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'''Homeopathy''' is a system of [[Complementary and Alternative Medicine]] that strives to treat 'like with like'; its remedies involve treating an illness with an infinitesimally small dose of a substance that, at bigger doses, can cause symptoms like those of the illness. Homeopaths believe that the 'potency' of a remedy can be ''increased'' by serial dilution, when combined with vigorous shaking. The word 'homeopathy' was coined by the German physician [[Christian Friedrich Samuel Hahnemann]] (1755-1843). Hahnemann, born in Meissen, studied medicine in Leipzig and Vienna, and became eminent as a linguist, as a practical physician and as a notably enlightened public health reformer before creating his new health system. He believed his new system to be humane and effective <ref>Hahnemann S (1796) translated into English as  [http://www.minutus.org/library/article_read.asp?id=6 "Essay on a New Principle"]. Hahnemann's[http://www.homeopathyhome.com/reference/organon/organon.html
''Organon der Heilkunst''] in English translation.</ref>, but it was received by the establishment with derision and contempt. <ref>
Dean ME (2001)
[http://shpltd.co.uk/dean-homeopathy.pdf Homeopathy and the progress of science] ''Hist Sci''xxxix</ref> Homeopathy has survived however, and today has more than 100,000 practitioners worldwide, and 500 million users.
[[Image:Samuel_Hahnemann.png|thumb|right|'''Samuel Hahnemann'''(1755-1843), the "father" of homeopathy]]  


'''Homeopathy''' (also spelled '''homœopathy''' or '''homoeopathy''') from the Greek ''όμοιος, hómoios'' (similar) and ''πάθος, páthos'' (suffering), is a therapy that strives to treat "like with like" (the etymological origin of the word homeopathy: 'similar suffering').<ref>[http://www.skylarkbooks.co.uk/Hahnemann_Biography.htm Samuel Hahnemann biography]</ref> The term "homeopathy" was coined by the [[Saxons|Saxon]] physician [[Christian Friedrich Samuel Hahnemann]] (1755&ndash;[[1843]]) and first appeared in print in 1807,<ref>Hahnemann, S. Fingerzeige auf den homöopathischen Gebrauch der Arzneien in der bisherigen Praxis. [Hufeland's] N.J.d.pract.Arzkd. (1807) 26:5-43)</ref> although he had previously outlined his axiom of medical similars in a series of articles and monographs from 1796 onwards.<ref>Hahnemann, S. Versuch über ein neues Prinzip zur Auffindung der Heilkräfte der Arzneisubstanzen, nebst einigen Blicken auf die bisherigen. [Hufeland's] J.d.pract.Arzkd. (1796) 2:391-439) and 2:465-561 This article in English translation can be read in the [http://www.minutus.org/library/article_read.asp?id=6 Essay on a New Principle, 1796]</ref> Homeopathy is an alternative medicine that is particularly popular in Europe and India <ref>[http://indianmedicine.nic.in/html/homoeopathy/homoe.htm Indian Ministry of Health and Family Welfare homeopathy page]</ref><ref>[http://bmj.bmjjournals.com/cgi/content/full/309/6947/107 Fisher P, Ward A "Medicine in Europe: Complementary medicine in Europe" ''BMJ'' 1994;309:107-111]</ref> although less so in the USA,<ref>Tindle HA, Davis RB, Phillips RS, Eisenberg DM "Trends in use of complementary and alternative medicine by US adults: 1997-2002"  ''Altern Ther. Health Med'' 2005 11:42-9.</ref> where such therapies have been subject to tighter regulation. Stricter European regulations have also been implemented recently by the EDQM.<ref>[http://www.pheur.org European Directorate for the Quality of Medicines] EDQM website</ref>
Homeopathy (also spelled ''homœopathy'' or ''homoeopathy'', from the Greek ''όμοιος, hómoios'' (similar) and ''πάθος, páthos'' (suffering))
[[Image:Samuel_Hahnemann.png|thumb|right|'''Samuel Hahnemann''', the father of homeopathy]]
regards diseases as "morbid derangements of the organism", that involve some disturbance in a 'vital force.' Homeopaths reject the standard medical diagnoses of named diseases; each case of sickness is a strictly individual phenomenon &mdash; "It is the man that is sick and to be restored to health, not his body, not the tissues". <ref>Kent JT ''Lectures on homoeopathic philosophy. Lecture 1; 'The Sick'''</ref>
Homeopathy rests on the premise of treating sick persons with very diluted agents that, in undiluted doses, produce similar symptoms in a healthy individual. Its proponents assert that the therapeutic potency of a remedy can be increased by serial dilution of the drug, combined with [[succussion]] or vigorous shaking. In common with conventional medicine, homeopathy regards diseases as <cite>morbid derangements of the organism</cite>.<ref>Organon &#0167; 11</ref> However, it differs in preferring to view each case of sickness as a strictly individual phenomenon.<ref>Morrell, Peter [http://www.homeoint.org/morrell/articles/uniqueness.htm ''Homeopathy Views the Uniqueness of Each Patient'']</ref> <cite>It is the man that is sick and to be restored to health, not his body, not the tissues.<ref>Lectures on Homoeopathic philosophy. J.T. Kent M.D. Lecture 1. &#0167; 1. "The Sick"</ref></cite> Homeopathy views a sick person as having a dynamic disturbance in a hypothetical "vital force," and so reject the standard medical diagnoses of named diseases. <ref>http://www.lyghtforce.com/HomeopathyOnline/Issue3/sequence.html Rudolf Verspoor ''Taking Homeopathy into the Shadows: A Sequential Causal Approach to Treating Chronic Disease'', Website: Homeopathy Online</ref>  


Some critics of homeopathy describe it as pseudoscience<ref>[http://www.skeptics.org.uk/article.php?dir=articles&article=homeopathy.php Homeopathy] at UK-Skeptics</ref> and quackery.<ref>[http://www.ncahf.org/pp/homeop.html NCAHF Position Paper on Homeopathy] National Council Against Health Fraud</ref> The theory of homeopathy is inconsistent with accepted laws of chemistry and physics, as it states that extreme dilution makes drugs more powerful by enhancing their "spirit-like medicinal powers."<ref>[http://homeopathyhome.com/reference/organon/63.html#269 Christian Friedrich Samuel Hahnemann's "Organon Of Medicine" translated by Dudgeon Fifth Edition § 269]</ref> Although many placebo-controlled clinical trials show a difference between homeopathic treatments and [[placebos]], most trials have methodological problems, and better-quality trials are more likely to give negative results.<ref>{{cite journal | author=Shang A ''et al.'' | title=Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy | journal=Lancet | year=2005 | pages=726-32 | volume=366 | id=PMID 16125589}}</ref> Additionally, cases have been reported of life-threatening illness resulting from attempts to treat serious conditions solely with homeopathic remedies.<ref>http://news.bbc.co.uk/2/hi/programmes/newsnight/5178122.stm</ref><ref>[http://www.pubmedcentral.gov/articlerender.fcgi?tool=pubmed&pubmedid=11082104 Delaunay P (2000) Homoeopathy may not be effective in preventing malaria ''BMJ'' 321: 1288]</ref>
==The Principle of Similars==
For the early Greek physician [[Hippocrates]] of Cos, who lived at about 400 BCE [http://www.iep.utm.edu/h/hippocra.htm],  the four 'humours' (blood, black bile, yellow bile and phlegm) were key to understanding disease. This idea persisted through the influence of [[Galen]] (131-201 AD) until at least 1858, and [[Rudolf Virchow]]'s theories of cellular pathology. Diseases, or so it was thought, were the result of some 'imbalance' of the humours, and conventional medicine still focused on restoring that balance, either by attempting to remove an excess of a humour, or by suppressing the symptoms. "Bloodletting, fever remedies, tepid baths, lowering drinks, weakening diet, blood cleansing and everlasting aperients and clysters (enemas) form the circle in which the ordinary German physician turns round unceasingly", wrote Hahnemann while translating into German the ''Treatise on Materia Medica'' (1789) by the Edinburgh physician [[William Cullen]]. <ref>See Peter Morrell, [http://homeoint.org/morrell/articles/index.htm Articles on Homeopathy];  ''Homeopathy Timeline''[http://www.wholehealthnow.com/homeopathy_pro/homeopathy_1825_1849.html] </ref>


==The principle of medical similars==
From 1783 onwards, disillusioned with the medicine of his day and the many toxic effects of its cures, Hahnemann began to use smaller and smaller doses of drugs, trying to minimise their toxic effects while retaining their efficacy. He had concluded that diseases are not caused by "...any disease matter, but that they are solely spirit-like derangements of the spirit-like power that animates the human body", and was searching for some way to harness this power for healing. Cullen had written that Cinchona bark (which contains quinine) was effective because it was bitter, and Hahnemann pondered about this; he felt that this explanation was implausible because other substances that were as bitter had no therapeutic value. Accordingly, he took Cinchona bark himself, and saw that its effects were similar to the symptoms of the diseases that it was prescribed for. . For Hahnemann, this was a conceptual breakthrough, and it led him to formulate the 'Principle of Similars' on which homeopathy is based, expressed by him as ''similia similibus curentur'' or 'let likes cure likes'. <ref>At least one writer has suggested that Hahnemann was hypersensitive to quinine, and that he might have had an allergic reaction ([http://www.angelfire.com/mb2/quinine/allergy.html Thomas WE "The basis of homeopathy"]). The notion of 'let likes cure likes' was not novel; others before Hahnemann, including Anton von Störck (1731-1803) had advocated "treatment by cautious use of poisons."  Hahnemann had studied briefly in Vienna, where Störck eventually became head of the University. (Lichocka Z "Chemical Analysis as a Method of Discovery in Pharmacy in the Age of Enlightenment in Europe" [http://5ichc-portugal.ulusofona.pt/uploads/LongPaper-LICHOCKAHalina.doc Halina])</ref>  
Homeopathy is based on the 'Principle of Similars', first expressed by Hahnemann in the exhortation ''similia similibus curentur'' or 'let likes cure likes'. This is the exact opposite of 'contraries' upon which the [[Galenic]] medicine of his day was based, and in which Hahnemann had been trained. The 'law of similars' is an ancient medical maxim <ref>[http://www.tcfnm.com/homeopathy.htm Website of The Center for Natural Medicine]</ref> <ref>[http://www.whonamedit.com/doctor.cfm/532.html whonamedit.com]</ref>, but its modern form is based on Hahnemann's conclusion that a constellation of symptoms induced by a given homeopathic remedy in a group of healthy individuals will cure a similar set of symptoms in the sick. Symptom patterns associated with various remedies are determined by 'provings', in which healthy volunteers are given remedies, and the resulting symptoms are compiled by observers into a 'Drug Picture'.


Speaking of his first proving, Hahnemann states: ''"with this first trial broke upon me the dawn that has since brightened into the most brilliant day of the medical art; that it is only in virtue of their power to make the healthy human being ill that medicines can cure morbid states, and indeed, only such morbid states are composed of symptoms which the drug to be selected for them can itself produce in similarity on the healthy."''<ref>[http://www.hpathy.com/materiamedica/hahnemann-materia-pura/china.asp Hahnemann, Materia Medica Pura, Cinchona] at Hpathy.com</ref>
Homepathic remedies are found by 'provings', in which volunteers are given substances, the effects of which are recorded as a 'Drug Picture'. Of his first proving, Hahnemann said: "with this first trial broke upon me the dawn that has since brightened into the most brilliant day of the medical art; that it is only in virtue of their power to make the healthy human being ill that medicines can cure morbid states, and indeed, only such morbid states are composed of symptoms which the drug to be selected for them can itself produce in similarity on the healthy." At first, Hahnemann tested substances that were then used as medicines, such as antimony and rhubarb, and poisons like arsenic, mercury and [[Belladonna]]. He recorded his first provings of 27 drugs in the ''[[Fragmenta de viribus]]'' in 1805 and later in his [http://www.hpathy.com/materiamedica/hahnemann-materia-pura/china.asp ''Materia Medica Pura''], which contained 65 drugs.  


Homeopathic practitioners rely on two types of reference in prescribing. The Homeopathic [[Materia Medica]]e comprise indexes of Drug Pictures organized by remedy and describe the symptom patterns associated with individual remedies. The [[Homeopathic repertory]] is an index of sickness symptoms, listing all remedies associated with specific symptoms. The first [[Homeopathic repertory]] was George Jahr's, published in 1835. <ref>[http://www.wholehealthnow.com/homeopathy_pro/george_jahr.html Website of Whole Health Now]</ref>
[[James Tyler Kent]] (1849-1921) [http://www.minimum.com/p7/engine/biopage.asp?n=241] was almost as important as Hahnemann to the development of homeopathy; his ''Lectures on Homoeopathic Materia Medica'' (1905) listed 217 remedies. Kent emphasized the metaphysical and clinical aspects of Hahnemann's teachings; the core doctrines of miasm and vital force, and the importance of spiritual factors as the cause of disease ("for it goes to the very primitive wrong of the human race, the very first sickness of the human race that is the spiritual sickness... which in turn laid the foundation for other diseases" ). Modern medicine recognizes that bacteria and viruses as the causes of many diseases, but for Kent "The microbe is not the cause of disease. We should not be carried away by these idle Allopathic dreams and vain imaginations but should correct the Vital Force". In the UK, his ideas became homeopathic orthodoxy by the end of the First World War, and some homeopaths still regard microbes as effects, not causes, of disease. <ref>Campbell A, [http://www.accampbell.uklinux.net/homeopathy/homeopathy-html/chapter08.html ''Kentian Homeopathy''], Chapter 8 of ''Homeopathy in Perspective'' ; Morrell P [http://www.homeoint.org/morrell/articles/pm_kent.htm ''Kent's influence on British homeopathy'']</ref>  


At first, Hahnemann tested substances commonly used as medicines in his time, such as antimony and rhubarb, and poisons, like arsenic, mercury and [[Belladonna]]. Perhaps in this he was mindful of [[Paracelsus]]: ''"poison is in everything, and no thing is without poison. The dosage makes it either a poison or a remedy."'' <ref>Source for Paracelsus quote at [http://en.thinkexist.com/quotation/poison-is-in-everything-and-no-thing-is-without/397986.html en.thinkexist.com]</ref> This subtle connection between poison and medicine, or 'what can kill can cure' was also observed by [[Shakespeare]]: "''In the infant rind of this small flower, poison hath residence and medicine power:...''" <ref>Romeo and Juliet: act 2, scene 3. Oxford Shakespeare complete works. Oxford: Oxford University Press, 1974: 774</ref>
Today, homeopaths use about 3000 different remedies from animal, plant, mineral, and synthetic substances, including 'Natrum muriaticum' (sodium chloride or table salt)[http://www.abchomeopathy.com/r.php/Nat-m], 'Oscillococcinum' (a 200C product made from duck heart and liver that is prescribed for colds and flu-like symptoms) 'Roadrunner' (''Geococcyx californianus'') [http://www.hpathy.com/repertory/] and 'Arnica' [http://www.jr2.ox.ac.uk/bandolier/booth/alternat/AT012.html]. Other 'isopathic' remedies involve diluting the agent or product of the disease; for example, [[Rabies]] nosode is made from the saliva of a rabid dog. Some homeopaths use more esoteric substances, known as 'imponderables' because they originate from electromagnetic energy 'captured' by alcohol or lactose ('X-ray', 'Sol' (sunlight), [http://www.hominf.org/posi/posiintr.htm 'Positronium'], and http://homeoint.org/clarke/e/elect.htm 'Electricitas'](electricity), or with a telescope ('Polaris'). Recent ventures into more esoteric remedies include [http://uk.geocities.com/veryscarymary/stormremedy1.html 'Tempesta'] (thunderstorm), and  [http://www.biolumanetics.net/tantalus/Cases/BerlinWall.htm 'Berlin wall'].


