Posted: 19 Aug 2004
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To some it is the snake oil of the New Age. To others it is a tried-and-trusted treatment that has been good enough for the likes of Bill Clinton, the Prince of Wales, Geri Halliwell and David Beckham.
Homoeopathy is big business and getting bigger. Yet there is little if any evidence to show that it works, and absolutely nothing to justify its central claim - that highly diluted solutions containing nothing but water can affect human health.
That is until now. Researchers have just published what could be the first hard evidence in a peer-reviewed scientific journal that appears to support the central idea behind homoeopathy.
The scientists, from Britain, France, Belgium, Italy and the Netherlands, have chosen the relatively obscure but respected Inflammation Research to publish what some call the "holy grail" of homoeopathy.
In summary, the study found that extremely dilute solutions can have a biological effect. Like homoeopathic remedies, the solutions in the experiments were so diluted that there was no realistic chance of a single molecule of the substance remaining in the liquid.
Scientists have likened this to believing in magic. How could something that was once dissolved in a solution, and can no longer be present in that solution, still have an effect? The scientists themselves are baffled. "We are not yet able to propose any theoretical explanation of these findings," they write. In showing that high dilutions exert a biological effect, the findings seem to break the laws of physics. Surely there must be errors in the experiment; an accusation the scientists reject. "Despite searching for artefacts, we have been unable to find any," they write.
An editorial in Inflammation Research explains why the journal published such controversial research: "The authors are unable to explain their findings but wished to encourage others to investigate this area," it says. "It is with this spirit of openness that the journal, after submitting the paper to a rigorous reviewing process, has agreed to publish the paper."
Understandably, the practitioners of homoeopathy have seized on the findings as vindication. Peter Fisher, of the Royal Homoeopathic Hospital in London and homoeopath to the Queen, said the findings were nothing short of groundbreaking. "History may come to view [the study] as a turning point in the scientific controversy surrounding homoeopathy," Dr Fisher said.
"Of course further repetition is required, but it may be that this represents the holy grail of basic research in homoeopathy," he said.
There are two central tenets of homoeopathy. The first is that an illness or malady can be treated by administering tiny amounts of a substance that might under normal circumstances actually result in similar symptoms - extract of onion for instance to treat hay fever.
The second belief is that the concentrations have to be really minute, so minute that the dilutions involved in effect get rid of the substance in question from the liquid solvent.
Homoeopathic solutions are diluted repeatedly to produce solutions that are millions of times weaker than they were originally. Often the solutions are so weak that they are equivalent to dissolving a tiny speck of something in a volume of water several times greater than all the world's oceans.
Scientifically, this would mean that the chance of just a single molecule of the homoeopathic remedy being left in the solution is next to nil. Sceptics say patients might just as well treat themselves with distilled water - which is cheaper.
Science cannot explain how such highly dilute solutions could have an effect, that is until the French biologist Jacques Benveniste came along. Working at his laboratory in Paris, Dr Benveniste formulated the idea that water retains a "memory" of what has been dissolved in it and that it is this memory that results in the homoeopathic effect. In 1988 Dr Benveniste published a study in the journal Nature in support of his water-memory theory. He claimed his experiments showed that an ultra-dilute solution exerted a biological effect.
However, the then editor of Nature, Sir John Maddox, had insisted that he would only agree to publication if he was able to investigate Dr Benveniste's laboratory procedures. A few weeks later Sir John invited an American science fraud investigator, Walter Stewart, and a professional magician and arch sceptic, James Randi, to watch over Dr Benveniste as he and his team tried to repeat the experiments.
The Nature investigation concluded that Dr Benveniste had failed to replicate his original study. In subsequent issues of Nature, Dr Benveniste suffered the professional ignominy of being ridiculed by arguably the most influential scientific journal in the world.
As a result, the idea of memory water was consigned to the dustbin of science history, or so it was thought.
France as a country is a keen advocate of homoeopathy and there were many French scientists who had not given up on the notion of investigating the phenomenon. Among them was a one-time collaborator of Dr Benveniste called Philippe Belon, who now works for a French homoeopathy company, Boiron.
Dr Belon, who fell out with Dr Benveniste a long time ago, has investigated high dilutions for 20 years and although he works for Boiron, and has himself tried homoeopathic remedies, he insists he is only interested discovering the truth about the claims.
In the spirit of scientific investigation he organised a collaboration between four different groups in Europe who all undertook to carry out identical high dilution experiments at separate places involving separate teams of scientists.
The British end was run by Professor Madeleine Ennis, an established asthma researcher at Queen's University of Belfast and an avowed sceptic of all things homoeopathic.
In fact Professor Ennis became involved in the project in the first place because she could not accept what some of her scientific colleagues were saying. "I told people I didn't believe it so they said 'why don't you try it'," Professor Ennis said.
The dilution experiments they carried out, and now published in Inflammation Research, involved a substance called histamine which is released by a type of white blood cell called a basophil. Normally basophils release histamine, and as levels of histamine rise this exerts a "negative feedback" which inhibits further release of histamine.
The four teams of scientists tested highly dilute solutions of histamine to see whether they still exert an effect on basophils in a test tube. At extreme dilutions, three out of four laboratories found a statistically significant effect and the fourth found an effect which just fell out of the typical range for statistical significance.
Professor Ennis emphasised that the research does not prove that homoeopathy works, nor does it even show that Dr Benveniste was right because he had used a different test for a high-dilution effect. "The paper didn't test homoeopathy, it tested high dilutions of histamine. I know what we tested and I cannot explain the results," said Professor Ennis.
For Dr Belon, however, the research does at least support the basic premise behind homoeopathy. "Of course it supports it, on the other hand it is not a demonstration that homoeopathy works," he said.
In whatever ways the latest findings are interpreted, they cannot be ignored. The experiments were repeated by four different teams using the same experimental protocol that involved a blind code - the scientists did not know whether they were working with a high dilution solution or a control sample of pure water until the code was broken at the end of the experiment.
When BBC Horizon televised a similar attempt at replicating the same experiment two years ago, the results were negative but scientists such as Dr Belon believe this was trial by media rather than science by the peer-review process.
This time, with a full scientific paper detailing the precise protocol, anyone can try to replicate the findings - and replication is the essence of science. Until others repeat the work it will take a lot to convince sceptics such as James Randi, who has offered $1m to the first person to prove the scientific basis of homoeopathy.
Mr Randi warns about reading too much in a single scientific paper. "A paper is a paper is a paper. Don't forget, two scientists wrote a paper, published in Nature, back in 1974, that endorsed the powers of Uri Geller," he said.
But the homoeopathic gauntlet has been thrown down. The question now is whether anyone will be brave enough to pick it up.