Homeopathy

Homeopathy: coined in German from Greek hómoios- ὅμοιος- "like-" + páthos πάθος "suffering"

Homeopathy (also spelled homoeopathy or homœopathy) is a form of alternative medicine in which practitioners use highly diluted preparations. Homeopathy was first proposed by German physician Samuel Hahnemann in 1796, based on an ipse dixit[4] axiom[5] formulated by Hahnemann, which he called the law of similars, preparations which cause certain symptoms in healthy individuals are given to patients who already exhibit similar symptoms. Homeopathic remedies are prepared by serial dilution with shaking by forceful striking, which homeopaths term succussion, after each dilution under the assumption that this increases the effect. Homeopaths call this process potentization. Dilution often continues until none of the original substance remains.[6] Apart from the symptoms, homeopaths use aspects of the patient's physical and psychological state in recommending remedies.[7] Homeopathic reference books known as repertories are then consulted, and a remedy is selected based on the totality of symptoms. Homeopathic remedies are, with rare exceptions, considered safe[8] though homeopathy has been criticized for putting patients at risk due to advice against conventional medicine such as vaccinations,[9] anti-malarial drugs,[10] and antibiotics.[11]

Homeopathy's efficacy beyond the placebo effect is unsupported by the collective weight of scientific and clinical evidence.[2][3][12][13][14] While some individual studies have positive results, systematic reviews of published trials fail to conclusively demonstrate efficacy.[15][16][17][18][19]

Furthermore, higher quality trials tend to report results that are less positive,[17][20] and most positive studies have not been replicated or show methodological problems that prevent them from being considered unambiguous evidence of homeopathy's efficacy.[2][13][21][22] A 2010 inquiry into the evidence base for homeopathy conducted by the United Kingdom's House of Commons Science and Technology Committee concluded that homeopathy is no more effective than placebo.[3] Depending on the dilution, homeopathic remedies may not contain any pharmacologically active molecules,[23] and for such remedies to have pharmacological effect would violate fundamental principles of science.[14][24] Modern homeopaths have proposed that water has a memory that allows homeopathic preparations to work without any of the original substance; however, there are no verified observations nor scientifically plausible physical mechanisms for such a phenomenon.[24][25] The lack of convincing scientific evidence supporting homeopathy's efficacy[26] and its use of remedies lacking active ingredients have caused homeopathy to be described as pseudoscience, quackery,[27][28][29][30][31] and a "cruel deception".[32] The regulation and prevalence of homeopathy is highly variable from country to country. There are no specific legal regulations concerning its use in some countries, while in others, licenses or degrees in conventional medicine from accredited universities are required. In several countries, homeopathy is covered by the national insurance coverage to different extents, while in some it is fully integrated into the national health care system. In many countries, the laws that govern the regulation and testing of conventional drugs do not apply to homeopathic remedies.[33]

Contents
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1 General philosophy
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1.1 Hahnemann's "Law of similars" 1.2 Miasms and disease 2.1 Preparation 2.2 Dilutions

2 Homeopathic remedies
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2.2.1 Dilution debate

2.3 Provings 2.4 Repertory 2.5 Homeopathic pills 2.6 List of ingredients 3.1 Isopathy 3.2 Flower remedies 3.3 Veterinary use

3 Related practices
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4 Medical and scientific analysis

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4.1 High dilutions 4.2 Effectiveness 4.3 Meta-analyses

4.3.1 Scientific explanations of effects

4.4 Effects in other biological systems 4.5 Methodological and publication issues 4.6 Ethics and safety

5 Regulation and prevalence 6 History
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6.1 Historical context 6.2 Hahnemann's concept 6.3 19th century: rise to popularity and early criticism 6.4 Revival in the late 20th century

• • • •

7 See also 8 References 9 Footnotes 10 External links
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10.1 Videos 10.2 Associations and regulatory bodies

General philosophy

A homeopathic remedy prepared from marsh Labrador tea. The "15C" dilution shown here contains no molecules of the original herb. Homeopathy is a vitalist philosophy which interprets diseases and sickness as caused by disturbances in a hypothetical vital force or life force. It sees these disturbances as manifesting themselves as unique symptoms. Homeopathy maintains that the vital force has the ability to react and adapt to internal and external causes, which homeopaths refer to as the law of susceptibility. The law of susceptibility implies that a negative state of mind can attract hypothetical disease entities called miasms to invade the body and produce symptoms of diseases.[34] However, Hahnemann rejected the notion of a disease as a separate thing or invading entity and insisted that it was always part of the "living whole".[35] Hahnemann proposed homeopathy in reaction to the state of traditional western medicine at that time, which often was brutal and more harmful than helpful.[citation needed]

Hahnemann's "Law of similars"
Hahnemann observed from his experiments with cinchona bark, used as a treatment for malaria, that the effects he experienced from ingesting the bark were similar to the symptoms of malaria. He therefore decided that cure proceeds through similarity, and that treatments must be able to produce symptoms in healthy individuals similar to those of the disease being treated.[36] Through further experiments with other substances, Hahnemann conceived of the law of similars, otherwise known as "let like be cured by like" (Latin: similia similibus curentur)[37][38] as a fundamental healing principle. He believed that by using drugs to induce symptoms, the artificial symptoms would stimulate the vital force, causing it to neutralise and expel the original disease and that this artificial disturbance would naturally subside when the dosing ceased.[36] It is based on the belief that a substance that in large doses will produce symptoms of a specific disease will, in extremely small doses, cure it. Hahnemann's law of similars is an "ipse dixit" "axiom",[5] in other words an unproven assertion made by Hahnemann, and not a true law of nature.[4]