Hahnemann recorded his first provings of 27 drugs in the ''[[Fragmenta de viribus]]'' in 1805 and later in his ''Materia Medica Pura'', which contained 65 proven drugs. He was most heavily engaged in proving in the 1790s and early 1800s, but he never abandoned these experiments. Another phase of proving commenced with his Miasm theory and The Chronic Diseases <ref>[http://homeoint.org/books/hahchrdi/index.htm Chronic Diseases - Samuel Hahnemann]</ref>, published in 1828, and containing 48 freshly 'proven' drugs.
The law of similars is not a scientific law, and a failure to cure can always be attributed to the wrong choice of remedy; in Kent's words, "I have often heard physicians tell me that it was due to suggestion that my medicines acted so well; but my answer to this is, that I suggest just as strongly with my wrong remedy as with the right one, and my patients improve only when they have received the similar or correct remedy".<ref>Kent JT (1926) ''New Remedies, Lesser Writings and Aphorisms & Precepts'', quoted in Treuherz F (1984) Origins of Kent's homeopathy ''J Amer Inst Homeo'' 77:130-49</ref>  


[[James Tyler Kent|Kent's]] ''Lectures on Homoeopathic Materia Medica'' (1905) lists 217 remedies, and new substances are continually added  to contemporary versions. Homeopathy uses many animal, plant, mineral, and synthetic substances. Examples include ''Natrum muriaticum'' (sodium chloride or table salt), ''[[Lachesis muta]]'' (the venom of the bushmaster snake), ''Opium'', and ''Thyroidinum'' (thyroid hormone). Other homeopathic remedies, ('isopathic' remedies') involve dilution of the agent or product of the disease. [[Rabies]] nosode, for example, is made by diluting the saliva of a rabid dog. Some modern homeopaths are exploring the use of more esoteric substances, known as "imponderables" because they do not originate from a material but from electromagnetic energy presumed to have been somehow "captured" by alcohol or lactose (''X-ray'', ''Sol'' (sunlight), [http://www.hominf.org/posi/posiintr.htm ''Positronium''], and [http://homeoint.org/clarke/e/elect.htm ''Electricitas''] (electricity) or through the use of a telescope (''[[Polaris]]''). Recent ventures by homeopaths into even more esoteric substances include [http://uk.geocities.com/veryscarymary/stormremedy1.html ''Tempesta''] (thunderstorm), and [http://www.biolumanetics.net/tantalus/Cases/BerlinWall.htm ''Berlin wall''].
There are many ways to find the most-similar remedy (the ''simillimum''), and homeopaths sometimes disagree. This is partly due to the complexity of the 'totality of symptoms' concept; homeopaths decide, from their knowledge and experience, which symptoms are the most characteristic: the Drug Picture in the Materia Medica is always more comprehensive than the symptoms of any individual. Other ways are through [[Dowsing|medical dowsing]] or other psychic powers, but these are not accepted by most homeopaths. <ref>[http://www.homeoinfo.com/08_non-classical_topics/dowsing/diagnostic_dowsing_machines.php Diagnostic dowsing machines]; [http://www.homeoinfo.com/08_non-classical_topics/dowsing/medical_dowsing.php "Medical dowsing"]</ref>


Today, about 3000 remedies are used in homeopathy; about 300 are based on comprehensive [[Materia Medica]] information, about 1500 on relatively fragmentary knowledge and the rest are used either without knowledge of their homeopathic properties or through speculative knowledge independent of the law of similars. This modern approach harks back to the ancient 'doctrine of signatures,' which Hahnemann  rejected as uncertain guesswork: ''"The ancients imagined that the yellow colour of the juice of...(Chelidonium, Yellow Poppy) was an indication (signature) of its utility in bilious diseases. The moderns from this extended its employment to hepatic diseases...the importance of human health does not admit of any such uncertain directions for the employment of medicines. It would be criminal frivolity to rest contented with such guesswork at the bedside of the sick. Only that which the drugs themselves unequivocally reveal of their peculiar powers in their effects on the healthy human body – that is to say, only their pure symptoms – can teach us loudly and clearly when they can be advantageously used with certainty; and this is when they are administered in morbid states very similar to those they are able to produce on the healthy body."''
===Preparation of similars ===
<ref>[http://www.hpathy.com/materiamedica/hahnemann-materia-pura/chelidonium.asp Hahnemann, Materia Medica Pura, section 19, Chelidonium majus] at Hpathy.com</ref>
The most characteristic&mdash;and controversial&mdash;principle of homeopathy is that the potency of a remedy can be enhanced (and the side-effects diminished) by dilution, in a procedure known as 'dynamization' or 'potentization'. Liquids are progressively diluted (with water or alcohol) and shaken by ten hard strikes against an elastic body ('succussion'). For this, Hahnemann had a saddlemaker construct a special wooden striking board covered in leather on one side and stuffed with horsehair. Insoluble solids, such as quartz and oyster shell, are diluted by grinding them with lactose ('[[trituration]]'). The original serial dilutions by Hahnemann used a 1 part in 100 or centesimal scale, or 1 part in 50,000 or Quintamillesimal ('LM' or 'Q' potencies). The dilution factor at each stage is 1:10 ('D' or 'X' potencies) or 1:100 ('C' potencies); Hahnemann advocated 30C dilutions for most purposes (i.e. dilution by a factor of 100<sup>30</sup> = 10<sup>60</sup>). The number of molecules in a given weight of a substance can be calculated by [[Avogadro's number]]; the chance that there is even one molecule of the original substance in a 15C solution is small, and it is very unlikely that one molecule would be present in a 30C dilution. Thus, homeopathic remedies of a high "potency" contain just water, but water that, according to homeopaths, retains some 'essential property' of one of the substances that it has contacted in the past. <ref>Hahnemann's board can be seen at the [http://www.igm-bosch.de/english/f10.htm Hahnemann Museum] in Stuttgart.
There are 6.02 × 10<sup>23</sup> molecules in one mole of a substance, and about 10<sup>32</sup> molecules of water in an Olympic size swimming pool; 25 metric tons of a 15C solution water contains, on average, just one molecule of the original substance.
[http://www.lsbu.ac.uk/water/''Water Structure and Behaviour''] has references to current scientific understanding of water, with entries on "memory effects" and homeopathy</ref>


Examples of this impulse to expand the materia medica include: the use of an isopathic (disease associated) agent as a first prescription in a 'stuck' case,<ref>Manish Bhatia [http://www.hpathy.com/tautopathy/tautopathy.asp Tautopathy - An Introduction]</ref> when the beginning of disease coincides with a specific event such as [[vaccination]]; the use of a chemically-related substance when a remedy that was well-indicated fails. A good example of this is found in the Bowel Nosodes <ref>[http://homeoint.org/books5/paterson/index.htm Bowel Nosodes]</ref> which were introduced by the British homeopaths, [[Edward Bach]] (1886-1936), John Paterson (1890-1954) and Charles Edwin Wheeler (1868-1946) in the 1920s. Their use is based on the variable bowel [[bacterial]] flora thought to be associated with persons of different homeopathic constitutional types. The Bowel Nosodes are rarely used outside British homeopathy.
Hahnemann's explanation for the increased strength of higher potencies was that the friction involved in succussion could release the hidden power of substances, including their curative power. As he wrote in 1825: "The effect of friction is so great, that not only the physical properties, such as caloric, odour, etc., are thereby called into life and developed by it, but also the dynamic medicinal powers of natural substances are thereby developed to an incredible degree".
 
More recently, homeopathy has embraced the use of substances based on their elemental classification (the [[periodic table]] or biological [[taxonomy]]). <ref>[http://www.homeoinfo.com/06_materia_medica/remedies/modern_divisions.php Douglas Hoff: Personal website]</ref> <ref>[http://janscholten.com/page5.html Jan Scholten: Personal website]</ref> This approach may well create neat systems for grouping remedies and classifying the ever-burgeoning [[Materia Medica]], but its usefulness is questioned by some purists on the basis that inherently it involves speculation about remedy action without provings.<ref>[http://www.simillimum.com/thelittlelibrary/Bookreviewsarticles/reviewscholten.html Homoeopathic Online Education]</ref>
 
There are many methods for determining the most-similar remedy (the ''simillimum''), and homeopaths sometimes disagree about the required remedy. This is partly due to the complexity of the 'totality of symptoms' concept; homeopaths do not use all symptoms, but decide which are the most characteristic; this subjective evaluation of case analysis rests crucially on knowledge and experience. Finally, the Drug Picture in the [[Materia Medica]] is always more comprehensive than the symptoms exhibited by any individual.
 
Alternative ways of selecting remedies are through [[Dowsing|medical dowsing]]<ref>[http://www.homeoinfo.com/08_non-classical_topics/dowsing/diagnostic_dowsing_machines.php "Diagnostic dowsing machines" www.homeoinfo.com]</ref> or the use of other [[psychic|psychic powers]].<ref>[http://www.homeoinfo.com/08_non-classical_topics/dowsing/medical_dowsing.php  "Medical dowsing" www.homeoinfo.com]</ref> <ref>[http://users.med.auth.gr/~karanik/english/vet/psyche1.htm Philip A.M. Rogers "Psychic methods of diagnosis and treatment in acupuncture and homeopathy."]</ref> However, these methods are controversial and not accepted by most homeopathic practitioners.
 
The law of similars is not a scientific law; it is not built on a hypothesis that can be falsified; a failure to cure homeopathically can always be attributed to incorrect selection of a remedy: ''I have often heard physicians tell me that it was due to suggestion that my medicines acted so well; but my answer to this is, that I suggest just as strongly with my wrong remedy as with the right one, and my patients improve only when they have received the similar or correct remedy''. <ref>James Tyler Kent, ''New Remedies, Lesser Writings and Aphorisms & Precepts'', Chicago: Ehrhart & Karl, 1926, quoted in Francis Treuherz, ''Origins of Kent's Homeopathy'', J Amer Inst Homeo, 77.4, 1984, 130-49; 140-1</ref>
 
''See also'': [[List of common homeopathic remedies]]
 
==Preparation of similars ==
===Succussion and dilution===
[[Image:Vijzel.jpg|thumb|Vijzel]]
The most characteristic&mdash;and controversial&mdash;principle of homeopathy is that the potency of a remedy can be enhanced (and the side-effects diminished) by dilution, in a procedure known as ''dynamization'' or ''potentization''. Liquids are progressively diluted (with water or alcohol) and shaken by ten hard strikes against an elastic body (''succussion''). For this purpose, Hahnemann had a saddlemaker construct a special wooden striking board covered in leather on one side and stuffed with horsehair. It can be viewed at the Hahnemann Museum in Stuttgart.<ref>[http://www.igm-bosch.de/english/f10.htm Website of The Institute for the History of Medicine]</ref> Insoluble solids, such as Quartz and Oyster shell, are diluted by grinding them with [[lactose]] (''[[trituration]]''). The original serial dilutions by Hahnemann were performed using a 1 part in 100 or centesimal scale, or 1 part in 50,000 or Quintamillesimal (LM or Q potencies). Higher 'potencies' are considered to be stronger 'deep-acting' remedies.
 
The dilution factor at each stage is traditionally 1:10 ('D' or 'X' potencies) or 1:100 ('C' potencies). Hahnemann advocated 30C dilutions for most purposes, i.e. dilution by a factor of 100<sup>30</sup> = 10<sup>60</sup>. As [[Avogadro's number]] is only 6.02 × 10<sup>23</sup> particles/mole, the chance of any molecule of the original substance being present in a 15C solution is small, and it is extremely unlikely that one molecule of the original solution would be present in a 30C dilution. For a perspective on these numbers, there are in the order of 10<sup>32</sup> molecules of water in an [[Olympic size swimming pool]]; to expect to get one molecule of a 15C solution, one would need to take 1% of the volume of such a pool, or roughly 25 metric tons of water. Thus, homeopathic remedies of a high "potency" contain, with overwhelming probability, only water. Practitioners of homeopathy believe that this water retains some 'essential property' of one of the substances that it has contacted in the past.  


===Alternative methods===
===Alternative methods===
High potency remedies were first produced in the 1830s. Though Hahnemann wished to see 30c as standard potency in homeopathy, most of his contemporaries preferred tinctures and 3x, while others, like the powerfully-built horse-trainer, Caspar Julius Jenichen (1787-1849), <ref>[http://homeoint.org/seror/biograph/jenichencj.htm Biography of Mr Caspar Julius Jenichen (1787-1849) http://homeoint.org]</ref> General Korsakoff (1788-1853) and Dr N Schreter (1803-1864), were busy raising potency to heights beyond his wildest dreams.
Hahnemann wanted to see 30C as the standard potency in homeopathy, but most of his contemporaries preferred tinctures and 3X, while others, including Caspar Julius Jenichen (1787-1849) and the Russian General Count Iseman von Korsakoff (1788-1853) [http://homeoint.org/seror/biograph/korsakoff.htm] were busy raising potency to extremes:


''Jenichen sat or stood stripped naked to the waist, holding the bottle in his fist in an oblique direction from left to right, and shook it in a vertical direction. The fluid, at every stroke, emitted a sound like the ringing of silver coins. He paused after every 25th potency, and the muscles of his naked arm vibrated...he was latterly able to give 8400 strokes in an hour.'' <ref>[http://homeoint.org/seror/biograph/jenichencj.htm Biography of Mr Caspar Julius Jenichen (1787-1849) http://homeoint.org]</ref>
:''Jenichen sat or stood stripped naked to the waist, holding the bottle in his fist in an oblique direction from left to right, and shook it in a vertical direction. The fluid, at every stroke, emitted a sound like the ringing of silver coins. He paused after every 25th potency, and the muscles of his naked arm vibrated...he was latterly able to give 8400 strokes in an hour.'' <ref>Biography of Caspar Julius [http://homeoint.org/seror/biograph/jenichencj.htm Jenichen] (1787-1849)</ref>


Such high potencies could not be made by traditional methods, but required succussion without dilution (Jenichen), higher dilution factors (LM potencies are diluted by a factor of 50,000), or machines which integrate dilution and succussion into a continuous process (Korsakoff). Such a Korsakoff potentising machine can be seen [http://www.helios.co.uk/Helios%20Potentising%20machine.html (here)] and [http://www.remedia.at/en/fluxionherstellung.html (here)]. Some old potentising devices can be seen [http://homeoint.org/photo/photodiv.htm (here)]. Such machines are still on sale today and some manufacturers claim it is undefined "vibrations" that produce the healing effect and, when the correct vibration is selected, only water need be added to produce a remedy.<ref>[http://www.orgoneshop.com/?open=61#82 "Homöo Plus" from www.bioenergetik.com]</ref> Today, ''[[radionics]]'' potentising devices are used by many homeopaths to prepare remedies, <ref>[http://www.remedydevices.com/mini8dial.htm Mini 8 Dial Radionic Potentiser White Mountain]</ref>. These are based on the work of the British engineer, Malcom Rae (1913-1979) <ref>[http://www.homeoint.org/photo/r/raem.htm Website of Homéopathe International]</ref> and the potentising devices he developed in the 1960s.<ref>[http://www.copenlabs.com/ Website of Sussex College of Technology - CopenLabs]</ref>
Such high potencies could not be made by traditional methods, but required succussion without dilution, higher dilution factors (LM potencies are diluted by a factor of 50,000), or "Korsakoff machines" [http://homeoint.org/photo/photodiv.htm] that continuously combine dilution and succussion. Such machines[http://www.helios.co.uk/Helios%20Potentising%20machine.html][http://www.remedia.at/en/fluxionherstellung.html] are still sold today; some claim that "vibrations" produce the healing effect and, that when the correct vibration is selected, only water need be added to produce a remedy. Today, ''[[radionics]]'' devices are used by many homeopaths to prepare remedies, based on the "geomagnetic potentiser" invented by Malcolm Rae (1913-1979) [http://www.copenlabs.com/], an electronic engineer and dowser. Another technique involves a "paper remedy" ''-  "finds out what they need, writes the remedy down on a piece of paper, they put it in their pocket and it works."''<ref> see Editorial, the New Zealand Homoeopathic Society [http://www.homoeopathica.org.nz/editorial_00.htm] The Toronto Chapter of the Canadian Society of Dowsers[http://www.dowsers.info/toronto/feb2001.htm]</ref>


Yet another technique used by a few homeopaths involves using ''"a paper remedy. Write the remedy and potency on a piece of paper and place the paper on the left hand side of the body with the writing towards the body."'' <ref>[http://www.homoeopathica.org.nz/editorial_00.htm Editorial at the web pages of the New Zealand Homoeopathic Society]</ref> One homeopath, ''"finds out what they need, writes the remedy down on a piece of paper, they put it in their pocket and it works."'' <ref>[http://www.dowsers.info/toronto/feb2001.htm Website of The Toronto Chapter of the Canadian Society of Dowsers]</ref> In essence, this comprises an emerging alternative homeopathic tradition, ''"`paper remedies' i.e., a name of a remedy just written on a piece of paper."''
In 1832, Korsakov described the method of 'dry grafting'. A single dry globule of a potentized remedy is put in a bottle half-filled with sugar globules. The bottle is shaken for five minutes, and this way all the globuli should be able to exert the influence of the initial remedy, "as if by contagion", as he put it. Hahnemann approved of the idea, saying that it "is a sort of infection, bearing a strong resemblance to the infection of healthy persons by a contagion brought near or in contact with them".
<ref>[http://www.grundlagen-praxis.de/debatte/englisch/wichmann.pdf Jörg Wichmann, Defining a different tradition for homeopathy.]</ref>
 
The practitioner's choice of what potency is appropriate derives in part from a judgement as to whether the disease is acute and superficial or 'deeper' and more chronic in nature; whether it is primarily physical or more mental/emotional; the patient's general sensitivity and previous reactions to remedies; and the practitioner's preferred posology (dosing regimen), e.g. low potency repeated often, vs. high potency repeated seldom. For example, French and German homeopaths generally prefer to use lower potencies than their American & British counterparts. Most homeopaths assert that the choice of potency is secondary to the choice of remedy: i.e. that a well-chosen remedy will act in a variety of potencies, but an approximately matched remedy might act only in certain potencies, or not at all.


