IS HOMEOPATHY GOOD MEDICINE?

By Anastasia Toufexis

When Dana Ullman's younger sister developed a nagging pain in her abdomen, their father, a pediatrician, couldn't find the cause or a cure. Neither could the five specialists who were called in on her case. Then Dana, a practitioner and leading proselytizer of homeopathy, stepped in. He prescribed a dose of calcium carbonate; two weeks later, his sister's pain had disappeared. Now whenever illness strikes, the Ullman family turns first to Dana's type of medicine.

So do millions of other Americans. After languishing for years in therapeutic backwaters, homeopathy is riding a wave of new--and controversial--popularity. Slickly packaged homeopathic remedies crowd the shelves of major drugstore chains, independent pharmacies and even supermarkets. In print ads and TV and radio commercials, such celebrities as Lauren Hutton, Larry King, Rush Limbaugh and Lindsay Wagner testify to their effectiveness.

Reflecting the growing interest in alternative therapies, especially for chronic ailments that mainstream medicine can't cure, more and more health specialists are urging patients to try such homeopathic remedies as ground honeybee for a sore throat, cuttlefish ink for hemorrhoids and bushmaster snake for hot flashes. An estimated 40% of chiropractors--and even some medical doctors--regularly recommend such substances. According to the National Center for Homeopathy, Americans today are spending more than $165 million a year for the preparations, and sales are rising 20% to 25% annually. Says Gilbert Weise Sr. of Jacksonville, Florida: "When I advertise that I'm a pharmacist with homeopathic medicines, I can't keep customers out of my shop."

Homeopathy's newfound success dismays many physicians, scientists and consumer advocates who regard the potions as ineffective at best and dangerous at worst--especially if they keep patients from seeking established treatments for serious ailments. "Anybody who understands science would regard them as worthless," declares retired psychiatrist Stephen Barrett of Allentown, Pennsylvania, a board member of the National Council Against Health Fraud.

As it happens, homeopathy was born out of frustration with mainstream medicine as it was practiced in the late 18th century. It was founded by Samuel Hahnemann, a German physician who was horrified by such standard therapies of his day as bloodletting, purging and blistering. Hahnemann eventually abandoned his medical practice and started looking for safer ways to treat patients. One of his investigations focused on quinine, then (and now) the treatment of choice for malaria. Though he was healthy, Hahnemann dosed himself with the drug and observed that he experienced the same fevers and chills that characterize the disease it is supposed to cure.

The experiment led him to formulate his famous Law of Similars. If a substance produces certain debilitating symptoms in a healthy person, he reasoned, then a small dose could be used to treat the same symptoms in an ill patient. Hahnemann called his new method of healing "homeopathy," from the Greek homoios (like) and pathos (suffering). Using his seven children as guinea pigs, he began testing hundreds of plants and minerals, eventually compiling the list of substances and symptoms that forms the core of today's Homeopathic Pharmacopoeia.

Hahnemann was a great believer in minimal intervention. To find how little medication could be given while still promoting healing, he began diluting his remedies. He would mix one part of an active ingredient with nine parts of water or alcohol, shake the solution briskly, then repeat the process as many as 30 times.

According to Hahnemann, the vigorous shaking transferred the "spiritlike" essence of the medicine to the solvent. And each successive shaking "potentized" the solution even further. Hahnemann believed that the extremely dilute solution, when taken by a patient, would jump-start the body's dormant "vital force" to combat illness. Hahnemann's Law of Infinitesimals--his belief that the more a remedy is diluted, the stronger its effect--is homeopathy's second major tenet.

With its kinder, gentler approach, homeopathy quickly gained converts across the Continent. To this day it enjoys immense popularity in Germany, the Netherlands and France, where the nation's 23,000 pharmacies are required by law to supply homeopathic remedies. Homeopathy spread abroad as well. In Britain members of the royal family have been ardent adherents since the 1830s. Queen Elizabeth reportedly travels with a little black box containing 24 homeopathic preparations, and Prince Charles is said to use arnica to heal bruises from falling off polo ponies.

