MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

The authors of this review aimed to present an overview of the literature on physicochemical research performed on homeopathic preparations with respect to publication quality and methods used. They searched major scientific databases to find relevant publications from its origin to the end of 2015. Publications were assessed using a scoring scheme, the Manuscript Information Score (MIS). Information regarding country of origin of the research and experimental techniques used was extracted.

The authors identified 183 publications. The rate of publication in the field was 2 per year from the 1970s until 2000. Afterward, it increased to over 5.5 publications per year. The quality of publications was seen to increase sharply from 2000 onward: before 2000, only 12 (13%) publications were rated as ‘‘high quality’’ (MIS ‡7.5); 44 (48%) publications were rated as ‘‘high quality’’ after 2000.

Countries with most publications were Germany (n=42, 23%), France (n=29, 16%), India (n=27, 15%), and Italy (n=26, 14%). Techniques most frequently used were electrical impedance (26%), analytical methods (20%), spectroscopy (20%), and nuclear magnetic resonance (19%).

The authors concluded that physicochemical research into homeopathic preparations is increasing both in terms of quantity and quality of the publications.

They also announce that there will be a further paper on the subject: In part 2, we aim to identify the most interesting experimental techniques. With this, we aim to be in a position to generate meaningful hypotheses regarding a possible mode of action of homeopathic preparations.

It might be relevant to ask who the authors are and where they come from. They are Klein SD, Würtenberger S, Wolf U, Baumgartner S, and Tournier A. And their affiliations are:

  • Institute of Complementary Medicine, University of Bern, Switzerland.
  • Scientific & Regulatory Affairs, Hevert-Arzneimittel GmbH & Co. KG, Germany.
  • Society for Cancer Research, Arlesheim, Switzerland.
  • Institute of Integrative Medicine, University of Witten/Herdecke, Germany.
  • Homeopathy Research Institute (HRI), London, United Kingdom.

In other words, they are without exception proponents of homeopathy, some burdened with considerable conflicts of interest in the subject. Personally, I think it unlikely that anything meaningful will ever come of this research. But unsurprisingly, the enthusiasts beg to differ: on facebook, the HRI claimed that this new systematic review is a major step towards developing clear and testable hypotheses regarding the mode of action of homeopathy.

In a previous blog-post I have tried to explain my reservations in some detail; please allow me to repeat them here:

… homeopaths have been keen to find more rational support for their theories. Thus they have developed several ‘sciency’ concepts to explain the mode of action of their highly diluted homeopathic remedies. For instance they postulated that water can form secondary structures that hold some information of the original substance (stock), even if it has long been diluted out of the remedy. Alternatively, they claimed that the shaking of the remedy generates nano-particles or silicone-particles which, in turn, are the cause of the clinical effects.

Today, I want to assume for a minute, that one of these theories is correct – they cannot all be right, of course. Homeopaths regularly show us investigations that seem to support them, even though it only needs a real expert in the particular field of science to cast serious doubt on them. I will nevertheless assume that, after potentisation, the diluent retains information via nano-particles or some other phenomenon. For the purpose of this mind-experiment, I grant homeopaths that, in this respect, they are correct. In other words, let’s for a moment assume that the ‘memory of water’ theory is correct.

As I have been more than generous, I want homeopaths to return the favour and consider what this would really mean: information has been transferred from the stock to the diluent. Does that prove anything? Does it show that homeopathy is valid?

Could the homeopaths who make this assumption be equally generous and answer the following questions, please?

