To start, I would like to agree with the pair that indeed homeopathy is very successful. As a set of ideas, they have been around for about 200 years. Many thousands of people practice homeopathy based on the principles described by Lia and Stephanie. And undoubtedy, there are millions of people that believe homeopathy has helped them with illness.
Furthermore, there is significant money to be made from homeopathy. The largest homeopathic pharmaceutical company in the world is the French-based Boiron with a annual turnover exceeding half a billion Euros. The British homeopathic company Ainsworths, discussed in the article, is smaller. Nonetheless, it holds Royal Warrants from the Queen and Prince Charles. These are indeed successful businesses.
But it is clear that Lia and Stephanie do not want us to believe that homeopathy is successful just because of its longevity and financial success. They want us to believe homeopathy is successful because its ideas are true and that it is effective.
Before we explore that, it is worth stating what ought to be obvious: throughout the history of medicine, many people have held incorrect medical beliefs that have persisted for a very long time. Persistence of a belief by countless people is not an argument for effectiveness. For example, bloodletting was a practice that was widely used for about 2,000 years right up into the 19th Century. And yet, throughout that time, it was certainly mostly ineffective and quite probably doing a lot of harm. It is quite probable that bloodletting was the cause of George Washington’s death. Nonetheless, amongst mainstream medical practitioners, this technique was seen as a something of a panacea, with text books claiming cures for everything from acne to cancer and leprosy.
But why should this be so? Why is it that people find it so hard to tell if a therapy is effective or not?
In 1850, about the time that bloodletting was dying out, the American doctor Worthington Hooker was considering why people believe treatments to be effective when they are not. His book, Lessons from the History of Medical Delusions is still very much relevant today.
Hooker realised that the history of medicine was a “succession of error, standing out in bold prominence, each one having, as it rose to its ascendancy, supplanted some error that preceded it.” He believed that if medicine was to move from sequential delusions towards effective truth, then we should not just look at why each successive medical theory was wrong, but to come up with general reasons why doctors and their patients continually make mistakes about what is effective and what is not.
The first and most important source of error was “the too ready disposition to consider whatever follows a cause as being a result of that cause”.
That is, just because people report improved symptoms after a treatment does not mean that the treatment is effective. We all know that for many common ailments our bodies are quite capable of healing and recovery. We may suffer from hay fever, a bad back, an infection or an injury. We do get better. Our bodies are good at this. Just because we have taken a herbal remedy, been to a chiropractor, or taken some homeopathic arnica does not mean our actions were effective. We may have recovered without such intervention. Of course, people take different amounts of time to recover. It is impossible to predict just how long this bruise will last, or how quickly our cold will clear up. We may try successive cures until something works. Even if we have a chronic illness that might last for years, we know people have good days and bad days. People inevitably seek treatments when symptoms are at their worst. It is equally inevitable that we will subsequently have better days, even if our chosen treatment was ineffective. Jumping to conclusions, based on simple experiences of treatments, can quickly lead us to error. This point may appear trivial, and yet it is the foundation for belief in all superstitious and pseudo-scientific treatments.
And this is exactly the mistake that Stephanie Kramer appears to have made in her article.
Stephanie described how she had a painful eye. Her doctor informed her that she had adenoviral conjunctivitis and that she had to “fight this one out” and let nature take its course. She was obviously dissatisfied with this advice as it would take “approximately 4 weeks” and she was in some pain. The position Stephanie found herself in was ripe for exploitation by an ‘alternative medicine': unhappiness with mainstream advice and having a painful but self-limiting condition.
And so Stephanie visited a homeopath working at Ainsworths homeopathic pharmacy in London. After a long consultation, her homeopath gave her three homeopathic remedies based on bee venom, the herb euphrasia and sulphur. After five days, her symptoms began to subside and she felt that homeopathy had ‘trumped medicine’.
Are we to be convinced by this? Of course not. Four weeks is the upper end of how long this infection lasts. Symptoms typically improve after a week or two. And this is exactly what Stephanie experienced.
But somehow, this experience has had a powerful effect on Stephanie and that now “homeopathy will be a part of [her] life forever”.
Nonetheless, despite the weakness of this anecdote, it is still possible that homeopathy was effective and that Stephanie’s illness was reduced in severity. So, how do we know that homeopathy is a delusion? And why do people not spot the simple mistake they have made?
