Evidence-based homoeopathy – myth or reality?

In an attack on homoeopathy, a team of physicians in the UK stated that anyone who practises or conducts research in homoeopathy is a quack or a pseudoscientist. Their exact words were ‘Homoeopathy has definitively and repeatedly been proved to work no better than placebo or nocebo. It is, in short, bogus.’^[1]

Increasingly, homoeopathic research is being viewed myopically; all the clinical and research evidence generated is disregarded and clubbed under the umbrella of pseudoscience. When the truth is that an increasingly large amount of evidence from meta-analyses, systematic reviews and randomised control trials demonstrate that homoeopathy is extremely effective as a treatment modality.^[2-5]

Several in vitro studies have shown effects attributable to very highly diluted substances.^[6,7] Cancer is one such area where numerous claims are made to demonstrate the efficacy of homoeopathy. Studies have reported on the utility of homoeopathic medicines in the management of cancer pain. Certain studies using cellular and animal models also elaborate on the mechanism of action of homoeopathic medicines in cancer. Some studies reported that apoptotic effects and modulation of gene expression of homoeopathic medicines in cancer while other studies negate this mechanism.^[8] More research is needed to draw conclusive evidence.

The need of the hour is in vitro studies that will yield more evidence-based results. A study conducted in Kolkata, India, and one conducted in the USA concluded that patients diagnosed with glioma, when treated with Ruta 6, showed better results compared with patients having other types of intracranial cancers. The findings of the study suggested that Ruta 6C treatment is mitogenic and non-clastogenic in normal cells, but antimitotic and apoptogenic in human MGRl glioma cancer cells. The in vivo and in vitro observations reported that Ruta has the novel property of preferentially killing human glioma brain cancer cells and protecting normal body cells. This contrasts with the conventional chemotherapy that kills not only cancer cells but also normal cells. Ruta 6C was found to target glioma brain cancer cells selectively and protect normal lymphocytes by inducing cell division in blood-forming cells.^[9] In this issue, Valle et al. evaluate the behaviour of breast cancer tumour cells (SKBR3 and PMC42) after the treatment with ultra diluted Ruta graveolens (Ruta D35). The findings of this study will encourage more such studies and allow us to demonstrate evidence-based homoeopathy to the world.^[10]

Evidence-based medicine (EBM) has become a buzzword in the current medical scenario. Unfortunately, the very premise of a scientific rational practice of medicine is taken to extremes under its pretext. It is said that the value of EBM comes from a careful and systematic review of the existing literature. That information, when put into the right context, can help us make good patient care decisions.^[11]

It is fortunate that homoeopathy is now being sought for more structurally advanced conditions; nevertheless, certain questions always play on the minds of homoeopathic physicians. How does one treat these conditions? How to record the data in an evidence-based manner? How to interpret the efficacy of homoeopathy in these conditions? In this issue, we have a case series on the application of homoeopathy in an autoimmune condition like alopecia Areata^[12] and case reports on management of a longstanding meibomian cyst^[13] and migraine.^[14] All these cases demonstrate the application of homoeopathy in an evidence-based manner.

Evidence-based homoeopathy is a much larger umbrella and a restricted view of the concept will not allow a comprehensive understanding of the efficacy of homoeopathy. Here, I call the lines of a poem by American jazz composer, musician, poet and philosopher Sun Ra:

‘Reality has touched against myth

Humanity can move to achieve the impossible

Because when you have achieved one impossible

Others, Come together to be with their brother, the first impossible

Borrowed from the rim of the myth’^[15]

To ensure the reality is perceived in the right way and not considered a myth: More research is needed, but more than that, a proper scientific documentation of our results, scrutiny by peers and timely publication is a pressing concern. It is the first step towards laying the foundation of evidence-based homoeopathy.