  1. How does a nano-particle of coffee, for instance, affect the sleep centre in the brain to make the patient sleep? Or how does a nano-particle of the Berlin Wall or a duck liver affect anything at all in the human body? The claim that information has been retained by the diluent is no where near to an explanation of a rational mode of action, isn’t it?
  2. Most homeopathic remedies are consumed not as liquids but as ‘globuli’, i. e.  tiny little pills made of lactose. They are prepared by dropping the liquid remedy on to them. The liquid subsequently evaporates. How is it that the information retained in the liquid does not evaporate with the diluent?
  3. The diluent usually is a water-alcohol mixture which inevitably contains impurities. In fact, a liquid C12 remedy most certainly contains dimensions more impurities than stock. These impurities have, of course, also been vigorously shaken, i. e. potentised. How can we explain that their ‘potency’ has not been beefed up at each dilution step? Would this not necessitate a process where only some molecules in the diluent are agitated, while all the rest remain absolutely still? How can we explain this fantastic concept?
  4. Some stock used in homeopathy is insoluble (for instance Berlin Wall). Such stock is not diluted but its concentration in the remedy is initially lowered by a process called ‘trituration’, a process which consists in grinding the source material in another solid material, usually lactose. I have granted you that potentisation works in the way you think. But how is information transferred from one solid material to another?
  5. Everything we drink is based on water containing molecules that have been inadvertently potentised in nature a million times and therefore should have hugely powerful effects on our bodies. How is it that we experience none of these effects each time we drink?

Now, homeopaths, let me propose a deal.

If you can answer these questions satisfactorily, I will no longer doubt your memory of water theory. If you cannot do this, I think you ought to admit that all your ‘sciency’ theories about the mode of action of highly diluted homeopathic remedies are really quite silly – more silly even than Hahnemann’s idea of a ‘spirit-like’ effect.

HELLO HOMEOPATHS OF THIS WORLD…

SO FAR NOBODY HAS TAKEN UP MY OFFER.

BUT IT STILL STANDS!

HOW ABOUT IT?

27 Responses to My challenge to the homeopaths of this world

  • Good luck with that.
    But James Randi has offered quite a lot of money, which to date he hasn’t been required to pay out. You’ll have seen some of the funnier ‘mind control’ demonstrations on YouTube, including the silly hillbilly who claimed he could turn the pages of a telephone directory with his thoughts, or read his “Flim- Flam’ book in which he exposes the young woman who did card tricks, thinking that the camera in front of her was the one that was filming her ( it wasn’t- another one to the side was, and picked up the cheating), or the young woman who could read the newspaper while blindfolded ( she couldn’t).
    I love the howl of outrage from a relative in the latter case (‘For pity’s sake, Mr Randi. Don’t you believe in Gaaad?’

  • A case that is well made deserves an answer, and this argument by Dr. Ernst is well made. I hope that it will be answered by those to whom he has addressed it to.

    • I hope so too, but I am not holding my breath – otherwise I would be dead, as the original post is almost 2 years old.

      • Edzard

        “…. but I am not holding my breath – otherwise I would be dead..”

        Holding breath to die is the most difficult activity. Almost impossible.

        But there are many other ways to die: shamed to death is one prominent method where you would like to die because of your deeds being exposed and being pulled off the pedestal, but cannot. Or dying from indigestion when made to eat all the wrong words written over time.

        The Hindu philosophy of life is very clear: you can die only after you have paid for the sins committed by you. Long years is not considered a boon.

        So while you are not dead, you can provide expert opinion on, as to how the alternative medicine got together to develop the opioid and hand it over to the scientific medicine to find ways to kill some more patients:

        “Every day, more than 115 Americans die after overdosing on opioids. The misuse of and addiction to opioids—including prescription pain relievers, heroin, and synthetic opioids such as fentanyl—is a serious national crisis that affects public health as well as social and economic welfare. The Centers for Disease Control and Prevention estimates that the total “economic burden” of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.
        How did this happen?

        In the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers, and healthcare providers began to prescribe them at greater rates. This subsequently led to widespread diversion and misuse of these medications before it became clear that these medications could indeed be highly addictive. Opioid overdose rates began to increase. In 2015, more than 33,000 Americans died as a result of an opioid overdose, including prescription opioids, heroin, and illicitly manufactured fentanyl, a powerful synthetic opioid.1 That same year, an estimated 2 million people in the United States suffered from substance use disorders related to prescription opioid pain relievers, and 591,000 suffered from a heroin use disorder (not mutually exclusive). Here is what we know about the opioid crisis:

        Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.
        Between 8 and 12 percent develop an opioid use disorder.
        An estimated 4 to 6 percent who misuse prescription opioids transition to heroin.
        About 80 percent of people who use heroin first misused prescription opioids.

