A group of international researchers wanted to determine whether homeopathic medicine actually works beyond the power of suggestion.

"We do know that people do get better with homeopathy," said co-investigator Dr. Matthias Egger, head of social and preventive medicine at the University of Bern in Switzerland. "I have friends who tell me they went to see a homeopath and got better.

"But the question is how does it work?"

After searching the medical literature, the researchers distilled 110 studies that compared homeopathic remedies to placebo, or dummy pills, and an equal number that compared conventional medicine treatments to placebo.

The team, whose paper appears Friday in the Lancet, matched the studies to ensure patient profiles were similar and the ailment being treated was the same. Ailments included respiratory tract infections, asthma and gastrointestinal problems.

Because small studies tend to produce effects that appear significant but may actually be misleading, the authors limited their analysis to patient trials for both homeopathic and conventional therapies that were well-designed and involved large numbers of patients.

"What we saw was when you looked at these good, large studies, you did no longer see an effect for homeopathy, whereas you still saw an effect for conventional medicine," Egger said Thursday from Bern.

"Conventional medicine interventions did better than placebo, whereas the homeopathy interventions basically did the same as placebo."

Egger stressed that the researchers aren't disputing patients' reports that taking homeopathic remedies makes them feel better.

"It just means that the reason why they feel better is probably not because of that little white pill," he said. "It's more likely to be due to the fact that they see someone, spend quite a bit of time with someone who takes a very detailed history of his or her symptoms and gives a lot of attention to this patient."

But Toronto naturopath Ruth Anne Baron disputed the researchers conclusions.

"They're saying that by looking at these 110 studies and subjecting them to this kind of statistical analysis that it conclusively proves that homeopathic treatment is no better than placebo," said Baron, president of the Ontario Association of Naturopathic Doctors.

"Now, all of us who use homeopathy clinically would definitely argue with that, and patients who use homeopathy would argue with that, as well.

"The homeopathic effect, I have felt it myself, I have seen it in my patients, but it's very elusive, it's so difficult to quantify it," she said. I personally believe we don't have a fine enough measurement tool yet."

Baron said the Lancet analysis involved studies using several different homeopathic approaches, not all of them considered valid by many practitioners. Furthermore, the alternative medicine system can't be studied using the same methods as conventional medicine, she added.

"One of the challenges always of studying homeopathy is that the basic, core premise of the homeopathic prescription is you must prescribe on the basis of the individual symptoms of the patient.

"We always come up with this big stumbling block with trying to study homeopathy in the same way that we study conventional medicine, which is: 'Here's the condition, here's the medicine. Let's put some (patients) on the medicine, others on placebo.'

"So it would be argued by homeopaths that the only valid study of the homeopathic effect is by doing the homeopathic technique, which is giving them the exact medicine that best supports that person's symptoms and comparing that to a sham treatment.

"The problem is you can't compare, they're very different approaches."

In an editorial accompanying the research, the Lancet writes that the conclusion drawn by Egger's team is not surprising. "Of greater interest is the fact that this debate continues, despite 150 years of unfavourable findings. The more dilute the evidence for homeopathy becomes, the greater seems its popularity.

"Surely the time has passed for selective analyses, biased reports or further investment in research to perpetuate the homeopathy versus allopathy (conventional medicine) debate. Now doctors need to be bold and honest with their patients about homeopathy's lack of benefit and with themselves about the failings of modern medicine to address patients' needs for personalized care."

Egger agrees there is a need for conventional doctors to offer patients the kind of personalized attention provided by homeopathic practitioners, because it appears to promote healing.

"The problem is that conventional doctors try to do this, but they often find it more difficult to do," he said. "For example, in the U.K. and also in Canada, they are basically in a strict system and the system to some extent dictates how long they can spend with a patient in a normal consultation.

"At the end of the day, it's all about costs."

Here are some facts about homeopathy:

WHAT IT IS:

-A method of healing based on the idea that substances causing specific symptoms in a healthy person can cure these symptoms in someone who is sick.

-Derived from the Greek "homeo," meaning same, and "pathos," meaning suffering.

-The remedies, among them pills and liquids, are prepared from plant, mineral and animal extracts that are highly diluted in a specific way that makes them non-toxic.

WHERE IT CAME FROM:

-Homeopathy was developed by German physician Samuel Hahnemann, who first published his treatise on treating illness in 1810. The sixth edition of Organon of Rational Therapeutics, published in 1921, is still used today as homeopathy's basic text.

THE CONTROVERSY:

-In the latest scientific questioning of homeopathy, an analysis of more than 200 international trials concludes the alternative medicine system may make patients feel better, but the impact is no greater than that of the placebo effect - a beneficial result that occurs because of a patient's expectation that the therapy will help.

-Practitioners and proponents of homeopathy dispute that the "homeopathic effect" is merely psychological.

QUICK QUOTE:

"If it is truly a placebo effect, isn't that a fine medicine. No side-effects. The symptoms are fine, the patient feels better. Perhaps we should be looking at how we could better harness the placebo effect, because it's certainly better than toxic side-effects that we have in many conventional medicines. . . . But I'm not granting that it is a purely placebo effect." - Toronto naturopath Ruth Anne Baron.

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