Is It Medicine?

Recently, we were at our local “natural and health foods” store. While my wife shopped for a specific supplement she was advised to use, I got to ride herd on my energetic five year old as he roamed around the store looking at everything. He loved the posters over by the pet food section, one of which showed a lion with a lamb curled up against it. He thought that was amazing and cute. Nearby was an entire wall of homeopathic products, including an entire array of products for pets. My son stopped and looked at the boxes, then turned and looked at me.

“Is this all medicine?” he asked.

I didn’t really feel like tackling that subject right there in the store. Not in any detail, anyway. “No,” I said.

“Okay,” he answered, and then he was off to look at the selection of vegan, glutin free baked goods.

What is homeopathy?

According to the American Institute of Homeopathy:

Homeopathy, or Homeopathic Medicine, is the practice of medicine that embraces a holistic, natural approach to the treatment of the sick. Homeopathy is holistic because it treats the person as a whole, rather than focusing on a diseased part or a labeled sickness. Homeopathy is natural because its remedies are produced according to the U.S. FDA-recognized Homeopathic Pharmacopoeia of the United States from natural sources, whether vegetable, mineral, or animal in nature.

The website goes on to explain that there are three guiding principles of homeopathy:

  1. “Like cures like”. A principal that a symptom can be treated with a substance that causes a similar symptom.
  2. The minimum dose. From the AIH website, “Homeopathic medicines are prepared through a series of dilutions, at each step of which there is a vigorous agitation of the solution called succussion, until there is no detectible chemical substance left. As paradoxical as it may seem, the higher the dilution, when prepared in this dynamized way, the more potent the homeopathic remedy. Thereby is achieved the minimum dose which, none the less, has the maximum therapeutic effect with the fewest side effects.”
  3. The single remedy. Again, from the AIG website, “Most homeopathic practitioners prescribe one remedy at a time. The homeopathic remedy has been proved by itself, producing its own unique drug picture. That remedy is matched (prescribed) to the sick person having a similar picture. The results are observed, uncluttered by the confusion of effects that might be produced if more than one medicine were given at the same time.”

Is homeopathy medicine?

Merriam-Webster defines medicine as:

1 a: a substance or preparation used in treating disease
b: something that affects well-being

2 a: the science and art dealing with the maintenance of health and the prevention, alleviation, or cure of disease
b: the branch of medicine concerned with the nonsurgical treatment of disease

3: a substance (as a drug or potion) used to treat something other than disease

So. By some definitions of medicine it qualifies. Homeopaths are certainly involved in “the science and art dealing with the maintenance of health and the prevention, alleviation, or cure of disease” and homeopathic medicines are certainly “a substance or preparation used in treating disease”.

Does homeopathy work?

No.

Uhm… could you elaborate on that?

There’s no way it could work. Let’s take another look at that second principle of homeopathy, the minimum dose. The AIH states that “Homeopathic medicines are prepared through a series of dilutions, at each step of which there is a vigorous agitation of the solution called succussion, until there is no detectible chemical substance left.”

Here’s how the dilutions work, as explained by a FAQ from Boiron (described as a “world leader in homeopathic medicines”):

What does the “C” listed after the active ingredient stand for?

The most common type of dilutions is “C” dilutions (centesimal dilutions). The 1C is obtained by mixing 1 part of the Mother Tincture with 9 parts of ethanol in a new vial and then vigorously shaking the solution (succussion). The result is a 1/100 dilution of the plant (the Mother Tincture being a 1/10 dilution of the plant itself). The 2C is obtained by mixing 1 part of the 1C with 99 parts of ethanol in a new vial and succussing. Recurrently, the 3C is obtained by mixing 1 part of the 2C with 99 parts of ethanol in a new vial and succussing.

What does the “X” listed after the active ingredient stand for?
X dilutions are decimal dilutions prepared similarly to C dilutions, but the factor of dilution is only 1/10 from one dilution to the next.

What does the “K” listed after the active ingredient stand for?
The K refers to a method of manufacturing known as the Korsakovian method. The Korsakovian method dilutes the homeopathic preparation of the substance at the rate of 1 part of the previous dilution with 99 parts of solvent.

What does the “CK” listed after the active ingredient stand for?
Korsakovian dilutions are manufactured using a device specially designed to ensure that the dilution process is reproducible from one dilution to the next. Only one vial is used for the entire process. Using ultra-purified water as the solvent, the machine removes 99% of the Mother Tincture and replaces it with the same volume of solvent. The vial is succussed for 10.5 seconds. The result is called 1CK. The 2CK is prepared identically from the 1CK. The automatic process using only 1 vial allows higher dilutions to be reached. The most common Korsakovian dilutions are 200CK, 1,000CK (also called 1M), 10,000CK (10M), 50,000 CK (50M) and 100,000CK (100M or CM).

What does “200CK” mean?
200CK means that the substance has been homeopathically diluted 200 times at the rate of 1 to 100.