        This issue has become a public health crisis with devastating consequences including increases in opioid misuse and related overdoses, as well as the rising incidence of neonatal abstinence syndrome due to opioid use and misuse during pregnancy. The increase in injection drug use has also contributed to the spread of infectious diseases including HIV and hepatitis C. As seen throughout the history of medicine, science can be an important part of the solution in resolving such a public health crisis.
        https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis

        This is from the Mecca of Science Based Medicine. Anyone found wanting?

        • Anyone found wanting?

          Yes, alternative medicine is found wanting. It needs to implement a system of ethics and educational courses in reality.

          I am beginning to get a grasp of the mechanics of your uncritical faculties, fellow Iqbal. You excel in abstract art, which is clearly evident in all your comments. Random bits and pieces, cut and pasted together, in a thread that usually has nothing to do with them. Because homeopathy is the culmination of abstract art in medicine, or abstract medicine for short, you seem to have incorporated abstract art in your way of thinking in general. “The alternative medicine” is a deity in your wild imagination, and it provided tools to science, such as the opioid. Your alternative reality would make an interesting fiction novel, fellow Iqbal.

          The Hindu philosophy of life is very clear: you can die only after you have paid for the sins committed by you. Long years is not considered a boon.

          I am sorry to ruin that too for you Iqbal, the Hindu philosophy is very clear and very irrelevant to reality. The sins you commit almost never have a direct connection to your life expectancy. If you are looking for indirect connections, well, pretty much everything has an indirect connection to your life expectancy. By such standards, any philosophy can be taken as valid. However, I see you want this Hindu statement quite badly to be the exact case. Well, good luck wishing!

          Oh, and, by the way, you posted in the wrong thread. This is about homeopathy. Look for one about opioids.

          • James

            My message was addressed to Edzard who supposedly has a PhD. Hopefully he would have understood the philosophy part.

            Philosophy is very different to Scientific medicine and cannot be understood on face value. Scientific medicine is paying the price for such stupidity.

            “I am sorry to ruin that too for you Iqbal, the Hindu philosophy is very clear and very irrelevant to reality.”

            Which 6 hours are longer: celebrating a promotion in a pub or waiting for your child, lying on the ICU bed, to open his eyes? How long life would you want if it was full of incidences of the second type?

            This should explain to you the long life meaning of Hindu philosophy.

          • How about waiting for your child lying on your home bed for 6 hours to open its eyes? Different bed, same situation. Only, on the ICU bed, the child has much higher chance to open its eyes in the end.

            Well, I am sorry you were born a couple millennia too late, fellow Iqbal. What you adopt from then, you cannot judge today with. This is contemporary philosophy.

        • @Iqbal:
          Grasshopper: “man with shit for brains often speaks with foul breath”.
          In 1900 (according to the History channel docu on drug use) 10% of the New York populous was addicted to morphine/heroin…about the same as today. I believe the “Chinese” and enterprising underworld entrepreneurs could take the blame in 1900, but I think ‘Big Pharma’ is not in the running.
          Do we get to blame “Big liquor” for drunk driving deaths, cirrhosis and pancreatitis?
          Perhaps we should put the blame for all of it where it belongs…..on religion and ineffectual ancient-pre-scientific “medicine, for had either of them worked or had any inherent value we wouldn’t be in the dilemma we now find ourselves?

          • Michael Kenny

            “I believe the “Chinese” and enterprising underworld entrepreneurs could take the blame in 1900, but I think ‘Big Pharma’ is not in the running.”

            I thought it was Columbia. But the message was little different:

            “In the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers, and health care providers began to prescribe them at greater rates.
            This subsequently led to widespread diversion and misuse of these medications before it became clear that these medications could indeed be highly addictive. Opioid overdose rates began to increase. In 2015, more than 33,000 Americans died as a result of an opioid overdose, including prescription opioids, heroin, and illicitly manufactured fentanyl, a powerful synthetic opioid.
            That same year, an estimated 2 million people in the United States suffered from substance use disorders related to prescription opioid pain relievers, and 591,000 suffered from a heroin use disorder (not mutually exclusive).”