Miasms and disease
In 1828, Hahnemann introduced the concept of miasms; underlying causes for many known diseases.[39] A miasm is often defined by homeopaths as an imputed "peculiar morbid derangement of [the] vital force".[40] Hahnemann associated each miasm with specific diseases, with each miasm seen as the root cause of several diseases. According to Hahnemann, initial exposure to miasms causes local symptoms, such as skin or venereal diseases, but if these symptoms are suppressed by medication, the cause goes deeper and begins to manifest itself as diseases of the internal organs.[41] Homeopathy maintains that treating diseases by directly opposing their symptoms, as is sometimes done in conventional medicine, is ineffective because all "disease can generally be traced to some latent, deep-seated, underlying chronic, or inherited tendency".[42] The underlying imputed miasm still remains, and deep-seated ailments can only be corrected by removing the deeper disturbance of the vital force.[43] Hahnemann's miasm theory remains disputed and controversial within homeopathy even in modern times. In 1978, Anthony Campbell, then a consultant physician at The Royal London Homeopathic Hospital, criticised statements by George Vithoulkas claiming that syphilis, when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the central nervous system.[11] This conflicts with scientific studies, which indicate that penicillin treatment produces a complete cure of syphilis in more than 90% of cases.[44] Campbell described this as "a thoroughly irresponsible statement which could mislead an unfortunate layman into refusing orthodox treatment".[11] Originally Hahnemann presented only three miasms, of which the most important was "psora" (Greek for itch), described as being related to any itching diseases of the skin, supposed to be derived from suppressed scabies, and claimed to be the foundation of many further disease conditions. Hahnemann believed psora to be the cause of such diseases as epilepsy, cancer, jaundice, deafness, and cataracts.[39] Since Hahnemann's time, other miasms have been proposed, some replacing one or more of psora's proposed functions, including tubercular miasms and cancer miasms.[41] The theory of miasms has been criticized as an explanation developed by Hahnemann to preserve the system of homeopathy in the face of treatment failures, and for being inadequate to cover the many hundreds of sorts of diseases, as well as for failing to explain disease predispositions as well as genetics, environmental factors and the unique disease history of each patient.[45]

Opium. and tissue. and synthetic substances in its remedies. Some modern homeopaths have considered more esoteric bases for remedies. derived from poison ivy. or placed under a glass of water that is then given to the patient. Such practices have been strongly criticised by classical homeopaths as unfounded. known as imponderables because they do not originate from a material but from electromagnetic energy presumed to have been "captured" by alcohol or lactose. organised alphabetically by remedy. Remedy is a technical term in homeopathy that refers to a substance prepared with a particular procedure and intended for treating patients. which means "a medicine or therapy that cures disease or relieves pain". mineral. These include paper remedies. Examples include Arsenicum album (arsenic oxide). Homeopaths also use treatments called nosodes (from the Greek nosos. put in their pocket. and respiratory discharges. Lachesis muta (the venom of the bushmaster snake). plant.[47] Homeopathy uses many animal. A homeopathic Materia medica is a collection of "drug pictures".[48] Homeopathic remedies prepared from healthy specimens are called sarcodes. speculative. and verging upon magic and superstition. and Thyroidinum (thyroid hormone). disease) made from diseased or pathological products such as fecal. urinary. Examples include X-rays[49] and sunlight. A homeopathic repertory is an index of disease symptoms that lists remedies associated with specific symptoms. it is not to be confused with the generally accepted use of the word.[citation needed] Some homeopaths also use techniques that are regarded by other practitioners as controversial.[46] Homeopathic practitioners rely on two types of reference when prescribing remedies: Materia medica and repertories. that describes the symptom patterns associated with individual remedies.000 different remedies commonly used in homeopathy. as well as the use of radionics to prepare remedies.Homeopathic remedies Homeopathic remedy Rhus toxicodendron. blood.[51] Today there are about 3. Natrum muriaticum (sodium chloride or table salt). where the substance and dilution are written on a piece of paper and either pinned to the patient's clothing.[52][53] Preparation .[50] Recent ventures by homeopaths into even more esoteric substances include thunderstorms (prepared from collected rainwater).

but found that material doses intensified the symptoms and exacerbated the condition. sometimes causing dangerous toxic reactions. Dilutions Main article: Homeopathic dilutions Three logarithmic potency scales are in regular use in homeopathy. ending up with the original material diluted by a factor of 100−6=10−12 (one part in one trillion or 1/1. . A 2C dilution requires a substance to be diluted to one part in one hundred. sugar or alcohol).000 parts of the solution.Mortar and pestle used for grinding insoluble solids. To facilitate succussion. dilution by a factor of 1060). are diluted by grinding them with lactose (trituration).[58] The end product is often so diluted that it is indistinguishable from the dilutant (pure water. and then some of that diluted solution diluted by a further factor of one hundred. a solution that is more dilute is described as having a higher potency.000.[55][56] Insoluble solids.000. Hahnemann created the centesimal or C scale. into homeopathic remedies. In producing remedies for diseases. He therefore specified that the substances be diluted. including quartz and oyster shells. as the concept of the atom or molecule as the smallest possible unit of a chemical substance was just beginning to be recognized. The centesimal scale was favored by Hahnemann for most of his life.000). diluting a substance by a factor of 100 at each stage.[61] In Hahnemann's time it was reasonable to assume that remedies could be diluted indefinitely. Hahnemann had a saddle-maker construct a special wooden striking board covered in leather on one side and stuffed with horsehair. Hahnemann believed that the succussion activated the vital energy of the diluted substance[54] and made it stronger. and more dilute substances are considered by homeopaths to be stronger and deeperacting remedies. Higher dilutions follow the same pattern. Hahnemann advocated using substances which produce symptoms like those of the disease being treated. In homeopathy. The greatest dilution that is reasonably likely to contain one molecule of the original substance is 12C. homeopaths use a process called dynamisation or potentisation whereby a substance is diluted with alcohol or distilled water and then vigorously shaken by ten hard strikes against an elastic body in a process called succussion. [57] A 6C dilution repeats this process six times.[6][59][60] Hahnemann advocated 30C dilutions for most purposes (that is. This works out to one part of the original substance in 10.000. such as quartz and oyster shell.

