Trick or Treatment (17 page)

Figure 4
John Snow’s map of cholera deaths in Soho, 1854. Each black oblong represents one death, and the Broad Street pump can be seen at the centre of the epidemic.

Other major scientific breakthroughs included vaccination, which had been growing in popularity since the start of the 1800s, and Joseph Lister’s pioneering use of antiseptics in 1865. Thereafter Louis Pasteur invented vaccines for rabies and anthrax, thus contributing to the development of the germ theory of disease. Even more importantly, Robert Koch and his pupils identified the bacteria responsible for cholera, tuberculosis, diphtheria, typhoid, pneumonia, gonorrhoea, leprosy, bubonic plague, tetanus and syphilis. Koch deservedly received the 1905 Nobel Prize for Medicine for these discoveries.

Without any comparable achievements attributed to homeopathy, and without any rigorous evidence or scientific rationale to support it, the use of these ultra-dilute homeopathic remedies continued to decline into the twentieth century in both Europe and America. For example, American homeopathy was dealt a severe blow in 1910 when the Carnegie Foundation asked Abraham Flexner to investigate ways of establishing higher standards for the admission, teaching and graduation of medical students. One of the key recommendations of the Flexner Report was that medical schools should offer a curriculum based on mainstream conventional practice, which effectively ended the teaching of homeopathy in major hospitals.

Homeopathy continued its steady decline, and by the 1920s it seemed that it was destined to become extinct around the world. Then, in 1925, there was a sudden and unexpected revival in Germany, the country where homeopathy had been invented. The man behind the resurgence was an eminent surgeon called August Bier, who used the homeopathic principle of ‘like cures like’ to treat bronchitis with ether and to cure boils with sulphur. His patients responded well, so he wrote up his findings in a German medical journal. This was the only paper on the subject of homeopathy to be published in Germany in 1925, but it triggered forty-five papers discussing homeopathy the following year, and over the next decade there was a renewed enthusiasm for the potential of ultra-dilute medicines.

This was a timely development for the Third Reich, whose leaders sought to develop the
Neue Deutsche Heilkunde
(the New German Medicine), an innovative medical system that would combine the best of both modern and traditional medicine. The first hospital to implement fully the
Neue Deutsche Heilkunde
was founded in Dresden in 1934 and was named after Rudolf Hess, who was Hitler’s deputy at the time. Hess was strongly in favour of incorporating homeopathy within the
Neue Deutsche Heilkunde
, partly because he believed it to be highly effective, and partly because it had been invented by a German. Furthermore, he viewed homeopathic remedies, most of which were cheap to manufacture, as a low-cost solution to meeting the needs of German healthcare.

Meanwhile, the German Ministry of Health was keen to test whether or not homeopathy was genuinely effective. The Third Reich’s chief medical officer, Dr Gerhard Wagner, instigated an unprecedented programme of research, which involved sixty universities and cost hundreds of millions of Reichsmarks. The research effort started immediately after the 1937 Homeopathic World Congress in Berlin and it continued for the next two years, with a particular focus on treating tuberculosis, anaemia and gonorrhoea. The team behind the homeopathy research project included pharmacologists, toxicologists and, of course, homeopaths, who together designed a series of detailed trials and then implemented them rigorously. It is worth noting that those involved in the trials were among the most respected people in their fields, and they maintained the highest ethical and scientific standards in their research.

The results were about to be announced in 1939, but the outbreak of the Second World War prevented publication. The original documents survived the war and were discussed again when the senior researchers reconvened in 1947, but unfortunately their conclusions were never formally announced. Worse still, the documents have never been seen again. It seems that the results of the first comprehensive study of homeopathy have been concealed, lost or destroyed.

Nevertheless, there exists one very detailed account of the Nazi research programme, which was written by Dr Fritz Donner and published post humously in 1995. Donner had joined the Stuttgart Homeopathic Hospital in the mid-1930s and had contributed to the national research programme in his capacity as a practising homeopath. According to Donner, who claims to have seen all the relevant documents, none of the trials gave any indication in favour of the efficacy of homeopathy: ‘It is unfortunately still not generally known that these comparative studies in the area of infectious diseases such as scarlet fever, measles, whooping cough, typhus etc generated results which were not better for homeopathy than for placebo.’ He also added: ‘Nothing positive emerged from these tests…except the fact that it was indisputably established that the views [of homeopaths] were based on wishful thinking.’

If Donner was correct, then his statement would be a damning indictment of homeopathy. The first comprehensive and rigorous programme to test the claims of homeopathy, conducted by researchers who were sympathetic to the philosophy and who were to some extent under pressure to prove its validity, had arrived at a wholly negative conclusion. Of course, we cannot be sure that Donner’s report was accurate, as the vital documents have never resurfaced. It would, therefore, be wrong to condemn homeopathy based on the testimony of one man’s view of research conducted seventy years ago. But even if we ignore the supposed negative results of the Nazi research programme, it is still interesting to note that between Hahnemann’s initial research and the end of the Second World War, a period of some one and a half centuries, nobody succeeded in publishing any conclusive scientific evidence to support the notion of homeopathy.

Nature’s miracle

After the Second World War, mainstream medicine in America and Europe continued its relentless progress, thanks to further important scientific breakthroughs such as antibiotics. Meanwhile the homeopathic tradition was managing to survive only with the patronage of some powerful and sympathetic supporters. For example, George VI was a fervent believer, so much so that he even named one of his horses Hypericum, after the homeopathic remedy based on St John’s wort; the horse went on to win the One Thousand Guineas at Newmarket in 1946. Two years later, King George played an influential role in enabling homeopathic hospitals to come under the umbrella of the newly formed National Health Service.

