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 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 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, in recent years 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 recent 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
1998 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. The
latest Harvard report on Americans' use of alternative therapies shows
that homeopathy accounts for less than 0.5 percent of
alternative-practitioner visits. Recently, 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. Last 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."
April 16, 2006
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