[61] patient would need to consume 1041 pills (a billion times the mass of the Earth). etc.[63] A given dilution on the Q scale is roughly 2. i. For example a remedy described as "20Q" has about the same concentration as a "47C" remedy.e. 1X = 1D. if it could be succussed 60 times. diluting the substance to ten times its original volume each stage. This potency scale appears to have been introduced in the 1830s by the American homeopath. Hahnemann never used this scale but it was very popular throughout the 19th century and still is in Europe.[68] Hahnemann is reported to have joked that a suitable procedure to deal with an epidemic would be to empty a bottle of poison into Lake Geneva. Critics and advocates of homeopathy alike commonly attempt to illustrate the dilutions involved in homeopathy with analogies.[64] X Scale Ø 1X 2X 6X 8X 12X 24X C Scale Ø — 1C 3C 4C 6C 12C Ratio 1:1 1:10 1:100 10−6 10−8 10−12 10−24 Note mother tincture [65] (undiluted) described as low potency called higher potency than 1X by homeopaths allowable concentration of arsenic in U.000 parts of diluent.[69][70] which is approximately correct. for example. drinking water[66] Has a 60% probability of containing one molecule of original material if one mole of the original substance was used.S. or 1034 gallons of 60X 30C 10−60 liquid remedy (10 billion times the volume of the Earth) to consume a single molecule of the original substance[67] −400 400X 200C 10 Dilution of popular homeopathic flu remedy Oscillococcinum Note: the "X scale" is also called "D scale". Constantine Hering. Some homeopaths developed a decimal scale (D or X). Dilution advocated by Hahnemann for most purposes. "12X" is the same level of dilution as "6C". Hahnemann also developed a quintamillesimal (Q) or LM scale diluting the drug 1 part in 50.35 times its designation on the C scale. the nominal dilution is one part in a million (10-6). The D or X scale dilution is therefore half that of the same value of the C scale.[71] One third of a drop of some original substance diluted into all .[69][70] Another example given by a critic of homeopathy states that a 12C solution is equivalent to a "pinch of salt in both the North and South Atlantic Oceans".[62] In the last ten years of his life. 2X = 2D.This bottle contains arnica montana (wolf's bane) D6.

Those favoring low dilutions stressed pathology and a strong link to conventional medicine. Hahnemann administered remedies to healthy volunteers. they have not been conclusively demonstrated to have any effect beyond that of a placebo.[80] At first Hahnemann used material doses for provings. after the original German word Prüfung. but like their counterparts. tea. though homeopaths themselves never used it for that purpose at that time. would make it impossible to determine which symptoms came from the remedy and which from the disease itself. marketed under the name Oscillococcinum. or wine for the duration of the experiment.the water on earth would produce a remedy with a concentration of about 13C. playing chess was also prohibited because Hahnemann considered it to be "too exciting". As there are only about 1080 atoms in the entire observable universe. His experiments did not initially consist of giving remedies to the sick. due to their early use of simple control groups.[75] Dilution debate Not all homeopaths advocate extremely high dilutions. but he later advocated proving with remedies at a 30C dilution. sick people were excluded from these experiments. They were forbidden from consuming coffee. After the experiments were over. The volunteers were observed for months at a time and made to keep extensive journals detailing all of their symptoms at specific times throughout the day. The split between lower and higher dilutions followed ideological lines.[61] and most modern provings are carried out using ultradilute remedies in which it is highly unlikely that any of the original molecules remain.[82] The lengthy records of self-experimentation by homeopaths have occasionally proven useful in the development of modern drugs: For example.[76][77] Some products with such relatively lower dilutions continue to be sold. evidence that nitroglycerin might be useful as a treatment for angina was discovered by looking through homeopathic provings.[72][68][73] A popular homeopathic treatment for the flu is a 200C dilution of duck liver.[78][79] Provings Hahnemann experimented on himself and others for several years before using remedies on patients. and some of the first application of statistics in medicine.[81] During the proving process.[84] His Fragmenta de Viribus (1805)[85] contained the results of 27 provings.[74] The high dilutions characteristically used are often considered to be the most controversial and implausible aspect of homeopathy. at which time he would interrogate them extensively concerning their symptoms. though they were allowed to drink beer and encouraged to exercise in moderation. Provings have been described as important in the development of the clinical trial. meaning "test". by virtue of its ability to induce symptoms similar to the disease itself. Therefore. The method used for determining which remedies were suitable for specific diseases was called proving. miasms and a spiritual interpretation of disease. while those favoring high dilutions emphasised vital force. Many of the early homeopaths were originally doctors and generally used lower dilutions such as "3X" or "6X". spices.[86] For James Tyler Kent's 1905 Lectures on . because he thought that the most similar remedy. A homeopathic proving is the method by which the profile of a homeopathic remedy is determined. rarely going beyond "12X".[83] The first recorded provings were published by Hahnemann in his 1796 Essay on a New Principle. systematic and quantitative procedures. and the resulting symptoms were compiled by observers into a drug picture. and his 1810 Materia Medica Pura contained 65. a dilution of one molecule in the observable universe would be about 40C. Hahnemann made the volunteers take an oath swearing that what they reported in their journals was the truth. Oscillococcinum would thus require 10320 more universes to simply have one molecule in the final substance.

including likes. Repertories are often very extensive and may include data extracted from multiple sources of materia medica. which is an index of symptoms. the homeopath chooses how to treat the patient. including questions regarding their physical. Such repertories increased in size and detail as time progressed.[90] Homeopathic pills . another homeopathic repertory. But because a practitioner first needs to explore the remedies for a particular symptom rather than looking up the symptoms for a particular remedy. The homeopath then attempts to translate this information into a complex formula of mental and physical symptoms. dislikes.[88] The first such homeopathic repertory was Georg Jahr's Symptomenkodex. Repertory Homeopathic repertory by James Tyler Kent. Classical homeopathy generally involves detailed examinations of a patient's history and infrequent doses of a single remedy as the patient is monitored for improvements in symptoms. created the Therapeutic Pocket Book. supplemented with clinical data.[87] From these symptoms. There is often lively debate among compilers of repertories and practitioners over the veracity of a particular inclusion. innate predispositions and even body type. 217 remedies underwent provings and newer substances are continually added to contemporary versions. their life circumstances and any physical or emotional illnesses. The first symptomatic index of the homeopathic materia medica was arranged by Hahnemann. This version was less focused on disease categories and would be the forerunner to Kent's later works. published in German (1835). is known as a homeopathic materia medica. which was then first translated to English (1838) by Constantine Hering as the Repertory to the more Characteristic Symptoms of Materia Medica. Homeopaths generally begin with detailed examinations of their patients' histories. A compilation of reports of many homeopathic provings. while clinical homeopathy involves combinations of remedies to address the various symptoms of an illness. one of his students Clemens von Bönninghausen. lists after each symptom those remedies that are associated with it. Soon after.Homoeopathic Materia Medica. mental and emotional states.[48][89] It consisted of three large volumes. Some diversity in approaches to treatments exists among homeopaths. the homeopathic repertory.

