Today we have with us a person, who started his journey as a musician and moved on to become a person keenly interested in science, research, alternative medicine and homeopathy. He is well known in homeopathic research circles for his constant efforts to explore and understand many research issues related to homeopathy. Please welcome – Dr. Lionel Milgrom.
MB: Dr. Milgrom, welcome to the Hpathy Hot-Seat! It is our pleasure to have a leading researcher like you with us today and I look forward to a riveting discussion on various research issues related to homeopathy.
But before that let me ask you – from professional musician to chemist to being a homeopath and now a homeopathic researcher – how would you describe your journey?
LM: Thank you Manish….yes, I see what you mean by the Hot Seat. Such kind plaudits (these days, I’m more used to brickbats and abuse from all those naughty sceptics of homeopathy….) followed by questions like this can make one feel quite uncomfortable, and not just in the posterior….! And because one is suddenly asked to review one’s life as a sequence of apparently connected events – when as far as I can tell they represent moments when I may have been more or less conscious or aware (consciousness/awareness, you understand, being something that fluctuates – lawfully – from moment to moment) – then the effort to ‘join up the dots’ into something ‘rational’ can produce a certain kind of inner vertigo like looking down the wrong end of a telescope….Well, I am digressing, and we haven’t even started yet!
Okay, describe my journey….we could call it interesting? Too vague, perhaps….but even though there appears to be some diversity in the subjects I have been – still am – interested in, they do connect, though it might take several months to try to explain exactly how. What I can say is that I feel nothing I have ever done has been wasted: experiences in one field can produce metaphors for helping me to understand what might be happening in another…which is NOT an invitation to get me to explain how music might be a metaphor for homeopathy. I suppose what I am trying to say is that interest in something has to be more than just mental or intellectual. It has to be emotional as well, and that is what turns any subject into a real roller coaster. So, how would I describe my journey so far? What a ride….! And long may it continue.
MB: Yes! Long may it continue…because I have many pointed questions to come! 😉 . I understand that you do not want to share all those little secrets of your musical and chemical life, but you won’t get me choking in the web of phrases like ‘inner vertigo like looking down the wrong end of a telescope‘. What’s that? I have never even looked at the right end of a telescope! Never mind! Let’s discuss about just ONE dot in your life. What was your introduction to homeopathy and what pushed you into the realm of professional homeopathy from the world of chemistry?
LM: Oh well…perhaps that was a metaphor too far…! But you really should get out more, Manish and treat yourself to a good look at the heavens through a telescope. So, what got me into homeopathy was when my wife and I moved to London (from Liverpool….now that is an interesting story….), back in the late ’70’s and we signed up with our local NHS GP who was also a medical anthroposophical homeopath. He said we could be treated conventionally or with homeopathy. I didn’t know what it was but we elected for homeopathic treatment and whatever ills we suffered from at the time seemed to be cured. I never really questioned what was happening until my wife contracted pneumonia after bronchitis shortly after our son was born. She had several courses of antibiotics which didn’t touch her and only made her weaker. Then he prescribed these tiny white pills – Bryonia, I think it was – and she started to improve. At which point, he also suggested that she learn with a teacher to do the anthroposophical movements called eurhythmy. From that time till this, she has never had bronchitis or pneumonia again.
It was then that I asked my GP what was in those little white pills. What he told me didn’t only just blow me away: it was also an affront to everything I had learned (or thought I’d learned) as a scientist, about chemistry, matter, molecules, etc, etc. My GP didn’t mind, and he observed my perplexity with wry amusement. So, I had a problem: the evidence of my own eyes (repeated again and again over the years with my three children and now with my patients – some of the time….!) demonstrated that what was supposed to be ‘nothing’ was clearly ‘doing something’. Yet every chemical bone in my body as it were, was screaming that this had to be impossible. Just what the hell was going on?!
So, I made a decision towards the beginning of the 90’s that I would spend some time trying to find out how homeopathy ‘worked’. Notice, I have put this in inverted commas. Because part of the problem here is the everyday language that we use in describing the world…but maybe we’ll get onto that later. However, it took several more years before I could devote my attention to this ‘problem’. I was still trying to carve out an academic career in chemistry, my parents fell ill, and my kids were growing up.