The dilutions on the medicines I looked at (I didn’t look at all of them) appear to range between 3C and 12C, counting by threes (3C, 6C, 9C, 12C), with one hitting 30C. Here’s what that looks like:

  • 3C: 1 part active ingredient to 9,999 parts solvent (100 parts per million, or PPM).
  • 6C: 1 part active ingredient to 9,999,999 parts solvent (0.1 PPM).
  • 9C: 1 part active ingredient to 9,999,999,999 parts solvent (0.0001 PPM).
  • 12C: 1 part active ingredient to 9,999,999,999,999 parts solvent (0.0000001 PPM).
  • 30C: 1 part active ingredient to 9,999,999,999,999,999,999,999,999,999,999 parts solvent (0.0000000000000000000000001 PPM)

For comparison, let’s talk about the US Environmental Protection Agency’s Maximum Containment Level Goals (MCLG), Maximum Contaminant Levels (MCL), and Maximum Residual Disinfectant Level Goals (MRDLG):

  • Maximum Contaminant Level Goal (MCLG) – The level of a contaminant in drinking water below which there is no known or expected risk to health. MCLGs allow for a margin of safety and are non-enforceable public health goals.
  • Maximum Contaminant Level (MCL) – The highest level of a contaminant that is allowed in drinking water. MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration. MCLs are enforceable standards.
  • Maximum Residual Disinfectant Level Goal (MRDLG) – The level of a drinking water disinfectant below which there is no known or expected risk to health. MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants.

With that in mind, let’s have a look at the EPA Table of Regulated Drinking Water Contaminants. If you go and look at it yourself, bear in mind that the units are in milligrams per liter (mg/L), which is equivalent to PPM:

  • Chlorine has a MCL of 4 PPM (effectively 4 5C dilutions).
  • Arsenic has a MCL of 0.01 PPM (meaning a 7C dilution)
  • Cyanide has a MCL of 0.2 PPM (two doses of a 6C dilution).
  • Lead has a MCL of 0.015 PPM (one and a half doses of a 7C dilution).
  • Mercury has a MCL of 0.002 PPM (two doses of an 8C dilution).

By sheer logic, if the “like cures like” principal was correct and the minimum dose worked, then we’d be immune to eye/nose irritation and stomach discomfort (caused by chlorine), circulatory system problems (arsenic), nerve damage and thyroid problems (cyanide), developmental development issues and kidney problems (lead), and kidney damage (mercury).

Moles and atoms and molecules

Let’s put it a different way, and talk about moles.

mole6

No, not these guys

A mole is the SI unit of that measures the amount of a chemical substance that contains as many elementary entities (atoms, molecules, whatever) as there are atoms in 12 grams of carbon-12. This odd calculation is used because the number of atoms in 12 grams of carbon-12 happens to be the same as the Avogadro constant: 602,214,085,774,000,000,000,000.

Why is this important? Watch, and see.

A homeopathic “mother tincture” is 10% ingredient and 90% solvent, by weight. So a mother tincture of peppermint would be, say, 1 gram of peppermint oil and 9 grams of water. The active ingredient of peppermint oil is menthol (C10H20O), and water is H2O. Consulting the Lenntech molecular weight calculator, menthol has a weight of 156.26 grams per mole and water weighs 18.02 grams per mole. So one gram of menthol has 3,853,923,497,849,737,616,792 molecules of menthol, and one gram of water has 33,419,205,647,835,738,068,812 molecules of water. So the mother tincture has a total of 304,626,774,328,371,380,236,100 molecules, and is only 1.2% menthol by quantity of atoms (despite being 10% menthol by weight).

A 1C dilution takes 1 gram of the mother solution and mixes that with 99 grams of water, giving us 100 grams of dilution with a total of 3,338,964,036,568,570,000,000,000 molecules, of which 385,392,349,784,973,000,000 are menthol.  That makes it 0.0115% menthol at this point.  Each dilution after that reduces the number of menthol atoms by a factor of 100, until at a 12C dilution you get 3.85 atoms (let’s be optimistic and call it 4).  So, at a 13C dilution, you quite literally have nothing but water.

Homeopathic-Dilutions_thumb18-621x210

Bear in mind that this is the case with a relatively simple molecule like menthol.  Most of the “active ingredients” in homeopathic dilutions are far more complex – according to Chemical composition, olfactory evaluation and antioxidant effects of essential oil from Mentha x piperita, for example, the components of peppermint essential oils were “menthol (40.7%) and menthone (23.4%). Further components were (+/-)-menthyl acetate, 1,8-cineole, limonene, beta-pinene and beta-caryophyllene”.  This reduces the number of atoms per gram of each ingredient, causing the atoms of each chemical that make up the ingredient to go away faster (although in the case of the peppermint essential oils, menthone’s molecular weight is 154.25 grams per mole, so you’d end up with about 2 atoms each of menthol and menthone at a 12C dilution).

So, is homeopathy medicine?  Only in a strict and narrow definition, because it is used to treat illnesses.  After all, the definition we looked at above doesn’t say the medicine has to work.  And it really doesn’t work.