Two weeks ago, Nobel laureate Venkatraman Ramakrishnan reportedly dismissed homoeopathy — along with astrology — as being “harmful and bogus”. Ramakrishnan, an Indian-born American and British structural biologist, was delivering a lecture titled “On Nobody’s Word: Evidence and Modern Science” at Panjab University in Chandigarh. Hindustan Times quoted him as saying: “No one in chemistry believes in homoeopathy. It works on placebo effect.”In his dismissal of the 200-year-old system of medicine, Ramakrishnan questioned a belief system that has a huge following not only in India but across the world. According to a report in Business Standard, globally, more than 600 million people use homoeopathy; of this, about 100 million are Indians. In India alone, there are more than 200,000 practitioners of homoeopathy. The AYUSH (ayurveda, yoga, unani, siddha, homoeopathy) ministry, established in 2014, has a dedicated body for research in homoeopathy. Given the high cost of allopathic treatment and the side effects that accompany evidence-based modern medicine, Indians often turn to the scientifically unproven, though mild and relatively inexpensive, homoeopathic treatment that claims to “treat” conditions, ranging from respiratory problems to mental health conditions.

The ‘science’ behind it



Developed in the late 18th century by German doctor Samuel Hahnemann, homoeopathy is based on two principles, both of which bear little scientific evidence. One, homoeopathic practitioners believe that “like cures like”, which simply means that a substance that could cause certain symptoms in a healthy person could, in minute doses, relieve the same symptoms in a sick person. For instance, peeling an onion triggers runny nose and watery eyes — symptoms that are often found in a person suffering from common cold. Homoeopaths claim that such symptoms could be treated by Allium cepa, a medicine prepared from red onions.

The second principle on which homoeopathy works involves diluting a substance — plant, animal material or chemical — rigorously in water or alcohol, so much so that only some or no traces of the actual substance remain. Homoeopathic practitioners, however, believe that the more a substance is diluted, the greater is its power to treat the symptoms.

Is it effective?



“They [homoeopaths] take arsenic compounds and dilute it to such an extent that just a molecule is left. It will not have any effect on you. Your tap water has more arsenic,” Ramakrishnan was quoted as saying. And there is scientific evidence to back his views. In 2015, in one of the most extensive studies on homoeopathy to date, the National Health and Medical Research Council in Australia reviewed more than 170 research papers on the alternative system of medicine to conclude that there is no reliable evidence that homoeopathy is effective for treating health conditions. A 2005 Lancet study found that “the clinical effects of homoeopathy are placebo effects”.

Critics often question a basic principle underlying homoeopathy called “water memory”, or the supposed ability of water to remember the shape of the substance it contained, even though none of the molecules may have been left after multiple dilutions. A 2010 report on homoeopathy by the House of Commons Science and Technology Committee said: “We consider the notion that ultra-dilutions can maintain an imprint of substances previously dissolved in them to be scientifically implausible.”



However, homoeopaths believe that the focus on “water memory” is overblown.

“All homoeopathy is not non-molecular,” says Raj Kumar Manchanda, director-general at the Central Council for Research in Homoeopathy, an autonomous organisation under the AYUSH ministry. “It is only when, in certain cases, low potencies are not effective that you might have to go for higher potencies. So, seventy to eighty per cent of combinations are as molecular as any other allopathic or ayurvedic or traditional drug. It is only twenty to twenty five per cent that are non-molecular.”



Manchanda — as do others who swear by homoeopathy — cites a study by the Indian Institute of Technology Bombay that found that homoeopathic medicines do contain medicinal molecules in nano sizes even after high dilutions.

However, there is little research to suggest whether the medicines really work.

“Claiming that homoeopathy is therapeutic without research is not right,” says B Dinesh Kumar, president of the Indian Pharmacological Society. “There is a need for validation of homoeopathy as a system of medicine.”



Limitations



Manchanda says that homoeopathy works well in most sub-acute and chronic cases. However, he advises against the use of homoeopathic medicines in acute and life-threatening conditions. Since homoeopathic remedies are believed to stimulate the body’s immune system so that the body heals on its own, in acute cases “the body’s immune mechanism sometimes doesn’t have enough time to react,” says Manchanda.

He even recommends the use of allopathic medicine when the “infection is severe” and following it up with homoeopathy in the long run, since it has no known side-effects.

It is not that homeopathy is without risks, though. In 2009, the US Food and Drug Administration ordered that Zicam, a homeopathic cold remedy, be pulled off the shelves after it found that, in 130 cases, people had reported losing their sense of smell.

According to Manchanda, however, homoeopathic medicines are incapable of causing any damage. “It is possible that after giving homoeopathic medicine you may not improve, but it is not possible that it will cause any harm,” he adds.