Tell Matsadi Masango homeopathy doesn't work and she will say you don't know what you are talking about.

Five years ago, 34-year-old Masango turned to homeopathy after orthodox medical treatment failed to treat incapacitating symptoms of food allergies.

Today she is symptom-free and she believes homeopathy is the reason.

Masango, of KPMG's corporate communications and advertising division, began showing signs of health problems early in 2000 - chronic itchy skin rashes, puffy, rheumy eyes, swollen lips and painful joints. She was often so tired she could not get out of bed and became unable to work.

She saw a GP who sent her for blood tests. When the results came back, he gave her a long list of all the foods to avoid. It depressed her just to look at it.

"It seemed there was very little I could safely eat," she says.

The doctor prescribed drugs that included cortisone. Her symptoms improved for a while then returned.

Six months later, she consulted a homeopath who said there could be no overnight cure, as homeopathy treated causes of health problems, not just symptoms. She also said Masango was likely to get worse before she got better. That she certainly did.

"At one stage, I got so bad, I thought of giving up the treatment," Masango says. "The homeopath persuaded me to persevere for six months."

She is glad she did. Almost to the day, six months later, Masango's symptoms vanished, never to return.

Orthodox doctors and scientists will dismiss that as "anecdotal evidence", not the rigorous scientific evidence they say proves that a medicine works. They believe homeopathy is "scientifically implausible", a "pseudoscientific remnant from the age of alchemy" - in a word, quackery, despite its widespread global use.

The Quackwatch website describes homeopathy as "the ultimate fake", its medicines "the only category of quack products legally marketable as drugs".

Yet homeopathy is the world's second most widely used form of medicine (see What is Homeopathy below). In Britain, there is even a hospital that practises only homeopathic medicine - London's Royal Homeopathic Hospital.

In South Africa, homeopathy is recognised by the health department and the Allied Health Professions Council. There are around 300 homeopaths registered to practise.

The debate about the efficacy of homeopathy resurfaced last month when The Lancet, the prestigious British medical journal, published an article saying a review of the scientific literature showed homeopathy to be ineffective, and its medicines no better than sugar water.

It also ran an editorial headlined "The end of homeopathy", saying the time for more studies was over and doctors needed to be "honest with patients about (its) lack of benefit".

The author of the article is Dr Matthias Egger from the University of Berne. Along with Swiss colleagues from Zurich University and a British team at the University of Bristol, he reviewed 19 electronic databases from 1995 to 2003 and compared 110 trials of homeopathic remedies against a placebo with 110 trials of conventional medicines also tested against a placebo.

Egger claimed to have found no convincing evidence the treatment worked any better than placebo - the dummy substance used in clinical medical trials.

Not surprisingly, homeopathic doctors quickly begged to disagree.

Dr Peter Fisher, clinical director of the Royal Homeopathic Hospital in London, said Egger's figures "did not add up".

His conclusion was based on not 110 clinical trials, but eight - clearly not statistically significant.

Fisher said that it was difficult to avoid the conclusion that Egger was "being selective to try to discredit homeopathy".

Certainly the timing appears suspect, following so closely on the back of a report in the Complementary Therapeutic Medicine Journal of June 2005 that concluded: "Patients seeking homeopathic treatment had a better outcome overall compared with conventional treatment, whereas total costs in both groups were similar".

That study included a World Health Organisation report, in draft form, set up to examine traditional medicine, which said most related studies published in the last 40 years had shown homeopathic remedies to be superior to placebo and "equivalent to conventional medicines in the treatment of illnesses, in both humans and animals".

Dr Neil Gower, national secretary of the Homeopathic Association of South Africa, says The Lancet study reflects "unbalanced research and analysis" of homeopathy and raises more questions than answers.

Of course one would expect Fisher and Gower to say those kinds of things, and it should not be left to the homeopathic community to comment on the validity of research conducted on their own profession. Others have been just as quick with objective comment. One is Dr Joyce Frye of the University of Pennsylvania.

She said The Lancet study's authors appeared to begin their work "with a bias firmly in place".

Their analysis clearly showed effects of homeopathic treatment - yet they found ways to disregard those, she said. Out of the millions of trials in conventional medicine, their primary outcome relied on the comparison of ridiculously small numbers.

Frye said the authors "began their work with the assumption that the effects observed in placebo-controlled trials of homeopathy could be explained by a combination of methodological deficiencies and biased reporting. Sound research is not conducted from this starting position".

Dr Iris Bell, a medical doctor at the University of Arizona, added that Egger's approach was "incomplete in attempting to evaluate homeopathic medicine, as it did not include criteria that would apply to high quality homeopathic research reflecting the nature of homeopathic practice".

Kisane Brasler, a 40-year-old mother of 20 from Sunninghill, Johannesburg, would like to see more co-operation between orthodox and complementary medicine. She turned to homeopathy three years ago after months of orthodox treatment failed to treat raised, painful joints in her hands that made them look like "those of an 80-year-old".

Homeopathy helped, and her hands now look normal.

She knows she has a health problem she will have to deal with for the rest of her life and says it "makes sense to use a natural medicine that is nutritionally based with no bad side effects".

Brasler says both orthodox medicine and homeopathy have benefits and neither has all the answers.

Each works well for some people and some conditions, but not for everything and everyone.

What Is Homeopathy?

Homeopathy is a natural, safe, holistic form of medicine that dates back to 1796, when Saxon physician Samuel Hahnemann first published the theory on which it is based.

It uses medicines, called homeopathics, that are natural substances, heavily diluted to avoid negative side effects and toxicity.

Homeopathy is based on a "like to like" method of treating illness. For example, if you have symptoms of a cold that are similar to mercury poisoning, then mercury would be your remedy. This is similar to the principles of conventional allergy treatment and vaccines .

Homeopathy started declining in the 20th century with the advent of antibiotics and other modern medicines. It has been enjoying a revival as patients become disaffected with the allopathic or orthodox medical establishment. They see it as cold and uncaring, with treatment and drugs that harm as much as help.

Homeopathy is also popular because its doctors often spend more time in consultation with patients than orthodox doctors spend. In addition, homeopathic medicines don't have serious side effects compared with conventional pharmaceutical drugs, and are usually much cheaper.

What are its drawbacks?

Finding the right homeopathic remedy can take more time and patience than conventional medicine because exactly the right remedy has to be taken for symptoms.

For example, there is no such thing as a standard homeopathic headache remedy - though this does not mean no such product is sold.

The remedy has to be matched to the particular headache - where it occurs, what brings it on, what type of pain it is, what aggravates it, the patient's state of mind, and what other symptoms may be experienced.

Also, the sheer range of remedies can cause practical problems for an average-sized pharmacy.

If the right remedy is not one of around 30 or more commonly used remedies, they can be difficult to obtain. - Homeopathic Society of South Africa and the Internet

  • This article was originally published on page 11 of The Star on September 07, 2005