According to normal homeopathic practice.[97] Other studies have also found that giving animals placebos can play active roles in influencing pet owners to believe in the effectiveness of the treatment when none exists. typically lactose). termed veterinary homeopathy.[23] when the drops have evaporated from the pills. remedies are prepared starting with active ingredients which are often serially diluted to the point where the product may no longer contain any molecules of those ingredients. the body that supports and represents homeopathic veterinarians is the International Association for Veterinary Homeopathy. known as "nosodes".[93] Flower remedies Flower remedies can be produced by placing flowers in water and exposing them to sunlight. homeopathic “remedy” Oscillococcinum Homeopathic pills are made from an inert substance (often sugars.[97] Medical and scientific analysis Pseudoscientific concepts . List of ingredients The list of ingredients seen on remedies may confuse consumers into believing that the product actually contains those ingredients. or from products of the disease.S. Animals may only be treated by qualified veterinary surgeons in the UK and some other countries. and the remedies are not succussed. as there has been little scientific investigation and current research in the field is not of a high enough standard to provide reliable data. the method of preparation is different. upon which a drop of liquid “remedy” is placed.Homeopathic pills. Thus the finished product may not contain any biologically "active ingredients" as that term is normally defined. The use of homeopathy in veterinary medicine is controversial.[48][92] Many so-called "homeopathic vaccines" are a form of isopathy. Bach flower remedies are prepared in "gentler" ways such as placing flowers in bowls of sunlit water. such as pus.[96] The FDA has not approved homeopathic products as veterinary medicine in the U.[95] Veterinary use The idea of using homeopathy as a treatment for other animals. The list of ingredients normally refers to the ingredients originally used in their preparation. Although the proponents of these remedies share homeopathy's vitalist world-view and the remedies are claimed to act through the same hypothetical "vital force" as homeopathy. dates back to the inception of homeopathy. Hahnemann himself wrote and spoke of the use of homeopathy in animals other than humans. there may be no "remedy" left. The most famous of these are the Bach flower remedies. Internationally. are made up either from things that cause the disease. Isopathy differs from homeopathy in general in that the remedies. In the UK. which were developed by the physician and homeopath Edward Bach. Related practices Isopathy Isopathy is a therapy derived from homeopathy and was invented by Johann Joseph Wilhelm Lux in the 1830s.[94] There is no convincing scientific or clinical evidence for flower remedies being effective. veterinary surgeons who use homeopathy belong to the Faculty of Homeopathy and/or to the British Association of Homeopathic Veterinary Surgeons.[91] Depending on the dilution.

George Vithoulkas Homeopathy's efficacy is unsupported by the collective weight of modern scientific research. Robin Murphy. which usually relies on some degree of patient .[9][10][11][13][104] Referring specifically to homeopathy. Nelsons. Luc De Schepper. [98][99] Pharmacological effect without active ingredients is inconsistent with the observed doseresponse relationships of conventional drugs. the British House of Commons Science and Technology Committee has stated: In the Committee’s view.[98] The lack of convincing scientific evidence supporting its efficacy[26] and its use of remedies without active ingredients have led to characterizations as pseudoscience and quackery. "placebo therapy at best and quackery at worst. Jan Scholten. The proposed rationale for these extreme dilutions – that the water contains the "memory" or "vibration" from the diluted ingredient – is counter to the laws of chemistry and physics.[100] leaving only non-specific placebo effects[12][101] [102] or various novel explanations. Jeremy Sherr. such as the law of mass action. Related scientific disciplines Chemistry. Heel. The modern mechanism proposed by homeopaths. worsening outcomes or exposing the patients to increased risk. water memory. Zicam Individuals: Paul Herscu."[31] Use of homeopathy may delay or replace effective medical treatment.Claims Proponents claim that illnesses can be treated with specially prepared extreme dilutions of a substance that produces symptoms similar to the illness. in the words of a 1998 medical review. Miralus Healthcare. The Government is reluctant to address the appropriateness and ethics of prescribing placebos to patients.[27][29][30][103] or. is considered implausible in that short-range order in water only persists for about 1 picosecond. Homeopathic remedies rarely contain any atom or molecule of the substance in the remedy. Rajan Sankaran. The extreme dilutions used in homeopathic preparations usually leave none of the original material in the final product. homeopathy is a placebo treatment and the Government should have a policy on prescribing placebos. Medicine Year proposed 1807 Original proponents Samuel Hahnemann Subsequent proponents Organizations: Boiron.

Homeopathic remedies are usually diluted to the point where there are no molecules from the original solution left in a dose of the final remedy. critics point out that water is therefore an extreme dilution of almost any conceivable substance.[106] critics have concluded that any effect that might have been present from the original substance can no longer exist. it would be necessary to take some two billion of them.[109] Practitioners of homeopathy contend that higher dilutions produce stronger medicinal effects.[110] rats. Prescribing of placebos is not consistent with informed patient choice-which the Government claims is very important-as it means patients do not have all the information needed to make choice meaningful. according to this interpretation. with shaking after each dilution. Since even the longest-lived noncovalent structures in liquid water at room temperature are only stable for a few picoseconds. By drinking water one would. prescribing pure placebos is bad medicine. since water will have been in contact with millions of different substances throughout its history. receive treatment for every imaginable condition.[100] This dose-response relationship has been confirmed in multitudinous experiments on organisms as diverse as nematodes. For these reasons.deception. in contrast to therapeutically inert water.[3] The National Center for Complementary and Alternative Medicine of the United States' National Institutes of Health states: Homeopathy is a controversial area of CAM because a number of its key concepts are not consistent with established laws of science (particularly chemistry and physics). Critics think it is implausible that a “remedy” containing a miniscule amount of an active ingredient (sometimes not a single molecule of the original compound) can have any biological effect—beneficial or otherwise. where the effects are dependent on the concentration of the active ingredient in the body.[108] Furthermore. Beyond ethical issues and the integrity of the doctor-patient relationship. This idea is inconsistent with the observed dose-response relationships of conventional drugs. beginning with a 10% or lower solution and working downwards. Others point to observational and anecdotal evidence that homeopathy does work and argue that it should not be rejected just because science has not been able to explain it. has noted that Park has also noted that "to expect to get even one molecule of the 'medicinal' substance allegedly present in 30X pills. [105] High dilutions The extremely high dilutions in homeopathy have been a main point of criticism. . Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS.[107] No evidence of stable clusters of water molecules was found when homeopathic remedies were studied using NMR. Park. former executive director of the American Physical Society.[112] Physicist Robert L. produces a therapeutically active remedy.[99] Homeopaths believe that the methodical dilution of a substance.[111] and humans. critics argue that continuing the scientific study of homeopathy is not worthwhile. which would total about a thousand tons of lactose plus whatever impurities the lactose contained".

