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Homeopathic dilutions

From Wikipedia, the free encyclopedia

In homeopathy, homeopathic dilution (known by practitioners as "dynamisation" or "potentisation") is a process in which a substance is diluted with alcohol or distilled water and then vigorously shaken in a process called "succussion". Insoluble solids, such as quartz and oyster shell, are diluted by grinding them with lactose (trituration). The founder of homeopathy, Samuel Hahnemann (1755–1843), asserted that the process of succussion activated the "vital energy" of the diluted substance,[1] and that successive dilutions increased the "potency" of the preparation, although other strands of homeopathy (such as Schuessler's) disagreed.

The concept is pseudoscience because, at commonly used dilutions, no molecules of the original material are likely to remain.[2] Therefore high homeopathic dilutions must be distinguished from low dilutions where there can be an overlap with herbal medicine.[3]

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Transcription

In 1948, American psychologist B F Skinner reported some unusual animal behaviour. He placed a succession of hungry pigeons inside a cage where an automated machine delivered food to them at certain intervals and observed that the birds started repeating actions that had coincided with the delivery of the food. They behaved as if their actions were influencing the food to appear as if there was some causal connection, when in fact there was none: the food would have appeared at the same intervals, whatever the birds did. At about the same time Skinner published his paper, "Superstition in the pigeon" psychologist Bertram Forer was conducting a study relating to a human superstition, astrology. He gave each of his subjects a test followed by a confidential personality analysis which he told them was based on their test results. When they were asked to rate their analysis for accuracy on a scale of nought to five, five being the most accurate the average rating came out as 4.26. Forer later revealed that all subjects had received exactly the same analysis taken from horoscopes in an astrology book. The Forer Effect, named after him refers to people's tendency to be impressed by personality readings given by astrologers and other pseudo-scientists which they're led to believe are tailored to them individually but are actually general enough to apply to most people. Forer's experiment, which has been replicated many times with the same basic results, is an important demonstration that the seemingly impressive accuracy of horoscopes can easily be reproduced without birthdays or planetary positions playing any role. According to superstition a wedding ring dangled over the belly of a pregnant woman can predict the baby's gender. A circular motion predicts a girl. A straight pendulum swing predicts a boy. This involves the same mechanism found in dowsing the superstitious belief that one can detect underground water or other hidden substances with dowsing rods. It actually works by amplifying small, almost imperceptible movements of the hand. This hand movement is often an unconscious 'ideomotor effect' whereby one's expectations lead one to make involuntary movements in line with those expectations. Sometimes, dowsing rods are even used on maps which are declared somehow to have the same detectable 'energies' as the terrain they depict. Wedding ring predictions, dowsing automatic writing and ouija board activity have all been attributed to the ideomotor effect though the person making the involuntary action might be convinced the movement is coming from elsewhere. Of course, often, there is a deliberate attempt to deceive others. The belief that we can contact spirits with ouija boards is one of countless superstitions surrounding death and countless television shows seek to give evidence of ghosts and spirit-channeling. Viewers send in footage in which spots of light are leapt on as so-called ghostly 'anomalies' and self-proclaimed mediums declare they can channel spirits in shows that disclaimers admit are 'for entertainment purposes only'. Interestingly, when magicians give their audiences apparently uncannily accurate details about their lives and relationships our typical response is "What's their trick?" But when others do the same, posing as psychic mediums the response is often, "They must have supernatural powers". All that differs between the self-proclaimed medium and self-confessed showman is presentation style. If the showman doesn't need supernatural powers, nor does the medium. In the fifth season of the so-called ghost-hunting show Most Haunted its resident medium, Derek Acorah, behaved as if possessed by the spirit of 'Kreed Kafer'. But it was later reported that this name had been invented and misinformation about the fictitious person had been fed to Derek prior to filming, to test his integrity. As filming began and Derek became swept up in the persona of the non-existent spirit, he didn't realise that 'Kreed Kafer' was an anagram of 'Derek Faker'. He went on to channel a similarly fictitious highwayman whose name was an anagram of 'Derek Lies'. Many superstitions revolve around the treatment of illness. And many want their superstition to be regarded as authentic medicine. Homoeopathy involves preparations that have been repeatedly and extremely diluted until it's statistically uncertain that there's even one molecule of active ingredient present. How do homoeopaths justify selling water as medicine? They claim water has a memory of the substances with which it's had contact. A major problem with this claim, even if there were valid evidence to support it is that the water the homoeopath sells you may have had contact not only with the substance claimed to treat your