            Either the doctors writing out prescriptions or the pharma companies producing opioid are to blame, or your argument runs along the lines of tobacco industry: people should exercise choices!!!!!

            Are these numbers above, large enough for Edzard to raise a red flag or one death in India from Epsom salt, that happens once in 12 years, is more important to be brought to notice of the medical world?

          • Turd upon turd, you never cease to amaze me, fellow Iqbal.

            Either the doctors writing out prescriptions or the pharma companies producing opioid are to blame, or your argument runs along the lines of tobacco industry: people should exercise choices!!!!!

            …or no real-world treatment is free from side effects of course. You surely have the expertise and the ability to make a valid concern look funny.

            With opioids out of the way, I assume you would treat acute pain with your toy medicine, right? Darn, it costs a lot! Well, it should, since it has the verified potential to save lives. On the other hand, it is much more versatile than it looks.

            Look, Iqbal…people are converting fast.

  • “The HRI claimed that this new systematic review is a major step towards developing clear and testable hypotheses regarding the mode of action of homeopathy.”

    Given homeopathic remedies have not, ever, been shown to have any ‘mode of action’ (aside from acting as placebo response inducers and thus improving homeopaths ability to satisfy their patients) – the basic premise falls – and any research into ‘mode of action’ is more of a waste of time, trouble and money than researching how many angels can sit on the head of a pin.

    We really must move on. Please.

  • A most valuable post. A lot of the criticism of homeopathy focuses on the ludicrous notion of ‘potentizing’ substances by extreme dilution accompanied by ‘succussion’, but I, too, have often wondered what is supposed to happen after a homeopathic tablet is ingested.

    For measurable molecules, we can easily determine ADME properties (absorption, distribution, metabolism, excretion) and PK/PD (pharmacokinetics/pharmacodynamics), but how do you do this for solvent memories? (BTW it can’t just be water that remembers a mother tincture: ethanol is also used and, as pointed out in the OP, the fluid is commonly transferred to a lactose tablet, which must therefore also retain the memory.) I personally find the ‘research’ demonstrating ‘nano-particles’ to be abysmally poor and hilariously mistaken, but suppose it’s correct: are the nano-particles excreted in the urine or the faeces? How long after they’re ingested do the memories or ‘nano-particles’ (let’s call them memoparticles for short) take to reach peak plasma levels? What is their half-life?

    Do the memoparticles cross the blood-brain barrier? Do they induce any liver enzymes? Are they metabolized to breakdown products that retain memories or altered particulate properties (e.g. pico-particles)?

    Let’s face it, the questions raised in the original post are not going to get any serious responses because, among all the varieties of toytown pseudo-medicines, homeopathy remains the most blatantly absurd. Its two basic principles (like cures like and potentizing by dilution) defy all known science, are unsupported by any evidence, and raise far more questions than the feeble explanations offered by believers can ever possibly answer.

    • An amazingly succinct, thoughtful and profound response! That puts about the finest point on the dubious (non) arguments any Homeopathetic could raise. But of course religions recoil from logic and questioning, and thus your words will fall on deaf ears (so perhaps a Chiropractic adjustment may be the answer?).

    • Actually, I think it remains of no interest to wonder if and how this type of sympathetic magic functions. The true question is how it can be possible for reasonable people that are also scientists with experience in biology, physics etc. to occasionally come to embrace this illusion and take a full-fledged jump into wonderland. Until one “asks around”, it does not become clear that they are virtually “all around”. I was left speechless when I realized what was going on “around”. This thing is contagious…

      • “The true question is how it can be possible for reasonable people that are also scientists with experience in biology, physics etc. to occasionally come to embrace this illusion and take a full-fledged jump into wonderland.” Quite. And maybe by asking in full-frontal detail exactly how this nonsense is ever expected to work one might get through to such ‘reasonable people’.

