Homeopathy: Difference between revisions
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{{Short description|Pseudoscientific system of alternative medicine}} |
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{{totally disputed}} |
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{{for|the journal|Homeopathy (journal){{!}}''Homeopathy'' (journal)}} |
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{{pp-vandalism|small=yes}} |
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{{good article}} |
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{{Use Oxford spelling|date=September 2016}} |
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{{Use mdy dates|date=August 2017}} |
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{{Infobox alternative medicine |
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| name = Homeopathy |
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| synonyms = Homoeopathy |
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| pronounce = {{IPAc-en|audio=En-uk-homeopathy.ogg|ˌ|h|oʊ|m|i|ˈ|ɒ|p|ə|θ|i}} |
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| image = Saxonia Museum fuer saechsische Vaterlandskunde III 19.jpg |
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| image_size = 250 |
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| alt = Samuel Hahnemann |
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| caption = [[Samuel Hahnemann]], originator of homeopathy |
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| claims = "Like cures like", dilution increases potency, disease caused by [[#Miasms and disease|miasm]]s |
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| topics = [[Alternative medicine]] |
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| orig-date = 1796 |
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| origprop = [[Samuel Hahnemann]] |
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| laterprop = {{Plain list| |
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* [[James Tyler Kent]] |
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* [[Royal S. Copeland]] |
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* [[George Vithoulkas]] |
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}} |
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| seealso = [[Humorism]], [[heroic medicine]] |
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| MeshID = D006705 |
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}} |
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{{Alternative medical systems|fringe}} |
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'''Homeopathy''' or '''homoeopathy''' is a [[pseudoscientific]]<ref>{{multiref |
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[[Image:Samuel_Hahnemann.png|thumb|right|'''Samuel Hahnemann''', the father of homeopathy]] |
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|1= |
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'''Homeopathy''' (also spelled '''homœopathy''' or '''homoeopathy''') from the Greek words ''όμοιος, hómoios'' (similar) and ''πάθος, páthos'' (suffering), is a system of [[alternative medicine]] that treats "like with like", using remedies that it is claimed would, in healthy individuals, produce similar symptoms to those it would treat in an ill patient. Practitioners believe that the potency of a remedy can be increased by systematically diluting the dosage, along with succussion or shaking, to a point where the original ingredient is not present. |
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|2={{cite book |author=Tuomela, R |title=Rational Changes in Science |chapter=Science, Protoscience, and Pseudoscience |publisher=Springer |year=1987 |isbn=978-94-010-8181-8 |veditors=Pitt JC, Marcello P |series=Boston Studies in the Philosophy of Science |volume=98 |pages=83–101 |doi=10.1007/978-94-009-3779-6_4 |author-link=Raimo Tuomela|issn = 0068-0346}} |
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|3={{cite journal |vauthors=Mukerji N, Ernst E |title=Why homoeopathy is pseudoscience |journal=Synthese |date=14 September 2022 |volume=200 |issue=5 |eissn=1573-0964 |doi=10.1007/s11229-022-03882-w |pmid=|s2cid=252297716 |url= |doi-access=free}} |
