Remedies at a homeopathic pharmacy in Varanasi, India. Photo: Jorge Royan/Wikimedia Commons
- The costliest harm from homeopathy arguably comes from the ways it causes adherents to delay proper medical diagnosis and treatment.
- Adding confusion in people’s minds, homeopathy can seem momentarily effective when used to treat conditions with fluctuating symptoms or those that can be self-correcting.
- Null results have done little to dent homeopathy’s popularity. A lot of it probably has to do with the perceived contrasts between modern medicine and homeopathy.
- Doctors trained in Western medicine are seen as uncaring and intolerant of patients’ concerns, whereas homeopaths are kind, engaging healers.
“In your opinion, homeopathy is pseudoscience. But what is the harm, if it brings some relief to desperate, scared patients in situations where allopathy is unable to help them?”
I’ve had variations of this talk with my mother for more than a decade during our regular transcontinental phone calls, so I’m well versed in our clashing views and competing terminologies. (Allopathy is the word homeopaths use to describe conventional modern medicine.) Homeopathy is a therapeutic system conceived by German physician Samuel Hahnemann in 1796. It relies on allegedly curative solutions of substances that are diluted to the point of nothingness, making them pharmacologically inert; yet it has millions of adherents around the world – including in India, where I was born and grew up.
Once I left home to pursue a career in biomedical research, my studies awakened me to the sheer absurdity of homeopathy. By the time I was a postdoc at the Johns Hopkins University School of Medicine, I couldn’t hold back. Discussions of homeopathy with my mother resembled a tug-of-war.
Then our exchanges took a turn. With time to reflect, I began to appreciate the reasons behind my mother’s abiding reliance on homeopathy. The primary of these was her deep personal trust in kindly Dr. Manmatha Nath Ganguly (may he rest in peace), the sole physician to three generations of her family in Kolkata, who treated them largely with homeopathic remedies.
On the flip side, my mother came to acknowledge that my exhortations against homeopathy came from a place of concern for her and my father’s well-being. Now in their 70s and 80s, my parents require real, science-based treatments for their many ailments, including heart conditions, high blood pressure, diabetes, and urological and neurological troubles.
Living far from home, I worried about whether they were seeking and receiving proper medical treatments. But my youthful passion for science over pseudoscience gradually yielded to pragmatism. Eventually I reached that too-rare state: a compromise. “Anytime either of you has a credible medical condition, you’ll visit your doctors and specialists and get proper medical care, okay?” I told my mom a few years ago while visiting, laying out the terms of our covenant. “For everything else, on a day-to-day basis, if homeopathy brings you peace of mind, by all means use it.”
My mother responded with her best smug, all-knowing smile, but so far both parents have obliged. This détente was facilitated, no doubt, by their love for me, their appreciation for my expertise and my willingness to engage in patient, jargon-free explanations of the scientific reasons for rejecting homeopathy. Most of all, though, I think I succeeded because I accepted that pushing back against pseudoscience is not an all-or-nothing proposition. I made peace with the overlapping rational thoughts and irrational beliefs that my parents hold. Don’t we all hold both kinds, to some degree?
My mother’s first impulse when dealing with heartburn or other minor health problems is still to reach for a homeopathic remedy; my father self-medicates with homeopathic pills. But both have also become accustomed to taking pharmaceuticals for their more serious conditions. They see that the medicines work. Recently, when my parents were diagnosed with COVID-19, they did not even contemplate messing around with homeopathy. They consulted their primary care doctors and followed quarantine protocols, and my father was treated back to health in the intensive care unit of the local, government-run specialty hospital.
I am a sample of one. Nonetheless, I hope my experience offers a lesson in how compassionate communication can help chart a path out of pseudoscience, even for those unwilling to reject it entirely.
I think a lot about my mother’s recurring question: “What is the harm?”
For one thing, homeopathic remedies are not necessarily cheap. According to one recent survey, global users spent more than $6 billion on them in 2020 – much of that paid out-of-pocket – and the market is growing at a rate of 12 percent a year. The remedies are not necessarily safe, either. They are regulated lightly or not at all in many parts of the world. As a result, they can contain questionable additives or dangerous levels of their ostensible active ingredients, despite the claimed extreme dilution.
In one set of incidents, hundreds of infants and toddlers in the United States suffered severe adverse reactions from homeopathic remedies containing belladonna, which were marketed as an anti-inflammatory. After years of investigation, the US Food and Drug Administration issued a consumer warning in 2016.
Herbal toxins are common starting materials for homeopathic pseudoscience. Nux vomica, a familiar homeopathic remedy in my childhood home, starts as an extract from the poisonous strychnine plant. Many homeopaths also advocate using nosodes – a type of remedy prepared by the homeopathic dilution of biological material such as body fluids or tissue taken from an animal or human with an infectious disease. Homeopaths often promote nosodes as “vaccine alternatives” for children, including for the prevention of COVID-19. No good evidence supports such claims.
The costliest harm from homeopathy arguably comes from the ways it causes adherents to delay proper medical diagnosis and treatment. In Germany, where homeopathy is mainstream, use of these remedies is associated with negative long-term economic outcomes, including higher outpatient costs and productivity losses. The same troubling phenomenon has been documented among breast cancer patients in Pakistan and Bangladesh.