==Miasms==
==Miasms==
By 1816, Hahnemann was concerned at the failure of his homeopathic remedies to produce lasting cures for chronic diseases. He found that ''"...the non-venereal chronic diseases, after being time and again removed homoeopathically … always returned in a more or less varied form and with new symptoms."'' To explain this, Hahnemann introduced the miasmatic theory, that three fundamental "miasms" are the underlying root causes of all the chronic diseases of mankind: [[Syphilis]], Sycosis (suppressed [[gonorrhoea]]), and Psora. This miasm theory was first published in 1828. <ref>The Chronic Diseases, their Nature and Homoeopathic Treatment, [[Dresden]] and [[Leipsic]], Arnold. Vols. 1, 2, 3, 1828; vol. 4, 1830</ref> Though Hahnemann first suspected miasms in 1816, he took 12 years before he published his views. It is possible that the study of [[Freemasonry]] under the guidance of his Patron, the Grand Duke Ferdinand of Anhalt-Coethen influenced his thinking.<ref>[http://www.homeoint.org/history/king/1-02.htm Website of Homéopathe International]</ref> He adopted a reclusive lifestyle while residing in [[Koethen]] and his new inclination towards metaphysical pursuits may explain his sudden adoption of Olfaction (inhaling the remedy), which he continued to use until his death in [[Paris]] in 1843.<ref>[http://www.hanp.net/general/article2 Website of The Homeopathic Academy of Naturopathic Physicians]</ref> Olfaction might derive from [[Arabian]] medicine and the art of [[Perfumery]].<ref>[http://www.iranian.ws/cgi-bin/iran_news/exec/view.cgi/4/6736/printer Manouchehr Saadat Noury "First Iranians who introduced perfumery" ''Persian Journal'' May 9, 2005]</ref>
By 1816, Hahnemann was concerned at the failure of homeopathic remedies to produce lasting cures for chronic diseases: "...the non-venereal chronic diseases, after being time and again removed homoeopathically … always returned in a more or less varied form and with new symptoms." He introduced the theory that three fundamental "miasms" underlie of all the chronic diseases of mankind: ''Syphilis'', ''Sycosis'' (suppressed gonorrhoea), and ''Psora''. Miasma, from the Greek for 'stain', was an old medical concept, used for "pestiferous exhalations". In Hahnemann's words: "...a child with small-pox or measles communicates to a near, untouched healthy child in an invisible manner (dynamically) the small-pox or measles, … in the same way as the magnet communicated to the near needle the magnetic property..."  


The miasm of Psora, he concluded, underpinned most of the chronic diseases known to medicine. Miasma, from the Greek for 'stain', was an old medical concept, used for "pestiferous exhalations". The sense of this is indicated by Hahnemann's Note 2 to §11 of the Organon:
According to Hahnemann, miasmatic infection causes local symptoms, usually in the skin. If these are suppressed by medication, the sickness goes deeper, and emerges later as organ pathologies. In the ''Organon'' he asserted that Psora was the cause of such diseases as epilepsy, cyphosis, cancer, jaundice, deafness, and cataract. However, even in his own time, many of his followers, including Hering, made almost no reference to Hahnemann’s concept of chronic diseases. Today, some homeopathic practitioners  find Hahnemann’s theory difficult to reconcile with current scientific knowledge, as it seems to ignore the importance of genetic, metabolic, nutritional, and degenerative factors in sickness, and fails to differentiate between the many different infectious diseases. Nevertheless, most homeopaths believe that the fundamental causes of disease are internal and constitutional and that it is contrary to good health to suppress symptoms, and they accept the concept of "latent Psora", the early signs of an organism’s imbalance which indicate that treatment is needed.
''"...a child with small-pox or measles communicates to a near, untouched healthy child in an invisible manner (dynamically) the [[small-pox]] or [[measles]], … in the same way as the magnet communicated to the near needle the magnetic property..."''


According to Hahnemann, miasmatic infection causes local symptoms, usually in the skin. If these are suppressed by external medication, the hidden sickness cause goes deeper, and manifests itself later as organ pathologies. In §80 of the ''Organon'' he asserted Psora to be the cause of such diseases as [[epilepsy]], cyphosis, [[cancer]], [[jaundice]], [[deafness]], and [[cataract]].
The miasm theory is not the 'be all and end all' of homeopathy. Hahnemann was also a powerful advocate of good hygiene, fresh air, regular exercise, and good nutrition as essential for good health (see his 1792 essay: ''The Friend of Health''). He was also a pioneer of humane treatment of the insane (1796, ''Description of Klockenbring During his Insanity'') a year before [[William Tuke]] and [[Philippe Pinel]], and he published tracts describing the cause of cholera as "excessively minute, invisible, living creatures", indicating his acceptance of some of the conventional ideas about infectious disease.<ref>Hahnemann S (1831) [http://www.minutus.org/library/article_read.asp?id=13 ''Asiatic Cholera'']</ref>


Even in his own time, many followers of Hahnemann, including Hering, made almost no reference to Hahnemann’s concept of chronic diseases. Perhaps they lacked Hahnemann's deep knowledge of cases from which the theory was distilled? Today, some homeopathic practitioners <ref>[http://www.homeopathy.ca/articles/interview-2001-2.html Website of  The Canadian Academy of Homeopathy]</ref> find Hahnemann’s theory difficult to reconcile with current knowledge of [[immunology]], [[genetics]], [[microbiology]] and [[pathology]], as it seems to ignore the importance of [[genetics|genetic]], [[congenital]], [[metabolic]], [[nutritional]], and [[degenerative]] factors in [[sickness]]; the theory also fails to differentiate the multitude of different [[infectious diseases]]. However, most insist that the key elements of his theory are valid. For instance, most of them believe that the fundamental cause of disease is internal and constitutional (i.e. the susceptibility to becoming ill), and that it is contrary to good health to suppress symptoms, especially skin eruptions and discharges. They also accept Hahnemann's concept of latent Psora, the early signs of an organism’s imbalance, which indicate that treatment is needed to prevent the development of more advanced disease.
== The Spread of Homeopathy ==
<blockquote>''"I do not expect that homeopathy will ever be established as a legitimate form of treatment, but I do expect that it will continue to be popular." [[James Randi]]'' (see[http://www.bbc.co.uk/science/horizon/2002/homeopathy.shtml]) </blockquote>


However, the miasm theory is not the 'be all and end all' of homeopathy. Hahnemann strongly advocated good [[hygiene]], fresh air, regular [[exercise]], good [[nutrition]] as precursors of good health (see his 1792 essay: ''The Friend of Health''); he was also a pioneer in 1792-3 of humane treatment of the [[insane]] (1796, ''Description of Klockenbring During his Insanity'') a year before [[William Tuke]] and [[Philippe Pinel]], and he published tracts in which he described the cause of [[Cholera]] as ''"excessively minute, invisible, living creatures"'' [http://www.minutus.org/library/article_read.asp?id=13 Asiatic Cholera, 1831]. Hahnemann's acceptance of this emerging idea of infectious disease before its final proof by [[Robert Koch]] and [[Louis Pasteur]] indicates some of his medical views incorporated ideas that were at the cutting-edge of contemporary science. These 17th-century epidemiological theories built on the ideas of [[Girolamo Fracastoro]] in the 16th century and the discovery of microbes by [[Anton van Leeuwenhoek]] one hundred years previously.
Homeopathy is popular in Europe and India, but less so in the USA, where non-orthodox therapies have been more tightly regulated. Stricter regulations have also been implemented recently in the EC. There are estimated to be more than 100,000 practitioners of homeopathy worldwide, and 500 million people receiving treatment. More than 12,000 medical doctors and licensed health care practitioners administer homeopathic treatments in the UK, France, and Germany. In Germany, homeopathy is recognized as a 'special form of therapy' since 1978, meaning that homeopathic remedies do not have to have been proved to be efficacious, but since 2004, most  are no longer covered by public health insurance. In Switzerland, homeopathic remedies were covered by the basic health insurance system, if prescribed by a physician, until June 2005, when the Government, after a 5-year trial, withdrew insurance coverage for homoeopathy and four other complementary treatments, as they did not meet efficacy and cost-effectiveness criteria.<ref>Fisher P, Ward A (1994) Medicine in Europe: Complementary medicine in Europe ''BMJ'' 309:107-111[http://bmj.bmjjournals.com/cgi/content/full/309/6947/107]; Homeopathy was regulated by the European Union in 2001, by Directive 2001/83/EC. [http://www.pheur.org European Directorate for the Quality of Medicines]</ref>


== History ==
In the UK, homeopathy was established by Dr Frederick Quin (1799-1878) at around 1827. (Two Italian homeopathic doctors (Drs Romani and Roberta) had been employed two years previously by the Earl of Shrewsbury, but had quickly returned to Naples as they could not tolerate the damp English climate.) Homeopathy became the preferred treatment of the upper classes: the Dukes of Edinburgh and Beaufort were among Quin's patients, and he became physician to the Duchess of Cambridge. At its peak in the 1870s, there were large hospitals in Liverpool, Birmingham, Glasgow, London and Bristol [http://www.homeoint.org/photo/bat/hopangla.htm#2] ; the Bristol hospital was funded by the [[W.D. & H.O. Wills]] tobacco family, while the Hahnemann Hospital in Liverpool was built by members of the Tate family of sugar importers, who also funded the Tate Gallery in London. Today, homeopathic remedies are sold over the counter, and there are five homeopathic hospitals funded by the [[National Health Service]] and many regional clinics. Homeopathy is not practised by most of the medical profession, but is supported by the [[Prince of Wales]] and other members of the royal family. <ref> Leary B ''et al'' (1998) It Wont Do Any Harm: Practice & People At The London Homeopathic Hospital, 1889-1923, in Juette R ''et al'' (1998) Eds. ''Culture, Knowledge And Healing: Historical Perspectives On Homeopathy In Europe And North America'' Sheffield Univ. Press, UK
In Hahnemann's day, the conventional theory of disease was based on the [[four humours]]. Mainstream medicine focused on restoring the balance in the humours, either by attempting to remove an excess of a humour (by such methods as bloodletting and purging, laxatives, enemas and nauseous substances that made patients vomit) or by suppressing symptoms associated with the humours causing trouble, such as by lowering the body temperature of patients who were feverish. By contrast, Hahnemann promoted an immaterial, [[Vitalism|vitalistic]] view of disease: ''"...homeopathy...can easily convince...that the diseases of man are not caused by any substance, any acridity...any disease matter, but that they are solely spirit-like (dynamic) derangements of the spirit-like power (the vital principle) that animates the human body."'' <ref>http://homeoint.org/books/hahorgan/orgapref.htm Organon, Preface, xxix</ref>
[http://www.homeoint.org/english/index.htm Homéopathe International The English language version]</ref>


[[Vitalism]] was a part of mainstream science in the 18th century. In the twentieth century, medicine discarded vitalism in favour of the [[germ theory]] of disease, following the work of [[Louis Pasteur]], [[Alexander Fleming]], [[Joseph Lister]] and many others. Modern medicine sees bacteria and viruses as [[Koch's postulates|the causes of many diseases]], but Kent, and some modern homeopaths regard them as effects, not causes, of disease. Others have adapted to the views of modern medicine by referring to disturbances in, and stimulation of, the immune system, rather than the vital force.
Homeopathy came to India with Dr Martin Honigberger (1795-1869) in Lahore, in 1829-30  India has the largest homeopathic infrastructure in the world, with 300,000 qualified homeopaths, 180 colleges, 7500 government clinics, and 307 hospitals. The Indian 'Association of Qualified Homoeopaths' is the largest of its kind, and 10% of the population are estimated to use homeopathy ''exclusively'' for their medical needs.
<ref>Kishore J (1973) About entry of homeopathy into India ''Bull Ind Hist Med'' 3:76-8; [http://www.ihma.in Indian Hopeopathic Medical Association];
Manchanda RK, Kulashreshtha M, Cost Effectiveness and Efficacy of Homeopathy in Primary Health Care Units of Government of Delhi- A study [http://www.delhihomeo.com/paperberlin.html]; Indian Ministry of Health and Family Welfare[http://indianmedicine.nic.in/html/homoeopathy/homoe.htm  homeopathy page]</ref>


Homeopathy stemmed from the idea of medical similars, that 'like cures like', while Hahnemann was translating into German the Materia Medica (1789) of [[William Cullen]], the so-called Scottish Hippocrates. On reading that Cinchona bark (which contains [[quinine]]) was effective because it was bitter, Hahnemann felt this implausible because other substances were as bitter but had no therapeutic value. To understand the effects of Cinchona bark, he decided to take it himself, and saw that his reactions were similar to the symptoms of the disease it was used to treat. At least one writer has suggested that Hahnemann was hypersensitive to quinine, and that he may have had an allergic reaction.<ref>[http://www.angelfire.com/mb2/quinine/allergy.html William.E.Thomas "The basis of homeopathy" Personal website]. </ref>
Homeopathy was brought to the USA by Dr Hans Burch Gram (1787-1840) in 1825 and became popular there partly because of the excesses of conventional medicine and partly by the influence of Constantine Hering (1800-1880). Hering immigrated to America in 1833 and became known as the 'father of American homeopathy' [http://www.homeoint.org/biograph/heringen.htm]. Hering's contributions to the theory of homeopathy include his "laws" of cure. [http://homeoint.org/cazalet/schmidt/lawofcure.htm]. He proposed that healing proceeds (and symptoms disappear):
:''From above downwards.
:''From within outwards.
:''From a more important organ to a less important one.
:''In the reverse order of their coming.''


Yet, this proving experiment by Hahnemann was by no means unique, as others before him had tried the same approach, such as, for example, Anton von Störck (1731-1803), "in the 1760’s, who advocated treatment by cautious use of poisons."<ref>[http://5ichc-portugal.ulusofona.pt/uploads/LongPaper-LICHOCKAHalina.doc Halina Zofia Lichocka "Chemical Analysis as a Method of Discovery in Pharmacy in the Age of Enlightenment in Europe" Proceedings of the 5th International Conference on the history of Chemistry]</ref> Indeed, Hahnemann had studied briefly in Vienna (1777) where Störck eventually became head of the University. The proving idea had also been recommended by the great Swiss medical botanist, Albrecht von Haller, (1708-77), who Hahnemann hugely admired, and whose Materia Medica he translated in 1806. Therefore, it might be said, that the proving experiment came to Hahnemann from several previous sources.
By 1900, hardly any city in the USA with a population of more than 50,000 was without a homeopathic hospital, but in the 1930s, the popularity of homeopathy waned, partly due to the [[Flexner Report]] of 1910, which led to the closure of virtually all medical schools teaching alternative medicine, and by the 1950s, homeopathy had almost disappeared. Nevertheless, in 1995 sales of homeopathic remedies were estimated at US$201 million, and the number of homeopaths increased from less than 200 in the 1970s to about 3,000 in 1996.
<ref>[http://nccam.nih.gov/health/homeopathy/ ''Questions and Answers About Homeopathy''] NCCAM, National Institutes of Health;


For Hahnemann, the whole body and spirit was the focus of therapy, not just the localised disease. Hahnemann spent a lot of time with his patients, asking them not only about their symptoms or illness, but also about their daily lives. This gentle approach contrasted with the violent forms of [[heroic medicine]] common at the time, which included techniques such as bleeding as a matter of course.
"Homeopathy spread first in Germany, then France, and England. Its greatest popularity, however, was in America." (Flinn LB (1976) Homeopathic influences in the Delaware community: a retrospective reassessment ''Del Med J'' 48:418-28 PMID 780153);


Nearly as important as Hahnemann to the development of homeopathy was [[James Tyler Kent]] (1849-1921). Kent's influence in the USA was limited, but in the UK, his ideas became the homeopathic orthodoxy by the end of the First World War.<ref>A. Campbell, [http://www.accampbell.uklinux.net/homeopathy/homeopathy-html/chapter08.html ''Kentian Homeopathy''], Chapter 8 of ''Homeopathy in Perspective''</ref> His most important contribution may be his repertory, which is still used today. Kent's attempt to rescue an idealized pure homeopathy from what he saw as its degenerate mongrel forms was authoritarian, as he sought to re-emphasize the metaphysical and clinical aspects of Hahnemann's teachings, in particular:
"...by the early 1840s American homeopathic practitioners were gaining considerable influence and prestige", (in Warner JH (1977) "The nature-trusting heresy": American physicians and the concept of the healing power of nature in the 1850's and 1860's. ''Perspectives on American History'' 11:291-324 PMID 11632694)</ref>


* insistence on the core doctrines of miasm and vital force;
==The skeptical view of homeopathy==
* emphasis on case totality rather than rote prescribing for 'named diseases'
<blockquote>''"As I understand it, the claim is that the less you use Homeopathy, the better it works. Sounds plausible to me."  [[David Deutsch]]'' [http://www.qubit.org/people/david/index.php?blog=20040808030513]</blockquote>
* emphasis on psychological symptoms (to supplement physical pathology) in prescribing; and
* regular use of very high potencies.


Influenced by [[Swedenborgianism]], Kent reputedly emphasized '[[spirituality|spiritual]] factors' as the root cause of disease.<ref>[http://www.homeoint.org/morrell/articles/pm_kent.htm Peter Morrell "Kent's influence on British homeopathy." Personal website]</ref>  
From the very beginnings of homeopathy, its claims were treated with skepticism by the medical and scientific establishments. Sir John Forbes (1787-1861), physician to Queen Victoria, declared in 1861 that most cases of disease which recover under homeopathy  "recover by means of the curative powers of Nature alone." He concluded that homeopathy is "one of the greatest delusions...of the healing art" and the only good it brings is by lessening "the monstrous polypharmacy which has always been the disgrace of our art - by at once diminishing the frequency of administration of drugs and lessening their dose." <ref>Agnew RAL (2005). John Forbes FRS (1787-1861). [http://www.jameslindlibrary.org The James Lind Library];  [http://www.jameslindlibrary.org/trial_records/19th_Century/forbes/forbes_biog.html]</ref> Professor Sir [[James Young Simpson]] said, of the highly diluted drugs, that there is "no poison, however strong or powerful, the billionth or decillionth of which would in the least degree affect a man or harm a fly." <ref>Simpson JY (1853) ''Homoeopathy, Its Tenets and Tendencies, Theoretical, Theological and Therapeutical'' Edinburgh: Sutherland & Knox 11</ref>
''<blockquote>"...for it goes to the very primitive wrong of the human race, the very first sickness of the human race that is the spiritual sickness... which in turn laid the foundation for other diseases." </blockquote>''  


=== Homeopathy around the world ===
Homeopathy was developed at a time when many of the most important concepts of modern chemistry and biology, such as molecules and germs, were understood poorly if at all. While proponents may consider the mechanism of homeopathy to be an interesting side issue, skeptics consider the lack of any plausible mechanism to be a serious problem, raising the bar on the quality of evidence required before accepting the existence of the phenomenon under the motto "Extraordinary claims require extraordinary proof".
There are estimated<ref>[http://www.dw-world.de/dw/article/0,1564,1575855,00.html Homeopathy Seeks More Acknowledgement] from Deutsche Welle</ref> to be more than 100,000 practitioners of homeopathy worldwide, with an estimated 500 million people receiving treatment. More than 12,000 medical doctors and licensed health care practitioners administer homeopathic treatment in the UK, France, and Germany. Homeopathy was regulated by the European Union in 2001, by Directive 2001/83/EC.