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|4={{cite book |vauthors=Baran GR, Kiana MF, Samuel SP |title=Healthcare and Biomedical Technology in the 21st Century |chapter=Science, Pseudoscience, and Not Science: How do They Differ? |publisher=Springer |year=2014 |pages=19–57 |doi=10.1007/978-1-4614-8541-4_2 |isbn=978-1-4614-8540-7 |quote=within the traditional medical community it is considered to be quackery }} |
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|5={{cite book |author=Ladyman J |veditors=Pigliucci M, Boudry M |year=2013 |pages=48–49 |publisher=University of Chicago Press |chapter=Chapter 3: Towards a Demarcation of Science from Pseudoscience |title=Philosophy of Pseudoscience: Reconsidering the Demarcation Problem |quote=Yet homeopathy is a paradigmatic example of pseudoscience. It is neither simply bad science nor science fraud, but rather profoundly departs from scientific method and theories while being described as scientific by some of its adherents (often sincerely). |isbn=978-0-226-05196-3}}}}</ref> system of [[alternative medicine]]. It was conceived in 1796 by the German physician [[Samuel Hahnemann]]. Its practitioners, called '''homeopaths''' or homeopathic physicians,<ref>{{Cite web |title=Homeopathic Physician Licensure |url=https://www.cga.ct.gov/2010/rpt/2010-R-0315.htm |access-date=2023-11-25 |website=OLR Research Report}}</ref> believe that a substance that causes symptoms of a disease in healthy people can cure similar symptoms in sick people; this doctrine is called ''[[similia similibus curentur]]'', or "like cures like".<ref name="Hahnemann" /> Homeopathic preparations are termed ''remedies'' and are made using [[homeopathic dilution]]. In this process, the selected substance is repeatedly diluted until the final product is chemically indistinguishable from the [[diluent]]. Often not even a single molecule of the original substance can be expected to remain in the product.<ref>{{Cite web |title=Homeopathy |url=https://www.rpharms.com/resources/quick-reference-guides/homeopathy |access-date=2019-11-17 |website=[[Royal Pharmaceutical Society]]}}</ref> Between each dilution homeopaths may hit and/or shake the product, claiming this makes the diluent "remember" the original substance after its removal. Practitioners claim that such preparations, upon oral intake, can treat or cure disease.<ref>{{Cite web |date=2017-10-18 |title=Homeopathy |url=https://www.nhs.uk/conditions/homeopathy/ |access-date=2019-11-10 |website=nhs.uk |language=en}}</ref> |
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All relevant scientific knowledge about physics, chemistry, biochemistry and biology contradicts homeopathy.<ref>{{multiref |
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Although homeopathy is reported to be rapidly growing in popularity, it is [http://www.jr2.ox.ac.uk/bandolier/booth/alternat/AT014.html controversial] and does not satisfy the [[scientific]] standards of conventional [[evidence-based medicine]]. |
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|1= |
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|2={{cite journal |last1=Shang |first1=Aijing |last2=Huwiler-Müntener |first2=Karin |last3=Nartey |first3=Linda |last4=Jüni |first4=Peter |last5=Dörig |first5=Stephan |last6=Sterne |first6=Jonathan AC |last7=Pewsner |first7=Daniel |last8=Egger |first8=Matthias |title=Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy |journal=The Lancet |volume=366 |pages=726–32 |year=2005 |doi=10.1016/S0140-6736(05)67177-2 |pmid=16125589 |issue=9487|s2cid=17939264 }} |
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|3={{cite journal|last=Ernst|first=E.|date=December 2012|title=Homeopathy: a critique of current clinical research|url=http://www.csicop.org/si/show/homeopathy_a_critique_of_current_clinical_research|journal=[[Skeptical Inquirer]]|volume=36|issue=6}} |
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|4={{cite web|title=Homeopathy|url=http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/pharmacologicalandbiologicaltreatment/homeopathy|access-date=October 12, 2014|publisher=American Cancer Society|archive-date=March 16, 2013|archive-url=https://web.archive.org/web/20130316003948/http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/pharmacologicalandbiologicaltreatment/homeopathy}} |
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|5=UK Parliamentary Committee Science and Technology Committee. [http://www.parliament.uk/business/committees/committees-a-z/commons-select/science-and-technology-committee/inquiries/homeopathy-/ "Evidence Check 2: Homeopathy"] |
