Time after time, properly conducted scientific studies have proved that homeopathic remedies work no better than simple placebos. So why do so many sensible people swear by them? And why do homeopaths believe they are victims of a smear campaign? Ben Goldacre follows a trail of fudged statistics, bogus surveys and widespread self-deception

There are some aspects of quackery that are harmless - childish even - and there are some that are very serious indeed. To my great delight, the author Jeanette Winterson launched a scientific defense of homeopathy in these pages. She used words such as ""nano"" meaninglessly, she suggested that there is a role for homeopathy in the treatment of HIV in Africa, and she said that an article in the Lancet today will call on doctors to tell their patients that homeopathic ""medicines"" offer no benefit.
The article does not say that, and I should know, because I wrote it. It is not an act of fusty authority, and I claim none: I look about 12, and I'm only a few years out of medical school. This is all good fun, but my adamant stance, that I absolutely lack any authority, is key: because this is not about one man's opinion, and there is nothing even slightly technical or complicated about the evidence on homeopathy, or indeed anything, when it is clearly explained.
And there is the rub. Because Winterson tries to tell us - like every other homeopathy fan - that for some mystical reason, which is never made entirely clear, the healing powers of homeopathic pills are special, and so their benefits cannot be tested like every other pill. This has become so deeply embedded in our culture, by an industry eager to obscure our very understanding of evidence, that even some doctors now believe it.
Enough is enough. Evidence-based medicine is beautiful, elegant, clever and, most of all, important. It is how we know what will kill or cure you. These are biblical themes, and it is ridiculous that what I am going to explain to you now is not taught in schools. So let's imagine that we are talking to a fan of homeopathy, one who is both intelligent and reflective. ""Look,"" they begin, ""all I know is that I feel better when I take a homeopathic pill."" OK, you reply. We absolutely accept that. Nobody can take that away from the homeopathy fan.
But perhaps it's the placebo effect? You both think you know about the placebo effect already, but you are both wrong. The mysteries of the interaction between body and mind are far more complex than can ever be permitted in the crude, mechanistic and reductionist world of the alternative therapist, where pills do all the work.
The placebo response is about far more than the pills - it is about the cultural meaning of a treatment, our expectation, and more. So we know that four sugar pills a day will clear up ulcers quicker than two sugar pills, we know that a saltwater injection is a more effective treatment for pain than a sugar pill, we know that green sugar pills are more effective for anxiety than red, and we know that brand packaging on painkillers increases pain relief. A baby will respond to its parents' expectations and behavior, and the placebo effect is still perfectly valid for children and pets. Placebo pills with no active ingredient can even elicit measurable biochemical responses in humans, and in animals (when they have come to associate the pill with an active ingredient). This is undoubtedly one of the most interesting areas of medical science ever.
""Well, it could be that,"" says your honest, reflective homeopathy fan. ""I have no way of being certain. But I just don't think that's it. All I know is, I get better with homeopathy.""
Ah, now, but could that be because of ""regression to the mean""? This is an even more fascinating phenomenon: all things, as the new-agers like to say, have a natural cycle. Your back pain goes up and down over a week, or a month, or a year. Your mood rises and falls. That weird lump in your wrist comes and goes. You get a cold; it gets better.
If you take an ineffective sugar pill, at your sickest, it's odds on you're going to get better, in exactly the same way that if you sacrifice a goat, after rolling a double six, your next roll is likely to be lower. That is regression to the mean.
""Well, it could be that,"" says the homeopathy fan. ""But I just don't think so. All I know is, I get better with homeopathy.""
How can you both exclude these explanations - since you both need to - and move on from this impasse? Luckily homeopaths have made a very simple, clear claim: they say that the pill they prescribe will make you get better.
You could do a randomized, controlled trial on almost any intervention you wanted to assess: comparing two teaching methods, or two forms of psychotherapy, or two plant-growth boosters - literally anything. The first trial was in the Bible (Daniel 1: 1-16, since you asked) and compared the effect of two different diets on soldiers' vigour. Doing a trial is not a new or complicated idea, and a pill is the easiest thing to test of all.
Here is a model trial for homeopathy. You take, say, 200 people, and divide them at random into two groups of 100. All of the patients visit their homeopath, they all get a homeopathic prescription at the end (because homeopaths love to prescribe pills even more than doctors) for whatever it is that the homeopath wants to prescribe, and all the patients take their prescription to the homeopathic pharmacy. Every patient can be prescribed something completely different, an ""individualized"" prescription - it doesn't matter.
Now here is the twist: one group gets the real homeopathy pills they were prescribed (whatever they were), and the patients in the other group are given fake sugar pills. Crucially, neither the patients, nor the people who meet them in the trial, know who is getting which treatment.
This trial has been done, time and time again, with homeopathy, and when you do a trial like this, you find, overall, that the people getting the placebo sugar pills do just as well as those getting the real, posh, expensive, technical, magical homeopathy pills.
So how come you keep hearing homeopaths saying that there are trials where homeopathy does do better than placebo? This is where it gets properly interesting. This is where we start to see homeopaths, and indeed all alternative therapists more than ever, playing the same sophisticated tricks that big pharma still sometimes uses to pull the wool over the eyes of doctors.
Yes, there are some individual trials where homeopathy does better, first because there are a lot of trials that are simply not ""fair tests"". For example - and I'm giving you the most basic examples here - there are many trials in alternative therapy journals where the patients were not ""blinded"": that is, the patients knew whether they were getting the real treatment or the placebo. These are much more likely to be positive in favor of your therapy, for obvious reasons. There is no point in doing a trial if it is not a fair test: it ceases to be a trial, and simply becomes a marketing ritual.
(Source: Guardian)