Reducing childhood illness: a recently published study compares homeopathy and conventional care

The Science Behind Homeopathy

The results of the study “Homoeopathy vs. conventional primary care in children during the first 24 months of life-a pragmatic randomised controlled trial,” comparing the benefits of homeopathy with conventional medical care for infants from birth through 24 months, have just been published. The unblinded study was a collaborative effort between Israeli physician Dr. Menachem Oberman, head of Shaarei Zedek Medical Center (SZMC)'s Center for Integrative Complementary Medicine, and Indian counterparts. India is one of the countries where homeopathic medicine is mainstream and widely used. They found that of the 108 Indian children in the study, the group (of 54 children) treated with homeopathy were sick less often, had fewer respiratory illnesses, needed fewer antibiotics, were taller but not heavier than conventionally treated children, and their treatment was less expensive. The Jerusalem Post’s health and science reporter Judy Siegel-Itzkovich relates that:

Oberbaum and his team reported “significantly fewer sick days than those in the conventional group with correspondingly fewer sickness episodes, as well as fewer respiratory illnesses over the 24-month period. They were taller but not heavier than their conventionally treated counterparts. They also required fewer antibiotics, and their treatment cost was lower.”

The authors concluded that “homeopathy, using conventional medicine as a safety backdrop, was more effective than conventional treatment in preventing sick days, sickness episodes, and respiratory illnesses in the first 24 months of life. It necessitated fewer antibiotics, and its overall cost was lower.”

According to Oberman, as Itzkovich wrote, the impetus for the study was the non-acceptance of homeopathy in many parts of the world and physician skepticism, despite its history and widespread use in Europe and the U.S.

OBERBAUM SAID that homeopathy is one of the best-known but most controversial schools of complementary and alternative medicine, but despite its more than 200-year history and long tradition of use in both Europe and the US, it isn’t integrated into conventional medicine in most parts of the world and is treated with varying degrees of skepticism and suspicion by physicians, academic scientists, and policymakers. Its unexplained biological mechanism and the lack of conclusive randomized controlled trials are largely responsible for this.

In the study, Oberman evaluated the effectiveness of the two systems, rather than comparing effectiveness for a single symptom.

He therefore decided to evaluate the comparative effectiveness of homeopathy using conventional medicine as a safety backdrop and therapeutic system rather than comparing the effectiveness for a single indication.

Why Randomized Trials Don’t Tell the Whole Story

In 2018, at an international seminar entitled “New Horizons in Water Science – Evidence for Homeopathy” held at the Royal Institute of Medicine in London, Dr. Oberman[1] introduced the study. He highlighted (@1:59) the widespread use of homeopathy in India as shown in the below screenshot of his talk. At the time, India boasted 300,000 homeopathic physicians with 10,000 new ones every year, 195 undergraduate colleges for homeopathy, 43 academic institutions for postgraduate education, 8,117 government dispensaries, 235 government hospitals, and 100 million people depending solely on homeopathy for their medical care, with an annual increase of 26.3% more people using homeopathy every year.
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Homeopathy, Oberman explained (@7:58), needs to be evaluated as a system (see the screenshot of his homeopathic trial formula below). 

He explained that while an RCT (randomized control trial) is interested in the effects of one variable, in homeopathy each person is viewed as having a unique disease and one or more treatments may be employed. Since homeopathy is multidimensional, multiple effects are possible. 

Moreover, an RCT aims to reduce the number of variables in an experiment and in the best-case scenario one variable only is examined in order to answer one crucial research question. Additional questions are then reduced to secondary questions. A successful hoeopathic treatment, however, is multidimensional, potentially improving mental, emotional, general, and local symptoms at the same time. Reducing an homeopathic effect to one variable only will distort the outcome of a, such an experiment. And the specific impact of an homeopathic treatment under examination, therefore, a priori, cannot serve as a suitable research instrument in homeopathy.

Following Dr. Oberman’s talk, Dr. Raj Kumar Manchanda, the study’s principal investigator, spoke about homeopathy and natural medicine in India. 

A Global Perspective on Homeopathy

Itzkovich noted the far-reaching influence of homeopathy and the many people worldwide who rely on it.

There are over 200,000 registered homeopathic doctors in India, with about 12,000 more graduating from homeopathy schools every year. Worldwide, over 200 million people reportedly use homeopathy on a regular basis. Besides India, it’s included in the national health systems of Switzerland, Mexico, Chile, and Pakistan, and is used by 100 million European Union residents in their day-to-day healthcare. Large numbers of people in North America also choose such treatments.

She lauded the publication of the homeopathy study in the peer-reviewed European Journal of Pediatrics as a “relatively unusual and an honorable achievement.” Yet, she focused on its non-acceptance among mainstream doctors, even asking his colleagues at Shaarei Zedek for their comments. Although the study was published in a peer-reviewed journal ([p]eer-reviewed articles are considered a highly credible source due to the stringent process they go through before publication), the doctors she spoke with believe that there is no evidence supporting natural medicine. 

