Screening for haemoglobinopathies in primary care.

Although light-hearted, Jeffries’ essay on homeopathy was out of step with recent moves to recognise the value of complementary and alternative therapies in medical practice, and did nothing to address the paradox of why homeopathic remedies have such widespread use even though they are scientifically implausible. Despite the methodological challenges inherent in evaluating complementary therapies, over 200 randomised controlled trials of homeopathic treatments have been published, together with several systematic reviews suggesting positive results. The conclusion of a meta-analysis published in the Lancet in 1997 was that the clinical effects of homeopathy could not solely be ascribed to placebo. There is undeniably a problem in explaining the mode of action of ultramolecular solutions. Future developments in our understanding of biophysics may or may not help. Homeopathic practice is, however, based on observational data stretching back over 200 years, and not on some theoretical construct that wilfully disregards conventional science. Homeopathy is part of the NHS, and used by hundreds of thousands of patients in Britain each year. Rather than repeating the well rehearsed concerns over evidence and mechanism, a more interesting debate would be to try and separate out the specific effects of homeopathy from non-specific effects, such as those relating to the nature of the homeopathic consultation.