<!--English speaking countries-->
In Hahnemann's day, many chemists believed that matter was infinitely divisible, so that it was meaningful to talk about dilution to any degree. Although the hypothesis of atoms can be traced back to the ancient Greeks, their size was not calculated until 1865 (by Loschmidt). There are 6.02×1023 particles in a mole (Avogadro's number), so homeopathic dilutions greater than about 24X or 12C are virtually certain to contain not even a single molecule of the initial substance. This is recognized by advocates of homeopathy, who assert that the essential healing power of their preparations is not to be found in the chemical action of molecules, but perhaps in the arrangement of the water molecules, giving rise to the expression 'the memory of water'. This concept is closely related to the belief in a 'vital force', which was common in Hahnemann's day, but was discarded by the scientific community as more and more life processes came to be describable in purely materialistic terms, and as the medical model of disease came to be focused on the failure of particular organs and processes in the body. <ref>There have been occasional reports of effects of highly diluted solutions on organic processes, including on histamine release by leukocytes (Davenas E ''et al'' Human basophil degranulation triggered by very dilute antiserum against IgE ''Nature'' [http://br.geocities.com/criticandokardec/benveniste01.pdf 333:816-8]); However, attempts to replicate these studies failed. Walach ''et al'' (2005) Research on Homeopathy: State of the Art ''J Alt Comp Medicine'' [http://www.iscmr.org/publications/2005_JACM_Homeopathy.pdf 11:813–29]</ref>.
'''Britain''' Homeopathy was first established in [[Britain]] by Dr Frederick Quin (1799-1878) around 1827, though two Italian homeopathic doctors (Drs Romani and Roberta) had been employed two years previously by the Earl of Shrewsbury based at [[Alton Towers]] in [[North Staffordshire]]; however, they soon returned to [[Naples]] as they could not tolerate the cool damp [[England|English]] climate. Homeopathy in the UK quickly became the preferred medical treatment of the upper classes: Regarding Dr Quin, ''"...with his connections, he was quickly established among the well-known and wealthy. Quin counted the Dukes of Edinburgh and Beaufort among his patients, and became physician to the household of the Duchess of Cambridge."'' <ref>Leary, B, Lorentzon M & Bosanquet, A, 1998, It Wont Do Any Harm: Practice & People At The London Homeopathic Hospital, 1889-1923, in Juette, Risse & Woodward, 1998 Juette, R, G Risse & J Woodward [Eds.], 1998, Culture, Knowledge And Healing: Historical Perspectives On Homeopathy In Europe And North America, Sheffield Univ. Press, UK, p.253</ref> Furthermore, ''"the principal supporters of the (homeopathic) hospital, until Quin's death in 1878, were members of the aristocracy."'' <ref>Leary, et al, 1998, 254</ref>
Homeopathy in Britain ''"...retained an elite clientele, including members of the royal family."'' <ref>Sharma, Ursula, 1992, Complementary Medicine Today, Practitioners And Patients, Routledge, UK, p.185</ref> and ''"...homeopathy still had much support from people in high places in the mid-nineteenth century..."'' <ref>Sharma, 1992, p.183</ref> At its peak in the 1870s [[Britain]] had many homeopathic dispensaries and small hospitals as well as large busy hospitals in [[Liverpool]], [[Birmingham]],<ref>[http://www.homeoint.org/photo/bat/hopangla.htm#2 Website of Homéopathe International]</ref> [[Glasgow]], [[London]] and [[Bristol]], almost exclusively funded and run by members of the local gentry.<ref>[http://www.homeopathyhome.com/reference/articles/ukhomhistory.shtml Website of Homeopathy Home]</ref> For example, the [[Bristol]] hospital [http://www.ubht.nhs.uk/homeopathy/General/hom1.jpg Image] was funded and run by several generations of the [[W.D. & H.O. Wills]] tobacco family, while the Hahnemann Hospital [[Liverpool]] [http://www.homeoint.org/photo/bat1/hop110-2.jpg Image] was built by members of the Tate family of sugar importers, who also funded the [[Tate Gallery]] in [[London]].<ref>[http://home.clara.net/mawer/liverpool.html Bryan Mawer Personal website]</ref>


In [[Britain]], homeopathic remedies are sold over the counter. Today Britain has five homeopathic hospitals, funded by the [[National Health Service]], and many regional clinics. Homeopathy is not practised by most of the medical profession, but there is public support for it, including from the [[Prince of Wales]] and many other members of the royal family.
For critics, a closely related question is that of logical consistency of the theory. The theory assumes that water is imprinted by the properties of molecules that it once came in contact with, even when the molecules are diluted away. If so, then where did the pure water used in this process come from? The water that homeopaths use was once in contact with other chemicals, including chemical wastes, radioactive metals, dinosaur urine, and various poisons. According to this skeptical interpretation of homeopathic theory, all water in the world should remember its contact with millions of chemical substances and not just the properties of the chemicals that the homeopath claims will be useful. The answer of the homeopaths, that dynamization involves succussion as well as dilution, is unconvincing, because it seems improbable that one can amplify order in a solution by shaking it, and because a lot of shaking goes on in the natural world as well. <ref>'''Skeptics''': "A close look at homeopathy" [http://www.skepticreport.com/health/hahnemann.htm skepticreport];  "A Skeptical Guide to Homeopathic History, Theories, and Current Practices", [http://www.homeowatch.org/ homeowatch];  "Dilution or Delusion?"
[http://www.skepticreport.com/health/dilutiondelusion.htm skepticreport];  "Magical Thinking in Complementary and Alternative Medicine"[http://www.csicop.org/si/2001-11/alternative.html CSIOP];  "Homeopathy - a Sceptical View" [http://www.bbc.co.uk/dna/h2g2/alabaster/A954740 BBC]</ref>
The largest organisation of homeopaths in Britain, the Society of Homeopaths, was founded in 1978 and has been growing steadily since; it now has 1300 members.<ref>[http://www.homeopathy-soh.org/ Website of The Society of Homeopaths]</ref> The medically qualified homeopaths in Britain are represented by the Faculty of Homeopathy: the Faculty, which was incorporated by an Act of Parliament in 1950, has over 1,400 members throughout the world.
'''India''' Homeopathy arrived in India with Dr Honigberger (1795-1869) in [[Lahore]], in 1829-30 <ref>[http://www.hpathy.com/Status/homeopathy-India.asp Website of Homeopathy for Everyone]</ref>, and is officially recognized. ''"The first doctor who brought homeopathy to India was Dr. Martin Honigburger, who first came to the Punjab...in 1829."'' <ref>Kishore J (1973) About entry of homeopathy into India, ''Bull Ind Hist Med'' 3:76-78</ref> [[India]] has the largest homeopathic infrastructure in the world, with 300,000 qualified homeopaths, 180 colleges, 7500 government clinics, and 307 hospitals.<ref>Manchanda RK, Kulashreshtha M, ''[http://www.delhihomeo.com/paperberlin.html Cost Effectiveness and Efficacy of Homeopathy in Primary Health Care Units of Government of Delhi- A study]''</ref> The Association of Qualified Homoeopaths in India (IHMA) is the largest of its kind. <ref>[http://www.ihma.in INDIAN HOMOEOPATHIC MEDICAL ASSOCIATION]</ref>


'''USA''' Homeopathy was established in the [[USA]] by Dr Hans Burch Gram (1787-1840) <ref>[http://nccam.nih.gov/health/homeopathy/ ''Questions and Answers About Homeopathy'' NCCAM, National Institutes of Health]</ref> in 1825 and rapidly gained popularity, partly because the excesses of conventional medicine were extreme there, and partly due to the efforts of Dr Constantine Hering (1800-1880):
== Scientific testing of remedies ==
''"Dr. Hering immigrated to America in 1833 and later became known as the father of American homeopathy."'' <ref>Frederick Karst, Homeopathy In Illinois, Caduceus, 4:2, 1988, pp.1-33; p.5</ref> Homeopathy in the US rose to great prominence. ''"By 1826 homeopathy had taken root in France, Italy, England and the Scandinavian countries....the doctrine arrived in New York in 1825."'' <ref>Cameron CS (1959) Homeopathy in Retrospect, ''Trans Stud Coll Phys Philadelp'', 27:28-33</ref> ''"Homeopathy spread first in Germany, then France, and England. Its greatest popularity, however, was in America."'' <ref>Flinn LB (1976) Homeopathic influences in the Delaware community A retrospective reassessment, ''Del. Med. Jnl.'' 48:418-428</ref> ''"Nowhere did (homeopathy) flourish as luxuriantly as in the United States."'' <ref>Cameron, op cit, 30</ref> ''"...by the early 1840s American homeopathic practitioners were gaining considerable influence and prestige."'' <ref>John Harley Warner, The Nature-Trusting Heresy, Perspectives on American History, 11, 1977, 291-324</ref> The use of homeopathy in America increased still further in the next decade, in 1880-1900 ''Hardly any city numbering over 50,000 souls was without a homeopathic hospital and many smaller communities could claim them."'' <ref>Cameron, op cit, 31</ref>  
<blockquote>''"It is not a matter of theory or belief or opinion … Homoeopathy must rest upon facts"  
[[James Tyler Kent]]''</blockquote>


===Historical note===
In the USA, homeopathic remedies are, like all health-care products, regulated by the [[Food and Drug Administration]], but unlike conventional medicines, homeopathic remedies need not be approved by the FDA before sale, nor do they need to be proved either safe or effective, nor to be labeled with an expiry date, or undergo finished product testing. Unlike conventional medicines, homeopathic remedies do not have to identify their active ingredients as they have few or no active ingredients.  
In the 1930s the popularity of homeopathy waned, especially in the USA and Europe, partly due to advances in conventional medicine and partly due to skepticism toward homeopathy, which led to the closure of virtually all medical schools teaching alternative medicine in the USA. Homeopathy in the West had a renaissance in the 1970s, largely because of [[George Vithoulkas]].


Homeopathy reached a peak of popularity in 1865&ndash;1885 and thereafter declined due partly to  recognition by the establishment of the dangers of large doses of drugs and bleeding, and via dissent between different schools of homeopathy. However, The Carnegie Foundation issued the [[Flexner Report]] in 1910 that supported allopathic (conventional) medical schools while condemning homeopathic schools. ''With newer medicines and $350 million being poured into allopathic medicine and hospitals by John D. Rockefeller, homeopathic schools began to close due to lack of support and money,"'' <ref>[http://www.elixirs.com/history.htm ''Brief History of Homeopathy'' Kathryn Jones at Elixirs.com]</ref> so that, by the 1950s, homeopathy had been virtually extinguished in the US.
As homeopathic remedies at potencies higher than about D23 (10<sup>-23</sup>) contain no detectable ingredients apart from the diluent (water, alcohol or sugar), there is no known basis for these preparations having medicinal action. A recent review concluded that "...there are some hints from experimental research that homeopathic substances diluted and succussed beyond Avogadro’s number are biologically active but there are no consistent effects from independently reproducible models." Although some patients report benefits from homeopathic preparations[http://www.homeopathy-soh.org/whats-new/documents/Positivehomeopathy.PDF], scientists usually attribute these to the [[placebo effect|Placebo Effect]], the [[regression fallacy]] and/or the [[Forer effect]].<ref>American Council on Science and Health,[http://www.acsh.org/search/txtQuickSearch.homeopathy/health_result.asp ''The Scientific Evidence on Homeopathy'']</ref>


In the USA, homeopathic remedies are, like all health-care products, regulated by the [[Food and Drug Administration]]. However, the FDA treats homeopathic remedies very differently than conventional medicines. Homeopathic products do not have to be approved by the FDA before sale, they do not have to be proved to be either safe or effective, they do not have to be labeled with an expiration date, and they do not have to undergo finished product testing to verify contents and strength. Unlike conventional drugs, homeopathic remedies do not have to identify their active ingredients on the grounds that they have few or no active ingredients. In the USA, only homeopathic medicines that claim to treat self-limiting conditions may be sold over the counter; homeopathic medicines that claim to treat a serious disease can be sold only by prescription.  
There is general agreement that [[evidence based medicine]] is the best way to assess the efficacy and safety of health-care practices. Ideally, drugs are tested in large, multi-centre, randomised, placebo-controlled, double-blind trials, to test whether the drug has an effect that is better than either a placebo or a different treatment. Some trials that have investigated homeopathy have indicated some efficacy above placebo. However, many are technically flawed or involve samples too small to allow firm conclusions to be drawn. Systematic reviews by[http://www.cochrane.org [[The Cochrane Collaboration]]] found insufficient evidence that homeopathy is beneficial for asthma, dementia, or induction of labor. They also found no evidence that homeopathic treatment prevents influenza, but reported that it appears to shorten the duration of the disease. Overall, systematic reviews have found no clear evidence of the efficacy of homeopathic remedies, but often the evidence has been too flawed to exclude possible beneficial effects either. <ref>[http://bmj.bmjjournals.com/cgi/content/full/321/7258/442 "Declaration of Helsinki should be strengthened" ]''BMJ'' 2000;321:442-445;  Jonas WB ''et al''(2003) A critical overview of homeopathy" ''Ann Intern Med'' [http://www.annals.org/cgi/reprint/138/5/393.pdf 138:393-399] {{cite journal | author=Jonas WB ''et al''| title=A systematic review of the quality of homeopathic clinical trials | journal=BMC Complement Altern Med | year=2001 | pages=12 | volume=1 | id=PMID 11801202}}</ref>.


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In 2005, The ''[[Lancet]]'' published a meta-analysis of 110 placebo-controlled homoeopathy trials and 110 matched conventional-medicine trials. The outcome suggested that the clinical effects of homeopathic remedies are likely to be placebo effects. The Lancet study is notable as a 'global' meta-analysis of homeopathy, not an analysis of particular remedies, i.e. it tested the hypothesis that ''all'' of the reported effects of homeopathic remedies are placebo effects. If so, then reports of positive effects reflect publication bias (the tendency to publish results when they show a positive effect but not when they are negative), and the ''magnitude'' of such effects should diminish with sample size and study quality. They analysed an equal number of conventional medicine trials similarly; these showed a real effect of treatment, in that the size of the reported effect was independent of sample size, but the trials of homeopathy remedies did not. The study does not prove that homeopathy is never effective, but is consistent with the interpretation that all reported effects are placebo effects. The Lancet article was accompanied by an editorial entitled "The end of homeopathy" which argued that doctors should recognise the absence of real curative powers in homeopathic medicine. The Lancet subsequently published a selection of critical correspondence. <ref>'''The Lancet study:'''{{cite journal | author=Shang A ''et al''| title=Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy |journal=Lancet |year=2005 |pages=726-32 |volume=366 |id=PMID 16125589}}; Fisher P (2006) Homeopathy and The Lancet [http://ecam.oxfordjournals.org/cgi/content/full/3/1/145'' eCAM'' 3:145-47]; Jobst KA (2005) Homeopathy, Hahnemann, and The Lancet 250 Years On: A Case of the Emperor's New Clothes? ''J Alt Comp Med'' 11:751-54.[http://www.liebertonline.com/toc/acm/11/5];
In '''Germany''', about 6,000 physicians specialize in homeopathy. In 1978 homeopathy, anthroposophically extended medicine and herbalism, were recognized as "special forms of therapy", meaning that their medications are freed from the usual requirement of proving efficacy. Since January 1, 2004 homeopathic medications, with some exceptions, are no longer covered by the country's public health insurance.<ref>[http://www.dhu.de/wc_800/archiv/GMG.shtml Gesundheitssystem: Was bringt das neue Gesetz?] (in German)</ref> Most private health insurers continue to cover homeopathy.
"As a fourth study says it's no better than a placebo, is this the end for homeopathy?" 
[http://www.guardian.co.uk/medicine/story/0,11381,1556831,00.html The Guardian Aug 26 2005];  The American Council on Science and Health [http://www.acsh.org/search/txtQuickSearch.homeopathy/health_result.asp "The Scientific Evidence on Homeopathy"]</ref>


In [[Switzerland]], homeopathic medications were formerly covered by the basic health insurance system, if prescribed by a physician. This ended in June 2005<ref>[http://www.kaufmann-net.ch/ Bundesratsentscheid über die Leistungen für Alternativmedizin: Information about Homeopathy in [[Switzerland]] by Vera Kaufmann, BHSc.Hom.] (in German)</ref>. The [[Swiss]] Government, after a 5-year trial, withdrew insurance coverage for homoeopathy and four other complementary treatments, claiming that they did not meet efficacy and cost-effectiveness criteria. This change applies only to compulsory insurance; homeopathy and other complementary medicine is covered by additional insurance, if the treatment is provided by a medical doctor.
== Medical organizations' attitudes towards homeopathy ==
<blockquote>''People use homeopathy because they believe it works. Although homeopathy, like other placebos, does not work in a clinical sense, it can induce physiological changes. It can also coincide with getting better anyway.'' [http://www.senseaboutscience.org.uk/pdf/SenseAboutHomeopathy.pdf ''Sense About Science'']</blockquote>


The histories of homeopathy in many different countries, written in their own languages, are available at the [http://www.lmhint.net/national.html Liga website]
The [[National Center for Complementary and Alternative Medicine]], part of the U.S. [[National Institutes of Health]], funds research into homeopathy. According to its [http://nccam.nih.gov/health/homeopathy/#q8 statement on homeopathy], "the results of individual, controlled clinical trials of homeopathy have been contradictory. In some trials, homeopathy appeared to be no more helpful than a placebo; in other studies, some benefits were seen that the researchers believed were greater than one would expect from a placebo." Nevertheless, "Some people feel that if homeopathy appears to be helpful and safe, then scientifically valid explanations or proofs of this alternative system of medicine are not necessary."