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|6={{cite journal|last1=Grimes|first1=D.R.|year=2012|title=Proposed mechanisms for homeopathy are physically impossible|journal=Focus on Alternative and Complementary Therapies|volume=17|issue=3|pages=149–55|doi=10.1111/j.2042-7166.2012.01162.x}} |
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|7={{cite web|date=September 2017|title=Homeopathic products and practices: assessing the evidence and ensuring consistency in regulating medical claims in the EU|url=http://www.easac.eu/fileadmin/PDF_s/reports_statements/EASAC_Homepathy_statement_web_final.pdf|access-date=1 October 2017|work=European Academies' Science Advisory Council|page=1|quote=... we agree with previous extensive evaluations concluding that there are no known diseases for which there is robust, reproducible evidence that homeopathy is effective beyond the placebo effect.}} |
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|8={{cite book |
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|author=Oliver Wendell Holmes Sr. |
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|title=Homoeopathy and its kindred delusions: Two lectures delivered before the Boston Society for the Diffusion of Useful Knowledge |
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|url=https://archive.org/details/64340260R.nlm.nih.gov |
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|location=Boston |
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|year=1842 |
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|author-link=Oliver Wendell Holmes Sr |
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}} as reprinted in |
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{{cite book |
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|author=Oliver Wendell Holmes Sr. |
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|title=Currents and counter-currents in medical science |
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|year=1861 |
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|publisher=Ticknor and Fields |
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|pages=72–188 |
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|url=https://catalog.hathitrust.org/Record/011611362 |
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|oclc=1544161 |
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|ol=14731800M |
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|author-link=Oliver Wendell Holmes Sr |
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}} |
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}}</ref> Homeopathic remedies are typically [[Biochemistry|biochemically]] inert, and have no effect on any known disease.<ref name="shang" /><ref name="pmid124926032">{{cite journal|last1=Ernst|first1=E.|author-link=Edzard Ernst|year=2002|title=A systematic review of systematic reviews of homeopathy|journal=British Journal of Clinical Pharmacology|volume=54|issue=6|pages=577–82|doi=10.1046/j.1365-2125.2002.01699.x|pmc=1874503|pmid=12492603}}</ref><ref name="inquiry_4504">{{cite web|date=February 22, 2010|title=Evidence Check 2: Homeopathy – Science and Technology Committee|url=https://publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/4504.htm|access-date=April 5, 2014|publisher=[[House of Commons of the United Kingdom|British House of Commons]] Science and Technology Committee}}</ref> Its theory of disease, centered around principles Hahnemann termed [[#Miasms and disease|miasms]], is inconsistent with subsequent identification of viruses and bacteria as [[germ theory of disease|causes of disease]]. Clinical trials have been conducted and generally demonstrated no objective effect from homeopathic preparations.<ref name="Caulfield20053">{{cite journal|last1=Caulfield|first1=Timothy|author-link=Timothy Caulfield|last2=Debow|first2=Suzanne|year=2005|title=A systematic review of how homeopathy is represented in conventional and CAM peer reviewed journals|journal=BMC Complementary and Alternative Medicine|volume=5|page=12|doi=10.1186/1472-6882-5-12|pmc=1177924|pmid=15955254 |doi-access=free }}</ref><ref name="sbm-fun">{{Cite news|last=Gorski|first=David|authorlink= David Gorski|date=October 13, 2008|title=Fun with homeopaths and meta-analyses of homeopathy trials|language=en-US|website=Science-Based Medicine|url=https://sciencebasedmedicine.org/fun-with-homeopaths-and-meta-analyses-of-homeopathy-trials/|access-date=2019-11-09}}</ref><ref name="Shelton" />{{rp|206|date=November 2012}}<ref name="Ernst20102">{{cite journal|last1=Ernst|first1=E.