By Dr Harsh Sharma, DHMS, BHMS
Homeopathy has been gaining popularity worldwide as it has been able to prove its efficacy everywhere. Patients, whether the high and mighty or the ordinary folks have seen the benefits of Homeopathy and swear by the efficacy of this system of medicine. This has led to a lot of heartburn for people who are inimical to this wonderful system of medicine and cannot digest its popularity. The reasons for this animosity may be due to their commercial interests or professional interests or plain jealousy. Often the critics have tried to spread the notion that Homeopathy is just placebo and nothing else. Many convoluted and irrational arguments are bandied about in defence of this hypothesis though none of these arguments will be able to stand up to close scrutiny.
Homeopathic medicine is real medicine
In a comprehensive research published in the British journal Homeopathy, it has been found that the placebo effect of Homeopathy is not at all in any way different from that seen in allopathy. In this study, 25 randomised clinical trials were studied about the placebo effects of medicines belonging to Homeopathy as well as allopathy. Out of the 25, 12 trials found that the placebo effect of homeopathy is less than that of allopathy. This clearly shows that the allegation hurled at homeopathy that it is merely placebo is just a futile argument aimed at saving their own reputation and casting aspersions on a wonderful science called Homeopathy. Another point needs to be noted here that Homeopathy works equally well on animals. If it was just placebo, it would not have worked on animals, whose mind is not likely to be influenced by the fact that he is being treated by a Homeopath or Homeopathic medicines and not an Allopath or Allopathic medicines. In fact, the poor animal would not even be able to make out whether he is being treated or not.
What is placebo and the placebo effect
Before moving further, it is necessary for one to understand the meaning of the term ‘Placebo’. The dictionary meaning of the term is ‘to please’. It is a Latin word which means ‘I shall please’. In medical parlance it is used to mean a substance that does not contain any medicine but is given to please the patient or to satisfy the patient or to reinforce the patient’s desire to get well. The placebo effect was first quantified by a Boston doctor, Dr Henry Beecher who had been chief of anesthesiology at Massachusetts General Hospital in Boston. In a paper titled “The Powerful Placebo’ published in the Journal of American Medical Association in 1955, he reviewed about a dozen studies that compared the effect of placebos with active medicines. He concluded that even dummy medicines had some medical effects. He postulated that up to 35 % of patients feel better when they are told that they are being given some effective and proven medicine even though they are actually given just dummy medicines.
Research has also suggested that some important factors like the size of the medicine or the tablet, colour of the medicine, brand of the medicine, the doctor or the hopsital prescribing the medicines also have an important role in influencing the placebo effect. The salient points are-
- When it comes to the size of the medicine or the tablet, research has found that bigger the size of the tablet, more the plaebo effect. Here it needs to be noted that the homeopathic medicines are usually given in very small sized pills and the possible placebo effect will be much less as compared to the much bigger sized allopathic tablets.
- Secondly, research has also shown that colour of the medicine also has an influence on the final outcome. Coloured tablets are more likely to have a placebo effect than white ones. In a study, blue tablets were found to have more effect than pink ones. Here also, one needs to notice that Homeopaths mostly use white coloured pills which are likely to have much less placebo effect when compared to coloured medicines used in allopathy.
- Thirdly, the brand of the medicine also has a bearing on the final outcome. A medicine sold by Pfizer, Novartis, Sanofi, Merck, Ranbaxy and Cipla are much more likely to influence the mind of the patient as compared to non branded medicines dispensed by homeopaths packed in ordinary glass or plastic vials.
- Injections are considered more powerful than medicines and it is worthwhile to note that homeopathy does not use injections; it has been the sole prerogative of the allopathic community.
Is the placebo effect for real
Not withstanding some researches that have come up with the above mentioned points, doubts have even been cast by some scientists at the very existence of the placebo effect. A study done by Danish medical philosophers Asbjorn Hrobjartssen and Peter Gotzsche at the University of Copenhagen and published in the new England Journal of Medicine concluded that the placebo effect in itself is a myth. They analyzed 114 placebo controlled trials done on 7500 patients and concluded that placebos are not anymore effective than no treatment at all, when it comes to relieving the symptoms of a disease.
Homeopathic case-taking causes the placebo effect
It has often been alleged and this is the biggest allegation hurled at Homeopathy, that it is the empathetic listening to the patient for a considerable period of time that is the most important determining factor in the outcome of the Homeopathic treatment. In that case, how can one explain the fact that a patient gets better from one Homeopathic doctor but not another, when all Homeopathic doctors give a lot of time to the patient? How can one explain the fact that it works even on mentally ill patients who cannot relate their suffering in detail ? And how does one explain the fact that the homeopathic medicines work even on cats, dogs, horses and cows who are not interviewed? Those poor animals would not even know that they are being treated or being given some medicine. Had Homeopathy been just placebo, it would not have worked on animals but just on human beings.
If the case taking or the first interview were such a big influencing factor, then how can one overlook the other factors that can influence the patient’s mind and the resultant placebo effect. Just take into account the setting of the homeopathic doctor vis-à-vis a big hospital. In most of the cases, a homeopath would be working out of his home or a small office or clinic. He would hardly have one or two support staff to schedule his appointments or dispense the medicines. On the contrary, a well known doctor with a fancy degree like MD or MS or even a DM in a big hospital, spread over acres and acres of land, with equipment and cost of building or infrastructure worth billions, with dozens of support staff and hundreds of patients visiting every day would have a far more imposing presence to influence the mind of the patient. If the patient expectation is a determining factor, then the expectations from a super specialist would be far more than compared to an ordinary homeopath.