=== Classical versus non-classical homeopathy ===
According to The UK [[National Health Service]] there have been about 200 randomised controlled trials evaluating homeopathy, but they have not produced clear clinical evidence that homeopathy works. "Many studies suggest that any effectiveness that homeopathy may have is due to the placebo effect, where the act of receiving treatment is more effective than the treatment itself."
Hahnemann's formulation of homeopathy is often referred to as ''classical homeopathy''. Classical homeopaths use one remedy at a time, and base their prescription also on incidental or constitutional symptoms. However, homeopathic remedies are often used both by professionals and by the public based on formulations marketed for specific medical conditions. Some formulations use a 'shotgun' approach of the most commonly indicated single remedies in mixture form, while others, such as those by ''Heel'' and ''Reckeweg'', are proprietary mixtures marketed for specific diagnostic criteria based on various diagnostic systems. Many members of the public are not familiar with classical homeopathy, and equate these practices with homeopathy; others are familiar with the classical approach but regard these as legitimate variants; while others consider it a misuse of the term. Use of non-classical approaches is confined mainly to places where over-the-counter preparations are popular and where many doctors use natural medicines in a conventional clinical setting.


== The popularity of homeopathy ==
In 1997, the [[American Medical Association]](AMA) adopted the following policy statement after a report on several alternative therapies including homeopathy: "There is little evidence to confirm the safety or efficacy of most alternative therapies. Much of the information currently known about these therapies makes it clear that many have not been shown to be efficacious. Well-designed, stringently controlled research should be done to evaluate the efficacy of alternative therapies" <ref>Report 12 of the [http://www.ama-assn.org/ American Medical Association] Council on Scientific Affairs {{cite web|url=http://www.ama-assn.org/ama/pub/category/13638.html|title=alternative theories including homeopathy|publisher=AMA}}</ref>


Homeopathy is much more popular in Europe and India than in the USA. A study exploring the use of complementary medicine found the following percentages of various countries' population to be using homeopathy for some of their health needs (data from 1985-92):<ref>[http://bmj.bmjjournals.com/cgi/content/full/309/6947/107 Fisher, P. Ward, A. "Medicine in Europe: Complementary medicine in Europe" ''BMJ'' 1994;309:107-111]</ref>
The [http://indianmedicine.nic.in/html/homoeopathy/homoe.htm Indian Ministry of Health and Family Welfare] states that:"Homeopathy has been recognised as one of the National Systems of Medicine and plays an important role in providing health care to a large number of people. Its strength lies in its evident effectiveness as it takes a holistic approach towards the sick individual through promotion of inner balance at mental, emotional, spiritual and physical levels."
{|"style=width:50%" cellpadding="2" align="center"
!width="150"|Country
!width="200"|Percentage of population using homeopathy
|-align="center"
|Belgium||56%
|-align="center"
|Denmark||28%
|-align="center"
|France||32%
|-align="center"
|Netherlands||31%
|-align="center"
|Sweden||15%
|-align="center"
|UK||16%
|-align="center"
|USA||3%
|}
The numbers using homeopathy is also increasing in Europe, with the British market increasing by about 20% per year, with even higher rates of growth in Germany and Portugal.<ref>[http://bmj.bmjjournals.com/cgi/content/full/309/6947/107 Fisher P. Ward A. "Medicine in Europe: Complementary medicine in Europe" ''BMJ'' 1994;309:107-111]</ref> Interestingly, while in Europe alternative medicine is usually regarded as complementary to conventional medical treatment, in India, 10% of the population are estimated to use homeopathy ''exclusively'' for their medical needs.<ref>[http://indianmedicine.nic.in/html/homoeopathy/homoe.htm Indian Ministry of Health and Family Welfare homeopathy page]</ref>


A more recent study indicates that the percentage of people seeking homeopathic treatment in the United States significantly declined from 3.4% in 1997 to 1.7% in 2002.<ref>Tindle HA, Davis RB, Phillips RS, Eisenberg DM. (2005) Trends in use of complementary and alternative medicine by US adults: 1997-2002'' Altern Ther Health Med'' 2005 11:42-9</ref>  
== Safety of homeopathic treatment ==
<blockquote>''"The highest ideal of cure is the speedy, gentle, and enduring restoration of health by the most trustworthy and least harmful way."  Samuel Hahnemann''</blockquote>


===Number of homeopaths===
The United States Food & Drug Administration's [http://www.fda.gov/fdac/features/096_home.html view of homeopathy] is that there is no real concern over the safety of most homeopathic products "because they have little or no pharmacologically active ingredients". There have been few reports of illness associated with the use of homeopathic products, but in cases that they reviewed, the FDA concluded the homeopathic product was not the cause of the adverse reactions. The main concern about the safety of homeopathy arises not from the products themselves, but from the possible withholding of more efficacious treatment, or from misdiagnosis of dangerous conditions by a non-medically qualified homeopath. For example, a 2006 survey by the UK charitable trust 'Sense About Science' revealed that homeopaths were advising travelers against taking conventional anti-malarial drugs, instead providing them with a homeopathic dilution of quinine. Even the director of the The Royal London Homeopathic Hospital condemned this:
In Britain, the number of homeopaths registered with the Society of Homeopaths increased from 15 to 708 between 1979 and 1999. Similarly, the number of homeopathic doctors in the UK was for most of the 20th century static at about 100-150. For example, it gradually rose from 185 in 1932 to 244 in 1972, <ref>[http://homeoint.org/morrell/articles/pm_brita.htm Data derived from print-copy Faculty Lists 1932-1990]</ref> an increase of 3.3% per annum, but in the 1980s it began to grow faster: for example, from 1972 to 1988 it grew from 244 to 586, a real increase of 15% per annum. This increase may reflect the number of British people using homeopathic treatment.


===Sales of homeopathic medicine===
:"I'm very angry about it because people are going to get malaria - there is absolutely no reason to think that homeopathy works to prevent malaria and you won't find that in any textbook or journal of homeopathy so people will get malaria, people may even die of malaria if they follow this advice.[http://news.bbc.co.uk/1/hi/uk/5178488.stm].
In the USA, in 1995, retail sales of homeopathic medicines were estimated at US$201 million, and growing at 20% per year, according to the American Homeopathic Pharmaceutical Association, and the number of homeopathic practitioners increased from fewer than 200 in the 1970s to approximately 3,000 in 1996. The increased popularity of homeopathy since the 1970s was accompanied by a rise in interest in other [[alternative medicine]]s.<ref>[http://www.thespiritofhomoeopathy.com/evolution.html Website of Homoeopathic Medical Publishers]</ref>


Professor Pasvol, a tropical medicine expert at Imperial College, London was reported as saying "Medical practitioners would be sued, taken to court and found guilty for far less. What this investigation has unearthed is appalling." <ref>[http://www.guardian.co.uk/science/story/0,,1820103,00.html ''Homeopaths 'endangering lives' by offering malaria remedies''] Alok Jha, Friday July 14 2006, [[The Guardian]]; Science and Technology - Sixth Report ''Science and Technology Committee Publications'' [http://www.publications.parliament.uk/pa/ld199900/ldselect/ldsctech/123/12301.htm]</ref>


==Scientific testing of homeopathic treatment==
A particular concern is that homeopaths discourage the use of vaccines. This attitude dating back to Hahnemann, who said "...to use a human morbific matter (a Psorin taken from the itch in man) as a remedy for the same itch or for evils arisen therefrom, stay away from it! Nothing can result from this but trouble and aggravation of the disease." Homeopathy is superficially like vaccination, in that vaccines contain a small dose of the "disease" against which they offer protection (a vaccine is usually made from a bacterium or virus that is either dead or weakened so that it cannot produce symptoms, while still providing enough information to the immune system to generate antibody production). However, to most homeopaths, vaccination is not consistent with the principles of homeopathy; even if it is a crude application of the law of similars, they believe that vaccination has serious short and long-term (health) consequences, and might arouse latent inherited and constitutional weaknesses.
===Early critiques of high dilutions===
[[John Forbes (physician)|Sir John Forbes]] (1787-1861), physician to [[Queen Victoria]] (1841-61) said the extremely small doses were regularly derided as useless, ridiculous and "an outrage to human reason."<ref>Sir John Forbes, ''Homeopathy, Allopathy and Young Physic'', London, 1846</ref> Although such homeopathic cures were accepted as valid by regular physicians at the time, they were ascribed entirely to the body's innate healing powers. And Professor Sir [[James Young Simpson]] said of the highly diluted drugs: "no poison, however strong or powerful, the billionth or decillionth of which would in the least degree affect a man or harm a fly." <ref>James Y Simpson, ''Homoeopathy, Its Tenets and Tendencies, Theoretical, Theological and Therapeutical'', Edinburgh: Sutherland & Knox, 1853, 11</ref>
 
===Mechanism of action of homeopathic preparations===
As homeopathic remedies at potencies higher than about D23 (10<sup>-23</sup>) contain no detectable ingredients apart from the diluent (water, alcohol or sugar), there is no known basis for these preparations having medicinal action. Some tests have suggested that potentized solutions up to D120 can have statistically significant effects on organic processes, including the growth of grain,<ref>Kolisko, Lily, ''Physiologisher und physikalischer Nachweis der Wirksamkeit kleinster Entitäten'', Stuttgart (1959), Junker, H. ''Biologisches Zentralblatt'', 45. Nr. 1 (1925), p. 26 and ''Plügers Arhiv f. ges. Phys. 219B Nr. 5/6 (1928)</ref> histamine release by leukocytes,<ref>Davenas, E., et al., "Human basophil degranulation trigtgered by very dilute antiserum against IgE", ''Nature", V. 333, pp. 816-8</ref><ref>Wälchli, Baumgartner and Bastide, "Effect of Low Doses and High Homeopathic Potencies in Normal and Cancerous Human Lymphocytes: An In Vitro Isopathic Study", ''Journal of Alternative and Complementary Medicine'', Jun 2006, Vol. 12, No. 5: 421-427</ref> and enzyme reactions.<ref>*Husemann, Friedwart, "The Activity of Very Small Entities: Its Verification from Kolisko (1923) to Benveniste (1988), ''The Anthroposophical Conceptual Basis of Potentization'', v. IV.
*Pelikan, W. and Unger, G. ''Die Wirkung potenzierter Substanzen Dornach (1965)
*Schwenk, Theodor, ''Grundlagen der Potenzforschung'', Stuttgart (1974)</ref> These publications are controversial since attempts to replicate some of these studies on leukocytes and enzymes have failed, even when using the potentization method. A recent review summarized the situation as follows: "...there are some hints from experimental research that homeopathic substances diluted and succussed beyond Avogadro’s number are biologically active but there are no consistent effects from independently reproducible models."<ref>Walach et al. (2005) Research on Homeopathy: State of the Art, ''J Alt Comp Medicine'' 11:813–29</ref>
 
Although some patients report benefits from homeopathic preparations,<ref>[http://www.homeopathy-soh.org/whats-new/documents/Positivehomeopathy.PDF Website of The Society of Homeopaths]</ref> the large majority of scientists attribute these effects to the [[placebo effect|Placebo Effect]], the [[regression fallacy]] and/or the [[Forer effect]]. Ideally, drugs are tested in large, multi-centre, randomised, placebo-controlled [[double-blind]] [[clinical trials]], to test whether the drug has an effect that is significantly better than either a placebo or an alternative treatment. Many clinical trials that partially meet these criteria have investigated homeopathy, and some have indicated efficacy above placebo.<ref>[http://www.annals.org/cgi/reprint/138/5/393.pdf Wayne B. Jonas, Ted J. Kaptchuk, and Klaus Linde, "A Critical Overview of Homeopathy" ''Ann. Intern. Med.''. 2003;138:393-399.]</ref> However, many of the trials are open to technical criticism or involve samples that are too small to allow firm conclusions to be drawn.<ref>{{cite journal | author=Jonas WB, Anderson RL, Crawford CC, Lyons JS | title=A systematic review of the quality of homeopathic clinical trials | journal=BMC Complement Altern Med | year=2001 | pages=12 | volume=1 | id=PMID 11801202}}</ref>
 
Some homeopathic apologists claim that orthodox double-blind trials are inherently insufficient for deriving evidence for the technique. <ref>{{cite web|url=http://news.bbc.co.uk/1/hi/health/4183916.stm|title=Homoeopathy's benefit questioned|publisher=BBC News}}</ref> since homeopathy is positioned as a [[holistic]] treatment, incorporating psychological/spiritual concerns as well as a supposedly active ingredient. Some critics <ref>[http://www.skepdic.com/homeo.html The Skeptic's dictionary ''Homeopathy'']</ref> have noted that homeopathy ''includes'' falsifiable claims, even if that is only part of the homeopathic process, or simply that such claimed immunity from orthodox scientific scrutiny is reminiscent of [[Pseudoscience#Identifying_pseudoscience|pseudoscience]].
 
===European Journal of Cancer 2006 study===
In January 2006 the European Journal of Cancer published a [[meta-analysis]] of six trials of homeopathic treatments for recovery from cancer therapy, including radio- and chemo-therapy.<ref>Milazzo S, Russell N, Ernst E Efficacy of homeopathic therapy in cancer treatment. ''Eur J Cancer.'' 2006 Feb;42(3):282-9.</ref> Three of the trials were randomised double-blind placebo-controlled clinical trials. The authors were from the Department of Complementary Medicine at the Universities of Exeter and Plymouth. Their analysis found insufficient evidence to support the use of homeopathic remedies in cancer treatment recovery. They concluded that "Further research should attempt to answer the many open questions related to homeopathy."
 
===Lancet 2005 study===
In August 2005, The [[Lancet]] published a [[meta-analysis]] of 110 placebo-controlled homoeopathy trials and 110 matched conventional-medicine trials <ref>{{cite journal | author=Shang A, Huwiler-Muntener K, Nartey L, Juni P, Dorig S, Sterne JA, Pewsner D, Egger M | title=Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy | journal=Lancet | year=2005 | pages=726-32 | volume=366 | issue=9487 | id=PMID 16125589}}</ref> based upon the Swiss government's [[Program for Evaluating Complementary Medicine]], or PEK. The outcome of this meta-analysis suggested that the clinical effects of homeopathy are likely to be placebo effects.
The Lancet paper is notable not least for its design, as another "global" meta analysis of homeopathy, not an analysis of particular effects, i.e. it tested the global hypothesis that the reported effects of homeopathy are placebo effects. If this is accurate, then the reported positive effects are due to placebo effects, publication bias, observer effects etc., and if so, then the magnitude of reported effects should diminish with sample size and study quality, and with the best studies there should be consistently no effect, and this is the prediction that the study sought to test. For comparison, they subjected an equal set of conventional medicine trials for identical analysis. These were matched for study disease and sample size, but not for trial quality which was significantly better in the homeopathic trials than the randomly chosen biomedical trials. The prediction was supported by the study - whereas the conventional tests showed a real effect independent of sample size, the homeopathy studies did not. The study does not prove that homeopathy is never effective or that all its findings are placebo effects, but does show that the totality of tests analysed show outcomes consistent with the interpretation that all of the reported effects are placebo effects. The Lancet accompanied the meta-analysis with invited editorials. The Lancet study was criticized by a number of homeopathic researchers and statisticians on methodological grounds.<ref>Peter Fisher. Homeopathy and The Lancet. eCAM 2006 3(1):145-147; doi:10.1093/ecam/nek007 [http://ecam.oxfordjournals.org/cgi/content/full/3/1/145]; see also Kim A. Jobst. Homeopathy, Hahnemann, and The Lancet 250 Years On: A Case of the Emperor's New Clothes? [[J Alt Comp Med]] 2005 11:751-754.[http://www.liebertonline.com/toc/acm/11/5]</ref>
 
===British Medical Journal 1991 study===
In 1991, three professors of medicine from the Netherlands performed a meta-analysis of 107 controlled trials, of which 81 showed that homeopathic medicines were effective, 24 showed they were ineffective, and 2 were inconclusive. They concluded, "The amount of positive results came as a surprise to us." The proportion of positive results may be biased by the so-called 'drawer effect,' where studies with positive results are more easily and more readily published than studies with negative results (which tend to end up in the desk drawer). They found evidence for successful treatment of respiratory and other infections, diseases of the digestive system, hay fever, rheumatological disease, mental or psychological problems and other ailments. In addition, they found evidence that homeopathic treatment helped patients recover after abdominal surgery and to address pain or trauma.
 