|author-link1=Edzard Ernst|year=2010|title=Homeopathy: What does the "best" evidence tell us?|url=https://www.mja.com.au/journal/2010/192/8/homeopathy-what-does-best-evidence-tell-us|journal=Medical Journal of Australia|volume=192|issue=8|pages=458–60|doi=10.5694/j.1326-5377.2010.tb03585.x|pmid=20402610|s2cid=42180344}}</ref> The fundamental [[Evidence and efficacy of homeopathy|implausibility of homeopathy as well as a lack of demonstrable effectiveness]] has led to it being characterized within the scientific and medical communities as [[quackery]] and [[fraud]].<ref name="Baran2014">{{cite book |vauthors=Baran GR, Kiana MF, Samuel SP |title=Healthcare and Biomedical Technology in the 21st Century |chapter=Science, Pseudoscience, and Not Science: How do They Differ? |publisher=Springer |year=2014 |pages=19–57 |doi=10.1007/978-1-4614-8541-4_2 |isbn=978-1-4614-8540-7 |quote=within the traditional medical community it is considered to be quackery }}</ref><ref name="Walport-Nonsense">{{cite news|last1=Collins|first1=Nick|date=April 18, 2013|title=Homeopathy is nonsense, says new chief scientist|work=[[The Daily Telegraph]]|url=https://www.telegraph.co.uk/health/healthnews/10003680/Homeopathy-is-nonsense-says-new-chief-scientist.html|access-date=September 9, 2013|archive-url=https://web.archive.org/web/20130420234704/http://www.telegraph.co.uk/health/healthnews/10003680/Homeopathy-is-nonsense-says-new-chief-scientist.html|archive-date=April 20, 2013}}</ref><ref name="oxcompus">{{cite book|author=Paul S. Boyer|url=https://archive.org/details/oxfordcompaniont00paul_0|title=The Oxford companion to United States history|year=2001|isbn=978-0-19-508209-8|page=[https://archive.org/details/oxfordcompaniont00paul_0/page/630 630]|publisher=Oxford University Press |quote=After 1847, when regular doctors organized the American Medical Association (AMA), that body led the war on "quackery", especially targeting dissenting medical groups such as homeopaths, who prescribed infinitesimally small doses of medicine. Ironically, even as the AMA attacked all homeopathy as quackery, educated homeopathic physicians were expelling untrained quacks from their ranks.|access-date=January 15, 2013|url-access=registration}}</ref> |
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Homeopathy achieved its greatest popularity in the 19th century. It was introduced to the United States in 1825, and the first American homeopathic school opened in 1835. Throughout the 19th century, dozens of homeopathic institutions appeared in Europe and the United States. During this period, homeopathy was able to appear relatively successful, as other forms of treatment could be harmful and ineffective. By the end of the century the practice began to wane, with the last exclusively homeopathic medical school in the United States closing in 1920. During the 1970s, homeopathy made a significant comeback, with sales of some homeopathic products increasing tenfold. The trend corresponded with the rise of the [[New Age movement]], and may be in part due to [[chemophobia]], an irrational aversion to synthetic chemicals, and the longer consultation times homeopathic practitioners provided. |
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Medical physicians who also practice homeopathy are licensed to practice medicine in many countries of the world, including such countries as the USA, England, France, Germany, Holland, and Switzerland. Though in some countries, including France, homeopathy is taught in mainstream medical schools, in most countries it is taught primarily in specialized colleges of homeopathy. |