[17][20][117] Abstract concepts within theoretical physics have been invoked to suggest explanations of how or why remedies might work. in which large groups of studies are analysed and conclusions drawn based on the results as a whole. including quantum entanglement. One of the earliest double blind studies concerning homeopathy was sponsored by the British government during World War II in which volunteers tested the effectiveness of homeopathic remedies against diluted mustard gas burns. and the highest-quality trials show that the remedies themselves have no effect.The laws of chemistry state that there is a limit to the dilution that can be made without losing the original substance altogether.[118] the theory of relativity and chaos theory. the evidence for homeopathy preparations being effective diminishes. even when using tests suggested by homeopaths themselves.[119] Meta-analyses Meta-analyses.[56][114] Effectiveness Old bottle of Hepar sulph made from calcium sulfide The effectiveness of homeopathy has been in dispute since its inception. and often include speculations which are incorrect in their application of the concepts and not supported by actual experiments. but such studies have warned that it was impossible to draw firm conclusions due to . However. small sample size. No individual preparation has been unambiguously demonstrated to be different from a placebo. with such problems as weaknesses in design or reporting. have been used to evaluate the effectiveness of homeopathy.[68][101][113] Scientific tests run by both the BBC's Horizon and ABC's 20/20 programs were unable to differentiate homeopathic dilutions from water. which is related to Avogadro's number. Early metaanalyses investigating homeopathic remedies showed slightly positive results among the studies examined. the explanations are offered by nonspecialists within the field. is roughly equal to homeopathic potencies of 12C or 24X (1 part in 1024).[23] This limit.[115] The methodological quality of the research base is generally low. and selection bias. as the quality of the trials become better. [2][116] Further.

et al...[15][16][22] One of the positive meta-analyses. by Linde. The Lancet medical journal published a meta-analysis of 110 placebo-controlled homeopathy trials and 110 matched medical trials based upon the Swiss government's Program for Evaluating Complementary Medicine. asthma. likely that our meta-analysis at least overestimated the effects of homeopathic treatments.have negative results.[20] In 2005. Since we completed our literature search in 1995. therefore. or otherwise a submission bias. seem to confirm the finding that more rigorous trials have less-promising results.[90] . a systematic review of the representation of homeopathy in the medical literature suggested that mainstream journals had a publication bias against clinical trials of homeopathy that showed positive results. or upper respiratory tract infection.[2] In 2005.[20] Reviews in all journals approached the subject in an apparently impartial manner. It seems. Evidence was not sufficient to recommend any therapeutic or preventative intervention. The fact that a number of the new high-quality trials.[13] The Cochrane Library found insufficient clinical evidence to evaluate the efficacy of homeopathic treatments for asthma[121] dementia.low methodological quality and difficulty in controlling for publication bias in the studies reviewed. Their analysis concluded that there was "insufficient evidence to support clinical efficacy of homeopathic therapy in cancer care".[14] A 2006 meta-analysis of six trials evaluating homeopathic treatments to reduce cancer therapy side effects following radiotherapy and chemotherapy found "encouraging but not convincing" evidence in support of homeopathic treatment. though most of the reviews published in CAM journals made no mention of the plausibility of homeopathy. and the opposite was the case for complementary and alternative medicine journals. and that homeopathy trials were less randomized and reported less on dropouts than other types of trials. and a recent update of our review for the most "original" subtype of homeopathy (classical or individualized homeopathy). there was no convincing evidence that any homeopathic remedy had better effects than placebo.. who wrote: The evidence of bias [in homeopathic trials] weakens the findings of our original meta-analysis. or PEK.[17] In 2001.[123] Other researchers found no evidence that homeopathy is beneficial for osteoarthritis. a meta-analysis of clinical trials on the effectiveness of homeopathy concluded that earlier clinical trials showed signs of major weakness in methodology and reporting. to the point that those results were clinically irrelevant. a considerable number of new homeopathy trials have been published.[124] migraines[125] or delayed-onset muscle soreness. when taking collectively all the systematic reviews. whereas 9 out of 10 reviews in mainstream journals mentioned a lack of plausibility of homeopathy in the introduction. The study concluded that its findings were compatible with the notion that the clinical effects of homeopathy are nothing more than placebo effects. [22] In 2002. and current evidence did not allow to recommend its usage in clinical treatment. The authors suggested that this could be due to an involuntary bias. in which positive trials tend to be sent to CAM journals and negatives ones to mainstream journals. a review of systematic reviews found that higher-quality trials tended to have less positive results. No difference from placebo was found for adenoid vegetation.[16] was later qualified by the authors. Also.[122] or for the use of homeopathy in induction of labor.[120] A 2007 systematic review of homeopathy for children and adolescents found that the evidence for attention-deficit hyperactivity disorder and childhood diarrhea was mixed.

