The Strange Case of Homeopathy

In 1994, NASA computer scientist Amy Lansky of Portola Valley, California, began wondering about her two-year-old son. Max knew the alphabet and could beat adults at memory games, but he barely spoke and, despite normal hearing, didn't seem to understand language. At preschool he was a loner. His main form of communication was poking people with his finger. Eventually, school officials urged Lansky to have him evaluated. The diagnosis: autism, a neurological and behavioral disorder for which there is no known remedy.

But Lansky refused to believe Max was untreatable. Her search for an answer led her to homeopathy, an 18th-century healing art now enjoying renewed popularity because of Americans' growing interest in alternative medicine. Homeopathy involves treating illnesses with such extreme dilutions of herbs, animal substances and chemical compounds that frequently not one molecule of the diluted substance is left in the solution. Homeopathy defies the known laws of science, not to mention common sense. But rigorous studies show it just may work.

In a German trial, a homeopathic treatment for vertigo outperformed the pharmaceutical remedy; at Harvard, subjects with mild brain injury showed significantly greater improvement with a homeopathic treatment than with a placebo. And homeopathic remedies have been found to augment conventional treatments, as well. In the case of infectious diarrhea, a University of Washington study found that children given the standard rehydration fluid containing water, sugar and salt, plus a homeopathic remedy, recovered after two and a half days—a day and a half earlier than those who received just the rehydration fluid.

"I believe new science will explain how homeopathy works," says Ellen Feingold, a Wilmington, Delaware, pediatrician who left conventional medicine to practice homeopathy. "But research is not my concern. I want to heal patients. As an M.D., I mostly suppressed symptoms. Now I truly heal people."

"Critics of homeopathy say that because its mechanism of action can't be explained, it can't possibly work," says Michael Carlston, a Santa Rosa, California, physician who has combined mainstream medicine and homeopathy for more than 30 years. "But that's hypocritical. Aspirin was used for 90 years before its efficacy was explained—and no doctors shunned it."

Strange Medicine

Shortly after her son's diagnosis, Lansky found a magazine article on alternative treatments for childhood behavioral problems.

Lansky's acupuncturist referred her to homeopath John Melnychuk. He did not perform a physical exam, nor did he order diagnostic tests. He just asked questions, including many that M.D.s would consider irrelevant. He explored Max's milk craving, his fitful sleep, the bluish tint in the whites of his eyes and his restlessness, intensity, sweetness, stubbornness and perfectionism. Then, using reference books, he looked for substances that produce the same effects in healthy people. This is the fundamental principle of homeopathy, the Law of Similars. It's the idea that illness can be cured by substances—plant, animal or mineral—that evoke the same symptoms in those who are well. Melnychuk decided to give Max Carcinosin, a treatment made from—of all things—an infinitesimal amount of human cancer tissue.

"There are two types of homeopathic remedies," Melnychuk explains. "Some treat symptoms; For example, arnica works well for muscle strains. Then there are 'constitutional' remedies, ones that have to be matched to the patient's personality. Max seemed to fit the Carcinosin profile, which includes symptoms of perfectionism, restlessness, sleep difficulties and milk cravings." However, Melnychuk cautions, not every autistic child should receive Carcinosin. "You have to tailor the remedy to the patient's unique traits."

Lansky mixed a little Carcinosin in water and gave Max a teaspoon each morning. Within two days, she noticed subtle changes: "Max's speech improved, and he seemed more socially aware." In the next two months the trend toward improvement continued.

Maybe It's Doing Nothing

Homeopathy developed during the late 18th century, a time when physicians knew little about disease. They treated most illnesses by bleeding patients and administering powerful laxatives. Such treatments were called "heroic measures," but the heroism was entirely on the part of patients, many of whom suffered more from these interventions than from their illnesses.

One 18th-century German doctor, Samuel Hahnemann, became so disgusted with heroic medicine that he closed his practice. But Hahnemann did not exactly reject conventional medicine. He was impressed with cinchona, the South American tree bark that was the first effective treatment for malaria. In 1790, Hahnemann ingested cinchona and became cold, achy, anxious and thirsty—all symptoms of malaria. That experience led him to postulate his Law of Similars.

Hahnemann tested hundreds of substances on himself—plants, animal parts and chemical compounds, including salt, zinc, gold and marigold flowers—cataloging their effects. Eventually, he reopened his practice but prescribed only homeopathic medicines.

Homeopathy was controversial from the outset because of Hahnemann's other postulate, the Law of Potentization, which holds that homeopathic medicines grow stronger as they became more dilute. Critics howl at the law. Homeopathy is "absurd," argues William Sampson, a clinical professor of medicine at Stanford University. "It is bankrupt in theory and practice."

