Confession time for Boots the chemist: homeopathy is crap

It was a borderline decision for me whether it was worth getting out of bed early to sit in on the House of Commons Science and Technology sub-Committee’s ‘evidence check’ on homeopathy yesterday and since the whole thing would soon be available online, I have to wonder why I bothered. That’s not to say I didn’t enjoy witnessing the reassuring predictability of the top drawer defenders of homeopathy such as Dr Peter Fisher and Robert Wilson who, as it turns out, are no better at defending the indefensible than any of the common or garden homeoquacks and punters who keep themselves busy spreading their crap all over the web.

Much has already been made of the admission by Paul Bennett, Professional Standards Director at Boots, which stocks homeopathy and other quack remedies aplenty. Responding to a question from the Chair, Phil Willis MP, on whether homeopathic remedies work better than placebo, he said,

I have no evidence to suggest that they are efficacious and we look very much for the evidence to support that so I am unable to give a yes or no answer to that question.

“It could go down as a Boot in Mouth moment” says the Daily Mail, which compares Bennett’s admission to that of Gerald Ratner, who in 1991 described the items sold in his chain of jewellery shops as “total crap”. They went out of business soon afterwards.

Paul Bennett can’t be a complete moron. He must have anticipated the question but perhaps not the emphatic directness with which it was put and which he found himself unable to dodge. In a split second he decided to come clean and quite right too, even if he does end up losing his job over it.

Although Dr Evan Harris did ask him if he had no qualms about selling stuff he didn’t believe in (the answer was ‘no’ in case, you’re wondering), Bennett got off pretty lightly, all things considered. Nobody mentioned the Boots Learning Store website, which promotes homeopathic remedies as if they are indeed efficacious and to be taken seriously.

The Learning Store website makes much of what it calls “the philosophy that like cures like” and gives a few examples of homeopathic ingredients and what they might treat. Take belladonna, for example. The wiki article on belladonna tells us that, “the symptoms of belladonna poisoning include dilated pupils, sensitivity to light, blurred vision, tachycardia, loss of balance, staggering, headache, rash, flushing, dry mouth and throat, slurred speech, urinary retention, constipation, confusion, hallucinations, delirium, and convulsions.” So which of those does belladonna treat homeopathically, according to Boots?

Why, acne, of course! If you’re wondering what the connection between belladonna and acne is and how treating one with the other fits the ‘like cures like’ idea, you are not alone. But we should take comfort in the thought that the question does at least occur to us and we don’t just take it as gospel, unlike the unsuspecting customers of Boots. And we shouldn’t perhaps be surprised that the ‘evidence’ that satisfies the likes of a director of a chain of shops is simply that a large number of customers think they work. “It’s a question for consumer choice,” he said. “They are licensed medicinal products, therefore we believe it’s right to make them available.” Fair enough. I hope Paul keeps his job.

That ‘it works for them’ is, of course, the overriding consideration of all defenders of homeopathy and one that Robert Wilson, Chairman of the British Association of Homeopathy Manufacturers, seemed unable to get past. His own answer to the question of whether it works beyond placebo was that in France and Germany, homeopathy is a “400 million euro business.”

“So is prostitution,” Phil Willis helpfully pointed out.

Asked for cast-iron evidence that homeopathy works, Robert Wilson claimed to have many trials showing a “strong efficaciousness” for homeopathy. Asked, not unreasonably, by Phil Willis why he hadn’t told Boots about all this evidence, Wilson protested that he had indeed told them, though as the high pressure interrogation continued he amended his answer to saying that Paul Bennett, “hasn’t asked us specifically about the efficaciousness of homeopathic medicines.”

Blimey! That’s a bit remiss of Boots isn’t it? And to think that Paul Bennett had only two minutes earlier, claimed to “look very much for the evidence”, when he hasn’t even asked for it! The hearing was already taking on the character of a comedy farce when Wilson delievered his coup de grâce:

You’ve got to ask, if these medicines didn’t work beyond the placebo effect, why do people keep buying them?

Exactly what all the homeopaths in the room were thinking, no doubt. Phil Willis, however, was unimpressed. “That wasn’t a serious point was it?” he said. (I love how on the video Edzard Ernst can be seen smiling broadly at this point. I think we all were.)

Of course it was a serious point, as far as Robert Wilson was concerned. In common with the bloke who sells them, all that really matters to the bloke who makes them is that customers want them. Evidence, shmevidence, as they say. In fairness, on being pressed, Robert Wilson did name one product — Arnica — for which, he claimed there is a very large, new trial showing a positive result. It was lead by Claudia Witt in Berlin but, alas, I am unable to find it (any help in tracking it down would be appreciated). Professor Jane Lawrence, Chief Scientific Adviser of the Royal Pharmaceutical Society, hadn’t seen it either, adding that she had recently reviewed all the evidence and believes there is no scientific or clinical evidence that supports the use of homeopathy.