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In the 21st century, a series of [[Meta-analysis|meta-analyses]] have shown that the therapeutic claims of homeopathy lack scientific justification. As a result, national and international bodies have recommended the withdrawal of government funding for homeopathy in healthcare. National bodies from Australia, the United Kingdom, Switzerland and France, as well as the [[European Academies' Science Advisory Council]] and the [[Russian Academy of Sciences]] have all concluded that homeopathy is ineffective, and recommended against the practice receiving any further funding.<ref name="Conversation-NHMRC">{{cite news |url=http://theconversation.com/no-evidence-homeopathy-is-effective-nhmrc-review-25368 |title=No evidence homeopathy is effective: NHMRC review |work=The Conversation |date=April 8, 2014 |last=Musgrave|first=I |access-date=January 10, 2015 }}</ref><ref>{{Cite web|title=Swiss make New Year's regulations |date=January 2012 |url=http://www.swissinfo.ch/eng/swiss-make-new-year-s-regulations/31867422 |publisher=Swiss Info |access-date=December 16, 2015}}</ref><ref>{{cite news|title=Homeopathic remedies are 'nonsense and risk significant harm' say 29 European scientific bodies|url=https://www.independent.co.uk/news/uk/home-news/homeopathy-nonsense-risk-harm-29-european-academies-science-advisory-council-remedies-a7963786.html|access-date=October 10, 2017|newspaper=The Independent|date=September 23, 2017}}</ref><ref>{{Cite web|date=2017-02-07|title=Memorandum #2. Homeopathy as pseudoscience|url=http://klnran.ru/en/2017/02/memorandum02-homeopathy/|access-date=June 25, 2019|website=[[Commission on Pseudoscience]]}}</ref> The [[NHS England|National Health Service in England]] no longer provides funding for homeopathic remedies and asked the [[Department of Health and Social Care|Department of Health]] to add homeopathic remedies to the list of forbidden prescription items.<ref>{{cite news|date=July 21, 2017|title=NHS to ban homeopathy and herbal medicine, as 'misuse of resources'|newspaper=Daily Telegraph|url=https://www.telegraph.co.uk/news/2017/07/21/nhs-ban-homeopathy-herbal-medicine-misuse-resources/ |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/news/2017/07/21/nhs-ban-homeopathy-herbal-medicine-misuse-resources/ |archive-date=January 11, 2022 |url-access=subscription |url-status=live|access-date=July 21, 2017}}{{cbignore}}</ref><ref name="TNHS">{{cite news|last1=Donnelly|first1=Laura|date=5 June 2018|title=High Court backs NHS decision to stop funding homeopathy|newspaper=Daily Telegraph|url=https://www.telegraph.co.uk/science/2018/06/05/high-court-backs-nhs-decision-stop-funding-homeopathy/ |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/science/2018/06/05/high-court-backs-nhs-decision-stop-funding-homeopathy/ |archive-date=January 11, 2022 |url-access=subscription |url-status=live|access-date=26 August 2018}}{{cbignore}}</ref><ref name="bbc-blacklist">{{Cite news |url=https://www.bbc.co.uk/news/health-34744858 |title=Homeopathy 'could be blacklisted' |last=Gallagher |first=James |date=2015-11-13 |work=BBC News |access-date=2017-12-05 |language=en-GB}}</ref> France removed funding in 2021,<ref name="GuardianFrance">{{Cite news |url=https://www.theguardian.com/world/2019/jul/10/france-to-stop-reimbursing-patients-for-homeopathic-treatment |title=France to stop reimbursing patients for homeopathy |agency=Agence France-Presse |date=2019-07-10 |work=The Guardian |access-date=2019-07-30 |language=en-GB |issn=0261-3077}}</ref><ref name="FranceEndFunding2021">{{cite web |url=https://www.francetvinfo.fr/sante/medicament/homeopathie/homeopathie-2021-signe-la-fin-du-remboursement_4240961.html |title=Homéopathie: 2021 signe la fin du remboursement |publisher=France Info | date=January 2021 | access-date=18 November 2023 }}</ref> while Spain has also announced moves to ban homeopathy and other pseudotherapies from health centers.<ref name="El Pais 2019-07-30">{{Cite news |url=https://elpais.com/elpais/2018/11/14/inenglish/1542203925_514487.html |title=Spain moves to ban pseudo-therapies from universities and health centers |last=Güell |first=Oriol |date=2018-11-14 |work=El País |access-date=2019-07-30 |language=en |issn=1134-6582}}</ref> |
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The term "homeopathy" was coined by the [[Saxony|Saxon]] physician [[Samuel Hahnemann]] ([[1755]]–[[1843]]) and first published in [[1796]]. |
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==History== |
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== Basic principles == |
