Homeopathy, as a cultural phenomenon, remains an enigma. In the two centuries since its invention it has failed to garner significant scientific support. In fact, developments in physics, chemistry, biology, and medicine have shown the underlying concepts of homeopathy to be wrong – guesswork and speculation that lept in the wrong direction.

It turns out, like does not cure like. This is nothing more than sympathetic magic – popular at the time but now considered nothing more than superstition without any scientific basis.

It also turns out that diluting a substance does not make it more potent – this nonsensical idea (ridiculed even in the 19th century) violates the laws of thermodynamics, and the chemical principle of mass action. This is especially true when you dilute a substance beyond the point where chance would have even a single molecule of active ingredient left behind. The background noise of chemicals in homeopathic water is orders of magnitude greater than the signal of whatever had previously been diluted in it.

I also understand that water does not have a magical memory of the vibrations of what was diluted in it. Transient interactions of water molecules does not, by any stretch of the imagination, confer upon water the ability to store and transmit complex chemical information from a solution to a tablet to a biological system.

It is therefore demonstrably true, even with simple high school level science, that the plausibility of homeopathy, for all practical purposes, and to the extent that it is possible to make such statements within the methodology of science – is zero.

If this were not enough, putting aside the non-existent plausibility of homeopathy and the staggering failure of two centuries to validate any of its principles, clinical trials of homeopathic remedies have failed to reliably detect any effect above and beyond placebo effects.

Therefore, in the eyes of science, homeopathy = total fail. It should be laid to rest and relegated to a footnote in the history of science – a pre-scientific idea that survived into modern times as pseudoscience. We can squeeze it in somewhere after healing crystals and before humoral theory and iridology.

But here comes the enigma – why does homeopathy persist at all? It seems that after the rise of science-based medicine in the early 20th century homeopathy was marginalized, but was able to survive because it had already entrenched itself sufficiently in politics and society. It then flew under the radar until the recent rise of CAM – the successful re-branding of fraudulent and unscientific modalities as “natural” and “alternative”.

So successful was this re-branding that the scientific community was partly cowed by the incessant demands for being “open-minded” and for “academic freedom.” This caused many scientists who should have known better to forget themselves, to look the other way while advocates slowly inserted nonsense into the health care structure and academic institutions.

We are beginning to see a push back in the scientific community. Michael Baum and Edzard Ernst have recently published a commentary in The American Journal of Medicine which reflects the new found “permission” within the medical community to once again call nonsense nonsense, and close the door on failed therapies.

Should we keep an open mind about astrology, perpetual motion, alchemy, alien abduction, and sightings of Elvis Presley? No, and we are happy to confess that our minds have closed down on homeopathy in the same way.

They then give a detailed justification for this attitude – a sufficient record of basic science and clinical failure to justify the conclusion that homeopathy cannot and does not work.

There has been criticism from other avenues as well. The World Health Organization (WHO) has traditionally taken a very permissive approach to unscientific medical modalities, motivated by a desire to be “open” to indigenous medicine. The WHO is a political organization, after all, and sometimes politics gets in the way of science.

But they are also advocates for world health, especially for vulnerable populations. It was brought to their attention by an organization called Sense About Science that homeopaths were pushing ineffective homeopathic treatments for malaria, TB, and HIV/AIDS. This forced the WHO to make the following clarifications (among others) regarding their position:

Dr Mukund Uplekar: TB Strategy and Health Systems, WHO: “WHO’s evidence-based guidelines on treatment of tuberculosis…have no place for homeopathic medicines.”

Dr Teguest Guerma, Director Ad Interim, HIV/AIDS Department, WHO: The WHO Dept. of HIV/AIDS invests considerable human and financial resources […] to ensure access to evidence-based medical information and to clinically proven, efficacious, and safe treatment for HIV… Let me end by congratulating the young clinicians and researchers of Sense About Science for their efforts to ensure evidence-based approaches to treating and caring for people living with HIV.”

Dr Sergio Spinaci, Associate Director, Global Malaria Programme, WHO:Thanks for the amazing documentation and for whistle blowing on this issue… The Global Malaria programme recommends that malaria is treated following the WHO Guidelines for the Treatment of Malaria”. (These guidelines do not include any use of homeopathy.)

Homeopathy is no longer flying under the radar. While pushing worthless nostrums for the worried well may be tolerated, they can no longer hide the fact that symptomatic treatment of self-limiting conditions is simply the foot in the door for hardcore quackery – the treatment of serious and even life-threatening illnesses with worthless remedies.

The WHO has recently run up against homeopathy again, this time with respect to the H1N1 pandemic and vaccine. While the WHO is trying to stem a pandemic with a vaccination program, homeopaths seem to be doing everything they can to frustrate this public health measure.

The Swiss Society of Homoeopathic Physicians was recently warning pregnant women not to get vaccinated against H1N1. This forced WHO vaccines chief Marie-Paule Kieny to make the following statements:

“This (advice) may result in putting pregnant women and their fetuses at risk of severe consequences in case of pandemic influenza virus infection.

“We … regret that the recommendation of the Swiss Society of Homoeopathic Physicians does not take WHO recommendations in this matter into consideration,” she said.

This is also not an isolated incident of homeopaths warning against the vaccine, claiming that homeopathy can treat the flu and prevent the pandemic. A Google search of “flu” and “homeopathy” leads to numerous homeopaths and homeopathic groups making similar claims. The National Center for Homeopathy writes:

Homeopathy has a long and impressive track record in epidemics of all kinds, including influenza, and we are confident of its potential now.

Homeopaths argue that homeopathy was effective in treating the 1918 H1N1 pandemic. Their reliance upon historical records, however, is demonstrably absurd. Such data is uncontrolled and highly unreliable. It reflects their preference for reliance upon low quality data rather than higher quality controlled data.

While the current generation of scientists and regulators are beginning to wake up to the fact that homeopathy is dangerous quackery, the public is still largely uninformed. Homeopathic products are often marketed simply as “natural” leading to widespread confusion in the public as to what, exactly, homeopathy is. Most people believe it is a synonym for herbal or natural remedies.

I encounter many patients and people with these false assumptions, and they are often shocked to learn the truth about homeopathy.

We need to have an open and transparent discussion in our society about homeopathy. The science has spoken – homeopathy is a failed belief system that has no place in modern health care. It is also a great example of the dangers of allowing a system of medicine that is based upon pseudoscience to flourish. Such systems will never limit themselves to “harmless” symptomatic treatments.

Given the evidence and the state of the science, the only responsible position is to completely dismantle homeopathy and close the door on this pseudoscience once and for all.

Posted by Steven Novella

Founder and currently Executive Editor of Science-Based Medicine Steven Novella, MD is an academic clinical neurologist at the Yale University School of Medicine. He is also the president and co-founder of the New England Skeptical Society, the host and producer of the popular weekly science podcast, The Skeptics’ Guide to the Universe, and the author of the NeuroLogicaBlog, a daily blog that covers news and issues in neuroscience, but also general science, scientific skepticism, philosophy of science, critical thinking, and the intersection of science with the media and society. Dr. Novella also contributes every Sunday to The Rogues Gallery, the official blog of the SGU.