Despite the high percentage of studies that provided evidence of success with homeopathic medicine, most studies were flawed in some way. Still, the researchers found 22 high-caliber studies, 15 of which showed that homeopathic medicines were effective. The meta-analysis concluded, "At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias. This indicates that there is a legitimate case for further evaluation of homoeopathy, but only by means of well performed trials."<ref>J. Kleijnen, P. Knipschild, G. ter Riet, "Clinical Trials of Homoeopathy," British Medical Journal, F 1991, 302:316-323.</ref>
 
===Basophil stimulation===
Madeleine Ennis and her team looked at the effects of ultra-dilute solutions of [[histamine]] on human white blood cells involved in inflammation. These cells, called [[basophils]], release histamine when they are stimulated. However, exposure to histamine stops these cells releasing any more, an example of [[negative feedback]] regulation. Three of the four participating groups observed this inhibitory effect with homeopathic solutions of histamine, solutions so dilute that they probably didn't contain a single histamine molecule. These low-dilution effects were seen in six of the 24 independent sets of experiments (Table 1 of paper).<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=15105967&query_hl=2&itool=pubmed_docsum Belon P, Cumps J, Ennis M, Mannaioni PF, Roberfroid M, Sainte-Laudy J, Wiegant FA. Histamine dilutions modulate basophil activation. ''Inflamm Res.'' 2004 May;53(5):181-8.]</ref> However, other investigators failed to find any effect from these ultra-dilute solutions and suggested that methodological problems accounted for the positive results.<ref>Guggisberg AG, Baumgartner SM, Tschopp CM, Heusser P. (2005) Replication study concerning the effects of homeopathic dilutions of histamine on human basophil degranulation in vitro.'' Complement Ther Med.'' 13:91-100.</ref>
 
===Evidence-based medicine===
There is widespread consensus in the medical community that [[evidence based medicine]] is the best standard for assessing efficacy and safety of health-care practices, for it is "the expression of the scientific method in clinical medicine." <ref>[http://bmj.bmjjournals.com/cgi/content/full/321/7258/442 "Declaration of Helsinki should be strengthened" ''BMJ'' 2000;321:442-445 ( 12 August )]</ref> Therefore, systematic reviews with strict protocols are essential to establish proof for various therapies. Much of modern medicine is subject to ongoing efforts to comply with evidence-based standards. Systematic reviews by the [[Cochrane Collaboration]] found insufficient evidence that homeopathy is beneficial for asthma, <ref>{{cite web|url=http://www.cochrane.org/reviews/en/ab000353.html|title=''Cochrane Collaboration-asthma''}}</ref> dementia, <ref>{{cite web|url=http://www.cochrane.org/reviews/en/ab003803.html|title=''Cochrane Collaboration-dementia''}}</ref> and induction of labor.<ref>{{cite web|url=http://www.cochrane.org/reviews/en/ab003399.html|title=''Cochrane Collaboration-induction of labor''}}</ref> They also found no evidence that homeopathic treatment can prevent influenza,<ref>{{cite web|url=http://www.cochrane.org/reviews/en/ab001957.html|title=''Cochrane Collaboration-influenza''}}</ref> but reported that it appears to shorten the duration of the disease. Systematic reviews conducted by other researchers found insufficient evidence that homeopathy is beneficial for osteoarthritis, <ref>{{cite web|url=http://www.jr2.ox.ac.uk/bandolier/booth/alternat/homearth.html|title=osteoarthritis article|publisher=Bandolier Journal}}</ref> migraine prophylaxis,<ref>{{cite web|url=http://www.jr2.ox.ac.uk/bandolier/booth/alternat/AT015.html|title=migraine prophylaxis article|publisher=Bandolier Journal}}</ref> delayed-onset muscle soreness,<ref>{{cite web|url=http://www.jr2.ox.ac.uk/bandolier/booth/alternat/AT011|title=delayed-onset muscle soreness article|publisher=Bandolier Journal}}</ref> or symptoms of menopause.<ref>{{cite web|url=http://www.jr2.ox.ac.uk/bandolier/band56/b56-3.html|title=symptoms of menopause article|publisher=Bandolier Journal}}</ref>
 
====Medical organizations' attitudes towards homeopathy====
*The [[National Center for Complementary and Alternative Medicine]], part of the U.S. [[National Institutes of Health]], states that:<ref>[http://nccam.nih.gov/health/homeopathy/#q8 NIH statement on homeopathy]</ref>
**The results of individual, controlled clinical trials of homeopathy have been contradictory. In some trials, homeopathy appeared to be no more helpful than a placebo; in other studies, some benefits were seen that the researchers believed were greater than one would expect from a placebo.
**A common theme in the reviews of homeopathy trials is that because of these problems and others, it is difficult or impossible to draw firm conclusions about whether homeopathy is effective for any single clinical condition.
**There is a point of view that homeopathy does work, but that modern scientific methods have not yet explained why. The failure of science to provide full explanations for all treatments is not unique to homeopathy.
**Some people feel that if homeopathy appears to be helpful and safe, then scientifically valid explanations or proofs of this alternative system of medicine are not necessary.
**The National Center for Complementary and Alternative Medicine continues to fund research into homeopathy.
 
*The UK [[National Health Service]] statement on homeopathy includes the following:
**Around 200 randomised controlled trials evaluating homeopathy have been conducted, and there are also several reviews of these trials. Despite the available research, it has proven difficult to produce clear clinical evidence that homeopathy works. Many studies suggest that any effectiveness that homeopathy may have is due to the placebo effect, where the act of receiving treatment is more effective than the treatment itself.
**Medical doctors and scientists do not generally accept homeopathy because its claims have not been verified to the standards of modern medicine and scientific method. Scientists argue that homeopathy cannot work because the remedies used are so highly diluted that in many there can be none of the active substance remaining.
**Supporters of homeopathy counter the scientific arguments with claims for a high success rates in babies, infants, and animals. Others argue that much of the research conducted into the effectiveness of homeopathy is not representative of routine homeopathic practice and that homeopathic treatment cannot be properly tested through standard clinical means. See [[anti-intellectualism]].
 
*In 1997, the following statement was adopted as policy of the [[American Medical Association]] (AMA) after a report on several alternative therapies including homeopathy:<ref>{{cite web|url=http://www.ama-assn.org/ama/pub/category/13638.html|title=alternative theories including homeopathy|publisher=American Medical Association}}</ref>
**There is little evidence to confirm the safety or efficacy of most alternative therapies. Much of the information currently known about these therapies makes it clear that many have not been shown to be efficacious. Well-designed, stringently controlled research should be done to evaluate the efficacy of alternative therapies.</blockquote>''
 
*The Indian Ministry of Health and Family Welfare states that:<ref>[http://indianmedicine.nic.in/html/homoeopathy/homoe.htm Indian Ministry of Health and Family Welfare homeopathy page]</ref>
**Homoeopathy today is a rapidly growing system and is being practiced almost all over the world. In India it has become a household name due the safety of its pills and gentleness of its cure.
**Homeopathy has been recognised as one of the National Systems of Medicine and plays an important role in providing health care to a large number of people. Its strength lies in its evident effectiveness as it takes a holistic approach towards the sick individual through promotion of inner balance at mental, emotional, spiritual and physical levels.
 
===Regulatory decisions===
In 2006 Australia's Therapeutic Goods Advertising Code Council (TGACC) found that a homeopathic Hangover Relief Oral Spray marketed by Brauer Natural Medicine P/L was "in breach of section 4(1)(b) of the Therapeutic Goods Advertising Code 2005 ( the Code ), which states that an advertisement must  contain correct and balanced statements only and claims which the sponsor has already verified , and section 4(2)(c) which prohibits misleading advertisements."<ref>[http://www.tgacc.com.au/complaintSingle.cfm?id=657 Website of the Therapeutic Goods Advertising Code Council]</ref> The TGACC is established under Australian law and the Therapeutic Goods Advertising Code is generally consistent with the [[World Health Organisation]]'s "Ethical Criteria For Medicinal Drug Promotion 1988"
 
== Misconceptions about homeopathy ==
It is a common misconception that homeopathic remedies use only natural herbal components (akin to [[herbology]]). Herbs are used, but homeopathy also uses non-biological substances (such as [[salt]]s) and components of animal origin, such as [[duck]] [[liver]] in the remedy [[oscillococcinum]]. In herbology, measurable amounts of herbs are used, while in homeopathy the active ingredient is diluted until it is no longer detectable, or to the point that they do not contain any of the original active ingredient at all (when the dilution exceeds the [[Avogadro's number]]). Homeopathy also uses substances of human origin, called ''[[nosode]]s''. Some people have the opposite misconception, that homeopathic remedies are  based only on [[toxicity|toxic]] substances like [[snake venom]] or [[mercury (element)|mercury]].
 
As the term homeopathy is well known and has good marketing value, the public can be confused by people who have adopted the term for other forms of therapy. For example, some companies combine homeopathic with non-homeopathic substances such as herbs or vitamins, and some preparations marketed as homeopathic contain no homeopathic preparations at all. Classical homeopaths argue that only remedies prepared and prescribed in accordance with the principles of Hahnemann can be called homeopathic. Many producers of homeopathic remedies also produce other types of alternative remedies under the same brand name, which can create confusion.
 
===Homeopathy and vaccination===
{{See also|Isopathy}}
To some, homeopathy, particularly the use of nosodes, resembles [[vaccination]], in that [[vaccine|vaccines]] contain a small dose of the "disease" against which they are to protect. Hahnemann interpreted the introduction of vaccination applied nowadays as such: <cite>But to use a human morbific matter (a Psorin taken from the itch in man) as a remedy for the same itch or for evils arisen therefrom, stay away from it! Nothing can result from this but trouble and aggravation of the disease.</cite><ref>Organon § 56 6th. edition</ref> Roberts: <cite>giving the identical instead of the similar means the difference between isopathy and homoeopathy.</cite><ref>H.A. Roberts: The Principles and Art of Cure by Homoeopathy, chapter 1</ref>
 
According to the philosophy of homeopathy, the body could become susceptible to "morbific noxious agents". The challenge of the homeopath is to prevent disease in the first place with the first sign of symptoms, this could be imminent, long before an acute disease appears.<ref>Organon § 31 </ref> Hahnemann classified succeeded vaccination of smallpox due to the interaction of two similar diseases (the law of similars).<ref>Organon § 56</ref> When an epidemic is near, one or a few remedies could be chosen to treat a population in order to prevent the epidemic.<ref>Organon § 33</ref> Hahnemann gave this the description of acute collective diseases.<ref>Organon § 73</ref> When the epidemic is there, according to Hahnemann, the homeopath observes a complete picture of the epidemic and can constitute from a small box of remedies the fitting remedy to each individual patient.<ref>Organon § 100-104</ref>
<ref>http://www.homeopathy.healthspace.eu/regular/homeopathy.php#Homeopathy-vaccination</ref>
In contrast, modern scientists and doctors see the two practices as fundamentally different. A [[vaccine]] is usually a preparation made from a [[bacterium]] or [[virus]] that cannot produce symptoms, while still providing enough information to the [[immune system]] to afford protection.<ref>''Understanding Vaccines: what they are and how they work.'' National Institute of Allergy and Infectious Diseases NIH Publication No. 03-4219 July 2003 [http://www.niaid.nih.gov/publications/vaccine/pdf/undvacc.pdf pdf]</ref> By preparing the immune system of a healthy organism to meet a future attack by the pathogen, vaccination hopes to prevent disease, in contrast to homeopathy's hope, which is to prevent or cure it with dilutions. Another important difference between homeopathic preparations and vaccine, is that vaccine contains measurable amounts of [[antigen]], usually [[proteins]] or [[carbohydrates]]<ref>Vliegenthart JF. ''Carbohydrate based vaccines.'' FEBS Lett. 2006 May 22;580(12):2945-50. PMID 16630616</ref> from the disease-causing organism, whereas homeopathic remedies have been diluted to such an extent they are unlikely to contain any detectable active ingredients.
The predominant view of homeopaths is that <cite>vaccination is not consistent with the principles of homeopathy, even if it is a crude application of the law of similars,</cite><ref>Rudi Verspoor [http://www.lyghtforce.com/HomeopathyOnline/Issue2/voice.html The Homeopathic View of Vaccination] Homeopathy Online</ref> they also believe that <cite>vaccination holds serious short and long-term (health) consequences</cite><ref>ibid</ref> and that
<cite>vaccination may potentially arouse latent inherited and constitutional  
weaknesses.</cite><ref>ibid</ref>
However, their main objection is that vaccination is a mass-applied technique based on the [[germ theory]] of disease, a view homeopaths reject, instead preferring to individualize each case of sickness.
 
== Safety of homeopathic treatment ==
The United States Food & Drug Administration considers that there is no real concern over the safety of most homeopathic products "because they have little or no pharmacologically active ingredients". There have been few reports of illness associated with the use of homeopathic products, but in cases that they reviewed, the FDA concluded the homeopathic product was not the cause of the adverse reactions. In one case, arsenic was implicated, although FDA analysis revealed that the concentration of arsenic was too low to cause concern.
 
The main concern about the safety of homeopathy arises not from the products themselves, but from the possible withholding of more efficacious treatment, or from misdiagnosis of dangerous conditions by a non-medically qualified homeopath.<ref>[http://www.publications.parliament.uk/pa/ld199900/ldselect/ldsctech/123/12301.htm Science and Technology - Sixth Report ''Science and Technology Committee Publications'']</ref> For example, a 2006 survey by the UK charitable trust "Sense About Science," revealed homeopathic practices which were advising travelers against taking conventional anti-malarial drugs, instead providing them with a homeopathic dilution of quinine. Even the director of the The Royal London Homeopathic Hospital condemned this:
 
:"I'm very angry about it because people are going to get malaria - there is absolutely no reason to think that homeopathy works to prevent malaria and you won't find that in any textbook or journal of homeopathy so people will get malaria, people may even die of malaria if they follow this advice." <ref>[http://news.bbc.co.uk/1/hi/uk/5178488.stm ''Homeopathic practices "risk lives"'' By Pallab Ghosh BBC News science correspondent]</ref>.
 
Several scientists said the homeopaths' advice was reprehensible and likely to endanger lives. Professor Geoffrey Pasvol, a tropical medicine expert at Imperial College in London was reported as saying "''Medical practitioners would be sued, taken to court and found guilty for far less. What this investigation has unearthed is appalling.''" <ref>[http://www.guardian.co.uk/science/story/0,,1820103,00.html ''Homeopaths 'endangering lives' by offering malaria remedies'' Alok Jha, science correspondent Friday July 14, 2006 The Guardian]</ref>.
{{Wikiquote}}


== Notes==
== Notes==
* Online etext of Hahnemann's ''Organon der Heilkunst'': [http://www.homeoint.org/books4/organon/ German original] ([http://www.med-serv.de/medizin-buch-hahnemann_organon_heilkunst-0-2-1.html other format]) and [http://www.homeopathyhome.com/reference/organon/organon.html English translation]
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== Sources ==
*About Bandolier and us (Bandolier Homeopathy - dilute information and little knowledge). Boundolier Journal,  [Electronic] [http://www.jr2.ox.ac.uk/bandolier/aboutus.html]
*{{cite journal | author=Almeida RM | title=A critical review of the possible benefits associated with homeopathic medicine | journal=Rev Hosp Clin Fac Med Sao Paulo | year=2003 | pages=324-31 | volume=58 | issue=6 | id=PMID 14762492}}
*{{cite journal | author=Cucherat M, Haugh MC, Gooch M, Boissel JP | title=Evidence of clinical efficacy of homeopathy. A meta-analysis of clinical trials. HMRAG. Homeopathic Medicines Research Advisory Group | journal=Eur J Clin Pharmacol | year=2000 | pages=27-33 | volume=56 | issue=1 | id=PMID 10853874 | url=http://nhscrd.york.ac.uk/online/dare/20001151.htm}}
*Ernst, E., ''Classical homeopathy versus conventional treatments: a [[systematic review]]'', ''Perfusion'', (1999); '''12''': 13-15
*{{cite journal | author=Kleijnen J, Knipschild P, ter Riet G | title=Trials of homeopathy | journal=BMJ | year=1991 | pages=960 | volume=302 | issue=6782 | id=PMID 1827743}}
*{{cite journal | author=Linde K, Clausius N, Ramirez G, Melchart D, Eitel F, Hedges LV, Jonas WB | title=Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials | journal=Lancet | year=1997 | pages=834-43 | volume=350 | issue=9081 | id=PMID 9310601}}
*{{cite journal | author=Linde K, Scholz M, Ramirez G, Clausius N, Melchart D, Jonas WB | title=Impact of study quality on outcome in placebo-controlled trials of homeopathy | journal=J Clin Epidemiol | year=1999 | pages=631-6 | volume=52 | issue=7 | id=PMID 10391656}}
*{{cite journal | author=Linde K, Melchart D | title=Randomized controlled trials of individualized homeopathy: a state-of-the-art review | journal=J Altern Complement Med | year=1998 | pages=371-88 | volume=4 | issue=4 | id=PMID 9884175 | url=http://nhscrd.york.ac.uk/online/dare/990167.htm}}
* Phillips Stevens Jr., (Nov-Dec, 2001), ''Magical Thinking in Complementary and Alternative Medicine'' [Electronic version]. Skeptical Inquirer. [http://www.findarticles.com/p/articles/mi_m2843/is_6_25/ai_79794372]
*Randi, J., An interview with James Randi: ''Homeopathy: The Test - programme summary'' [Electronic version]. BBC. [http://www.bbc.co.uk/science/horizon/2002/homeopathy.shtml]
*Randi, J., Educational Foundation. "The JREF Million Dollar Paranormal Challenge 'FAQ'". [http://www.randi.org/research/faq.html] Retrieved 13 September, 2005.
*Yutar, G., Dr, (April 16, 2006), ''Homeopathy - Why and when?'' Yatar's bolg on blogspot.com [Electronic version].[http://dryutar.blogspot.com/]
*Walach, H., ''Unspezifische Therapie-Effekte. Das Beispiel Homöopathie'' [PhD Thesis]. Freiburg, Germany: Psychologische Institut, Albert-Ludwigs-Universität Freiburg, (1997)


== External links ==
== External links ==
=== Neutral ===
* ''Complementary Medicine - Therapies: Homeopathy''[http://www.bbc.co.uk/health/healthy_living/complementary_medicine/therapies_homeopathy.shtml ] BBC's "Complementary Medicine" article on Homeopathy
*A recent article on homeopathy testing from the [http://www.annals.org/cgi/content/full/138/5/393/ Annals of Internal Medicine]
* [http://www.acampbell.org.uk/homeopathy/index.html ''Homeopathy In Perspective''] &mdash; critical online book, covering the history and present state of homeopathy
* [http://www.bbc.co.uk/science/horizon/2002/homeopathy.shtml BBC's ''Horizon'' on homeopathy] (transcripts, discussion, etc.)
* [http://www.bbc.co.uk/health/healthy_living/complementary_medicine/therapies_homeopathy.shtml Complementary Medicine - Therapies: Homeopathy] BBC's "Complementary Medicine" article on Homeopathy
* [http://www.acampbell.org.uk/homeopathy/index.html Homeopathy In Perspective] &mdash; critical online book, covering the history and present state of homeopathy
* [http://www.fda.gov/fdac/features/096_home.html FDA's view of homeopathy]
* [http://www.lsbu.ac.uk/water/ Water Structure and Behaviour]&mdash; balanced and up-to-date references to current scientific understanding of water, with specific entries on "memory effects" and homeopathy
*[http://wo-pub2.med.cornell.edu/cgi-bin/WebObjects/PublicA.woa/5/wa/viewHContent?website=nyp&contentID=182&wosid=FCacmtM3Z6J8C7BHET1G1g Columbia-Presbyterian Hospital's presentation of homeopathic medicine]
* [http://www.vetscite.org/publish/articles/000051/index.html Can homeopathy withstand scientific testing? 30 November 2004 by F.J. van Sluijs] A recent Dutch overview.
 