"There is no basis for believing that homeopathy has any effect," says Robert Baratz, president of the National Council Against Health Fraud, in Peabody, Massachusetts. "Homeopathy is a magnet for untrustworthy practitioners who pose a threat to public safety. It's quackery."

Maybe homeopathy involves treatment with nothing. If true, it's still an improvement over 18th-century heroic medicine—even if patients get little more than water.

By the late 19th century, conventional medicine had moved away from heroic measures. As they disappeared, the medical opposition led by homeopaths lost steam. The discovery of antibiotics and other modern drugs further strengthened conventional medicine at homeopathy's expense. While homeopathy remained popular in Europe, there were fewer than 100 homeopaths in the U.S. by the early 1970s. Critics dismissed homeopathic treatment as placebo.

Strange Power

Placebos have no direct impact on the body. But when given to treat almost any illness—from colds to serious conditions—about one-third of recipients report benefits. "Placebos work as well as they do because of the mind's ability to affect the body," says Brown University psychiatrist Walter Brown. Many studies have shown that when a doctor offers any treatment, people expect it will help, and that expectation itself can aid healing. Also, through a mind-body mechanism not entirely understood, placebos trigger the release of endorphins, the body's mood-elevating, pain-relieving compounds. "Improvement in patients receiving homeopathy is simply a placebo effect," Sampson says.

But studies consistently yield conflicting reports. British researchers are divided as to the power of arnica, often prescribed by homeopaths for musculoskeletal pain. Patients who received arnica after wrist surgery for carpal tunnel syndrome reported significantly less pain than did those in a placebo group; yet patients with other joint conditions had no such luck (among 58 rheumatoid arthritis sufferers, the placebo group reported significantly greater pain relief).

In 1991, Dutch epidemiologists analyzed 105 studies of homeopathic treatment from 1966 to 1990, most from French and German medical journals. Eighty-one studies found patients had benefited from homeopathy, prompting the Dutch researchers to conclude that "the evidence is to a large extent positive. [It] would probably be sufficient for establishing homeopathy as treatment for certain conditions." A 1997 German analysis of 89 studies agreed that homeopathy is often significantly more beneficial than the use of placebos.

Preferring Alternatives

Ambiguous as the evidence is, homeopathy has enjoyed renewed popularity in the U.S., coinciding with Americans' ambivalence about mainstream medicine.

One-half to two-thirds of Americans have used alternative therapies, and Americans visit alternative practitioners more often than they visit conventional practitioners—some 600 million consultations a year. They now spend $30 billion a year on alternative therapies, according to a report in Newsweek, and have as much confidence in alternative practitioners as they do in M.D.s, according to a study in the journal Annals of Internal Medicine.

Americans have not lost confidence in physicians—they've just expanded their view of what's medically helpful, believing that the combination of mainstream and alternative medicine will provide the best results. "The renewed interest in homeopathy," explains Dana Ullman, author of eight books on the subject, "is part of the groundswell of interest Americans have shown for all the alternative therapies. People are not satisfied with conventional medicine."

Homeopathy is not the only alternative therapy conventional medicine can't fully explain. The energy pathways deemed fundamental to acupuncture don't correspond to any known structures in the body, but a National Institutes of Health report concluded, "The data in support of acupuncture are as strong as those for many accepted Western medical therapies."

Nonetheless, homeopathy is nowhere near as accepted as acupuncture. A Harvard report on Americans' use of alternative therapies shows that homeopathy accounts for less than 0.5 percent of alternative-practitioner visits. University of Maryland researchers surveyed coverage for alternative therapies by six major managed-care plans—five covered chiropractic, four covered acupuncture, none covered homeopathy. "Homeopathy," Ullman says, "is the Rodney Dangerfield of alternative therapies: It gets no respect."

Impossible Cure

Amy Lansky didn't care that homeopathy is one of America's least accepted alternative therapies. After nine months of homeopathic treatment, Max was a different child: talkative, active, sociable and popular. Under Melnychuk's guidance, Lansky gradually decreased his dose of Carcinosin, eventually discontinuing it. Max continued to improve. By age five, he was virtually indistinguishable from any other kid. "He now sees Melnychuk maybe twice a year," says Lansky. "As far as I'm concerned, he's cured." Max's experience led Lansky to quit her job and study homeopathy full-time. In the fall, she hung out a shingle. "As a scientist," she explains, "I recognize that homeopathy is implausible. But I've seen it cure my son."