Homeopathy flourished too in 19th century America. By 1900 there were 22 homeopathic colleges and 15,000 practitioners--a sixth of the U.S. medical profession. But interest faded with advances in orthodox medicine, and by 1950 homeopathy was all but forgotten in the U.S.

Its revival renews a question that was never settled: Does it work? The Law of Similars sounds something like modern medicine's concept of immunization, but scientists point out that the resemblance is superficial. For the Law of Infinitesimals they have nothing but scorn. The high number of dilutions--marked on packages as 12X, 24X and so on--ensures that not enough active ingredient is left to do any harm. But it also ensures that not enough is left to do any good. Consumer Reports in July examined homeopathic treatments for vaginal yeast infections, noting that the 28X dilution means that "the mixture had 10 trillion quadrillion times as much of the inert ingredients as active ingredients." To stimulate the body's defenses with little--or none--of the original medication, scientists contend, would require a miracle.

"It is just the reverse of everything we believe according to the basic principles of physiology," declares Professor Varro Tyler of Purdue University, an expert on herbal remedies. "We believe that the greater the dose, the greater the physiological response. They believe that even after there is no drug left, you still get a response."

Advocates claim that evidence of homeopathy's efficacy is emerging, citing a list of scientific papers published in recent years in such reputable journals as Pediatrics, the British Medical Journal, Lancet and Nature. But there is only a handful of these reports, and they are far from definitive. The ultimate test of scientific validity is whether the results can be duplicated, and so far they have not been.

One heralded study, conducted by French researcher Jacques Benveniste and published by Nature in 1988, was challenged by a Nature-sponsored team of investigators who flew to Paris to watch Benveniste repeat his experiments. The team found that the tests were "ill-controlled" and failed to exclude "systematic error, including observer bias."

Enthusiasts insist that science as yet lacks the tools to properly assess homeopathy and that its effectiveness should be taken on trust. "If you don't have faith in the healing, it won't work," says Kyra Walsh, owner of Walsh Homeopathics in Evanston, Illinois. "Belief is a part of the process."

Belief is the entire process, contend scientists. About 30% of positive reactions to all drugs can be attributed simply to patients' faith in their power, the so-called placebo effect. "Thought processes can control people's responses," says Purdue's Tyler. "You might as well take a milk-sugar tablet. It's a lot cheaper."

The people making money on the homeopathy boom are not likely to endorse that recommendation. Todd Dankmyer, spokesman for the National Association of Retail Druggists, acknowledges that "we have not done a scientific analysis of whether the products are good, bad or indifferent." But, he adds, "we see homeopathy as a valuable market niche."

That attitude outrages antihomeopathy activists like Barrett, who believe that druggists as health professionals have a moral obligation to their customers. "They don't even discuss among themselves whether selling an ineffective product is an ethical issue," he says. But pharmacist Jerry Zlotnik, executive vice president of Ohio's Medic Discount Drug chain, sees no need to defend the health benefits of the products he sells. Says Zlotnik: "I also carry candy, cigarettes, beer and wine."

Still, opposition is mounting. More than 40 critics, including physicians, pharmacologists and other skeptics (among them a former Time senior editor), have petitioned the FDA to require that homeopathic preparations meet the same standards of safety and efficacy as other drugs. The agency, which until now has had a hands-off policy toward homeopathic cures, has sent warning letters to several firms that market remedies for serious illnesses that require a physician's supervision.

Taking another route, Donald Driscoll, a public-interest lawyer, has filed several lawsuits in California against major drug chains--including Payless, Long's and Walgreens--charging that the packaging and inserts for homeopathic preparations constitute false advertising. "We don't want companies to claim these remedies are effective unless they have evidence for it," says Driscoll." So far, that evidence is missing.

--Reported by Wendy Cole/Chicago and D. Blake Hallanan/San Francisco

With reporting by WENDY COLE/CHICAGO AND D. BLAKE HALLANAN/SAN FRANCISCO