What is science? How important is theory, especially in medical science? How much do we have to worry if cures in living organisms cannot be explained by basic sciences, like chemistry?
It is a fact that many patients experience curative effect from homeopathic medicines, although we cannot explain the mechanism of action of these remedies. Is it a mere placebo effect? This seems unlikely after a significant number of randomised clinical trials (RCT).
What is the role of science in homeopathy in this stage? It seems superfluous to perform more RCT's; sceptics will continue to stress the implausibility. One of their objections is that effects of homeopathy are not very great, and there they have a point! Indeed we cannot state that homeopathy is a perfect method, there are many flaws. Probably more than half of our prescriptions are not efficacious (in fact placebo's) because of weaknesses in our methodology. In our paper 'Truth or probability? A proper scientific identity for homeopathy' we try to establish a scientific identity for homeopathy.
Our main instruments, materia medica and repertory, are outdated. There are structural shortcomings in the way the repertory is composed. Our materia medica is based on subjective and retrospective data, with a definite risk of confirmation bias. The Committee for Methods and Validation (CMV) of the Dutch association of homeopathic physicians (VHAN) organises meetings to validate materia medica on clearcut cases. These clearcut cases must constitute a reliable materia medica.
Can we use science to improve our method? Indeed we can, but RCT has nothing to offer in this respect. RCT can answer the question if the homeopathic medicine Rhus toxicodendron cures arthritis, but that is not our real question. Rhus toxicodendron will only cure if other criteria are met, eg if there is 'amelioration by motion'. Our scientific question is the real meaning of a symptom like 'amelioration by motion'.
It is perfectly possible to use scientific methods to improve and modernise homeopathy. In 1763 Bayes formulated his theorem to calculate chances of certain facts, based on previous experience with these facts. Bayes' theorem is becoming increasingly popular in science in the last decades. This theorem suits homeopathy perfectly. In fact, Hahnemann's rule that peculiar (rare) symptoms are most important is a consequence of Bayes' theorem. Hahnemann already stated that the symptom 'amelioration by motion' occurred much more frequently in Rhus toxicodendron patients than in other patients. In bayesian terminology we say that the Likelihood Ratio (LR) of the symptom 'amelioration by motion' for 'Rhus toxicodendron=10 if this symptoms occurs 10 times as frequently in Rhus toxicodendron patients than in other patients.
A comprehensive explanation of Bayes' theorem is given by yudkowsky.net.
The CMV is performing prospective assessment of likelihood ratio of homeopathic symptoms. This website contains several papers on this subject, dealing with the scientific problems that such research might meet. These papers have been published in 'Homeopathy'. Sofar it seems feasible to perform this kind of research. As you will see, there is a lot of work to be done. We hope to infect our colleagues with our enthusiasm. Below we demonstrate what kind of changes we can expect in our repertory and our method if LR becomes a standard approach in homeopathy.
Of course, our committee supports other initiatives to improve our method, like George Vithoulkas' efforts to validate the repertory, see the Vithoulkas website.
The Committee for Methods and Validation
Erik Stolper, chairman
Lex Rutten, project leader of the LR-project
Roland Lugten
Rob Barthels
Lex Rutten, MD
Aard 10 - 4813 NN Breda, Netherlands