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Homeopathy was created in 1796 by [[Samuel Hahnemann]].<ref>{{Cite journal|last=Loudon|first=Irvine|date=December 2006|title=A brief history of homeopathy|journal=Journal of the Royal Society of Medicine|volume=99|issue=12|pages=607–610|doi=10.1177/014107680609901206|issn=0141-0768|pmc=1676328|pmid=17139061}}</ref> Hahnemann rejected the mainstream medicine of the late 18th century as irrational and inadvisable, because it was largely ineffective and often harmful.<ref name="Lasagna"> |
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=== The law of similars === |
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{{cite book |
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The "natural law" expressed by Hahnemann, the one from which homeopathy derives its name, is '''similia similibus curentur''' - let like cure like. This means that the appropriate substance to treat a disease is that one which induces similar symptoms in a healthy person. Thus, the logical structure of the homeopathic doctrine is tripartite: one should know the symptoms of diseases, one should know the symptoms induced by appropriate substances, and there should be a set of rules to find the corresponding remedy for a given disease picture. |
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|author =Lasagna L |
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|title =The doctors' dilemmas |
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|location =New York |
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|publisher =Collier Books |
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|year =1970 |
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|orig-date =1962 |
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|page =33 |
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|isbn =978-0-8369-1669-0 |
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}}</ref><ref name="isbn0-393-06661-4">{{cite book |author1=Edzard Ernst |author-link1=Edzard Ernst|author2=Singh, Simon |author-link2=Simon Singh|title=Trick or Treatment: The Undeniable Facts about Alternative Medicine |publisher=W. W. Norton |location=New York |year=2008 |isbn=978-0-393-06661-6 |title-link=Trick or Treatment: The Undeniable Facts about Alternative Medicine }}</ref> He advocated the use of single drugs at lower doses and promoted an immaterial, [[vitalism|vitalistic]] view of how living organisms function.<ref name="Pray2003">{{cite book|author=W. Steven Pray|title=a History of Nonprescription Product Regulation|url=https://books.google.com/books?id=uadgq04eLr0C&pg=PA192|access-date=January 21, 2013|date=August 1, 2003|publisher=Psychology Press|isbn=978-0-7890-1538-9|page=192}}</ref> The term ''homeopathy'' was coined by Hahnemann and first appeared in print in 1807.<ref> |
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{{cite journal|author=Dean ME|year=2001|title=Homeopathy and "the progress of science"|url=http://www.shpltd.co.uk/dean-homeopathy.pdf|journal=Hist Sci|volume=39|issue=125 Pt 3|pages=255–83|bibcode=2001HisSc..39..255E|doi=10.1177/007327530103900301|pmid=11712570|archive-url=https://web.archive.org/web/20060101084902/http://www.shpltd.co.uk/dean-homeopathy.pdf|archive-date=January 1, 2006|access-date=March 31, 2009|s2cid=23943688}} |
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</ref> He also coined the expression "[[allopathic medicine]]", which was used to pejoratively refer to traditional Western medicine.<ref name="Whorton2004">{{cite book|author=Whorton JC|url=https://books.google.com/books?id=RU0DndWVSPoC&pg=PA18|title=Nature Cures: The History of Alternative Medicine in America|publisher=[[Oxford University Press US]]|year=2004|isbn=978-0-19-517162-4|location=New York|pages=18, 52}}</ref> |
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===Concept=== |
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==== Provings and pathogenesies ==== |
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[[File:Samuel Hahnemann Monument, Scott Circle.jpg|thumb|[[Samuel Hahnemann Monument]], Washington, D.C., with the inscription ''Similia Similibus Curentur'' – "Like cures Like"]] |
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The crucial task was to find out the symptoms associated with various substances, remedial '''pathogeneses''' (also spelled ''pathogenesies''; the singular forms being ''pathogenesis'' and ''pathogenesy''). They are to be determined through provings on healthy persons (''provers''), who ingest the substance (most often diluted), and then carefully note all changes they experience on any perceptible level (physical, emotional, cognitive). Such pathogeneses constitute the homeopathic ''Materia Medica''. |