Perhaps in the end, this was all to the good because having quite a few years to consider how to start, I began to realise that trying to attack this ‘problem’ with a purely scientific mind-set would not be enough. Something else was needed. It was then that I decided to train as a professional homeopath in London – to learn how to ‘walk the walk, and talk the talk’ of homeopathy. But then that had to be put off for another year, when my father died and my mother had to be taken care of. Eventually however, I started my 4-year part-time course of homeopathic study at the (sadly now defunct) London College of Homeopathy, and qualified in October 1999….
I should point out that there was another entrance to my homeopathic studies. Several years before I started to train, I was approached by the wife of a friend of mine. She was working in the remedy production facility of the famous homeopathic pharmacy Ainsworths in London. She wanted to know if I could provide small amounts of pure inorganic compounds – salts etc – as starting materials to make potentised remedies. As a chemist, of course, I could do this quite easily and this brought me into contact with Ainsworths’ owner in London, Tony Pinkus. He is a qualified pharmacist and so we began what became a series of interesting exchanges around homeopathy. I provided more compounds and Tony very generously provided many of the books I needed for my homeopathic studies. Later, towards the end of my homeopathy course, we embarked on a research project to see if it would be possible to use a powerful spectroscopic technique, called Nuclear Magnetic Resonance (NMR), to look at the potentisation process. After three years, this provided one or two surprises – some not altogether pleasant – but it resulted in the first published paper (see LR Milgrom, KR King, J Lee, and AS Pinkus. On the investigation of homeopathic potencies using low resolution NMR T2 relaxation times: an experimental and critical survey of the work of Roland Conte et al. British Homeopathic Journal 2001;90:5-13).
So you see, it wasn’t quite that I was pushed from one world into another – from chemistry into homeopathy. What has really happened is that these worlds for me have come into contact…. or perhaps collision might be a better way of describing it! Remember, I said nothing is ever wasted….so as well as studying homeopathy and learning how to practice it with real suffering people (as opposed to just thinking about it academically), it has also resulted in a change in how I understand chemistry and science….indeed, how we look at the world.
MB: Yes, homeopathy changes the way you look at life. I think nearly every person who is passionate about homeopathy became a convert after seeing some radical cures – myself included. And I can easily understand how your ‘chemical bones’ must have felt on realizing the implausibility of what we are dealing with, because my metaphysical bones felt exactly the same way, when I tried to understand the science behind homeopathy.
Now this leads to four questions:
1. Where do I buy a good telescope …something close to Hubble? Or do I need a bigger one?
2. Do you provide any grants for buying telescopes to people whom you suggest to get a telescope?
3. What on earth is an anthroposophical homeopath?
4. There are so many ways in which we could research the underlying mechanism of homeopathic remedies. What led you to choose NMR as the starting point of your research?
LM: You could try the on-line site http://www.naaptol.com/buy-online/WO-shopping-best-deals-W107O/cameras/telescopes.html which I think is based in India…but as far as I know, there aren’t any Hubbles on that site….just good old fashioned reflector and refractor scopes…..and no, I do not give out grants for anything, not even telescopes, because as I suspect like most of us, I don’t have that kind of money….!
Anthroposophical homeopathy is based on the teachings of the philosopher, scientist and spiritual teacher Rudolph Steiner. I do not want to get side-tracked into a description of what it is all about, but anybody who is interested can look up http://www.anthroposophy.org.uk/ and find out for themselves.
We chose NMR for the starting point of our research because back in 1998, we were trying to reproduce the work of a French group led by Dr Roland Conte. As most homeopathic remedies are made up in water/alcohol mixtures (or triturated with lactose or glucose), hydrogen is the most common element in these mixtures. And the nucleus of a hydrogen atom can be thought of as a tiny magnetic gyroscope. This behaviour of hydrogen atoms in a chemical mixture can be quite easily detected using NMR. It is one of the most powerful analytical tools used by chemists.
So the thinking was that if the homeopathic potentisation process somehow altered the way all these little magnetic gyroscopes interacted with each other in the solvent (this is all described under the blanket term, The Memory of Water), then NMR should be the ideal ‘tool’ for observing these changes. Conte and his research group had published a little book describing their experiments and how the changes they observed using NMR continued long passed the point when the original substance had been diluted out of existence.
At that time, quite a few homeopaths in the UK were very enthusiastic about Conte’s work, and were even hailing it as the ‘breakthrough’ that would prove ‘how homeopathy worked’. So we thought it might be a good idea to see if we could reproduce this work, following as much as we could glean from his quite difficult writings about his experimental protocol.