Let’s move onto Worthington Hooker’s second reason why people fall into medical delusions. The second error is to “adopt exclusive views and notions“, that is to see an idea as being the One True Theory of medicine.
Once someone has had an epiphany with homeopathy, as described by Stephanie, then it is an easy to start getting steeped in the esoteric knowledge possessed by homeopaths. This is an extremely alluring process, much like how cults suck people in, where you feel like you are becoming privileged to exclusive knowledge.
Homeopathy is based on a number of so-called ‘Laws’. The first, as described by Lia in the article, is the principle of ‘like-cures-like’. For example, because onions make you cry, then onions can treat symptoms of runny eyes, such as in hayfever. Because bee venom causes swelling, then bee venom can treat swelling, such as in Stephanie’s infected eye.
Homeopaths claim they have found the true laws of illness and health. And indeed, the founder of homeopathy, Samuel Hahnemnann, denounced mainstream doctors as actually harming patients by not following his ideas and instead applying ‘allopathic’ medicine. But of course, such a law is nonsense. We now know that disease and illness are caused by many factors including different infectious agents, genetic and environmental problems. The homeopathic belief that living bodies have a ‘vital force’ that when imbalanced causes ill health is a pre-scientific and superstitious notion.
And as our initiate moves deeper into the exclusive cult of homeopathy, they become ready for making another of Hooker’s errors: to run to extremes, and to believe things that are quite the opposite of what the mainstream believe. The second law of homeopathy is quite bizarre and is not discussed in Lia and Stephanie’s article. Instead they present an ‘acceptable’ but misleading version of it in stating that homeopathy uses “highly dilute substances” to treat illness. This is not strictly true. Instead, homeopaths are taught that they should use the ‘minimum dose’ of their medicine and that you should prepare those doses by sequential dilution and shaking of the original tincture. And that the more you dilute a substance, the greater is its ‘potency’. In practice, this means that homeopathic remedies are so dilute that no substance remains and that all you are given is sugar pills. So, Stephanie did not receive bee venom, euphrasia and sulphur, but three sets of sugar pills merely labeled with these names.
Such a notion of dilution resulting in larger effects is counter to our everyday understanding of the world. You do not make coffee stronger by diluting it. You do not get drunk on shandy. Because all homeopathic remedies are essentially identically inert pills, homeopaths are free to make remedies from any and all substances no matter how poisonous, harmless or daft. On Ainsworths sales site, you can buy remedies made from Asbestos, Positronium, Tyrannosaurus Rex, Brillo Pad and Twiglets. You are not told about such remedies on public blog posts because you are not in the cult and you are still freely thinking.
The philosopher Stephen Law describes in his book Believing Bullshit how people get trapped in cult like thinking. He describes it as getting sucked into an intellectual black hole. That is, once you pass a threshold of belief there is no way out for you. You are trained to think in certain constrained ways that prevent you seeing your own obvious errors. You are condemned to believe things that the outside world sees as absurd. Worthington Hooker anticipated one way you can get stuck in that hole in his next reason why medical delusions persist: the disposition to theorise instead of encountering the labour of strict observation.
Homeopaths do not allow their beliefs to be challenged by facts, instead the facts are twisted to fit into their theory. If a patient gets better, homeopathy works; if a patient gets worse, then that is a reaction to the remedy, and homeopathy works; if a patient stays the same then it is because you need to be patient with homeopathy, and homeopathy works. No outcome of a homeopathic encounter could challenge their belief in their theory. All narratives fit.
And as for me, I will be denounced conspiratorially as a shill for the pharmaceutical companies. I will be told I am closed minded and ignorant. I will be told to try homeopathy myself and not to try to shut down choice for others. I will be told how modern medicine kills thousands of people, apparently. Anything other than engage with the arguments that homeopathy is a delusion based on simple misunderstandings of cause and effect and of cult-like thinking.
And the harms? Well they are just sugar pills. But a wedge has now been driven between Stephanie and her doctor. She may have been given good medical advice about her conjunctivitis from her doctor, such as how to avoid infecting others. But instead she has fallen for the magical thinking of the homeopath. That did little harm this time – her condition cleared up on its own. But next time, with a more serious condition, who will she be listening to?