is not convincing because of methodological shortcomings and inconsistencies.Health organisations such as the UK's National Health Service. These 19 studies showed a pooled odds ratio of 1. improvements are attributed to homeopathy when the actual cause is the cessation of the treatment causing side effects in the first place Lifestyle changes — homeopaths often recommend diet and exercise. symptoms vary over time and patients tend to seek care when discomfort is greatest. which can cause unpleasant side effects. individualized homeopathy works better than nonclassical variations. The evidence. they may feel better anyway but because the timing of the visit to the homeopath they attribute improvement to the remedy taken Non-homeopathic treatment — patients may also receive non-homeopathic care simultaneous with homeopathic treatment.23 in favor of individualized homeopathy over the placebo. The authors concluded "that the results of the available randomized trials suggest that individualized homeopathy has an effect over placebo. to my knowledge. 19 of which were placebo-controlled and provided enough data for meta-analysis. A 1998 review[129] found 32 trials that met their inclusion criteria. but no difference was seen when the analysis was restricted to the methodologically best trials. has stated that the claim assumes without evidence that classical." He adds: "There is. and this is responsible for improvement though a portion or all of the improvement may be attributed to the remedy Cessation of unpleasant treatment — often homeopaths recommend patients stop getting conventional treatment such as surgery or drugs. if the preparations themselves are ineffective.[130] Jack Killen. as well as limitations in alcohol or coffee consumption and stress reduction. or otherwise affect an individual's biology • • • • • • ." Jay Shelton. Clinical studies of the medical efficacy of homeopathy have been criticised by some homeopaths as being irrelevant because they do not test "classical homeopathy". exercise. says homeopathy "goes beyond current understanding of chemistry and physics. author of a book on homeopathy.[128] There have. been a number of clinical trials that have tested individualized homeopathy.17 to 2.[127] and the FASEB[107] have issued statements of their conclusion that there is no convincing scientific evidence to support the use of homeopathic treatments in medicine. environmental agent or treatment for a different ailment. may have occurred Regression toward the mean — since many diseases or conditions are cyclical. no condition for which homeopathy has been proven to be an effective treatment.[126] the American Medical Association. however. all of which can increase health and decrease symptoms The placebo effect — the intensive consultation process and expectations for the homeopathic preparations can result in the release of endorphins or other body-effecting chemicals which alleviate pain or other symptoms. acting deputy director of the National Center for Complementary and Alternative Medicine. may appear to cure diseases or alleviate symptoms:[131] • Unassisted natural healing — time and the body's ability to heal without assistance can eliminate many diseases of their own accord Unrecognized treatments — an unrelated food."[26] Scientific explanations of effects Mainstream science offers a variety of explanations for how homeopathy. however.

"We believe that experimental data have been uncritically assessed and their imperfections inadequately reported. ignoring meta-analytic studies in favour of cherry picked positive results.[133] and enzyme reactions. a type of white blood cell. consisting of Nature editor and physicist Sir John Maddox. but that the researchers had allowed "wishful thinking" to influence their interpretation of the data. After investigating the findings and methodology of the experiment. the team found that the experiments were "statistically ill-controlled". and the promotion of an observational study . Effects in other biological systems Old homeopathic belladonna remedy. with very few articles reporting null results. stating the research on homeopathy is problematic for a variety of reasons. "interpretation has been clouded by the exclusion of measurements in conflict with the claim". Upon replication in four separate laboratories the study was published. and concluded."[25][139][140] James Randi stated that he doubted that there had been any conscious fraud. concern and reassurance provided by a homeopath as part of the consultation can assure the patient the symptoms are minor and easily treated. These included the high publication biases of alternative therapy journals.[134][135][136][137][138] In 1987. and sceptic and magician James Randi.[139] Methodological and publication issues Ben Goldacre published an article on homeopathy in The Lancet. This caring engagement can prove particularly effective when conventional physicians have limited time with the patient or cannot provide a diagnosis or treatment. Nature assembled an independent investigative team to determine the accuracy of the research. such evidence is disputed since attempts to replicate them have failed. sceptical of the results. requested that the study be replicated in a separate laboratory. or alleviate tension that could exacerbate a preexisting condition.• Psychological healing — the care. released histamine when exposed to a homeopathic dilution of anti-immunoglobulin E antibody. The journal editors.[132] histamine release by leukocytes. While some articles have suggested that homeopathic solutions of high dilution can have statistically significant effects on organic processes including the growth of grain. American scientific fraud investigator and chemist Walter Stewart. The paper purported to have discovered that basophils. Still sceptical of the findings. French immunologist Jacques Benveniste submitted a paper to the journal Nature while working at INSERM.

[151] While Hahnemann was opposed to such preparations. a process referred to as "suppression".. since homeopathic remedies are completely ineffective against the malaria parasite. then a consultant physician at The Royal London Homeopathic Hospital. advising her on or around 20 August that she no longer needed to take her heart medication. and critique has been all too often met with avoidance rather than argument.[8] Zicam Cold “remedy” Nasal Gel."[141] Ethics and safety As homeopathic remedies usually contain only water and/or alcohol. I feel confident that if she follows the advice she will regain her health.[10][154][155] This puts visitors to the tropics who take this advice in severe danger. Campbell described this as a thoroughly irresponsible statement which could mislead an unfortunate layman into refusing conventional medical treatment.15). Instances of arsenic poisoning have occurred after use of arsenic-containing homeopathic preparations. Anthony Campbell.[142] 340 cases were settled out of court in 2006 for 12 million U.[9][149][150] Some homeopaths suggest that vaccines be replaced with homeopathic "nosodes". would develop into secondary and tertiary syphilis with involvement of the central nervous system. reportedly caused a small percentage of users to lose their sense of smell..[141] Homeopaths claim that use of conventional medicines will "push the disease deeper" and cause more serious conditions. diseased tissue. Only in rare cases are the original ingredients present at detectable levels.[143] In 2009..walled themselves off from academic medicine.S.[10][154] [155] Also. criticised statements made by George Vithoulkas to promote his homeopathic treatments. created from biological material such as pus. the final diagnosis being "acute heart failure due to treatment discontinuation". in one case in 2004. and adding on 23 August. have "." The patient was admitted to hospital the next day. Goldacre also states that homeopaths who misrepresent scientific evidence to a scientifically illiterate public. This may be due to improper preparation or intentional low dilution. bacilli from sputum or (in the case of "bowel nosodes") feces.(that Goldacre described as "little more than a customer-satisfaction survey") as if it were more informative than a series of randomized trials.. a homeopath instructed one of her patients to stop taking conventional medication for a heart condition. but the FDA warned Zicam via a Warning Letter that this policy does not apply when there is a health risk to consumers.[144] Zicam was launched without a New Drug Application (NDA) under a provision in the FDA’s Compliance Policy Guide called "Conditions Under Which Homeopathic Drugs May be Marketed" (CPG 7132. the FDA advised consumers to stop using three discontinued cold remedy products manufactured by Zicam because it could cause permanent damage to users' sense of smell. when treated with antibiotics.[156][157] In 1978.[11] This claim echoes the idea that treating a disease with external medication used to treat the symptoms would only drive it deeper into the . dollars. which contains 2X (1:100) zinc gluconate. advising her on 22 June 2004 to "Stop ALL medications including homeopathic". "She just cannot take ANY drugs – I have suggested some homeopathic remedies . they are thought to be generally safe. Vithoulkas stated that syphilis. modern homeopaths often use them although there is no evidence to indicate they have any beneficial effects. and died eight days later.[145] Critics of homeopathy have cited other concerns over homeopathic medicine.[147][148] Some homeopaths (particularly those who are non-physicians) advise their patients against immunisation.[152][153] Cases of homeopaths advising against the use of anti-malarial drugs have been identified. most seriously cases of patients of homeopathy failing to receive proper treatment for diseases that could have been easily diagnosed and managed with conventional medicine and who have died as a result[146] and the "marketing practice" of criticizing and downplaying the effectiveness of mainstream medicine.