She asked Prof. Jonathan Halevy, SZMC’s longtime director-general and now president for his comments on the paper. In 2005 Halevy wrote the comprehensive, Hebrew-language book, Complementary and Alternative Medicine.” In response to her query, Halevy stated that there is “no proven evidence of their benefits of any complementary techniques except perhaps acupuncture,” and suggested she ask a leading pediatrician.

Itzkovich then asked Prof. Yechiel Schlesinger, director of SZMC’s Wilf Children’s Hospital and an expert in infectious diseases for his thoughts about the study. Schlesinger congratulated Oberman on having his paper published in a peer-reviewed journal and getting dramatic results, but still said, “In general, integrative medicine is an orphan. It’s illogical, with no proven scientific basis.” 

While he does not use homeopathy on his patients, or even recommend it, he commended his colleague for getting his research published by a recognized, widely read, peer-reviewed journal and producing “dramatic results.”

. . .

“In general, integrative medicine is an orphan. It’s illogical, with no proven scientific basis,” Schlesinger stressed.

The Debate: Natural Medicine vs. Mainstream Medicine

Evidence-based homeopath Dana Ullman, MPH, CCH, asked this very question: how does natural medicine stack up to mainstream medicine? In her 2010 article (updated in 2017) "How scientific is modern medicine really?" published in the Huff Post, she wrote that most medical treatments are not scientifically proven, as doctors and patients believe. Rather, she called it “a clever and profitable marketing ruse.”

Doctors today commonly assert that they practice "scientific medicine," and patients think that the medical treatments they receive are "scientifically proven." However, this ideal is a dream, not reality, and a clever and profitable marketing ruse, not fact.

What the Evidence Really Says

She cited the British Medical Journal’s 2007 review of medical practices which found that most came up lacking.

The British Medical Journal's "Clinical Evidence" analyzed common medical treatments to evaluate which are supported by sufficient reliable evidence (BMJ, 2007). They reviewed approximately 2,500 treatments and found:

     ◾ 13 percent were found to be beneficial
     ◾ 23 percent were likely to be beneficial
     ◾ Eight percent were as likely to be harmful as beneficial
     ◾ Six percent were unlikely to be beneficial
     ◾ Four percent were likely to be harmful or ineffective.
     ◾ 46 percent were unknown whether they were efficacious or harmful

She also noted the US government’s evaluation of medical treatments in the late 1970s that had similar results.

In the late 1970s, the US government conducted a similar evaluation and found a strikingly similar result. They found that only 10 percent to 20 percent of medical treatment had evidence of efficacy (Office of Technology Assessment, 1978).

Rethinking the ‘Science’ of Modern Medicine

Pointing out the contradiction between what doctors say about the efficacy of medical treatments, the poor results patients experience, and the massive amounts of money that go to the medical industry, “we are certainly not getting our money’s worth,” Ulman concluded.

Doctors like to point to the "impressive" efficacy of their treatments in real serious diseases, like cancer, and doctors (and drug companies) are emphatic about asserting that anyone or any company that says (or even suggests) that they have a treatment that might help people with cancer are "quacks." However, do they maintain this same standard when evaluating their own treatments? Even a recent issue of Newsweek highlighted the fact that "We Fought Cancer, and Cancer Won" (Begley, 2010). Despite the truly massive amounts of money that doctors, hospitals and drug companies are effectively extracting from patients, employers, insurance companies and governments, we are certainly not getting our money's worth.

Ulman turned the tables on mainstream medicine, likening it to the “quackery” which is often used to describe alternative or natural medicine.

"Quackery" is commonly defined as the use of unproven treatments by individuals or companies who claim fantastic results and who charge large sums of money. Although modern physicians may point their collective finger at various "alternative" or "natural" treatment modalities as examples of quackery, it is conventional medical treatments today that are out-of-this-world expensive, and despite real questionable efficacy of their treatments, doctors give patients the guise of "science."

Could Integrative Medicine Be the Future?

Ullman believes that the best option would be to make mainstream medicine more scientific and develop an integrative model to include naturopathic and homeopathic methods as a way of honoring Hippocrates' dictum “First, do no harm.”

I certainly realize that many of us have benefited greatly from modern medicine, but I also realize that many of us have been hurt greatly from it too. The challenge for all of us is to determine how can we make modern medicine more "scientific," more effective and more safe. I have previously made clear that my own point of view on this subject is that we must develop a more "integrative model" of medicine and healing and that we should utilize various naturopathic and homeopathic methods as a way to honor the Hippocratic tradition of "First, do no harm."