In one of our talks, I told my mom the tragic story of Australia’s Penelope Dingle, who was diagnosed with advanced-stage rectal cancer. With medical management, eight out of 10 patients at this stage live on for five or more years. Dingle chose to pursue homeopathic treatment for seven months, during which time the cancer metastasised. She was dead within two years.
Adding confusion in people’s minds, homeopathy can seem momentarily effective when used to treat conditions with fluctuating symptoms, such as irritable bowel syndrome, or those that can be self-correcting, such as vertigo or hemorrhoids. When I was a child, Dr. Ganguly “cured” my mumps with homeopathic belladonna. What I didn’t know then was that mumps naturally runs its course in two weeks, typically leaving no lasting damage. These illusory homeopathic success stories increase the impulse to ignore real treatment when patients face life-threatening conditions.
During a professional stint in the pharmaceutical industry, I observed the time-consuming, labour-intensive process needed to develop a new drug, test its efficacy and safety, and bring it to market. In many Western countries, including the United States, homeopathy bypasses such scrutiny. No wonder I regularly came across absurdities like homeopaths selling ground-up pieces of the Berlin Wall to cure mental and physical illnesses.
So yes, there is both tangible and intangible harm in homeopathy, and as a science professional, I feel obliged to confront it.
I also grapple seriously with another of my mother’s questions: “If homeopathic remedies are merely snake oil, as you say, why are so many people devoted to them?”
Homeopathy is – as she says – popular across much of the globe. In Germany it is classified as legal medicine. In India and Bangladesh, homeopathy is incorporated directly into the public health system. In the last four-odd decades, there has been no dearth of research and clinical studies seeking scientific evidence to justify that support.
The late French immunologist Jacques Benveniste famously claimed that water could form a physical “memory” of molecules that are no longer present, justifying the homeopathic dilutions; nobody has been able to rigorously validate his finding. A large 2005 meta-study detected no evidence of homeopathic health impacts, nor did exhaustive reviews by governments of the United Kingdom and Australia and the European Academies’ Science Advisory Council.
Null results have done little to dent homeopathy’s popularity, however. The reasons are multilayered. A lot of it probably has to do with the perceived contrasts between modern medicine and homeopathy. In the popular view – some of which I absorbed from my family as a child – modern or “Western” medicine is expensive, relying on drugs that often have a plethora of side effects, whereas homeopathy is natural, holistic, and gentle. (In India, people often regard homeopathy as local and traditional, ignoring the inconvenient fact of its Western origin.)
Doctors trained in Western medicine, be it in India, in the United States, or elsewhere, are seen as uncaring and intolerant of patients’ concerns, whereas homeopaths are kind, engaging healers.
There is a kernel of truth here. Modern doctors operate under ethical, scientific, regulatory and economic constraints that make it difficult for them to build the lasting trust and to provide the personal access that local homeopaths, operating with fewer constraints, can offer. As hospitals become larger and more consolidated, the contrast grows more acute. Just look at my family’s devotion to Dr. Ganguly, with his soft voice and gentle eyes peering from behind a pair of Gandhi-style glasses.
I asked my mother how her family became so enamored of homeopathy. “It was, first and foremost, a matter of trust, not so much in homeopathy or allopathy, but in Dr. Ganguly,” she replied. “We knew he’d provide us with the best medical care, regardless of the ‑pathy involved.”
The homeopathy industry has helped stoke latent distrust of modern medicine. High-profile celebrities, such as Bollywood star Amitabh Bachchan and Britain’s Prince Charles, have further elevated the profile of homeopathy. The wealthy and privileged have convenient access to modern medicine in times of true need, however. The hoi polloi they influence often get locked into a pseudoscience approach until it is too late.
“We were untouched by the curse of knowledge,” my mother told me. “You lost faith in homeopathy because you ferreted out its physics and chemistry and whatnot. We just did what Dr. Ganguly instructed us, and you can’t say it hasn’t served us well!”
Without question, Dr. Ganguly provided a level of trust and reassurance that is difficult to find with a doctor in a busy hospital. There was also an unacknowledged level of complexity in the way he worked. Dr. Ganguly was not a pure homeopath, even if that is how my family viewed him. He would flexibly switch to “allopathic” drugs and surgical procedures as needed, drawing on his medical training in England.
Dr. Ganguly’s example suggests a path forward. Practitioners of modern medicine would do well to emulate the concern and warmth that are considered the hallmark of homeopathy practitioners. They can also build trust by accommodating patients who use unproven alternative treatments, so long as those treatments are benign. Trust-building is itself an important part of the cure, after all.
Empirical research has shown that a congenial, reassuring physician elicits better health outcomes. A 2011 study evaluating 700-odd people suffering from the common cold revealed that patients who felt a strong positive connection with their physician experienced a stronger immune response and a greater reduction in severity of the cold after their doctor’s visit. Conversely, directly confronting patients about beliefs like homeopathy can cause them to dig in their heels or feel helpless, which can exacerbate their conditions.
For these reasons, medical educators are increasingly emphasising compassion and empathy as ways to improve both clinical outcomes and patient experiences. The empathetic approach also appears to reduce burnout and enhance job satisfaction among physicians. In parallel, many hospitals in the United States have initiated systematic training to improve physician–patient communication. Such programs show some success in dispelling vaccine hesitancy.
From my refurbished perspective, Dr. Ganguly is a useful role model after all. In health care, the key principle is harm reduction. Every patient who takes a required medication or accepts a life-saving vaccine reaps the benefits – even if the same individual takes a few inert tinctures as well.