Homeopathy, fundamentalism, and the memory of water

Sir, Pointing out the obvious (i.e., that seeking homeopathic treatment for cancer prior to early conventional diagnosis could be dangerous, and claiming efficacy for homeopathy’s ultra-highly diluted remedies runs counter to Avogadro’s hypothesis) does not exonerate Dr. Sagar’s editorial of grossly misrepresenting the Memory of Water (MoW) hypothesis 1. This compounds an unwarranted slur not only on homeopathy, those who practice it, and the millions around the world who benefit from it, but the many scientists researching MoW. For his description of MoW simply ignores recent published research from the materials, physical, and biochemical sciences 1–6. In addition, the editorial evinces the usual evangelical faith in the “gold standard” drug-testing procedure, the double-blind randomized-controlled trial (DBRCT), and its presumed infallibility at providing incontestable evidence for or against the efficacy of homeopathy, or indeed any therapeutic modality 7. First, Hahnemann never suggested water might be able to “remember” anything: MoW is a 20th-century epithet. Second, MoW has nothing whatever to do with “subatomic fields”: this would mean invoking the kind of particle–particle interactions more familiar from high-energy physics experiments! Rather, MoW is a supramolecular phenomenon involving trillions of water molecules 8, dynamically interrelated and correlated by well-characterized intermolecular forces (for example, non-static hydrogen bonding, van de Waal interactions, and so on), which would no doubt survive interaction with the –OH groups of lactose. There is now published literature (some of which I include here) in reputable journals supporting the kind of dynamic water “structures” alluded to by MoW 1–5. Its take-home message is that it is water structure, not content, that is important 2. We are still left with the problem of how MoW might lead to cure of the patient. I would agree that there is, as yet, much speculation but little research in this area to repudiate. Assuming it were ever to get the proper funding, however, such research would require much closer collaboration between the physical and biomedical sciences, and is perhaps a timely reminder of the intellectual parochialism that is a perennial feature of the latter. As for the DBRCT, its methodology assumes implicitly that a therapeutic intervention and the context in which it is given may be considered in complete isolation from one another. Thus, therapeutic modality (in homeopathy, the remedy; in acupuncture, the needle) provides efficacy, while the extended interview provides context. Ultimately, it is this separation of therapy and context that justifies testing against a “placebo,” one of the least understood concepts in biomedicine. Of course, all this fits neatly into the biomedical paradigm and its assertion of a purely molecular basis to disease. In reality, problems arise for the DBRCT immediately the separation of therapy and context is realised for what it is: an arithmetic convenience allowing measurements to be made, statistics to be gathered, and inferences to be drawn. Patient individuality [something long accepted—in addition to disease/ remedy similarity—in homeopathy and in complementary and alternative medicine (CAM), but generally of far lesser importance in conventional biomedicine] means that therapy and context have to be seen as intimately correlated. Under these circumstances, a fundamentalist approach to the principles of the DBRCT turns it into a blunt instrument that breaks this correlation, effectively destroying the very therapeutic effect it is trying to investigate 7. It is not surprising, therefore, that over time, DBRCTs of homeopathy and other CAMs deliver at best equivocal results or reductions in effect sizes, or both. Perhaps the DBRCT is not the “gold standard” of research quality after all, but the scientific equivaL E T T E R TO T H E E D I TO R