the 23rd power - and it’s this number which gives the 10:23 Challenge its name.

But this is all knowledge gained after the fact. Back at the Brisbane 10:23 Challenge, organiser, Jayson Cooke, has brought along a copy of the book, Trick or Treatment (2008) by physicist and science journalist, Simon Singh and medical doctor, professor of complementary medicine and former homeopath, Professor Edzard Ernst. Trick or Treatment provides a fair, thorough and scientifically credible assessment of alternative medicines, explained in layman’s terms. I flick through the chapter on homeopathy as my colleagues pass out flyers and converse with passers-by.

I have a giggle at a skeptical verse written by Episcopalian Bishop William Croswell Doane (1832-1913), who described the homeopathic method thus:

Stir the mixture well

Lest it prove inferior,

Then put half a drop

Into Lake Superior.

Every other day

Take a drop in water,

You’ll be better soon

Or at least you oughter.

It reminds me of Tim Minchin’s beat poem, Storm, written more than a century later:

Science adjusts its beliefs based on what’s observed
Faith is the denial of observation so that Belief can be preserved.
If you show me
That, say, homeopathy works,
Then I will change my mind
I’ll spin on a fucking dime
I’ll be embarrassed as hell,
But I will run through the streets yelling,
“It’s a miracle! Take physics and bin it!
Water has memory!”
And while its memory of a long lost drop of onion juice is Infinite
It somehow forgets all the poo it’s had in it!

While homeopaths continue to claim credibility for their profession, Singh and Ernst’s careful review of the scientific literature concludes that “there is a mountain of evidence to suggest that homeopathic remedies simply do not work.” Unfortunately, this message is not widely disseminated to the general public. It doesn’t help, either, that pharmacies stock homeopathic products on their shelves, and that the description of homeopathy on the Queensland Health Department website provides no warning that it’s been proven completely ineffective (beyond placebo).

And, as I hand out flyers in the shimmering heat of a Brisbane summer’s morning, I find that, no matter what the facts are, there are people, like the late Penelope Dingle, who simply don’t want their illusions shattered.

“Good morning!” I chirp to a well-dressed, middle-aged lady, making her way towards the Queen Street Mall, “We’re having a homeopathy awareness day, would you like a flyer?”

She stops in her tracks and gives me a huge smile, “Oh, I already know all about homeopathy!” she beams.

“Do you know it doesn’t work?” I ask.

Her face darkens and she thrusts my hand aside.

“I don’t want to know about that!” she thunders.

I get the feeling I’ve just ruined her day.

As I return to the rickety little card table which is our only prop, apart from our flyers, water-bottles and homeopathic pills and potions, I notice that Jayson is deep in discussion with a casually dressed couple in their early fifties. I catch pieces of the conversation: “… the science is indisputable ... it simply doesn’t work …”

But the woman’s body language shows she’s simply not buying the argument. I edge closer to hear how this conversation will pan out. Unable to counter Jayson’s quiet, but insistent recitation of facts, the woman finally hisses loudly, “You just won’t understand. You’re all being paid by Big Pharma!”

I see Jayson’s jaw drop but he counters beautifully.

“Ma’am, if we were financed by Big Pharma, don’t you think we’d have a better table?”