the former site of Bristol Homeopathic Hospital. is highly regulated in some countries and mostly unregulated in others. The argument that this information is not relevant or important for customers is quite simply ridiculous."[162] Michael Baum. has described homoeopathy as a “cruel deception”.body and conflicts with scientific studies.[158] Edzard Ernst. chemistry. These treatments are biologically implausible and the clinical tests have shown they don't do anything at all in human beings. In some countries. and that students should be taught where unproven systems such as homeopathy depart from evidence-based medicine. If homeopathy is correct. Let people buy what they want. and pharmacology must be incorrect.. Michael Baum and Edzard Ernst—writing to other physicians —wrote that "Homeopathy is among the worst examples of faith-based medicine. the first Professor of Complementary Medicine in the United Kingdom and a former homeopathic practitioner. much of physics. Professor Emeritus of Surgery and visiting Professor of Medical Humanities at University College London (UCL).[32] In an article entitled "Should We Maintain an Open Mind about Homeopathy?"[163] published in the American Journal of Medicine.[159][160][161] has expressed his concerns about pharmacists who violate their ethical code by failing to provide customers with "necessary and relevant information" about the true nature of the homeopathic products they advertise and sell: "My plea is simply for honesty. It is practised worldwide and professional qualifications and licences are needed in most countries.. but tell them the truth about what they are buying.. Regulation and prevalence Main article: Regulation and prevalence of homeopathy Hampton House. These axioms [of homeopathy] are not only out of line with scientific facts but also directly opposed to them. that ethical dilemmas inherent in recommending products lacking proven safety and efficacy data be discussed. there are no specific legal regulations .[44] A 2006 review by W.. one of two homeopathic hospitals run by the NHS. Steven Pray of the College of Pharmacy at Southwestern Oklahoma State University recommends that pharmacy colleges include a required course in unproven medications and therapies. which indicate that penicillin treatment produces a complete cure of syphilis in more than 90% of cases.[3] Homeopathy is fairly common in some countries while being uncommon in others.".[33] Regulations vary in Europe depending on the country.

homeopathy is not covered. In Austria.that further clinical trials of homeopathy could not be justified. licences or degrees in conventional medicine from accredited universities are required.concerning the use of homeopathy. which usually relies on some degree of patient deception.[33] The Swiss government. In Germany. In other countries.[166] The Indian government recognises homeopathy as one of its national systems of medicine.. stating that they did not meet efficacy and cost-effectiveness criteria. it does not work beyond the placebo effect) and that explanations for why homeopathy would work are scientifically implausible. [165] private health insurance policies sometimes include homeopathic treatment. select committee inquiry. It also concludes that the Medicines and Healthcare products Regulatory Agency (MHRA) should not allow homeopathic product labels to make medical claims without evidence of efficacy. including funding of homeopathy under the National Health Service and government policy for licensing homeopathic products. As they are not medicines..[33] Some homeopathic treatment is covered by the public health service of several European countries. The Government is reluctant to address the appropriateness and ethics of prescribing placebos to patients. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS." the Committee said. Denmark. because government consideration of scientific evidence was not the basis for their establishment. homeopathic products should no longer be licensed by the MHRA. homeopathy is a placebo treatment and the Government should have a policy on prescribing placebos.[3] The Committee also stated: . The inquiry sought written evidence and submissions from concerned parties. Prescribing of placebos is not consistent with informed patient choice-which the Government claims is very important-as it means patients do not have all the information needed to make choice meaningful.. The Committee concluded . and Luxembourg. while in others. MPs inquired into homeopathy to assess the Government's policy on the issue. In the Committee’s view.given that the existing scientific literature showed no good evidence of efficacy . such as Belgium. while France. Beyond ethical issues and the integrity of the doctor-patient relationship. after a 5-year trial. including France..[167] and a minimum of a recognised diploma in homeopathy and registration on a state register or the Central Register of Homoeopathy is required to practice homeopathy in India. the NHS should cease funding homeopathy.[169][170] In February 2010 the House of Commons Science and Technology Committee concluded that: . The Committee concurred with the Government that the evidence base shows that homeopathy is not efficacious (that is. the United Kingdom. the public health service requires scientific proof of effectiveness in order to reimburse medical treatments and homeopathy is listed as not reimbursable[164] but exceptions can be made. Austria and Denmark mandate licences to diagnose any illness or dispense of any product whose purpose is to treat any illness. The decision by the House of Commons Science and Technology Committee follows a written explanation from the Government in which it told the select committee that the licensing regime was not formulated on the basis of scientific evidence. "The three elements of the licensing regime (for homeopathic products) probably lie outside the scope of the .[168] In the United Kingdom. prescribing pure placebos is bad medicine. withdrew homeopathy and four other complementary treatments in 2005. no specific regulations exist.

