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Millions of people around the world swear by the alternative medicine homeopathy. In Britain, the Royal Family endorses and uses it. But that hasn't deterred the editors of The Lancet, the prestigious British medical journal, which has launched an all-out attack on homeopathy. In its current issue, The Lancet published a massive study that compared the results of 110 trials of homeopathy with the same number of trials of conventional medicine. The conclusion: benefits attributed to homeopathy were, at best, placebo effects.

The study is accompanied by an article featuring criticism of a World Health Organization (WHO) draft report that, as currently written, gives homeopathy some leeway, as well as a commentary on bias in research and The Lancet's no-holds-barred editorial comment.

Homeopathy was invented by an 18th Century German physician named Samuel Hahnemann, who argued that diseases could be cured by administering substances, mostly herbs or minerals, that produce the same symptoms as the disease. And, he claimed, the effects of these substances could be enhanced by diluting them. How much? The greater the dilution, it seems, the greater the benefit.

That theory, for which there is not a shred of evidence, is evident in the homeopathic sections of health food stores and major drugstore chains. There, consumers can see, on the homeopathic containers, such notations as 10X, or 80X or even 30C. Each X signifies that the active substance has undergone a ten-to-one dilution, each C a hundred-to-one dilution. Between each dilution, the solution is shaken vigorously, an action that proponents claim transfers the properties of the substance to the surrounding water.

But by the laws of chemistry, at 24 X there is just a 50 percent chance that s single molecule of the active substance remains. And at 200C, the dilution of a popular homeopathic flu remedy, the active ingredient is long gone. What nonsense!

Chances are that The Lancet is somewhat premature in announcing the "death" of homeopathy, which involves a large and very profitable industry and the loyalty of many of the consumers it has duped. In fact, The Lancet notes, ""the debate continues, despite 150 years of unfavourable findings. The more dilute the evidence for homoeopathy becomes, the greater seems its popularity."

But there are encouraging signs. The Swiss Government, after a five-year trial, has withdrawn insurance coverage for homeopathy. Even the U.S. National Center for Complementary and Alternative Medicine, which has been criticized for being too open to spurious alternative medicine claims, has little good to say abut homeopathy. Its website states, "Systematic reviews have not found homeopathy to be a definitively proven treatment of any medical condition."

Now, The Lancet concludes, it's up to the doctors, who "need to be bold and honest with their patients about homeopathy's lack of benefit." For scientifically-literate physicians, that shouldn't be so difficult to do.

• Leon Jaroff
• A British Medical Journal has high hopes