illness but with countless other substances during its natural existence. The '10:23' campaign has staged mass overdoses of homoeopathic products around the world to protest against their sale and raise awareness of the problems with homoeopathic claims. Homoeopathy hasn't been shown to have any effect beyond placebo: when receiving and having confidence in a dummy treatment can itself lead to an improvement in health. Some feel that if placebos sometimes show improvement then deceiving people into thinking a fake medicine actually works does no harm or is ethically justified. Among the well-known objections to this idea is that if people come to rely on treatments with no scientific validity they may fail to pursue treatments that would be effective. But a 2010 study by Ted Kaptchuk and his colleagues indicates that the placebo effect may work even when you know it's a placebo. They divided IBS patients into two groups. One received no treatment; the other was given dummy pills twice daily and told the pills had no active ingredient. The word 'placebo' was even printed on the pill bottle. And yet the study's results showed that the group who knew they were taking placebos had significantly greater relief from their symptoms than the no-treatment group. As Kaptchuk points out, there may be a benefit simply in the performance of a medical ritual. More research is needed in this area but anything that might help to rid us of medical deception would seem to be worthwhile. As a child, I was brought up to think there was a divine creator of the universe that listened and responded to prayers. If I prayed and nothing happened I was told I must have prayed for the wrong thing or didn't pray hard enough or that my prayer was answered but in an indirect way I'd discover later. I eventually worked out that a god that moved so mysteriously I had no idea what it had actually done, may as well not be there at all. Ann prays she'll find a parking space in town. She finds one. Was her prayer answered, or was it too trivial a request to make of a god and just a happy coincidence she got her space? If it's coincidence in this case, why not in others? On what basis do people rule out coincidence? Careful analysis or unreliable intuition? Ben's daughter suddenly stops breathing. He prays she'll be okay until the ambulance arrives. She dies. Are we meant to believe Ben's prayer wasn't good enough? Or that there was a different divine plan for him and the child? If our fates are already divinely decided then prayer would have no effect even if gods existed. Big problems arise when superstitions get so well-established that any outcome reinforces them. So if you pray, dance for rain or put on what you think is a lucky hat then get the results you want, you go on praying, dancing, or wearing the hat. But if you don't get the desired results, you still pray, dance or wear the hat certain that it will work for you again. In this way you create a bias towards confirming the causal connection you've made and a blindness to conflicting information that would help you identify your mistake. Once that happens, you've built a barrier to rational thinking and you've departed from reality. Like Skinner's pigeons, you're left flapping about in a psychological cage of your own making blocked from realising your actions are not having the effect you imagine. If we find Skinner's pigeons quaint and amusing; if we find ourselves thinking, "If only they could understand"; how much more should we, with our much greater intelligence be prepared to examine our own behaviour and confront the false beliefs that are literally getting us nowhere? Superstitions can give some a comforting illusion that they have more control in their life than they actually do. But their effects can be more oppressive especially when the superstitious insist that others share or support these irrational beliefs. We might know people whose reaction when we put new shoes on a table or open an umbrella indoors is clearly designed to make us stop the 'unlucky' behaviour and thereby validate their magical thinking. This is one way in which superstitions extend their tyrannical grasp beyond the believer, and we do well to resist this kind of manipulation. If some are happy to let evidence-free beliefs rule their lives, so be it. But they've no right to expect the collaboration of others. When you reject superstition, you no longer feel protected by good luck charms but you also stop worrying about black cats and broken mirrors. Holy water can't bless you, but curses can't harm you. Crystals or homoeopathy may not improve your health but you'll also be less vulnerable to psychological and financial exploitation from medical charlatans. You can't control people with magic rituals but they can't do the same to you. Perhaps most importantly, good and evil supernatural forces no longer get the credit or blame for what human beings do. Instead it can be clearly understood that people are responsible for their own kindness, cruelty, generosity, meanness, laziness or hard work. Owning responsibility can give a sense of genuine self-control but it does mean learning from mistakes. When we follow superstitions, our mistakes become invisible to us because we've already mixed them into our whole way of thinking. If we tell ourselves magic can solve our problems or rid us of guilt for any wrong we do, that's a much easier ride than thinking critically or holding ourselves accountable. But if the price is denying reality, becoming fearful of knowledge, being unable to distinguish true and false claims, or demonizing difference it's worth considering the possibility that that easy ride will cheat you out of much more in the long run. With a little careful, critical thought we can identify our own cages of superstition and walk free of them.