It was excrutiating to listen to Robert Wilson pontificate about whether trial results were “statistically significant”, when it was obvious he didn’t have a clue what he was talking about. On and on he gibbered about the importance of sample size, at one point making the ludicrous assertion that “any sample size of less than 500 is not going to be statistically relevant”. In trying to educate him, Dr Evan Harris needed all the patience of a kindergarten teacher. “Whether a sample size is statistically significant depends on the frequency of the outcome you’re measuring,” Evans said gently, before trying to pin Wilson down to accepting that the best way to consider the evidence is to look at the totality of it and especially systematic reviews from which flawed trials have been excluded, rather than cherry-picking individual trials — a point that had been made early on by Ben Goldacre.

Wilson wasn’t having any of it however. Rather than concede what must have seemed a very elementary point to everyone listening (apart from the homeoquacks),  he just gave further vent to his obsession with sample size, even though this was totally irrelevant in the context. I wonder if Paul Bennett learned any lessons about how to prevaricate, fudge issues and dodge questions he doesn’t like by listening to this maestro.

Evan Harris
The wide-eyed Dr Evan Harris, MP

On the whole, I did enjoy the hearing. Ben Goldacre, Edzard Ernst and Tracey Brown (Sense about Science) all made useful contributions, as did the mild-mannered Dr James Thallon of the West Kent NHS, which took the heroic decision to close down the Tunbridge Wells homeopathic hospital a couple of years back. But the star of the show for me was Evan Harris who, in a most engaging wide-eyed and innocent manner, did his best to draw the quacks on some of the most unhinged aspects of homeopathy.

“Do you think homeopathic provings represent good evidence of effectiveness?” he asked Robert Wilson. (The short answer was “no” but, predictably, he went all round the houses with it.) “Why does the water retain the memory of the homeopathic ingredient and not the memory of all the poo that’s been it?” He addressed this one to Dr Peter Fisher, who’d obviously been asked the same question many times and had his answer off pat. Use highly purified doubly-distilled and de-ionised water in the first place — apparently if it’s that pure it will have forgotten about the poo but will remember any subsequently added ingredient provided the mixture is shaken properly.

“I would have thought it would have less memory if it was shaken,” said Evan, keeping a straight face. But leaving the water alone or just stirring it has been investigated and “it doesn’t induce the same structural effects,” responded Fisher, just as earnestly. Evan asked him how much the shaking was needed but Fisher could see where he was heading and side-stepped neatly saying something about research being in its early stages. It seems Dr Fisher has discounted all the painstaking research done by Samuel Hahnemann himself 200 years ago and which is faithfully reproduced by the homeopathy manufacturers of the 21st century. Let’s have a reminder:

…one grain of this powder is dissolved in 500 drops of a mixture of one part of alcohol and four parts of distilled water, of which one drop is put in a vial. To this are added 100 drops of pure alcohol and given one hundred strong succussions with the hand against a hard but elastic body.

Source: Hahnemann’s Organon of Medicine

Oh for crying out loud! How did we ever get to the stage that we need to have an HOC sub-Committee consider whether this lunacy should be part of our National Health Service or not? Enough already.

28 thoughts on “Confession time for Boots the chemist: homeopathy is crap”

  1. One small correction – I believe Wilson asked why people would buy something that doesn’t work, not Bennett.

    This is the best coverage I’ve read so far. Several blogs and mainstream media are being too easily distracted by Bennett’s “own goal”. Bennett might be the scapegoat that lets the rest of the silliness off the hook.

    I saw a comment somewhere that Wilson’s “positive” trial had something like 25 participants. I can’t find where I read it (thought it was linked from JREF) but I’ll go looking.

  2. Back again…

    There is this one

    I’m not experienced in reading papers (or summaries) but if this is it, it doesn’t look too amazing…

    “CONCLUSIONS: In all three trials, patients receiving homeopathic arnica showed a trend towards less postoperative swelling compared to patients receiving placebo. However, a significant difference in favour of homeopathic arnica was only found in the CLR trial.”

    The CLR trial had just 57 participants. What does “a trend toward less … swelling” mean?

