LONDON: Homeopathy, hugely popular in several parts of the world, favoured medical remedy of the British royal family for generations, has an effect but only in the mind, according to a study published in a leading medical journal on Thursday.

The conclusions of the Lancet analysis are seen as a body blow for proponents of homeopathy, which has been around for 250 years and has attained cult-like status among aficionados.

Swiss scientists compared the results of more than 100 trials of homeopathic medicines with the same number of trials of conventional medicines in a range of conditions. They found that homeopathy had no more than a placebo effect.

A hard-hitting editorial in the Lancet, titled "The end of homeopathy," demands that doctors recognise the absence of real curative powers in homeopathic medicine. It is hardly surprising that homeopathy does badly compared with conventional medicine, it says — it is more surprising that the debate continues after 150 years of unfavourable findings. "The more dilute the evidence for homeopathy becomes, the greater seems its popularity."

Homeopathy was developed in Germany by Samuel Hahnemann in the late 1700s. A doctor and a chemist, he believed that disease showed the body was out of balance, and that this could be put right by the "similia principle" — otherwise known as "like cures like." The theory is that a tiny dose of the source of the problem, diluted in many parts water, will stimulate the body into combating it.

Homeopathic remedies are tailored to the individual, which is part of their appeal. A homeopath will assess not just the physical cause of the illness but also the emotional state, personality and temperament of the patient before deciding what remedy to use.

The authors of the Lancet study were Matthias Egger and colleagues from the University of Berne. They looked at 110 trials using homeopathic remedies and 110 using conventional medicine in matching conditions. They looked for an effect in both the smaller, low quality trials and in larger, higher quality trials. Homeopathic remedies were more likely to have had a positive effect in the small, low quality trials. In the better trials, they say, homeopathy was no better than a placebo. "Our study powerfully illustrates the interplay and cumulative effect of different sources of bias," says Prof. Egger

The study is published as concern mounts among some doctors about a report, now in draft form, which has been prepared by an office of the World Health Organisation set up to examine traditional medicine. The report, says Prof. Ernst, comes to the opposite conclusion from the Swiss team and finds that homeopathic medicine is effective. "It is totally scandalous," he said. "It is unbelievable considering it is the WHO. It does all the wrong things and it is very selective in what it includes and it exaggerates the positive conclusions of clinical trials and neglects the negative clinical trials."

A further article in the Lancet says there is widespread concern among "sceptics of alternative medicine" over the WHO report, which states that most of the studies published in the last 40 years have shown homeopathic remedies to be superior to placebo and "equivalent to conventional medicines in the treatment of illnesses, in both humans and animals."

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