Background

The founder of homeopathy, Samuel Hahnemann found that undiluted doses caused reactions, sometimes dangerous ones, so specified that preparations be given at the lowest possible dose.[4] To counter the reduced potency at high dilutions he formed the view that vigorous shaking by striking on an elastic surface – a process termed succussion – was necessary.[4] It has been said that Hahnemann came to this conclusion after deciding preparations subjected to agitation in transit, such as in saddle bags or in a carriage, were more "potent".[5]: 16  Hahnemann had a saddle-maker construct a special wooden striking board covered in leather on one side and stuffed with horsehair.[6]: 31  The process of dilution and succussion is termed "dynamization" or "potentization" by homeopaths.[7][8] In industrial manufacture this may be done by machine. There are differences of opinion on the number and force of strikes, and some practitioners dispute the need for succussion at all. There are no laboratory assays and the importance and techniques for succussion cannot be determined with any certainty from the literature.[5]: 67–69 

Potency scales

This bottle contains Arnica montana (Leopard's Bane, Fallkraut) D6, i.e. the nominal dilution is one part in a million (106).

Three main logarithmic dilution scales are in regular use in homeopathy. Hahnemann created the "centesimal" or "C scale", diluting a substance by a factor of 100 at each stage. There is also a decimal dilution scale (notated as "X" or "D") in which the preparation is diluted by a factor of 10 at each stage.[9] The centesimal scale was favoured by Hahnemann for most of his life, although in his last ten years Hahnemann developed a quintamillesimal (Q) scale which diluted the drug 1 part in 50,000.[10] The greatest dilution reasonably likely to contain at least one molecule of the original substance is around 12C.[11]

A 2C dilution requires a substance to be diluted to one part in one hundred, and then some of that diluted solution diluted by a further factor of one hundred. This works out to one part of the original substance in 10,000 parts of the solution.[12] A 6C dilution repeats this process six times, ending up with the original material diluted by a factor of 100−6=10−12. Higher dilutions follow the same pattern. In homeopathy, a solution that is more dilute is described as having a higher potency, and more dilute substances are considered by homeopaths to be stronger and deeper-acting.[13] The end product is often so diluted that it is indistinguishable from the dilutant (typically ethanol or pure water for liquids, milk sugar for insoluble solids).[14][15][16]

Hahnemann advocated 30C dilutions for most purposes (that is, dilution by a factor of 1060).[17] Hahnemann regularly used dilutions up to 300C but opined that "there must be a limit to the matter".[18]: 322  In Hahnemann's time it was reasonable to assume that preparations could be diluted indefinitely, as the concept of the atom or molecule as the smallest possible unit of a chemical substance was just beginning to be recognized. It is now known that the greatest dilution that is reasonably likely to contain one molecule of the original substance is 12C, if starting from 1 mole of original substance (see Avogadro constant for justification).

Some homeopaths developed a decimal scale (D or X), diluting the substance to ten times its original volume each stage. The D or X scale dilution is therefore half that of the same value of the C scale; for example, "12X" is the same level of dilution as "6C". Hahnemann never used this scale but it was very popular throughout the 19th century and still is in Europe. This potency scale appears to have been introduced in the 1830s by the American homeopath Constantine Hering.[19] In the last ten years of his life, Hahnemann also developed a quintamillesimal (Q) or LM scale diluting the drug 1 part in 50,000 parts of diluent.[20] A given dilution on the Q scale is roughly 2.35 times its designation on the C scale. For example, a preparation described as "20Q" has about the same concentration as one described with "47C".[21]

Potencies of 1000C and above are usually labelled with Roman numeral M and with the centesimal 'C' indicator implied (since all such high potencies are centesimal dilutions): 1M = 1000C; 10M = 10,000C; CM = 100,000C; LM (which would indicate 50,000C) is typically not used because of confusion with the LM potency scale.

The following table is a synopsis comparing the X and C dilution scales and equating them by equivalent dilution. However, the homeopathic understanding of its principles is not explained by dilution but by "potentisation", hence one can not assume that the different potencies can be equated on the basis of equivalence of dilution factors.

X Scale C Scale Ratio Note
1X ― 1:10 described as low potency
2X 1C 1:100 called higher potency than 1X by homeopaths
6X 3C 10−6
8X 4C 10−8
12X 6C 10−12
24X 12C 10−24 Has a 60% probability of containing one molecule of original material if one mole of the original substance was used.
26X 13C 10−26 If pure water were used as the diluent, no molecules of the original solution remain in the water.
60X 30C 10−60 Dilution advocated by Hahnemann for most purposes: on average, this would require giving two billion doses per second to six billion people for 4 billion years to deliver a single molecule of the original material to any patient.
400X 200C 10−400 Dilution of popular homeopathic flu preparation Oscillococcinum
Note: the "X scale" is also called "D scale". 1X = 1D, 2X = 2D, etc.