  3. Every time I hear a homeopath say that they use double distilled water in response to “what about past memories of the water?” I have to struggle to keep a straight face. Yes, distilled water is kind of “pure” and you can even say that double-distilled water is “ultra pure” (triple distilled water would be a bit purer still). But that doesn’t mean it’s free from impurities – I think Peter Fisher even said that it has impurities in the ppb to ppt range but nobody caught on that. I guess that most homeopaths have no idea what ppb stands for and that it still is way more than the amount of most of their “diluted” substances that will (in theory) be in their remedies.

  4. Vicky

    I was in the public area as well and noticed the ppb nonsense Fisher spouted. Unfortunately, heckling in a Commons Select Committee is frowned upon, apparently!

    I suspect many of them just don’t do numbers. 1 ppm is 3C and 1 ppb is between 4C and 5C and 1 ppt is 6C. So, even if they managed to get a water purity of 1 ppb (I’m not sure what the impurity level of distilled water would be), there will still more of the original water impurities (all sorts of molecules) in a 6C that the ‘active’ ingredient! Then there’s the silica dissolved from from the glass test tube…

  5. Have they shown that distilling water gets rid of its “memory”? I would have thought that if shaking, separating and banging didn’t dislodge said memory, what good would distilling do?

  6. The purest water theoretically available (and certainly purer than that used by homeopaths) is 18.3 Megohm water (identified by having a specific resistance greater than 18.3 Megohm-cm at 25C. It contains <5 ppb of total organic carbon, <10 ppb of total dissolved solids, and <1 colony forming unit per mL of micro-organisms source.

    This means that even the purest possible water will contribute impurities during the preparation of homeopathic products. In fact, there will come a point in the dilution cycle where the amount of impurities in the water will be about the same as the amount of “ingredient”. These impurities are being succussed along with the “ingredient” and although more impurities are added with each dilution, there should be the same concentrating effect on the vital energy of the impurities from the initial aliquot as for the “ingredient”.

    In short, homeopaths are providing a “treatment” of unknown nature each time, which will vary depending on the original water source, the atmospheric composition of the labs and probably the skin cells of the homeopaths carrying out the work.

    Homeopaths truly are fricken idiots.

  7. A year of so back I went round all my local boots and asked the pharmacists if Arnica was any good for bruising (in response to a pub argument). They all answered with variations of no or not really. All but 1 recommended ibuprofen for the pain and a hot compress after a day or 2 to get the swelling down. When I asked one why they sold it if it didn’t work he shrugged and said it was something that sold…

  8. With respect to this business of the purity of their base solvents, the immediate question that should have been pitched back at Fisher was, “What did Hahnemann use?”

    The hilarious thing about these numpties is that as soon as they try to grab hold of some credibility due to their current scientificky methods, it immediately calls their entire historical basis for practice into question.

    An essential feature of the mental make-up of the typical SCAMster is an inability to follow an argument to its logical conclusion. They have to live in a fog of unreconciled contradictions or else their house of cards collapses.

  9. Excellent description of the events. I left 10 minutes late for a presentation because I couldn’t take my eyes off the video feed. It will be very interesting to see what happens next.

  10. […] the immediate question that should have been pitched back at Fisher was, “What did Hahnemann use?”

    Judging from the Organon’s 6th edition (published 1921, Hahnemann died in 1843) I think it’s safe to say that although he indeed used distilled water (or rather a mixture of alcohol and distilled water) for one step of the process, except for the 1:100 dilution steps he did almost everything quite differently (found an English online version here, but didn’t check if it says the same as the German version; preparation is explained in §270).
    Just another one of those things homeopaths usually keep quiet about.

  11. The quality of distillation or other methods of purification doesn’t really matter when you understand that the water will only ever remember the supposedly beneficial qualities of whatever is/was in it. All detrimental qualities of contaminants are long forgotten through the dilution/succussion process.

    Homeopathic water only has happy memories.

  12. Oh dear !
    You poor disillusioned little people. Please try to learn some long words and you might sound credible. Oh and please study the subject a little more.
    Dr Evan Harris does indeed have big wide eyes, perhaps he should see a homeopath.
    When you have learnt some big words and also studied your history books you’ll find that the world was once thought to be flat…by people just like you
    One day if you are not very careful you will be left behind in the dark ages
    I’m sure this will not be printed..but hope it is read by you poor little scaredy cats
    Dr Fisher & colleagues have more intelligence & knowledge in their finger nails than you have collectively in your silly litttle heads

  13. Hi Sarah, nice to hear from you.

    I sense you don’t agree with my post or the comments beneath it. What particular thing do you think any of us have got wrong?

    By the way, I don’t know why you were “sure this will not be printed”. I am always pleased to receive comments that do so much to confirm what I say about people who believe in homeoquackery.

    I’d be even happier to hear reasoned, intelligent arguments, however.

    Care to try some?


