This is the second paragraph from Ben Goldacre’s recent comment piece Benefits and risks of homeopathy in The Lancet’s November 17 edition.

During the cholera epidemic in the 19th century, death rates at the London Homoeopathic Hospital were three times lower than those at the Middlesex Hospital. (6) The reason for homoeopathy’s success in this epidemic is even more interesting than the placebo effect. At the time, nobody could treat cholera, and while medical treatments such as blood-letting were actively harmful, the homoeopaths’ treatments were at least inert.

(6) Hempel S. The medical detective. London, UK: Granta Books, 2006

Notice how Goldacre doesn’t give us the actual figures. (And this is The Lancet, not the Guardian.) Neither does he clarify that his reasoning is speculation, not established fact. The actual mortality percentages would allow readers to make some kind of sensible judgement about his conjecture that medical treatments exacerbated mortality while homeopathic treatment equated to no treatment at all.

Here they are:

In the London Cholera epidemic of 1854, of the 61 cases of cholera treated [at the London Homeopathic Hospital], 10 died, a percentage of 16.4; of the 331 cases of choleraic and simple diarrhoea treated, 1 died. The neighbouring Middlesex Hospital received 231 cases of cholera and 47 cases of choleraic diarrhea. Of the cholera patients treated 123 died, a fatality rate of 53.2 per cent., among the victims being one of the nurses.

Morrell, P and Cazelet, S. The History of the London Homeopathic Hospital

From a quick trawl through various literature on the subject, it would appear untreated cholera has a mortality rate of anywhere between 30-80%. Typically it seems to be around 50-60% and can kill within a matter of hours.

16.4% mortality against 50-60% mortality for untreated cholera would not appear to be consistent with the idea that homeopathic treatment was inert. 16.4% mortality against even 30% mortality for untreated cholera would not appear to be consistent with the idea that homeopathic treatment was inert. At the time, the London Homeopathic Hospital was at Golden Square, close to the epicentre of the outbreak.

The figures for homeopathic treatment were so striking to the medical establishment of the time, that they suppressed them.

Now, a circular was addressed by the President of the Board of Health to various Metropolitan hospitals and to qualified practitioners, requesting returns of cholera cases, with details of the circumstances, treatment and results. The object was to determine by comparison, for the public good, what treatment experience showed to be the best for the new plague. Returns were sent in from the London Homœopathic Hospital, giving the names and addresses of the patients treated, the symptoms, remedies, and result in each case, and a summary of those results. This was not a question of theory, or of any particular school; it was a question of facts and statistics affecting the public health. But the report of the Board of Health was presented to Parliament without the slightest reference to the London Homœopathic Hospital or to the brilliant results which its physicians had achieved by undaunted self-sacrifice in a time of great public calamity. Complaint was, of course, made to the Board of Health and duly reterred to its Medical Committee, with the result that the Board received from the committee a resolution, which, for ingenuity of disingenuousness and illiberality, can hardly ever have been equalled. It was this :

“That by introducing the returns of homœopathic practitioners they (the Treatment Committee) would not only compromise the value and utility of their averages of Cure, as deduced from the operation of known remedies, but they would give an unjustifiable sanction to an empirical practice, alike opposed to the maintenance of truth and to the progress of science.”

In the first place, the remedies “unknown” to the Treatment Committee were such as camphor, copper, hellebore, arsenic, and other drugs well known to medicine. In the second place, it was their bounden duty to “compromise” the averages of old methods by more successful new methods in their search for the best results. Thirdly, the interference with empirical practice was no part of the statistical duty before them. And lastly, the “progress of science” was de facto obstructed by their refusal to “compromise” their averages by a factor which contained the very object of their search. The perversity was too plain, and Lord Robert Grosvenor (afterwards Lord Ebury) moved on May 17, 1855, in the House of Commons for “Copies of Letters addressed to the General Board of Health complaining of the omission of any notice of certain returns in relation to the treatment of cholera and correspondence between the President of the Board and the Medical Council, with copies of the returns which have been rejected by the Medical Council.” The House of Commons, which was more anxious for the “progress of science” and the “value and utility of averages” than for “the operation of known remedies,” to say nothing of its great duty to the people it represented, forthwith ordered a special return of the ignored homœopathic statistics, which was in due course made by the Board of Health, and these returns were ordered by the House to be printed on May 21, 1855. They remain among Parliamentary Papers to this day, a standing monument alike of the success of the new policy and of the obscurantism of the old.

Morrell, P and Cazelet, S. The History of the London Homeopathic Hospital

These results were not an isolated fluke. According to Julian Winston, homeopathic historian, who made an extensive search of the literature:

“When Cholera finally struck Europe in 1831 the mortality rate (under conventional treatment) was between 40% (Imperial Council of Russia) to 80% (Osler’s Practice of Medicine). Out of five people who contracted Cholera, two to four of them died under regular treatment.

“Dr Quin, in London, reported the mortality in the ten homeopathic hospitals in 1831-32 as 9%; Dr Roth, physician to the king of Bavaria, reported that under homeopathic care the mortality was 7%; Admiral Mordoinow of the Imperial Russian Council reported 10% mortality under homeopathy; and Dr Wild, Allopathic editor of Dublin Quarterly Journal, reported in Austria, the Allopathic mortality was 66% and the homeopathic mortality was 33% “and on account of this extraordinary result, the law interdicting the practice of Homeopathy in Austria was repealed.”

Winston, Julian. Some history of the treatment of epidemics with Homeopathy. 2001. Unpublished work

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