At first, it looked as if we were getting similar results, but the more we tried, the more these results seemed to vary: no two experiments ever gave results that by any stretch of the imagination could be considered similar. After three years (Tony Pinkus even had a computer-controlled automatic potentising machine built so we could run up 30c potencies in about half an hour: it is still being used today to make really high potency remedies), we were getting nowhere when we discovered quite by chance that the glassware being used in these experiments really made a huge amount of difference.
If we used specially hardened glass called Pyrex, then there were no results at all: whatever effects we and presumably Conte thought we had observed, simply disappeared. If we used ordinary ‘soft’ glass then we got the highly irreproducible results we had been obtaining all the time, and that Conte had also got. Quite simply, what seemed to be happening was that the water used in these experiments was dissolving out small amounts of silica from the glassware, and the effects of this dissolved silica (which was different each time) was what we had been observing. So that all the results we had got and presumably Conte had as well, were simply experimental artefacts of the glassware being used. That was the unpleasant surprise we found from this work. Still, it has now made me very cautious when looking at experiments like this which claim to have found a way of measuring the molecular mechanisms of potentisation. It just goes to show how incredibly careful one has to be when engaging in this kind of research.
MB: What? No grants to buy a telescope!! I’ll ask for donations from our subscribers…
And yes, the NMR research looked really promising initially. There were some other positive results by Sacks[i], Baumagartner et al[ii] and Smith & Boericke[iii]. But some other studies[iv],[v] failed to reproduce the results. So where are we at present regarding homeopathy research and spectroscopy? Can we at all rely on NMR spectroscopy to find out the mechanism of action of homeopathic remedies? Or is it a closed chapter?
LM: No it isn’t a closed chapter Manish, and work is continuing not just with NMR but also using other spectroscopic techniques, such as Raman and UV-visible spectroscopies. All we showed was just how careful it is necessary to be in this kind of work.
Demangeat[vi] recently reported an experiment in which they measured 20-MHz R1 and R2 water proton NMR relaxation rates in ultrahigh dilutions (range 5.43·10-8 M – 5.43·10-48 M) of histamine inwater (Hist-W) and in saline (Hist-Sal), prepared by iterative centesimal dilutions under vigorous agitation in controlled atmospheric conditions. Six independent series of preparations were performed, representing about 7000 blind measurements. R2 exhibited a very broad scatter of values in both native histamine dilutions and solvents. No variation in R1 and R2 was observed in the solvents submitted to the iterative dilution/agitation process. By contrast, histamine dilutions exhibited slightly higher R1 values than solvents at lowdilution, followed by a slow progressive return to the values of the solvents at high dilution. Unexpectedly, histamine dilutions remained distinguishable fromsolvents up to ultrahigh levels of dilution (beyond 10-20 in Hist-Sal). A signi!cant increase in R2 with increased R2/R1was observed in Hist-W. R1 and R2were linearly correlated in solvents, but uncorrelated in histamine dilutions. After a 10-min heating/cooling cycle of the samples in their sealedNMR tubes (preventing any modi!cation of the chemical composition and gas content), all of the relaxation variations observed as a function of dilution vanished, the R2/R1 ratio and the scatter of the R2 values dropped in all solutions and solvents, and the correlation between R1 and R2 reappeared in the Hist-W samples. All these results pointed to a more organized state of water in the unheated samples, more pronounced in histamine solutions than in solvents, dependent on the level of dilution. Itwas suggested that stable supramolecular structures, involving nanobubbles of atmospheric gases and highly ordered water around them, were generated during the vigorous mechanical agitation step of the preparation, and destroyed after heating. Histamine molecules might act as nucleation centres, amplifying the phenomenon which was thus detected at high dilution levels. So you can clearly see that the NMR chapter is not closed yet!
But I would seriously question that clause in your next to last sentence, ‘….to find out the mechanism of action of homeopathic remedies?’ Is that all a homeopathic remedy is in the end; just another ‘drug’ that somehow acts on the body via some kind of biochemical ‘mechanism’, which it is our job to discover?
In which case, what are we to make of Kent’s statement, ‘A remedy is only homeopathic when it cures the case.’ Presumably then, this must mean that a bottle of Belladonna 30c pills made by dilution and succussion of Deadly Nightshade, sitting on a shelf and that have not been prescribed yet, is not a homeopathic remedy….!