  14. Sarah H – It’s a pity that with all that intelligence & knowledge, Dr. Fisher, et. al. have no evidence homeopathy works better than a placebo.

    I doubt any homeopathy skeptic is afraid of being proven wrong. It’s unlikely though, as evidence of efficacy is never forthcoming and rather than subjecting their claims to the same rigorous trials as what is accepted as medicine, homeopaths tend to dodge and put up excuses as to why their practice is somehow untestable.

    If homeopathy actually worked, don’t you think many people would like to prove it so in order to help cure disease, etc.? If homeopaths kept evidence of efficacy to themselves, wouldn’t that be horribly unethical, given the amount of pain, suffering, and death caused by disease around the world? And if homeopathy doesn’t work, isn’t it cruel and unethical for homeopaths to take people’s money to give them false hope?

  15. Re Sarah H’s comment

    It is rather baffling that people as learned and erudite as Dr Fisher and Prof Lewith seem to employ most of their undoubted intelligence turning contorted intellectual somersaults to try and make 2+2 = 5,000.

    What a waste of intelligence and effort – and years.

  16. Sarah

    How long ago did “People like us” think the world was flat? No one other than some right wing religions in the first millenia AD have thought the world flat. Hardly anyone has thought that since the first millenia BC. The ancient Greeks knew the earth was round (well an oblate spheroid actual, but we’ll let them off), and as its with the ancient Greeks that Skepticism really begins I think you’ll find it is you, the non skeptic, who has their historical links with Flat Earthers.

    Read your history, then comment.

    Excellent article Skepticat. I’m new to your blog but shall endeavour to check in with it!

    Alex Pryce
    Edinburgh Skeptics

  17. Yes or No may be the question with homeopathy but the answer is ……. maybe, even some clinically proven medicine will only work on particular individuals with specific symptoms. The role of anyone involved in healthcare is to make a patient FEEL better, if a person walks into Boots, buys a homeopathic remedy (or a bottle of perfume for that matter) and FEELS better, is that not a treatment in it’s self? Sometimes there are no cures, no treatments, no medicine and the only way to judge a patient’s health is by the way they FEEL.
    I guess that the vast majority of homeopathic customers buy products because they make them FEEL better and not because they actually make them better.
    Is a placebo not a medicine?
    Homeopathy needs to know it’s place in the scientific community, it has no proof yet so it cannot make a claim, it is not a substitute for any proven medicine and this is something that the general public needs to be aware of CLEARLY.

  18. There is absolutely nothing wrong with making patients feel better – compassion is an essential aspect of humanity. However, the problem comes in when claims are made and money changes hands. Individuals, corporations, and governments have finite resources to spend on medical care and it is in the population’s best interest that those resources are spent on treatments that work better than placebo, even if non-efficacious “faith-based” treatments such as homeopathy make people feel better.

    Certainly a simple hug, a kind word, and the support of friends and family would work as well as distilled, agitated water and cost a lot less, and there’d be no chance of deluding credulous souls that the “treatment” would work against malaria, colic, or cancer.

  19. Sorry Paul,

    The job of healthcare practitioners is not to make the patient FEEL better, but to make them better.

    If someone has cancer, making them FEEL better will only do that- make them FEEL better. It will have no bearing or affect on the actual tumour.

    This is the problem with placebo and the people who say “what’s wrong with placebo” when challenged on the fact that homeopathy is only placebo.

    The problem with placebo is that it only affects how you feel. If you’ve got a cold or a pain in the back, or if you have something mild that will probably clear up by itself then Placebo is fine, it’ll make you feel better whilst the condition sorts itself out.

    If however you have a serious underlying problem then placebo will still only make you feel better and in no way counter the underlying issue. And if the placebo you are taking is homeopathic then you delay seeking real medical advice and help.

    Sometimes people may be unaware that there is a serious underlying issue and the homeopathy makes them feel better, but they still have the problem. An example (Actually to do with psychic healing- not homeopathy I know, but as far as I’m concerned they are in the same league): A woman went to see a psychi healer regarding her kidney stones, she was “treated” and felt fine, no pain at all. Great. A year later she, as part of a documentary, went to a REAL doctors and had an x-ray. The kidney stones were not only still there but had grown. The documentary in question was to do with Indigo Children and feature a well known “Healer” who ahs been debunked by BadPsychics- though I forget his name.

    Anyway, long post I know, but don’t overestimate the power of placebo nor underestimate the importance of real medicine. Feeling better is not enough. Being better is the goal. You accept homeopathy needs to know its place (I would say that place is in the bin) but don’t rely too much on placebo.

    Alex Pryce
    Edinburgh Skeptics

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