Thursday, 12 February 2015

The Conflation Game - How Misunderstanding the Differences Between Homeopathic and Natural Remedies can Cloud our Thinking

Homeopathy and natural and herbal medicines are not the same thing, but they are often conflated - mistakenly seen as two parts of a single concept.  In this blog, I'll explain the differences between homeopathy and natural medicines, and then discuss why getting clear on these differences is important for making ethical decisions about how we treat our dogs. 

What is Homeopathy? 

Homeopathy was invented in Germany in the 19th Century, by Samuel Christian Friedrich Hahnemann.  He believed that illnesses ought to be treated by restoring the patient�s �vital force�. 

The first principle of homeopathy is that "like cures like". If your dog has a fever, you should treat him with something that is also known to cause fever, in order to balance out his "vital forces". If the dog is itching, we should treat him with something that causes itching, and so forth.

The second principle of homeopathy is that the potency of an ingredient is increased the more times it is diluted using a special shaking method. This is based on the idea, roughly speaking, that "water has a memory". In practice, this means that some homeopathic preparations contain a handful of molecules of the active ingredient listed on the bottle. Some have been shown to contain, on average, less than one molecule - nothing at all that could work, even if the principle of "like cures like" made sense. 

We should all hope that water doesn't have a memory, at least not in the sense of being able to cause effects in the body because of what it "remembers". I wouldn't want memories of velociraptor pee, elephant tears and spawning trout to get into my glass of water!


What are "natural medicines"?

Using plants, animals, and fungi as medicine is a practice as old as human civilization itself. Even our companion animals have been said to administer natural remedies to themselves - most people believe that dogs eat grass to induce vomiting or settle their stomachs somehow, although this is disputed!

Natural remedies are also supposed to contain significant and measurable amounts of their active ingredient.  To make a natural remedy, the drug company takes the plant source, treats it to make the active ingredients available, and then encapsulates the desired dosage of the ingredient into a deliverable form, like drops or a pill.

Information about which chemicals found in nature are good for which ailment has come down from a variety of sources - different cultures, experiments and so on. This means there is no single underlying principle, like the homepath's "like cures like", determining which substances to use.

Some systems, like ayurveda and naturopathy, are based on beliefs that are as far-fetched as homeopathy, involving mysticism and other spiritual practices, so consumers should take care that they are informed about the reasoning behind the claim that such and such a herb will cure something.  However, it is possible to use natural remedies without subscribing to magical thinking.

The data on whether natural remedies for dogs are effective is patchy, which is something I have discussed in an earlier article.*  However, whether you believe a particular remedy or formulation is effective or not, at least nothing in principle rules out some remedies being effective.  We don't have to give up on commonsense beliefs, like water just being water.

Why does it matter?

The reason this is important is that studies have shown homeopathic preparations not to be effective. There is ample scientific proof that the principles of homeopathy are unsound, and that medications based on those principles are ineffective.  

In contrast, many preparations derived from natural sources like fungi and plants are effective.  Many poisons and recreational drugs are obtained from nature's larder, as well as more conventional remedies.  There are issues around just how safe and effective commercial natural remedies are, as the recent story about unsafe herbal medicines for humans shows, but the principle that a dose of a chemical derived from a plant, animal or fungus can treat or cure diseases in dogs makes sense. 

The difference in potential for efficacy is one reason why we should be clear about getting the distinction right.  Homeopathy simply cannot work.  Natural remedies could work, even if some of them don't.  In arguments, conflating homeopathy with natural medicine leads advocates of homeopathy to give critics a false dichotomy.  Either they accept that "alternative medicine" works, or they should reject the fact that many medicines derived from plants are well known to work, and even prescribed by "allopathic" doctors.  If you've been prescribed St John's Wort for depression, or peppermint oil for digestive discomfort and you've felt any benefits from them, you "have to" believe in homeopathy too.  As we've seen, this is clearly not the case.  I can keep downing my peppermint oil capsules every time I eat Indian food whilst simultaneously claiming that all homeopathic products are useless and should be removed from drugstores.  There's no incoherence in this position once we get clear on the distinction.  "Alternative medicine" encompasses everything from herbal supplements to crystal healing, and there's no need to believe in all of it or none at all. 

Another reason is that if we equate homeopathy with naturally-derived supplements like Zylkene or Anxitane for our dogs, and we want to try these supplements, we might automatically assume that we should see a "homeopathic vet".  This is not the case.  Many "allopathic" vets and veterinary behaviorists are knowledgeable about supplements like Zylkene and Anxitane, indeed many will sell them to you without prescription.  They are also widely available online and in pet stores, so there's no need to give up on your family's vet.

When we are looking at supplements, it is because our dog has a problem and is suffering.  If a dog is suffering, the most ethical thing to do is choose those options that have the best chance of working.  There is a lot of evidence that homeopathy doesn�t work, and as we have seen, the principles it is based on don�t fit into common sense or science.  Natural remedies, by contrast, at least could work, so if you have a commitment to trying over-the-counter remedies, it seems ethical to choose the path with the most chance of having some effects.  Conflating homeopathy and natural medicine is inaccurate, and it gives homeopathy false credibility.

* SkeptVet blog has also generated a lot of information on natural supplements for dogs, a list of articles can be found here.

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