In America, it was the influence of men like Senator Royal Copeland that allowed homeopathy to survive despite the general trend away from Hahnemann’s philosophy and towards the use of treatments with a more scientific and reliable foundation. Both a homeopath and a politician, Copeland successfully persuaded his colleagues that the 1938 Federal Food, Drug, and Cosmetic Act should include the Homeopathic Pharmacopeia of the United States. The Act was supposed to protect patients from unproven or disproven remedies, and yet the claims of homeopathy were still based merely on anecdote and Hahnemann’s preaching. So, by including the entire homeopathic catalogue, the Act was giving undue credence to remedies that had no scientific basis.

In India, homeopathy was not only surviving, but it was actually thriving at every level of society, and this success had nothing to do with political manoeuvring or royal patronage. Homeopathy had been introduced there in 1829 by Dr Martin Honigberger, a Transylvanian physician who joined the court of Maharajah Ranjit Singh in Lahore. The idea then spread rapidly throughout India, prospering largely because it was perceived as being in opposition to the imperialist medicine practised by the British invaders. Attitudes towards British medicine were so negative, in fact, that vaccination programmes and attempts to quarantine plague casualties both failed dismally in the mid-nineteenth century.

Moreover, Indians who wanted to pursue a career in conventional medicine often encountered prejudice when they attempted to join the Indian Medical Service, so a more realistic (and cheaper) career option was to train to be a homeopathic practitioner. It was also felt that homeopathy and the Hindu Ayurvedic system of medicine could work together in harmony, and there were even rumours that Hahnemann himself had studied traditional Indian medicine.

As the decades passed, tens of millions of Indians grew to rely solely on homeopathy for their healthcare. And, having imported homeopathy from the West, India then exported it back to the West in the 1970s. At a time when Western patients were looking to the East for alternative systems of medicine – such as acupuncture and Ayurvedic therapies – they also began to embrace homeopathy once again. It was considered by many Westerners to be an exotic, natural, holistic and individualized form of medicine, and an antidote to the corporate medicine being peddled by giant pharmaceutical corporations in Europe and America.

Meanwhile, Western scientists continued to scoff. There were a few scientific trials examining the benefits of homeopathy in the 1950s, 1960s and 1970s, but they were so flimsy that the results were unreliable. In short, there was still no sound evidence to support the idea that such ultra-dilute solutions could act as meaningful medicines. Therefore scientists still considered it absurd that any medical system could be built upon this principle.

Scientists even began to poke fun at homeopaths. For example, because homeopathic liquid remedies are so dilute that they often contain only water, scientists would sarcastically endorse their use for the treatment of one particular medical condition, namely dehydration. Or they would jokingly offer to make each other a drink of homeopathic coffee, which was presumably incredibly diluted and yet tasted incredibly strong, because homeopaths believe that lower amounts of active ingredient are associated with greater potency. Similar logic also implied that a patient who forgot to take a homeopathic remedy might die of an overdose.

Homeopaths accepted that repeated dilution inevitably removes the presence of the active ingredient, and sure enough chemical analysis has always confirmed that ‘high-potency’ homeopathic remedies are based on nothing more than pure water. Homeopaths were adamant, however, that this water was special because it had a memory of the active ingredient that it once contained. This caused the Australian Council Against Health Fraud to make fun of homeopathy by pointing out that this memory must be highly selective: ‘Strangely, the water offered as treatment does not remember the bladders it has been stored in, or the chemicals that may have come into contact with its molecules, or the other contents of the sewers it may have been in, or the cosmic radiation which has blasted through it.’

Then, in June 1988, the laughing suddenly stopped.
Nature
, arguably the most respected science journal in the world, published a research paper with the snappy title ‘Human basophil degranulation triggered by very dilute antiserum against IgE’. It took a little deciphering before non-specialists could appreciate the significance of the paper, but very rapidly it became clear that here was a piece of research that seemed to back up some of the claims of homeopaths. If the paper was correct, then ultra-dilute solutions that did not contain any active ingredient did indeed have an impact on biological systems. This could only be possible if the ingredient had left a memory of itself in the water. In turn, such a discovery would imply that homeopaths might have been right all along.

This piece of research, which has become the most famous experiment in the history of homeopathy, was conducted by a charismatic French scientist named Jacques Benveniste, a former racing driver who had taken up medical research after suffering a back injury. Although he published several important scientific papers on a variety of subjects during the course of his career, he would ultimately be remembered only for his
Nature
paper on homeopathy, which shocked the scientific establishment and made headlines around the world.

Benveniste’s controversial paper had surprisingly humble beginnings. The research began when one of his colleagues was looking at how
basophils
, a type of white blood cell, reacted to a particular allergen. This is akin to the allergic reaction that might be experienced when pollen hits the eye, but on a much smaller scale. Benveniste’s chosen allergen was supposed to be only mildly diluted, but the technician accidentally created a solution so dilute that it was devoid of the allergen. Nevertheless, the technician was stunned to find that the solution still had a significant impact on the basophils. Benveniste was equally astonished, so he asked for the unplanned ultra-dilution experiment to be repeated. Again, the basophils seemed to react to an allergen that was no longer in the solution. Benveniste was not aware of homeopathy at the time, but it was not long before someone pointed out that his experiments were demonstrating the sorts of effects that homeopaths had been championing for two centuries. The results implied that water had some kind of memory of what it had previously contained, and that this memory could have a biological impact. It was such a weird conclusion that Benveniste later commented, ‘It was like shaking your car keys in the Seine at Paris and then discovering that water taken from the mouth of the river would start your car!’