MB: If the process of potentisation is not altering some of the properties between the water molecules, what could be other possible explanations for the effect of homeopathic remedies?
LM: That’s not quite what I said, Manish! Indeed, it is very likely that the process of potentisation is doing something to the dynamic intermolecular structure of hydrogen bonds that exists between water molecules – it would be foolish to think of a glass of water simply as a vast collection of billions upon billions of individual molecules randomly going about their watery business! We are finding out new and amazing things about this ubiquitous fluid, and certainly the recent work of Rustum Roy et al (R. Roy, W. A. Tiller, I. Bell, and M. R. Hoover, The Structure of Liquid Water; Novel Insights from Materials Research; Potential Relevance to Homeopathy, Materials Research Innovations, Volume 9, Issue 4, December 2005, pg. 577-608) in the US and others, has shown that water molecules could very well form themselves into ever-changing geometrical patterns, and these patterns might well be influenced by the combination of what was originally dissolved in the water and the potentisation process. Indeed, it seems more than likely that even when the original substance has been diluted out of existence, its influence on the formation and dissolution of these patterns remains, in other words, a possible mechanism for the Memory of Water. Anyone who is interested in the science behind this would be strongly advised to take a look at the web-site of Professor Martin Chaplin from London Southbank University (see http://www1.lsbu.ac.uk/water/) which has an excellent section on the Memory of Water and homeopathy.
But you see Manish, my question is this. Is this telling us about how homeopathy ‘works’, or is it suggesting new and interesting details about how water ‘works’? Because there is more, much more to homeopathy than water molecules, and there certainly is more to human beings than just being a huge intricate collection of biochemical reactions whose dysfunction is to be treated with specially-tailored drugs, wouldn’t you agree? Or do you think that homeopathy is simply some esoteric branch of biochemistry?
Remember Kent’s statement: ‘A remedy is homeopathic when it cures the case.’ Surely what this is implying is that the ‘remedy’ is more than the bottle of pills we give to our patients after the consultation. It is also what has passed between two human beings during the therapeutic process. And my point is this: I do not think it is possible to disentangle the ‘pills’ from the ‘therapeutic process’, and that this must also be true of any therapeutic modality, including conventional medicine. They are all of a piece. So what I have been trying to do over the last few years is to map out the ‘shape’ of this therapeutic process – something which I have called Patient-Practitioner-Remedy (PPR) Entanglement – using as my model for this, entanglement as understood in quantum theory.
MB: Dr. Milgrom, I personally see it as two different aspects. One, that deals with how our remedies transmit information during potentization and two, how they interact with the living body. The first one has to be some form of bio-physical phenomenon, otherwise the whole concept of potentization would end up as a ‘ritual’. We do know that our remedies work not just in sick people but also during provings. So if there is an ‘effect’, there has to be a ’cause’ too. The remedy-patient entanglement is an important part of the therapeutic process and the remedy and the patient cannot be seen separately in the process of cure but I still feel that not all of the action of the remedy can be attributed to the ‘entanglement’. Research does prove that about 30% of the therapeutic effect of a treatment is due to placebo response – part of the entanglement. But what about the rest? I think we need to separate the research on ‘high-dilutions’ and ‘effect of homeopathic remedies’. What the concept of high-dilution proposes has repercussions not just for homeopathy but also for the entire set of physical-chemical and biological science.
What we do know about the ‘Memory of Water’ so far is that water and ethanol produce complex solutions and they do transmit information about the solutes through hydrogen bonds and lattice formation. But we also know that neither the hydrogen bonds nor the lattices are stable enough to store information indefinitely. The thermodynamic changes also do not last indefinitely. So what else could it be?
Another question that this brings up is – let us suppose that water-ethanol aqueous solutions do have some ‘memory’ but then how do you explain the action of dry homeopathic pills and the medicines that are only triturated in sugar of milk?Do we have any common thread in this? Clearly the same mechanism could not be working here – four different substances – water, ethanol, sugar of milk powder and cane sugar pills.
LM: Careful Manish! Your questions are in acute danger of becoming as long as my answers….which in the end I suppose is how it should be….! So, I’ll break down this last one into two parts and deal with the second – about the Memory of Water – first.