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Hahnemann conceived of homeopathy while translating a medical treatise by the Scottish physician and chemist [[William Cullen]] into German. Being sceptical of Cullen's theory that [[cinchona]] cured [[malaria]] because it was bitter, Hahnemann ingested some bark specifically to investigate what would happen. He experienced fever, shivering and [[arthralgia|joint pain]]: symptoms similar to those of malaria itself. From this, Hahnemann came to believe that all effective drugs produce symptoms in healthy individuals similar to those of the diseases that they treat.<ref name="UllmanReichenberg-Ullman1994">{{cite book|author1=Robert W. Ullman|author2=Judyth Reichenberg-Ullman|title=The patient's guide to homeopathic medicine |url=https://archive.org/details/patientsguidetoh00robe |url-access=registration|access-date=January 24, 2013|date=October 1, 1994|publisher=Picnic Point Press|isbn=978-0-9640654-2-0|pages=[https://archive.org/details/patientsguidetoh00robe/page/1 1]–2}}</ref> This led to the name ''"homeopathy"'', which comes from the {{langx|grc|ὅμοιος}} ''hómoios'', "-like" and {{lang|el|πάθος}} ''páthos'', "suffering".<ref>{{Cite journal|last1=Merrell|first1=Woodson C.|last2=Shalts|first2=Edward|date=2002|title=Homeopathy|journal=The Medical Clinics of North America|volume=86|issue=1|pages=47–62|doi=10.1016/s0025-7125(03)00071-3|issn=0025-7125|pmid=11795090}}</ref> |
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The doctrine that those drugs are effective which produce symptoms similar to the symptoms caused by the diseases they treat, called "the law of similars", was expressed by Hahnemann with the Latin phrase ''[[similia similibus curentur]]'', or "like cures like".<ref name="Hahnemann" /> Hahnemann's law of similars is unproven and does not derive from the [[scientific method]].<ref name="Kirk">{{cite journal|date=December 1894|editor2=John Hugh McQuillen|editor3=George Jacob Ziegler|editor4=James William White|editor5=Edward Cameron Kirk|editor6=Lovick Pierce Anthony|title=A wail from the waste-basket|url=http://quod.lib.umich.edu/d/dencos/acf8385.0036.001/1050:349?didno=ACF8385.0036.001;rgn=full+text;view=image|journal=[[The Dental Cosmos]]|type=editorial|volume=36|issue=12|pages=1030–32|editor=J. D. White}}</ref> An account of the effects of eating cinchona bark noted by [[Oliver Wendell Holmes Sr.|Oliver Wendell Holmes]], published in 1861, failed to reproduce the symptoms Hahnemann reported.<ref name="Holmes" />{{rp|128}} Subsequent scientific work showed that cinchona cures malaria because it contains [[quinine]], which kills the ''[[Plasmodium falciparum]]'' parasite that causes the disease; the mechanism of action is unrelated to Hahnemann's ideas.<ref name="Atwood-BTTF1">{{cite web |url=http://www.sciencebasedmedicine.org/homeopathy-and-evidence-based-medicine-back-to-the-future-part-i/ |title=Homeopathy and evidence-based medicine: back to the future |publisher=[[Science Based Medicine]] |date=January 4, 2008 |access-date=September 9, 2013 |last=Atwood |first=Kimball}}</ref> |
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This technique is based upon a naive idea that most changes experienced by provers after intaking a remedy are produced by the remedy. However, it became known rather soon that the very fact of taking part in a proving can exert considerable psychogenic effect. The symptoms of provings can be elicited by pure vehicle given by way of a drug. For instance, when Wesselhoeft had to conduct a re-proving of ''Carbo vegetabilis'', he began by furnishing his fellow-workers with a number of blank powders of sugar of milk. No inconsiderable array of symptoms were reported to him as the result of the ingestion of these placebos, before a single particle of the drug has been absorbed. Strictly speaking, it was an instance of the '''nocebo effect''', particularly easy to elicit in hysterical persons. The so-called ''seminar provings'' widely practiced today present just this picture of mass-hysteria. Homoeopaths do not deny the fact. To quote a proving master (Jeremy Sherr): "''For instance in the proving of Diamond quite a few provers experienced tearing or straining of tendons and ligaments in the ankle and wrist joints. However, in addition to the provers experiencing these symptoms a large number of 'extras' - supervisors, placebo provers, other class members and close relatives - experienced similar injuries...''" His explanation of the induced symptoms is of no less interest than the fact itself:: "''All the individuals participating become a whole and unified organism... their vital forces merge''". |
