Homeopathy's apparent success is fully explained without any active ingredient

Goldacre walks through why homeopathic remedies can feel effective to patients and practitioners even though rigorous meta-analyses, once methodologically weak trials are excluded and publication bias accounted for, consistently show no benefit over placebo. The explanation lies in a cluster of ordinary, well-understood effects: the placebo response itself, regression to the mean (many ailments naturally improve on their own over time regardless of treatment), and the confidence and attention a sympathetic practitioner provides during a lengthy consultation.

He notes an ironic historical case: during a nineteenth-century cholera epidemic, homeopathic hospitals had lower death rates than conventional ones — not because the sugar pills worked, but because conventional treatments of the era, like bloodletting, were actively harmful, while inert homeopathic remedies simply did nothing either way. Goldacre uses this to show how a genuinely observed pattern can support entirely the wrong causal story if you don't examine the full context.

Takeaway: feeling better after a treatment is not evidence the treatment worked — bodies heal, attention soothes, and averages regress, with or without medicine.