=== Advocacy ===
* [http://www.homeopathic.com/articles/intro/history.php A condensed history of homeopathy]
* [http://www.homeopathyusa.org/ American Institute of Homeopathy]
* [http://www.hpathy.com/ Extensive Homeopathy Information and Discussion Forum]
* [http://www.homeopathy.org/ North American Society of Homeopaths]
* [http://www.homeopathy-soh.org/ The Society of Homeopaths - UK Organisation Representing Professional Homeopaths]
* [http://www.holisticmed.com/www/homeopathy.html Homeopathy Links from The Holistic Medicine Resource Center]
* Homoeopathy India Foundation web site http://www.e-homoeopathy.com
* [http://www.hmedicine.com Homeopathy Medicine Portal] Products and Directory with extensive user forums on homeopathic remedies and debates.
* [http://www.a-r-h.org Alliance of Registered Homeopaths]
* [http://www.homeoint.org/english/index.htm Homéopathe International] &mdash; The English language version of ''Homéopathe International''
* [http://www.wholehealthnow.com/homeopathy_pro/homeopathy_1825_1849.html Homeopathy Timeline] with historical and biographical information
* Adjuvant homeopathic treatment in breast cancer, a pilot study [http://www.thieme-connect.de/ejournals/abstract/ahz/doi/10.1055/s-2005-862573] (in German)
* [http://www.webhomeopath.com/ Webhomeopath - an on-line homeopathic repertory]
* [http://www.whonamedit.com/doctor.cfm/532.html Christian Friedrich Samuel Hahnemann] A historical overview
 
=== Critical ===
* [http://www.theness.com/articles.asp?id=6 An Overview] By Steven Novella
* [http://www.randi.org/jr/02-02-2001.html A skeptic's view of homeopathy]
* [http://www.csicop.org/si/2001-11/alternative.html Magical Thinking in Complementary and Alternative Medicine]
* [http://www.homeowatch.org/ HomeoWatch (Homeopathy Watch)] &mdash; A Skeptical Guide to Homeopathic History, Theories, and Current Practices, operated by [[Stephen Barrett]], M.D. (founder of [[Quackwatch]])
* [http://www.bbc.co.uk/dna/h2g2/alabaster/A954740 H2G2 entry on homeopathy].
* [http://www.skepdic.com/homeo.html The Skeptics Dictionary]
* [http://www.acsh.org/search/txtQuickSearch.homeopathy/health_result.asp "The Scientific Evidence on Homeopathy"] - American Council on Science and Health
*[http://www.skepticreport.com/health/hahnemann.htm A close look at homeopathy]
*[http://www.skepticreport.com/health/dilutiondelusion.htm Dilution or Delusion?]
*[http://www.ncahf.org/pp/homeop.html National Council Against Health Fraud Position Paper on Homeopathy]
*[http://news.bbc.co.uk/1/hi/programmes/newsnight/5178122.stm Malaria Risk of Homeopathic Advice]
*[http://www.homeopathystore.in/homeopathy/the_danger_of_homoeopathic_prescribing.htm The Danger Of Homoeopathic prescribing]
 
{{Homoeopathy}}


[[Category:Alternative medicine]]
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Revision as of 23:05, 1 November 2005

Homeopathy is a system of Complementary and Alternative Medicine that strives to treat 'like with like'; its remedies involve treating an illness with an infinitesimally small dose of a substance that, at bigger doses, can cause symptoms like those of the illness. Homeopaths believe that the 'potency' of a remedy can be increased by serial dilution, when combined with vigorous shaking. The word 'homeopathy' was coined by the German physician Christian Friedrich Samuel Hahnemann (1755-1843). Hahnemann, born in Meissen, studied medicine in Leipzig and Vienna, and became eminent as a linguist, as a practical physician and as a notably enlightened public health reformer before creating his new health system. He believed his new system to be humane and effective [1], but it was received by the establishment with derision and contempt. [2] Homeopathy has survived however, and today has more than 100,000 practitioners worldwide, and 500 million users.

File:Samuel Hahnemann.png
Samuel Hahnemann(1755-1843), the "father" of homeopathy

Homeopathy (also spelled homœopathy or homoeopathy, from the Greek όμοιος, hómoios (similar) and πάθος, páthos (suffering)) regards diseases as "morbid derangements of the organism", that involve some disturbance in a 'vital force.' Homeopaths reject the standard medical diagnoses of named diseases; each case of sickness is a strictly individual phenomenon — "It is the man that is sick and to be restored to health, not his body, not the tissues". [3]

The Principle of Similars

For the early Greek physician Hippocrates of Cos, who lived at about 400 BCE [9], the four 'humours' (blood, black bile, yellow bile and phlegm) were key to understanding disease. This idea persisted through the influence of Galen (131-201 AD) until at least 1858, and Rudolf Virchow's theories of cellular pathology. Diseases, or so it was thought, were the result of some 'imbalance' of the humours, and conventional medicine still focused on restoring that balance, either by attempting to remove an excess of a humour, or by suppressing the symptoms. "Bloodletting, fever remedies, tepid baths, lowering drinks, weakening diet, blood cleansing and everlasting aperients and clysters (enemas) form the circle in which the ordinary German physician turns round unceasingly", wrote Hahnemann while translating into German the Treatise on Materia Medica (1789) by the Edinburgh physician William Cullen. [4]

From 1783 onwards, disillusioned with the medicine of his day and the many toxic effects of its cures, Hahnemann began to use smaller and smaller doses of drugs, trying to minimise their toxic effects while retaining their efficacy. He had concluded that diseases are not caused by "...any disease matter, but that they are solely spirit-like derangements of the spirit-like power that animates the human body", and was searching for some way to harness this power for healing. Cullen had written that Cinchona bark (which contains quinine) was effective because it was bitter, and Hahnemann pondered about this; he felt that this explanation was implausible because other substances that were as bitter had no therapeutic value. Accordingly, he took Cinchona bark himself, and saw that its effects were similar to the symptoms of the diseases that it was prescribed for. . For Hahnemann, this was a conceptual breakthrough, and it led him to formulate the 'Principle of Similars' on which homeopathy is based, expressed by him as similia similibus curentur or 'let likes cure likes'. [5]

Homepathic remedies are found by 'provings', in which volunteers are given substances, the effects of which are recorded as a 'Drug Picture'. Of his first proving, Hahnemann said: "with this first trial broke upon me the dawn that has since brightened into the most brilliant day of the medical art; that it is only in virtue of their power to make the healthy human being ill that medicines can cure morbid states, and indeed, only such morbid states are composed of symptoms which the drug to be selected for them can itself produce in similarity on the healthy." At first, Hahnemann tested substances that were then used as medicines, such as antimony and rhubarb, and poisons like arsenic, mercury and Belladonna. He recorded his first provings of 27 drugs in the Fragmenta de viribus in 1805 and later in his Materia Medica Pura, which contained 65 drugs.

James Tyler Kent (1849-1921) [10] was almost as important as Hahnemann to the development of homeopathy; his Lectures on Homoeopathic Materia Medica (1905) listed 217 remedies. Kent emphasized the metaphysical and clinical aspects of Hahnemann's teachings; the core doctrines of miasm and vital force, and the importance of spiritual factors as the cause of disease ("for it goes to the very primitive wrong of the human race, the very first sickness of the human race that is the spiritual sickness... which in turn laid the foundation for other diseases" ). Modern medicine recognizes that bacteria and viruses as the causes of many diseases, but for Kent "The microbe is not the cause of disease. We should not be carried away by these idle Allopathic dreams and vain imaginations but should correct the Vital Force". In the UK, his ideas became homeopathic orthodoxy by the end of the First World War, and some homeopaths still regard microbes as effects, not causes, of disease. [6]

Today, homeopaths use about 3000 different remedies from animal, plant, mineral, and synthetic substances, including 'Natrum muriaticum' (sodium chloride or table salt)[11], 'Oscillococcinum' (a 200C product made from duck heart and liver that is prescribed for colds and flu-like symptoms) 'Roadrunner' (Geococcyx californianus) [12] and 'Arnica' [13]. Other 'isopathic' remedies involve diluting the agent or product of the disease; for example, Rabies nosode is made from the saliva of a rabid dog. Some homeopaths use more esoteric substances, known as 'imponderables' because they originate from electromagnetic energy 'captured' by alcohol or lactose ('X-ray', 'Sol' (sunlight), 'Positronium', and http://homeoint.org/clarke/e/elect.htm 'Electricitas'](electricity), or with a telescope ('Polaris'). Recent ventures into more esoteric remedies include 'Tempesta' (thunderstorm), and 'Berlin wall'.

The law of similars is not a scientific law, and a failure to cure can always be attributed to the wrong choice of remedy; in Kent's words, "I have often heard physicians tell me that it was due to suggestion that my medicines acted so well; but my answer to this is, that I suggest just as strongly with my wrong remedy as with the right one, and my patients improve only when they have received the similar or correct remedy".[7]

There are many ways to find the most-similar remedy (the simillimum), and homeopaths sometimes disagree. This is partly due to the complexity of the 'totality of symptoms' concept; homeopaths decide, from their knowledge and experience, which symptoms are the most characteristic: the Drug Picture in the Materia Medica is always more comprehensive than the symptoms of any individual. Other ways are through medical dowsing or other psychic powers, but these are not accepted by most homeopaths. [8]

Preparation of similars

The most characteristic—and controversial—principle of homeopathy is that the potency of a remedy can be enhanced (and the side-effects diminished) by dilution, in a procedure known as 'dynamization' or 'potentization'. Liquids are progressively diluted (with water or alcohol) and shaken by ten hard strikes against an elastic body ('succussion'). For this, Hahnemann had a saddlemaker construct a special wooden striking board covered in leather on one side and stuffed with horsehair. Insoluble solids, such as quartz and oyster shell, are diluted by grinding them with lactose ('trituration'). The original serial dilutions by Hahnemann used a 1 part in 100 or centesimal scale, or 1 part in 50,000 or Quintamillesimal ('LM' or 'Q' potencies). The dilution factor at each stage is 1:10 ('D' or 'X' potencies) or 1:100 ('C' potencies); Hahnemann advocated 30C dilutions for most purposes (i.e. dilution by a factor of 10030 = 1060). The number of molecules in a given weight of a substance can be calculated by Avogadro's number; the chance that there is even one molecule of the original substance in a 15C solution is small, and it is very unlikely that one molecule would be present in a 30C dilution. Thus, homeopathic remedies of a high "potency" contain just water, but water that, according to homeopaths, retains some 'essential property' of one of the substances that it has contacted in the past. [9]

Hahnemann's explanation for the increased strength of higher potencies was that the friction involved in succussion could release the hidden power of substances, including their curative power. As he wrote in 1825: "The effect of friction is so great, that not only the physical properties, such as caloric, odour, etc., are thereby called into life and developed by it, but also the dynamic medicinal powers of natural substances are thereby developed to an incredible degree".

Alternative methods

Hahnemann wanted to see 30C as the standard potency in homeopathy, but most of his contemporaries preferred tinctures and 3X, while others, including Caspar Julius Jenichen (1787-1849) and the Russian General Count Iseman von Korsakoff (1788-1853) [14] were busy raising potency to extremes:

Jenichen sat or stood stripped naked to the waist, holding the bottle in his fist in an oblique direction from left to right, and shook it in a vertical direction. The fluid, at every stroke, emitted a sound like the ringing of silver coins. He paused after every 25th potency, and the muscles of his naked arm vibrated...he was latterly able to give 8400 strokes in an hour. [10]

Such high potencies could not be made by traditional methods, but required succussion without dilution, higher dilution factors (LM potencies are diluted by a factor of 50,000), or "Korsakoff machines" [15] that continuously combine dilution and succussion. Such machines[16][17] are still sold today; some claim that "vibrations" produce the healing effect and, that when the correct vibration is selected, only water need be added to produce a remedy. Today, radionics devices are used by many homeopaths to prepare remedies, based on the "geomagnetic potentiser" invented by Malcolm Rae (1913-1979) [18], an electronic engineer and dowser. Another technique involves a "paper remedy" - "finds out what they need, writes the remedy down on a piece of paper, they put it in their pocket and it works."[11]

In 1832, Korsakov described the method of 'dry grafting'. A single dry globule of a potentized remedy is put in a bottle half-filled with sugar globules. The bottle is shaken for five minutes, and this way all the globuli should be able to exert the influence of the initial remedy, "as if by contagion", as he put it. Hahnemann approved of the idea, saying that it "is a sort of infection, bearing a strong resemblance to the infection of healthy persons by a contagion brought near or in contact with them".

Miasms

By 1816, Hahnemann was concerned at the failure of homeopathic remedies to produce lasting cures for chronic diseases: "...the non-venereal chronic diseases, after being time and again removed homoeopathically … always returned in a more or less varied form and with new symptoms." He introduced the theory that three fundamental "miasms" underlie of all the chronic diseases of mankind: Syphilis, Sycosis (suppressed gonorrhoea), and Psora. Miasma, from the Greek for 'stain', was an old medical concept, used for "pestiferous exhalations". In Hahnemann's words: "...a child with small-pox or measles communicates to a near, untouched healthy child in an invisible manner (dynamically) the small-pox or measles, … in the same way as the magnet communicated to the near needle the magnetic property..."

According to Hahnemann, miasmatic infection causes local symptoms, usually in the skin. If these are suppressed by medication, the sickness goes deeper, and emerges later as organ pathologies. In the Organon he asserted that Psora was the cause of such diseases as epilepsy, cyphosis, cancer, jaundice, deafness, and cataract. However, even in his own time, many of his followers, including Hering, made almost no reference to Hahnemann’s concept of chronic diseases. Today, some homeopathic practitioners find Hahnemann’s theory difficult to reconcile with current scientific knowledge, as it seems to ignore the importance of genetic, metabolic, nutritional, and degenerative factors in sickness, and fails to differentiate between the many different infectious diseases. Nevertheless, most homeopaths believe that the fundamental causes of disease are internal and constitutional and that it is contrary to good health to suppress symptoms, and they accept the concept of "latent Psora", the early signs of an organism’s imbalance which indicate that treatment is needed.