  • I hoped that someone would help Edzard by answering some of his questions. Seeing that no one wants to face the usual barrage of IDIOTIC, DIM WIT ETC! response from ‘Edzard’, I will answer one of his questions.

    Dr Rawlins is a magician and understands that the audience is enthralled only because they don’t know the trick. It is similar with homeopathy, those that have had the ‘conversion experience’ (‘initiation’) receive a new understanding that the un-initiated do not have. Trying to explain homeopathy to the uninitiated is like trying to explain difficult maths to those that have difficulty understanding maths albeit that they may be bright in other subjects.

    I selected this question because it is something that even Professor Dawkins has provided great entertainment in trying to criticize. https://www.youtube.com/watch?v=eN6U6cpGzss
    He makes the point that homeopathic remedies are mixtures equivalent to one drop in the ocean, when in fact high potencies are made with 1 drop and less than two litres of soluent.

    If I make a Rum and Coke: 300ml Coke and 50 ml Rum, it will be a strong drink. I drink it and get down to the last 50 ml and realise that there is no Rum left so I add 300 ml of Coke. The soluent is neutral to the mixture as it is from the same bottle so the Coke stays Coke but the Rum is weakened by the dilution. Distilled water, ethanol and lactose in ‘potentisation’ remain at constant strength (impurities and all) while the ‘stock’ undergoes changes in potency through stages of ‘potentisation’.

    I know that you are going to say that eventually the Coke will completely dilute the Rum out of the vessel but maybe you won’t because you seem to have adjusted your viewpoint from total opposition, to conditional opposition to the theory of potentisation. ‘Well maybe something remains but so what.’ Same principle applies Edzard, you can’t understand point 3 so you can’t understand any of the other points either.

    As Dr Rawlins has been saying for sometime: just give up and move on

    • and which of my questions do you think you have answered?

      • I am not going to spoil the fun for anyone, you are the EXPERT:
        These impurities have, of course, also been vigorously shaken, i. e. potentised. How can we explain that their ‘potency’ has not been beefed up at each dilution step? Would this not necessitate a process where only some molecules in the diluent are agitated, while all the rest remain absolutely still? How can we explain this fantastic concept?

    • @Greg.

      Like Edzard, I’m not sure which question you think you’re answering, but you seem to have a very feeble grasp of dilution mathematics. ‘1 drop’ is an imprecise unit, but it was the equivalent of the old ‘minim’ (~0.06 mL) and its current metric volume is ~0.04 mL [https://en.wikipedia.org/wiki/Drop_(unit)], so let’s say 1 drop is ~0.05 mL (50 µL). So 1 drop in 2 L of solvent is a dilution of 40,000. That’s between 4X and 5X on a homeopathic scale.

      To make a 30C dilution with less than two litres of solvent (let’s be generous and round it up to 2 L) you’d need to measure an initial volume of 2 x 10^-57 mL, which simply can’t be done. There isn’t even an SI prefix smaller than ‘yotta-‘ (10^-24), so you’d need to invent a further eleven 1,000-fold step prefixes to accommodate this exquisitely tiny volume (I’d suggest the ‘grega-‘ for 10^–57). Starting with one drop you’d need 13 successive dilutions of one drop into 2 L solvent, so that’s 26 L in total. One drop diluted to homeopathic 30C in a single step would require 5 x 10^58 L of solvent. The volume of water on the planet is estimated at around 1.4 x 10^21 L [https://water.usgs.gov/edu/earthhowmuch.html] so Richard Dawkins’s video is entirely vindicated.

      Your rum and coke example is equally dumb. Adding 300 mL of coke to 50 mL of rum is a 7-fold dilution. You’d need to repeat the process 70 times to get a homeopathic 30C dilution of the rum!

      You said: “Trying to explain homeopathy to the uninitiated is like trying to explain difficult maths to those that have difficulty understanding maths albeit that they may be bright in other subjects.” I think you meant: “Trying to explain homeopathic dilutions when you haven’t the vaguest grasp of even simple maths is likely to reveal just how deeply ignorant supporters of homeopathy really are.”