Again, I would refer readers to Prof Martin Chaplin’s excellent web-site. You are right to raise the problem of thermodynamics. Of course, thermodynamic changes do not last indefinitely, but it turns out that a solution that has been diluted AND succussed is actually thermodynamically more stable than one that has been merely diluted – by about 8 kcals/mol, if my (watery…!) memory serves me well. Admittedly, this isn’t much, and it is known that if homeopathic dilutions are heated beyond a certain point, then they lose their potency. So, it would appear that the Memory of Water is somehow intimately linked with the organised pattern of dynamic hydrogen bonds in water/ethanol mixtures (Prof Chaplin’s web-site again).
Ideas for how solutes could transmit information to the solvent they are dissolved in are now coming from materials science (see the work of Roy et al in the US). So, in solid-state physics, when a layer of atoms is laid down on a pre-existing surface, then the crystalline structure of that surface is transmitted to the layer even if the layered atoms are completely different (and so left to themselves would form their own separate crystalline structure) to those of the pre-existing surface. And that structural difference is transmitted to further layers that are put down. Roy et al have taken this idea and applied it to the dynamic structural changes that could occur as a substance is diluted and succussed in the homeopathic manufacturing process. So it is not unreasonable to suppose that the act of succussion produces small ‘cavitations’ or ‘nanobubbles’ in the solution. These are tiny volumes in the solution where much energy is concentrated, and their effect is to disrupt previous patterns of dynamic hydrogen bonding in the solvent, and allow the formation of new ones, initially around a dissolved solute.
You are right to raise the issue of what happens with dry homeopathic pills and medicines that are triturated in lactose or glucose (I generally prefer the latter, just in case my patient might have a problem with lactose intolerance). So, what is the common denominator between a water/ethanol mixture and lactose/glucose? Again, it is hydrogen bonds, or to be more specific -OH groups. Water as you know, is H2O, or we could write it as H-OH. Ethanol is C2H5-OH. It is the -OH group that is the common denominator between water and ethanol and is the reason why they are so miscible with each other, but only to a point. As we make the hydrocarbon part of an alcohol (that’s the C2H5– bit) longer and longer, it becomes less and less miscible with water.
Now, when we look at the chemical structure of a sugar like lactose or glucose, we find that it is fairly bristling with -OH groups. At this point, it is probably best to imagine that the chemical effect of an -OH group is a bit like a tiny little Velcroâ„¢ ‘hook’: it makes a molecule containing -OH groups ‘sticky’ towards other molecules with -OH groups or groups like them. This means that lactose and glucose will readily dissolve in water because of the ‘sticky’ attraction between water’s -OH groups, and those on the lactose or glucose (but not very soluble in ethanol because of the water-repelling effect of the C2H5– group: that’s why we use water/ethanol mixtures for our tinctures which are then dropped onto lactose or glucose globules).
Now, if you’ve followed me so far, what this means is that any Memory of Water effect we have produced by making up a liquid potency is most likely ‘frozen in’, when that liquid potency is dropped onto the lactose/glucose globules, by virtue of their own -OH groups and hydrogen bonding.
As for triturating with lactose/glucose, well, bearing in mind what I have said so far about -OH groups and that these molecules are bristling with them, it is not too hard to imagine that the grinding is similar to succussion and that the lactose/glucose is acting as if it were a solid ‘solvent’. So I think the common thread in all of this is the presence of dynamically hydrogen bonding -OH groups in water, ethanol, lactose, and glucose. The rest is how we get the solute into really intimate contact with this dynamic hydrogen bonding: with solvents such as water/ethanol it is by dilution and succussion. With dry solid ‘solvents’ such as lactose/glucose, it is through thorough grinding.
MB: Alright, this gives us some food for thought. Some very interesting ideas about the possibility of transmitting ‘information’ between the solute and the solvent …and we do have some common strands in our different vehicles too! Can you now give your views on my other questions pertaining to the PPR entanglement?
LM: Yes, now let us now deal with the first part of your question. You may be right that there are two different aspects, the first dealing with how remedies transmit information during potentisation (i.e., via some form of biophysical phenomenon) and second, how they interact with the whole living body, e.g., via PPR entanglement). Clearly, from what I have just said, potentisation is more than a ritual, and perhaps not all of the action of the remedy can be attributed to PPR entanglement. And we do know that the effectiveness of remedies and ordinary drugs is lower in randomised controlled trials (RCTs) than in ‘real-life’ practice. So it seems as if we have a real dichotomy here….or do we? Could it be that actually, they are both different aspects of the same phenomenon?