The miasm theory is not the 'be all and end all' of homeopathy. Hahnemann was also a powerful advocate of good hygiene, fresh air, regular exercise, and good nutrition as essential for good health (see his 1792 essay: The Friend of Health). He was also a pioneer of humane treatment of the insane (1796, Description of Klockenbring During his Insanity) a year before William Tuke and Philippe Pinel, and he published tracts describing the cause of cholera as "excessively minute, invisible, living creatures", indicating his acceptance of some of the conventional ideas about infectious disease.[12]

The Spread of Homeopathy

"I do not expect that homeopathy will ever be established as a legitimate form of treatment, but I do expect that it will continue to be popular." James Randi (see[19])

Homeopathy is popular in Europe and India, but less so in the USA, where non-orthodox therapies have been more tightly regulated. Stricter regulations have also been implemented recently in the EC. There are estimated to be more than 100,000 practitioners of homeopathy worldwide, and 500 million people receiving treatment. More than 12,000 medical doctors and licensed health care practitioners administer homeopathic treatments in the UK, France, and Germany. In Germany, homeopathy is recognized as a 'special form of therapy' since 1978, meaning that homeopathic remedies do not have to have been proved to be efficacious, but since 2004, most are no longer covered by public health insurance. In Switzerland, homeopathic remedies were covered by the basic health insurance system, if prescribed by a physician, until June 2005, when the Government, after a 5-year trial, withdrew insurance coverage for homoeopathy and four other complementary treatments, as they did not meet efficacy and cost-effectiveness criteria.[13]

In the UK, homeopathy was established by Dr Frederick Quin (1799-1878) at around 1827. (Two Italian homeopathic doctors (Drs Romani and Roberta) had been employed two years previously by the Earl of Shrewsbury, but had quickly returned to Naples as they could not tolerate the damp English climate.) Homeopathy became the preferred treatment of the upper classes: the Dukes of Edinburgh and Beaufort were among Quin's patients, and he became physician to the Duchess of Cambridge. At its peak in the 1870s, there were large hospitals in Liverpool, Birmingham, Glasgow, London and Bristol [20] ; the Bristol hospital was funded by the W.D. & H.O. Wills tobacco family, while the Hahnemann Hospital in Liverpool was built by members of the Tate family of sugar importers, who also funded the Tate Gallery in London. Today, homeopathic remedies are sold over the counter, and there are five homeopathic hospitals funded by the National Health Service and many regional clinics. Homeopathy is not practised by most of the medical profession, but is supported by the Prince of Wales and other members of the royal family. [14]

Homeopathy came to India with Dr Martin Honigberger (1795-1869) in Lahore, in 1829-30 India has the largest homeopathic infrastructure in the world, with 300,000 qualified homeopaths, 180 colleges, 7500 government clinics, and 307 hospitals. The Indian 'Association of Qualified Homoeopaths' is the largest of its kind, and 10% of the population are estimated to use homeopathy exclusively for their medical needs. [15]

Homeopathy was brought to the USA by Dr Hans Burch Gram (1787-1840) in 1825 and became popular there partly because of the excesses of conventional medicine and partly by the influence of Constantine Hering (1800-1880). Hering immigrated to America in 1833 and became known as the 'father of American homeopathy' [21]. Hering's contributions to the theory of homeopathy include his "laws" of cure. [22]. He proposed that healing proceeds (and symptoms disappear):

From above downwards.
From within outwards.
From a more important organ to a less important one.
In the reverse order of their coming.

By 1900, hardly any city in the USA with a population of more than 50,000 was without a homeopathic hospital, but in the 1930s, the popularity of homeopathy waned, partly due to the Flexner Report of 1910, which led to the closure of virtually all medical schools teaching alternative medicine, and by the 1950s, homeopathy had almost disappeared. Nevertheless, in 1995 sales of homeopathic remedies were estimated at US$201 million, and the number of homeopaths increased from less than 200 in the 1970s to about 3,000 in 1996. [16]

The skeptical view of homeopathy

"As I understand it, the claim is that the less you use Homeopathy, the better it works. Sounds plausible to me." David Deutsch [23]

From the very beginnings of homeopathy, its claims were treated with skepticism by the medical and scientific establishments. Sir John Forbes (1787-1861), physician to Queen Victoria, declared in 1861 that most cases of disease which recover under homeopathy "recover by means of the curative powers of Nature alone." He concluded that homeopathy is "one of the greatest delusions...of the healing art" and the only good it brings is by lessening "the monstrous polypharmacy which has always been the disgrace of our art - by at once diminishing the frequency of administration of drugs and lessening their dose." [17] Professor Sir James Young Simpson said, of the highly diluted drugs, that there is "no poison, however strong or powerful, the billionth or decillionth of which would in the least degree affect a man or harm a fly." [18]

Homeopathy was developed at a time when many of the most important concepts of modern chemistry and biology, such as molecules and germs, were understood poorly if at all. While proponents may consider the mechanism of homeopathy to be an interesting side issue, skeptics consider the lack of any plausible mechanism to be a serious problem, raising the bar on the quality of evidence required before accepting the existence of the phenomenon under the motto "Extraordinary claims require extraordinary proof".

In Hahnemann's day, many chemists believed that matter was infinitely divisible, so that it was meaningful to talk about dilution to any degree. Although the hypothesis of atoms can be traced back to the ancient Greeks, their size was not calculated until 1865 (by Loschmidt). There are 6.02×1023 particles in a mole (Avogadro's number), so homeopathic dilutions greater than about 24X or 12C are virtually certain to contain not even a single molecule of the initial substance. This is recognized by advocates of homeopathy, who assert that the essential healing power of their preparations is not to be found in the chemical action of molecules, but perhaps in the arrangement of the water molecules, giving rise to the expression 'the memory of water'. This concept is closely related to the belief in a 'vital force', which was common in Hahnemann's day, but was discarded by the scientific community as more and more life processes came to be describable in purely materialistic terms, and as the medical model of disease came to be focused on the failure of particular organs and processes in the body. [19].

For critics, a closely related question is that of logical consistency of the theory. The theory assumes that water is imprinted by the properties of molecules that it once came in contact with, even when the molecules are diluted away. If so, then where did the pure water used in this process come from? The water that homeopaths use was once in contact with other chemicals, including chemical wastes, radioactive metals, dinosaur urine, and various poisons. According to this skeptical interpretation of homeopathic theory, all water in the world should remember its contact with millions of chemical substances and not just the properties of the chemicals that the homeopath claims will be useful. The answer of the homeopaths, that dynamization involves succussion as well as dilution, is unconvincing, because it seems improbable that one can amplify order in a solution by shaking it, and because a lot of shaking goes on in the natural world as well. [20]

Scientific testing of remedies

"It is not a matter of theory or belief or opinion … Homoeopathy must rest upon facts" James Tyler Kent

In the USA, homeopathic remedies are, like all health-care products, regulated by the Food and Drug Administration, but unlike conventional medicines, homeopathic remedies need not be approved by the FDA before sale, nor do they need to be proved either safe or effective, nor to be labeled with an expiry date, or undergo finished product testing. Unlike conventional medicines, homeopathic remedies do not have to identify their active ingredients as they have few or no active ingredients.

As homeopathic remedies at potencies higher than about D23 (10-23) contain no detectable ingredients apart from the diluent (water, alcohol or sugar), there is no known basis for these preparations having medicinal action. A recent review concluded that "...there are some hints from experimental research that homeopathic substances diluted and succussed beyond Avogadro’s number are biologically active but there are no consistent effects from independently reproducible models." Although some patients report benefits from homeopathic preparations[24], scientists usually attribute these to the Placebo Effect, the regression fallacy and/or the Forer effect.[21]

There is general agreement that evidence based medicine is the best way to assess the efficacy and safety of health-care practices. Ideally, drugs are tested in large, multi-centre, randomised, placebo-controlled, double-blind trials, to test whether the drug has an effect that is better than either a placebo or a different treatment. Some trials that have investigated homeopathy have indicated some efficacy above placebo. However, many are technically flawed or involve samples too small to allow firm conclusions to be drawn. Systematic reviews byThe Cochrane Collaboration found insufficient evidence that homeopathy is beneficial for asthma, dementia, or induction of labor. They also found no evidence that homeopathic treatment prevents influenza, but reported that it appears to shorten the duration of the disease. Overall, systematic reviews have found no clear evidence of the efficacy of homeopathic remedies, but often the evidence has been too flawed to exclude possible beneficial effects either. [22].

In 2005, The Lancet published a meta-analysis of 110 placebo-controlled homoeopathy trials and 110 matched conventional-medicine trials. The outcome suggested that the clinical effects of homeopathic remedies are likely to be placebo effects. The Lancet study is notable as a 'global' meta-analysis of homeopathy, not an analysis of particular remedies, i.e. it tested the hypothesis that all of the reported effects of homeopathic remedies are placebo effects. If so, then reports of positive effects reflect publication bias (the tendency to publish results when they show a positive effect but not when they are negative), and the magnitude of such effects should diminish with sample size and study quality. They analysed an equal number of conventional medicine trials similarly; these showed a real effect of treatment, in that the size of the reported effect was independent of sample size, but the trials of homeopathy remedies did not. The study does not prove that homeopathy is never effective, but is consistent with the interpretation that all reported effects are placebo effects. The Lancet article was accompanied by an editorial entitled "The end of homeopathy" which argued that doctors should recognise the absence of real curative powers in homeopathic medicine. The Lancet subsequently published a selection of critical correspondence. [23]

Medical organizations' attitudes towards homeopathy

People use homeopathy because they believe it works. Although homeopathy, like other placebos, does not work in a clinical sense, it can induce physiological changes. It can also coincide with getting better anyway. Sense About Science

The National Center for Complementary and Alternative Medicine, part of the U.S. National Institutes of Health, funds research into homeopathy. According to its statement on homeopathy, "the results of individual, controlled clinical trials of homeopathy have been contradictory. In some trials, homeopathy appeared to be no more helpful than a placebo; in other studies, some benefits were seen that the researchers believed were greater than one would expect from a placebo." Nevertheless, "Some people feel that if homeopathy appears to be helpful and safe, then scientifically valid explanations or proofs of this alternative system of medicine are not necessary."

According to The UK National Health Service there have been about 200 randomised controlled trials evaluating homeopathy, but they have not produced clear clinical evidence that homeopathy works. "Many studies suggest that any effectiveness that homeopathy may have is due to the placebo effect, where the act of receiving treatment is more effective than the treatment itself."

In 1997, the American Medical Association(AMA) adopted the following policy statement after a report on several alternative therapies including homeopathy: "There is little evidence to confirm the safety or efficacy of most alternative therapies. Much of the information currently known about these therapies makes it clear that many have not been shown to be efficacious. Well-designed, stringently controlled research should be done to evaluate the efficacy of alternative therapies" [24]

The Indian Ministry of Health and Family Welfare states that:"Homeopathy has been recognised as one of the National Systems of Medicine and plays an important role in providing health care to a large number of people. Its strength lies in its evident effectiveness as it takes a holistic approach towards the sick individual through promotion of inner balance at mental, emotional, spiritual and physical levels."

Safety of homeopathic treatment

"The highest ideal of cure is the speedy, gentle, and enduring restoration of health by the most trustworthy and least harmful way." Samuel Hahnemann

The United States Food & Drug Administration's view of homeopathy is that there is no real concern over the safety of most homeopathic products "because they have little or no pharmacologically active ingredients". There have been few reports of illness associated with the use of homeopathic products, but in cases that they reviewed, the FDA concluded the homeopathic product was not the cause of the adverse reactions. The main concern about the safety of homeopathy arises not from the products themselves, but from the possible withholding of more efficacious treatment, or from misdiagnosis of dangerous conditions by a non-medically qualified homeopath. For example, a 2006 survey by the UK charitable trust 'Sense About Science' revealed that homeopaths were advising travelers against taking conventional anti-malarial drugs, instead providing them with a homeopathic dilution of quinine. Even the director of the The Royal London Homeopathic Hospital condemned this:

"I'm very angry about it because people are going to get malaria - there is absolutely no reason to think that homeopathy works to prevent malaria and you won't find that in any textbook or journal of homeopathy so people will get malaria, people may even die of malaria if they follow this advice." [25].

Professor Pasvol, a tropical medicine expert at Imperial College, London was reported as saying "Medical practitioners would be sued, taken to court and found guilty for far less. What this investigation has unearthed is appalling." [25]

A particular concern is that homeopaths discourage the use of vaccines. This attitude dating back to Hahnemann, who said "...to use a human morbific matter (a Psorin taken from the itch in man) as a remedy for the same itch or for evils arisen therefrom, stay away from it! Nothing can result from this but trouble and aggravation of the disease." Homeopathy is superficially like vaccination, in that vaccines contain a small dose of the "disease" against which they offer protection (a vaccine is usually made from a bacterium or virus that is either dead or weakened so that it cannot produce symptoms, while still providing enough information to the immune system to generate antibody production). However, to most homeopaths, vaccination is not consistent with the principles of homeopathy; even if it is a crude application of the law of similars, they believe that vaccination has serious short and long-term (health) consequences, and might arouse latent inherited and constitutional weaknesses.

Notes

  1. Hahnemann S (1796) translated into English as "Essay on a New Principle". Hahnemann's[http://www.homeopathyhome.com/reference/organon/organon.html Organon der Heilkunst] in English translation.
  2. Dean ME (2001) Homeopathy and the progress of science Hist Scixxxix
  3. Kent JT Lectures on homoeopathic philosophy. Lecture 1; 'The Sick'
  4. See Peter Morrell, Articles on Homeopathy; Homeopathy Timeline[1]
  5. At least one writer has suggested that Hahnemann was hypersensitive to quinine, and that he might have had an allergic reaction (Thomas WE "The basis of homeopathy"). The notion of 'let likes cure likes' was not novel; others before Hahnemann, including Anton von Störck (1731-1803) had advocated "treatment by cautious use of poisons." Hahnemann had studied briefly in Vienna, where Störck eventually became head of the University. (Lichocka Z "Chemical Analysis as a Method of Discovery in Pharmacy in the Age of Enlightenment in Europe" Halina)
  6. Campbell A, Kentian Homeopathy, Chapter 8 of Homeopathy in Perspective ; Morrell P Kent's influence on British homeopathy
  7. Kent JT (1926) New Remedies, Lesser Writings and Aphorisms & Precepts, quoted in Treuherz F (1984) Origins of Kent's homeopathy J Amer Inst Homeo 77:130-49
  8. Diagnostic dowsing machines; "Medical dowsing"
  9. Hahnemann's board can be seen at the Hahnemann Museum in Stuttgart. There are 6.02 × 1023 molecules in one mole of a substance, and about 1032 molecules of water in an Olympic size swimming pool; 25 metric tons of a 15C solution water contains, on average, just one molecule of the original substance. Water Structure and Behaviour has references to current scientific understanding of water, with entries on "memory effects" and homeopathy
  10. Biography of Caspar Julius Jenichen (1787-1849)
  11. see Editorial, the New Zealand Homoeopathic Society [2] The Toronto Chapter of the Canadian Society of Dowsers[3]
  12. Hahnemann S (1831) Asiatic Cholera
  13. Fisher P, Ward A (1994) Medicine in Europe: Complementary medicine in Europe BMJ 309:107-111[4]; Homeopathy was regulated by the European Union in 2001, by Directive 2001/83/EC. European Directorate for the Quality of Medicines
  14. Leary B et al (1998) It Wont Do Any Harm: Practice & People At The London Homeopathic Hospital, 1889-1923, in Juette R et al (1998) Eds. Culture, Knowledge And Healing: Historical Perspectives On Homeopathy In Europe And North America Sheffield Univ. Press, UK Homéopathe International The English language version
  15. Kishore J (1973) About entry of homeopathy into India Bull Ind Hist Med 3:76-8; Indian Hopeopathic Medical Association; Manchanda RK, Kulashreshtha M, Cost Effectiveness and Efficacy of Homeopathy in Primary Health Care Units of Government of Delhi- A study [5]; Indian Ministry of Health and Family Welfarehomeopathy page
  16. Questions and Answers About Homeopathy NCCAM, National Institutes of Health; "Homeopathy spread first in Germany, then France, and England. Its greatest popularity, however, was in America." (Flinn LB (1976) Homeopathic influences in the Delaware community: a retrospective reassessment Del Med J 48:418-28 PMID 780153); "...by the early 1840s American homeopathic practitioners were gaining considerable influence and prestige", (in Warner JH (1977) "The nature-trusting heresy": American physicians and the concept of the healing power of nature in the 1850's and 1860's. Perspectives on American History 11:291-324 PMID 11632694)
  17. Agnew RAL (2005). John Forbes FRS (1787-1861). The James Lind Library; [6]
  18. Simpson JY (1853) Homoeopathy, Its Tenets and Tendencies, Theoretical, Theological and Therapeutical Edinburgh: Sutherland & Knox 11
  19. There have been occasional reports of effects of highly diluted solutions on organic processes, including on histamine release by leukocytes (Davenas E et al Human basophil degranulation triggered by very dilute antiserum against IgE Nature 333:816-8); However, attempts to replicate these studies failed. Walach et al (2005) Research on Homeopathy: State of the Art J Alt Comp Medicine 11:813–29
  20. Skeptics: "A close look at homeopathy" skepticreport; "A Skeptical Guide to Homeopathic History, Theories, and Current Practices", homeowatch; "Dilution or Delusion?" skepticreport; "Magical Thinking in Complementary and Alternative Medicine"CSIOP; "Homeopathy - a Sceptical View" BBC
  21. American Council on Science and Health,The Scientific Evidence on Homeopathy
  22. "Declaration of Helsinki should be strengthened" BMJ 2000;321:442-445; Jonas WB et al(2003) A critical overview of homeopathy" Ann Intern Med 138:393-399 Jonas WB et al (2001). "A systematic review of the quality of homeopathic clinical trials". BMC Complement Altern Med 1: 12. PMID 11801202.
  23. The Lancet study:Shang A et al (2005). "Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy". Lancet 366: 726-32. PMID 16125589.
    Fisher P (2006) Homeopathy and The Lancet eCAM 3:145-47; Jobst KA (2005) Homeopathy, Hahnemann, and The Lancet 250 Years On
    A Case of the Emperor's New Clothes? J Alt Comp Med 11:751-54.[7];
    "As a fourth study says it's no better than a placebo, is this the end for homeopathy?" The Guardian Aug 26 2005; The American Council on Science and Health "The Scientific Evidence on Homeopathy"
  24. Report 12 of the American Medical Association Council on Scientific Affairs alternative theories including homeopathy. AMA.
  25. Homeopaths 'endangering lives' by offering malaria remedies Alok Jha, Friday July 14 2006, The Guardian; Science and Technology - Sixth Report Science and Technology Committee Publications [8]

External links

  • Complementary Medicine - Therapies: Homeopathy[26] BBC's "Complementary Medicine" article on Homeopathy
  • Homeopathy In Perspective — critical online book, covering the history and present state of homeopathy