    • PS. You can indeed make 30C from much less than 2 litres of solvent with successive dilution steps, starting from one drop (0.05 mL) and successively adding 5 mL 30 times, which is probably what you meant, but that’s only 150 mL — much less than 2 litres! Nothing alters the fact that that’s the equivalent of 1 drop in ~5 x 10^58 mL, which is substantially more than the volume of water on the planet.

  • Wowza!! And the score so far:
    Frank: 100,000,000,000,000,000,000,000,000,000,
    Greg: -1.
    So sad when you’re bad at math AND all the other subjects as well. 🙁

    • GMH at Homeopathy of Hahnemann knows the answer:
      ‘The Dawkins idea of one drop of a substance diluted in the ocean contrasted with the homeopathic method of 30 serial dilutions shows that these are completely different conceptions. The contact volume of 1 drop in the ocean is vastly different from the contact volume in the process of producing a 30 CH potency as a mere 150ml of liquid is used in the homeopathic preparation of the 30th potency, compared to the trillions of litres in the oceans in the ‘Dawkins explanation’.

      • Wow! I replicated Hahnemann’s calculation (1 drop + 150 mL total diluent provides a 30C solution) from scratch on my pocket calculator.

        Now, Greg, please explain exactly what ‘contact volume’ means, and how summing 30, 100-fold sequential dilutions of one drop plus 5 mL differs in total ‘contact volume’ from one drop plus 5 x 10^58 mL. It may seem obvious to you, but dilution is dilution and I clearly need to be educated.

        While you’re still in the mood for rational discussion, please go on to answer the following questions.

        1) The smallest volume that can be accurately manipulated with a micropipette is 0.1 µL. What total volume of diluent would be needed to make a 30CH preparation from 0.1 µL with successive 100-fold dilutions?

        2) How would the ‘contact volume’ compare with sequential 100-fold dilutions from one drop?

        3) How does succussion affect ‘contact volume’?

        4) From homeopathic principles, how hard should a container with 5 mL volumes be banged against a leather-bound book and with what force and frequency?

        5) Is the answer to 4 the same for the 0.1 µL situation? What size container should be used?

      • Sorry: question 4 should have read “From homeopathic principles, how hard should a container with 5 mL volumes be banged against a leather-bound book and with what frequency?”

      • This “contact volume” of 1 drop in the ocean is almost the same as that of the final quantity of ingredient in the last 5 mL of liquid after having used a total of only 150 mL of liquid. There is no vast difference, almost no difference at all actually, unlike the lies in the GMH statement. The final quantity of ingredient in 5 mL (of 30 CH) is so vastly small that if we had to magnify it enough to make it look like a drop, the 5 mL would look like trillions of litres of liquid. This is an analogy, and it is wrong that homeopaths make arguments by interpreting it literally. Nobody said so much liquid exists in the first place. However, even this magnification analogy makes a wrong comparison….

        …you see, this Dawkins argument, though extremely enlightening, is incorrect. Unfortunately, reality is even more harsh! Taking into account the finite divisibility of matter, a 30C dilution of anything, ending up with 5 mL of liquid (after using only 150 mL of liquid), contains precisely no ingredient. It ceases to exist from some point on (see Avogadro). Therefore, 1 drop of ingredient in multiple trillions of trillions of litres of liquid is actually infinitely more than what is contained in 5 mL of some 30C dilution that was made using “only” 150 mL.

        Therefore, one drop diluted in the ocean and 30 serial dilutions are indeed different conceptions…as per the GMH statement. The result of the 30 serial dilutions is guaranteed to contain nothing, whereas the ocean will still contain 1 drop of the initial ingredient, which, compared to nothing…is, frankly, quite a lot! Now, why homeopaths think this argument is in their favor, when it actually is totally against them, is a mystery…

Leave a Reply

Your email address will not be published. Required fields are marked *

Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted.


Click here for a comprehensive list of recent comments.

Categories