are best placed to make decisions on what treatment is appropriate for their patients . vitalism was part of mainstream science. which was made from 64 substances including opium. and viper's flesh. A nineteen page document details the Government´s response. used laxatives and enemas. and cleanliness. the germ theory of disease.[174][175] Such measures often worsened symptoms and sometimes proved fatal. and it states that "our continued position on the use of homeopathy within the NHS is that the local NHS and clinicians. however. believing that diseases have spiritual.including complementary or alternative treatments such as homeopathy . anticipating homeopathy.[173] but it was Hahnemann who gave it a name and laid out its principles in the late 18th century. [35][180] (At the time. with the development of microbiology. mainstream medicine employed such measures as bloodletting and purging." The response also stated that "the overriding reason for NHS provision is that homeopathy is available to provide patient choice".and provide accordingly for those treatments.[179][184] Hahnemann's concept See also: Samuel Hahnemann . including exercise. such as Venice treacle.[182][183]) Hahnemann also advocated various lifestyle improvements to his patients. rather than Whitehall. diet.[178] Hahnemann rejected such methods as irrational and inadvisable.In July 2010 the newly elected UK Secretary of State for Health deferred to local NHS on funding homeopathy. [172] History 1857 painting by Alexander Beydeman showing historical figures and personifications of homeopathy observing the perceived brutality of medicine of the 19th century Historical context In the 16th century the pioneer of pharmacology Paracelsus declared that small doses of “what makes a man ill also cures him".[179] Instead. medicine discarded vitalism. vitalistic view of how living organisms function. and administered complex mixtures. [181] and advances in chemistry. In the 20th century. At that time. he favored the use of single drugs at lower doses and promoted an immaterial. as well as physical causes. myrrh.[176][177] While the virtues of these treatments had been extolled for centuries.

[189] Hahnemann believed that large doses of drugs that caused similar symptoms would only aggravate illness.[6] proposing that this process aroused and enhanced "spirit-like medicinal powers held within a drug". John Franklin Gray (1804– 1882) was the first practitioner of Homeopathy in the United States. Hahnemann came to believe that all effective drugs produce symptoms in healthy individuals similar to those of the diseases that they treat. The Organon of the Healing Art. but did experience fever. is still used by homeopaths today. considered to be the father of homeopathy Hahnemann conceived of homeopathy while translating a medical treatise by Scottish physician and chemist William Cullen into German.[36] The term "homeopathy" was coined by Hahnemann and first appeared in print in 1807. he devised a technique for making dilutions that he believed would preserve a substance's therapeutic properties while removing its harmful effects.[190] He gathered and published a complete overview of his new medical system in his 1810 book.[188] The first collection of provings was published in 1805 and a second collection of 65 remedies appeared in his book.000 practitioners in the United States. the most important concept of homeopathy. symptoms similar to some of the early symptoms of malaria.[21] Because medical . the disease that the bark was ordinarily used to treat.[188] These time-consuming tests required subjects to clearly record all of their symptoms as well as the ancillary conditions under which they appeared.[185] Upon ingesting the bark.[36] 19th century: rise to popularity and early criticism Homeopathy achieved its greatest popularity in the 19th century.[186][187] Hahnemann began to test what effects substances produced in humans. From this. in 1810. This later became known as the "law of similars". The first homeopathic schools opened in 1830.[191] By 1900. shivering and joint pain. so he advocated extreme dilutions of the substances. beginning in 1828 in New York City.Samuel Hahnemann. although he began outlining his theories of "medical similars" or the "doctrine of specifics" in a series of articles and monographs in 1796. he noticed few stomach symptoms. Dr. and throughout the 19th century dozens of homeopathic institutions appeared in Europe and the United States. published in 1921. there were 22 homeopathic colleges and 15. whose 6th edition. Hahnemann ingested some of the bark specifically to see if it cured fever "by virtue of its effect of strengthening the stomach".[36] Being skeptical of Cullen's theory concerning cinchona's action in malaria. Hahnemann saw these data as a way of identifying substances suitable for the treatment of particular diseases. Materia Medica Pura. a procedure which would later become known as "homeopathic proving".

however strong or powerful.[194] From its inception. By the 1950s there were only 75 pure homeopaths practicing in the U. where the treatments used at the time were often harmful and did little or nothing to combat the diseases. even if ineffective.[197] The members of the French Homeopathic Society observed in 1867 that some of the leading homeopathists of Europe were not only abandoning the practice of administering infinitesimal doses.S. Homeopathy: How It Really Works.[198] The last school in the U.[192] Homeopathic remedies. was also a vocal critic of homeopathy and published an essay in 1842 entitled Homœopathy. science based medicine. the billionth or decillionth of which would in the least degree affect a man or harm a fly. but were also no longer defending it. however.[199] However.[200] Greek homeopath George Vithoulkas performed a "great deal of research to update the scenarios and refine the theories and practice of homeopathy" beginning in the 1970s. Sr.[90][201] in Brazil during the 1970s and in Germany during the 1980s. and it was revived worldwide.[193] During 19th century epidemics of diseases such as cholera."[196] 19th century American physician and author Oliver Wendell Holmes. said in 1843 that the extremely small doses of homeopathy were regularly derided as useless.[204] See also • • • • • 10:23 campaign Allopathy Electrohomeopathy List of homeopathic preparations Sympathetic magic References • Shelton.[36] Revival in the late 20th century Main article: Regulation and prevalence of homeopathy The Food.practice of the time relied on ineffective and often dangerous treatments. would almost surely cause no harm.[195] James Young Simpson said in 1853 of the highly diluted drugs: "No poison. exclusively teaching homeopathy closed in 1920. Jay (2004). homeopathy was criticized by mainstream science. death rates in homeopathic hospitals were often lower than in conventional hospitals. Drug. and its kindred delusions. physician to Queen Victoria.[36] The relative success of homeopathy in the 19th century may have led to the abandonment of the ineffective and harmful treatments of bloodletting and purging and to have begun the move towards more effective. and Cosmetic Act of 1938 (sponsored by New York Senator and Homeopathic Physician Royal Copeland) recognized homeopathic remedies as drugs. N.[202] The medical profession started to integrate such ideas in the 1990s[203] and mainstream pharmacy chains recognized the business potential of selling homeopathic remedies. patients of homeopaths often had better outcomes than those of the doctors of the time. ISBN 1-59102-109-X . making the users of homeopathic remedies less likely to be killed by the treatment that was supposed to be helping them. Buffalo. homeopathy made a significant comeback and sales of some homeopathic companies increased tenfold.Y: Prometheus Books. in the mid to late 1970s.[177] One reason for the growing popularity of homeopathy was its apparent success in treating people suffering from infectious disease epidemics.S. Sir John Forbes. "an outrage to human reason".

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