The topic of alternative medicine is subject to much disagreement. As in most realms, extreme opinions are rarely correct. Clearly, some treatments under the umbrella of alternative medicine are helpful, while some are quackery and serve as a placebo at best. There are also significant numbers of medicines and treatments (homeopathic or conventional) whose efficacy or even safety is uncertain or varies greatly from person to person. We are not in the position to take a stand on the important question of which treatments fall into which category.
These questions are relevant regarding cases in which we want to do something to help heal the sick in a situation in which the action would otherwise be forbidden.[1] However, your question does not depend on the efficacy of the “medicine.” Although it is true that a beracha is not usually recited before ingesting medicine, as you assume, it is not the status of “medicine” that uproots the need for a beracha. Rather, berachot were instituted for the benefits one gets from food (primarily, taste), not for any medical benefits. If one receives both benefits – taste and healing – he must recite a beracha.[2] Therefore, if a medicine’s taste is good, a beracha on it would be required, regardless of if the medicine is actually effective or not. If something one is ingesting with medicinal intent does not have a good taste, then irrespective of any medicinal value, there would be no beracha.
There is still a question regarding a beracha for something taken for medicinal purposes that has additives that give it a somewhat positive taste. The Sha’ar HaTziyun[3] writes that medicinal food does not need to have a particularly good taste in order to warrant a beracha; the essential factor is that it does not have a bad taste. One might claim that the classic sources discuss cases in which the therapeutic agent has a reasonable taste; if the medicinal part tastes bad and a sweetener improves it, the sweetener is still the medicine’s less important part and should not count regarding berachot.[4] However, the rule that the beracha follows an item’s more important ingredient applies only when the important part requires a beracha. Since the medicinal part does not, we should make a beracha on the sweetener.[5]
However, there are cases in which a beracha requirement is doubtful. If one swallows a pill, that is not considered a manner of eating for the purposes of berachot, even if the pill leaves a sweet taste on the tongue before swallowing.[6]
Furthermore, Rav S.Z. Auerbach is quoted by several works as minimizing the number of cases in which one makes a beracha on medicines. Nishmat Avraham[7] quotes him as saying that if the sweetener is on the outside of a chewable pill and one enjoys the taste before getting to the medicinal part, a beracha should be recited, but if the tastes are all mixed together, there should be no beracha. This is based on the assumption that the mixture does not have a taste that would interest anyone as a food.
V’Zot HaBeracha[8] cites and explains Rav Auerbach from a different angle. A food without positive taste can attain taste that warrants a beracha even when eaten for medical purposes by means of external flavoring. However, an external taste cannot turn a non-food (e.g., a pure medicine) with negative taste into a food unless the medicinal mixture actually has a distinctly good taste.
Not all poskim agree with Rav Auerbach,[9] and it is logical to say that as long as one appreciates the positive element, the fact that the negative element reduces the enjoyment of the taste does not eliminate the need for a beracha. However, especially considering that we do not make berachot in cases of doubt,[10] it is difficult to require a beracha contrary to Rav Auerbach’s opinion. According to every opinion, there will be borderline cases regarding how to halachically categorize the situation, and here too we should not make a beracha in a case of doubt. (It is laudable in such cases to first eat something else that requires the beracha of Shehakol, having in mind to cover the medicine.)