Dilutions

Serial dilution of a solution results, after each dilution step, in fewer molecules of the original substance per litre of solution. Eventually, a solution will be diluted beyond any likelihood of finding a single molecule of the original substance in a litre of the total dilution product. The "Korsakovian" method may also be used. In the Korsakovian method the vessel in which the preparations are manufactured is emptied, refilled with solvent, with the volume of fluid adhering to the walls of the vessel deemed sufficient for the new batch.[5]: 270  The Korsakovian method is sometimes referred to as K on the label of a homeopathic preparation.[22][23] Another method is Fluxion, which dilutes the substance by continuously passing water through the vial.[24] Insoluble solids, such as granite, diamond, and platinum, are diluted by grinding them with lactose ("trituration").[5]: 23 

The molar limit

If one begins with a solution of 1 mol/L of a substance, the dilution required to reduce the number of molecules to less than one per litre is 1 part in 1×1024 (24X or 12C) since:

6.02×1023/1×1024 = 0.6 molecules per litre

Homeopathic dilutions beyond this limit (equivalent to approximately 12C) are unlikely to contain even a single molecule of the original substance and lower dilutions contain no detectable amount. ISO 3696 (Water for analytical laboratory use) specifies a purity of ten parts per billion, or 10×10−9 ― this water cannot be kept in glass or plastic containers as they leach impurities into the water, and glassware must be washed with hydrofluoric acid before use. Ten parts per billion is equivalent to a homeopathic dilution of 4C.

Analogies

Critics and advocates of homeopathy alike commonly attempt to illustrate the dilutions involved in homeopathy with analogies.

An example given states that a 12C solution is equivalent to a "pinch of salt in both the North and South Atlantic Oceans",[25][26] which is approximately correct.[27] One-third of a drop of some original substance diluted into all the water on earth would produce a preparation with a concentration of about 13C.[28][29][30]

A popular homeopathic treatment for the flu is a 200C dilution of duck liver, marketed under the name Oscillococcinum. As there are only about 1080 atoms in the entire observable universe, a dilution of one molecule in the observable universe would be about 40C. Oscillococcinum would thus require 10320 times more atoms to simply have one molecule in the final substance.[31]

Another illustration of dilutions used in common homeopathic preparations involves comparing a homeopathic dilution to dissolving the therapeutic substance in a swimming pool.[32][33] There are on the order of 1032 molecules of water in an Olympic-size swimming pool and if such a pool were filled entirely with a 15C homeopathic preparation, to have a 63% chance of consuming at least one molecule of the original substance, one would need to swallow 1% of the volume of such a pool, or roughly 25 metric tonnes of water.[34][35]

The high dilutions characteristically used are often considered to be the most controversial and implausible aspect of homeopathy.[36]

Proposed explanations

Homeopaths maintain that this water retains some "essential property" of the original material, because the preparation has been shaken after each dilution.[37] Hahnemann believed that the dynamisation or shaking of the solution caused a "spirit-like" healing force to be released from within the substance. Even though the homeopathic preparations are often extremely diluted, homeopaths maintain that a healing force is retained by these homeopathic preparations.[35] Modern advocates of homeopathy have proposed a concept of "water memory", according to which water "remembers" the substances mixed in it, and transmits the effect of those substances when consumed. This concept is inconsistent with the current understanding of matter, and water memory has never been demonstrated to have any detectable effect, biological or otherwise. The claim often given to support "water memory" is that science does not fully understand water. In fact a great deal is known about the structure and properties of liquid water, from both theoretical and experimental studies, because of its importance in biochemistry, its relative molecular simplicity and the quantum mechanical nature of hydrogen bonding which make it a popular substance to study in theoretical chemistry.[38] The actual memory of water can be measured experimentally and is found to be around 50 femtoseconds, which is 0.00000000000005 seconds.[39] Generally considered to be pseudoscience by the scientific community, one disputed study into the so-called memory of water, conducted by Jacques Benveniste, claims to have demonstrated that water can be energetically imprinted upon.[40][41][42] Another such study, published in 2003 by Swiss chemist Louis Rey, claims to have found that homeopathically diluted solutions of sodium chloride and lithium chloride have a very different hydrogen bond structure from normal water, as measured by thermoluminescence.[43][44]

Dilution debate

Not all homeopaths advocate extremely high dilutions. Many of the early homeopaths were originally doctors and generally used lower dilutions such as "3X" or "6X", rarely going beyond "12X"; these dilution ("trituration") levels were still popular in the late 20th century with advocates of Wilhelm Heinrich Schüßler's 12 biochemic tissue salts, for example. The split between lower and higher dilutions followed ideological lines. Those favoring low dilutions stressed pathology and a strong link to conventional medicine, while those favoring high dilutions emphasised vital force, miasms and a spiritual interpretation of disease.[45][46][47] Some products with both low and high dilutions continue to be sold, but like their counterparts, they have not been conclusively demonstrated to have any effect when tested against placebo.[48][49]

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This page was last edited on 14 April 2024, at 19:50
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