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Just add water

Musician Emily Li Kit-yiu was struck with diarrhoea, chronic bronchitis and colds so often that she became exhausted with repeated visits to the doctor. She also suffered from chronic shoulder pain, fatigue and insomnia.

A chance encounter with homeopathy last year changed all that. 'The chronic ailments that had afflicted me for years went away after three treatments by the homeopath,' she says.

Li, 43, is so taken with homeopathy that she took a course to learn about the alternative medicine. She has since become an armchair homeopath who prescribes remedies for herself and her friends. 'I have not paid any visits to the doctor since I took up homeopathy,' she says.

Dramatic accounts of miraculous recoveries like Li's are common among those who believe in the efficacy of homeopathy. But it is often regarded as quackery among the medical profession. That's because clinical studies do not prove the efficacy of the highly diluted substances that homeopaths say trigger internal healing processes.

Of the dozen systematic reviews of homeopathy published so far, most conclude the remedies are no different from a placebo.

In spite of the criticism, homeopathic medicine is the second most widely used therapeutic system in the world, according to the World Health Organisation. The practice commands a large following in India, Canada and Europe. In countries such as Britain and America, practitioners must have undergraduate medical training before they specialise in homeopathy.

There are about five practising homeopaths in Hong Kong. One of them, Arden Wong Wai-tak, says that while mainstream doctors prescribe a cocktail of drugs to treat patients, homeopaths choose only one remedy. Their treatments are made from plants, animals and minerals.

'There are several hundred remedies in common use. How we choose a particular remedy out of hundreds is based on long discussions with the patients, who have to describe their condition in detail,' Wong says.

There are dozens of medicines for treating back pain, for example. It depends on the individual: some back pain eases when the patient is standing and the weather is warm, while it worsens when sitting down or during winter. Pain can also be caused by hardened back muscles.

'The most difficult job is to find the one among the many remedies that suits the condition,' Wong says. 'That's why the first consultation lasts an hour. There might be the possibility that the patient fails to mention something in the initial consultations, and the right remedy is found later.'

The way the remedies are made draws the most vehement criticisms of homeopathy. The process involves serial dilution with water and intense shaking. Serial dilution removes the chemical toxicity of ingredients like arsenic used in remedies.

But critics of homeopathy say the remedies are so diluted there are hardly any molecules of the ingredient left. So they could not have any efficacy. Homeopaths counter that the process of intense shaking, which they term 'succession', transfers the essence of the ingredients to the water, which retains a memory of the substance.

'We often use the analogy of a CD. Under the microscope, it is nothing more than a piece of plastic at the chemical level. But CDs actually contain different songs, be they classical or pop,' Wong, who was trained in Australia, says.

The way the remedy is taken also adds to the doubts of detractors. Only one tiny pill mixed with water is taken each day. Wong recommends an even smaller dosage - one pill mixed with 60 millilitres of water. The patient takes just one tablespoon of the solution in the morning and another at night.

Homeopathy, invented by German physician Samuel Hahnemann two centuries ago, revolves around the 'like cures like' principle ('homeo' means 'similar' in Greek).

The principle holds that if a substance causes a symptom (for instance, an onion makes my nose run), then that substance (allium cepa, or onion bulb extract) can cure a disease that is characterised by a runny nose (for example, a common cold).

Wong says this is similar to the concept of using toxic remedies to cure ailments caused by toxicity, which was embraced by ancient Chinese doctors: 'If a perfectly healthy person takes the remedy, he will suffer from all the symptoms that afflict the patient who is taking the same remedy,' he claims.

Unlike TCM practitioners in Hong Kong, homeopaths in the city do not require accreditation. Dr Lo Wing- lok, an infectious-diseases specialist and People's Health Action chairman, says anybody who applies for a business registration can practise, and this can be risky for patients.

'The medical effects cited by patients and homeopaths are nothing more than claims,' he says. 'There are no medical guidelines regulating how the practice should be conducted. In cases of medical blunders or ineffective treatment, it's difficult for patients to make complaints. They can only seek recompense through the civil court.

'Another problem is delayed treatment. Some patients who go to homeopaths are reluctant to seek medical help due to their aversion to drugs. They might miss out on the chance to get cured.'

But all the criticisms hardly dampen the enthusiasm of Crystal Lee Wai-ching, a lecturer at a tertiary institution. She was a doubter, but says many detractors have never tried homeopathy.

'I tried it myself and it works for me,' Lee says. 'My two-year-old daughter had rashes recently. Our general practitioner misdiagnosed it as ringworm. But my homeopath treated it as eczema, and she healed quickly after taking the remedy. There may be coincidences. But I have encountered so many coincidences regarding my homeopathy treatments that they could not all be fortuitous.'

For Emily Li, the care and time her homeopath dedicates to her well-being make her feel like she is in good hands. 'My visit to doctors last only about a minute. They just ask general questions before prescribing a cocktail of drugs,' she says. 'They never explain to me the underlying causes of my illnesses.'

Lo says such extensive discussions can produce a placebo effect. 'The response from a compassionate clinician is in itself soothing and has therapeutic effects.'

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