Experimental research in homœopathy — a critical review (Conclusion)

Report on the status of research on homœopathy with recommendations for future research

Medicine has its roots in the art of practice, but scientific validation is of increasing importance in the incorporation of new therapeutics. There have been a number of well-designed research studies on homœopathy, but much remains to be done toward understanding its modus operandi and its relationship to the healing process. An examination and understanding of homœopathy by contemporary science would undoubtedly lead to its wider acceptance and use. For a critical and comprehensive review of research on homœopathy, the reader is referred to Scofield's two-part reviews, 1,2 This report addresses results from the most experimentally promising and rigorous studies in the modern literature and addresses some areas of proposed investigation. It highlights important research areas that are cost-effective at three distinct levels from the fundamental to the applied: (1) the physics and chemistry of homœopathy preparations, (2) laboratory studies using homœpathic preparations on cells and organisms, and (3) clinical trials using homœopathic medicines.

Growth stimulation of dwarf peas (Pisum sativum L.) through homeopathic potencies of plant growth substances

BACKGROUND

Efficacy of higher homeopathic potencies is controversial. Universally accepted specific detection assays for homeopathic dilutions do not exist. Basic research has to develop a spectrum of standardized tools to investigate the mode of action and nature of homeopathic potencies.

OBJECTIVE

Can the shoot growth reaction of dwarf peas (gibberellin- deficient mutants) be regarded as evidence of treatment with homeopathic potencies of plant growth substances?

MATERIALS AND METHODS

Pea seed (Pisum sativum L. cv. Fruher Zwerg) is immersed for 24 hours in homeopathic potency or control solutions for soaking. Plants germinate and grow in a standard cultivation substrate under controlled environmental conditions. Shoot length is measured 14 days after planting.

RESULTS

A screening of homeopathic potencies (12x-30x) of four different plant growth substances revealed biological activity of certain potency levels of gibberellin and kinetin (p < 0.05). Growth stimulation through gibberellin 17x (5 x 10(-18 M)) was assessed in six independent replications; results confirmed those of the screening (p < 0.05). The effect of gibberellin 17x seemed to weaken during the course of the experiments.

CONCLUSION

The results back the hypothesis that homeopathic potencies of plant growth substances affect pea shoot growth. Dwarf peas might thus be an interesting system model for studying the action of homeopathic potencies. Further work is required to identify all boundary conditions modulating the reactivity of this system.

Quality assessment of physical research in homeopathy

OBJECTIVES

To assess the evidence of published experiments on homeopathic preparations (potencies) that target physical properties (i.e., assumed structural changes in solvents).

METHOD

A suitable instrument (the Score for Assessment of Physical Experiments on Homeopathy [SAPEH]) was developed through consensus procedure: a scale with 8 items covering 10 criteria, based on the 3 constructs, methodology, presentation, and experiment standardization. REVIEWED PUBLICATIONS: Written reports providing at least minimal details on physical experiments with methods to identify structural changes in solvents were collected. These reports were scored when they concerned agitated preparations in a dilution less than 10(-23), with no other restrictions. We found 44 publications that included 36 experiments (the identity of 2 was unclear). They were classified into 6 types (dielectric strength, 6; galvanic effects, 5; light absorption, 4; nuclear magnetic resonance [NMR], 18; Raman spectroscopy, 7; black boxes of undisclosed design, 4).

RESULTS

Most publications were of low quality (SAPEH < 6), only 6 were of high quality (SAPEH > 7, including 2 points for adequate controls). These report 3 experiments (1 NMR, 2 black boxes), of which 2 claim specific features for homeopathic remedies, as does the only medium-quality experiment with sufficient controls.

CONCLUSIONS

Most physical experiments of homeopathic preparations were performed with inadequate controls or had other serious flaws that prevented any meaningful conclusion. Except for those of high quality, all experiments should be repeated using stricter methodology and standardization before they are accepted as indications of special features of homeopathic potencies.

A new database on basic research in homeopathy

A new database on 'Basic Research on Homeopathy' has been established. It contains research on biological systems and physico-chemical effects of the succussion process. It is aimed at the elucidation of the working mechanism of the homeopathic similia principle following application of low doses and potencies of substances. By the end of 2000, this database included 829 experiments in 782 primary publications. The publications are classified according to organism and field of interest. Several reasons for the relatively high number of experiments and publications are presented. It is concluded that the research community would benefit from a European research agenda with a priority on the translation of relevant publications from the different European languages into English.

Can biological activity be maintained at ultra-high dilution? An overview of homeopathy, evidence, and Bayesian philosophy

Forty percent of general practitioners in the Netherlands practice homeopathy. With over 100 homeopathic medical schools, homeopathy is practiced in India along with conventional Western medicine in government clinics. In Britain, 42% of general practitioners refer patients to homeopaths. Two recent meta-analyses of homeopathy both indicate that there is enough evidence to show that homeopathy has added effects over placebo. Against this evidence is a backdrop of considerable scientific scepticism. Homeopathic remedies are diluted substances--some are so diluted that statistically there are no molecules present to explain their proposed biological effects (ultra-high dilutions or UHDs). Without knowledge of the evidence, most scientists would reject UHD effects because of their intrinsic implausibility in the light of our current scientific understanding. The objective of this article is to critically review the major pieces of evidence on UHD effects and suggest how the scientific community should respond to its challenge. Such evidence has been conducted on a diverse range of assays--immunologic, physiological, behavioral, biochemical, and clinical in the form of trials of homeopathic remedies. Evidence of UHD effects has attracted the attention of physicists who have speculated on their physical mechanisms. Included is a critique of several experiments that form the Benveniste affair which was sparked by a publication in Nature that advocated the existence of UHD effects of anti-immunoglobulin E (IgE) on human basophils, and is the paradigm example of how a controversial phenomenon can split the scientific community. It is argued that if the phenomenon was uncontroversial, the evidence suffices to show that UHD effects exist. However, given that the observations contradict well-established theory, normal science has to be abandoned and scientists need to decide for themselves what the likelihood of UHD effects are. Bayesian analysis describes how scientists ought rationally to change their prior beliefs in the light of evidence. Theories by Kuhn and Lakatos indicate that whether UHD effects are proved or not depends on the beliefs and behaviors of scientists in their communities. This article argues that there is as yet insufficient evidence to drive rational scientists to a consensus over UHD effects, even if they possessed knowledge of all the evidence. The difficulty in publishing high-quality UHD research in conventional journals prevents a fair assessment of UHD effects. Given that the existence of UHD effects would revolutionize science and medicine, and given the considerable empirical evidence of them, the philosophies of science tell us that possible UHD effects warrant serious investigation by conventional scientists and serious attention by scientific journals.

Critical review and meta-analysis of serial agitated dilutions in experimental toxicology

1. We conducted an overview and quantitative meta-analysis of all experimental literature on the protective effects of serial agitated dilutions (SADs) of toxin preparations. 2. Articles were systematically collected and evaluated for scientific quality using pre-defined methodological criteria and then independently analysed for validity. 3. We found 105 publications exploring the effects of SAD preparations in toxicological systems. 4. The quality of evidence in these studies was low with only 43% achieving one half of the maximum possible quality score and only 31% reported in a fashion that permitted reevaluation of the data. 5. Very few studies were independently replicated using comparable models. 6. Among the high quality studies, positive effects were reported 50% more often than negative effects. 7. Four of 5 outcomes meeting quality and comparability criteria for meta-analysis showed positive effects from SAD preparations. 8. Average percent protection over controls in these preparations was 19.7 (95%Cl 6.2-33.2). 9. Further research with special attention to methodological detail and independent replication should be done.