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====Provings==== |
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But even with stricter procedures, psychogeny is inevitable, in particular, due to the introductory instruction of provers, which procedure strongly suggests a possibility of adverse reactions, such as "''...If in doubt phone your supervisor. Be on the safe side and do not take further doses.''" Still further the psychogenic pressure, however unobtrusive, is promoted by discussing the symptoms with the prover, which is a widely spread practice nowadays. |
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Hahnemann began to test what effects various substances may produce in humans, a procedure later called "homeopathic proving". These tests required subjects to test the effects of ingesting substances by recording all their symptoms as well as the ancillary conditions under which they appeared.<ref name="Haehl1922">{{cite book|author=Richard Haehl|title=Samuel Hahnemann: His Life and Work: Based on Recently Discovered State Papers, Documents, Letters, Etc|url=https://books.google.com/books?id=Q80gR6OxDVsC&pg=PA101|access-date=January 24, 2013|year=1922|publisher=B. Jain Publishers|isbn=978-81-7021-693-3|page=101}}</ref> He published a collection of provings in 1805, and a second collection of 65 preparations appeared in his book, ''Materia Medica Pura'' (1810).<ref name="Kirschmann2004">{{cite book|author=Anne Taylor Kirschmann|title=A vital force: women in American homeopathy |url=https://archive.org/details/vitalforcewomeni0000kirs|url-access=registration|access-date=January 28, 2013|year=2004|publisher=Rutgers University Press|isbn=978-0-8135-3320-9|page=[https://archive.org/details/vitalforcewomeni0000kirs/page/11 11]}}</ref> |
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As Hahnemann believed that large doses of drugs that caused similar symptoms would only aggravate illness, he advocated for extreme dilutions. A technique was devised for making dilutions that Hahnemann claimed would preserve the substance's therapeutic properties while removing its harmful effects.<ref name="Dynamization and Dilution">{{cite web |title=Dynamization and dilution |work=Complementary and Alternative Medicine |publisher=[[Creighton University]] Department of Pharmacology |url=http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm |archive-url=https://web.archive.org/web/20020826082134/http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm |archive-date=August 26, 2002 |access-date=March 24, 2009}}</ref> Hahnemann believed that this process enhanced "the spirit-like medicinal powers of the crude substances".<ref name="Organon_5th_269">{{cite book |author=Hahnemann S |title=The organon of the healing art |year=1833 |publisher=Keats Pub. |edition=5th |at=aphorism 269 |isbn=978-0-87983-228-5}}. |
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In fact, proving protocols look as unordered heaps of disparate sensations and disturbances, many of them accidental, unrelated to the action of the substance. But to make things still more confused, the principle of provings only on healthy provers was soon neglected. In 1796, Hahnemann wrote: "''The reaction of the diseased organism ... to an untested or imperfectly tested remedy, gives such intricate results, that their appreciation is impossible for most acute physician. Either nothing happens, or there occur aggravations, changes, amelioration, recovery, death - without the possibility of the greatest practical genius being able to divine what part of the diseased organism, and what the remedy (in a dose, perchance, too great, moderate, or too small) played in effecting the result.''" However, a great part of the symptoms included into pathogeneses were obtained on sick persons, with disease symptoms often taken for pathogenetic ones. And Hahnemann was the first to lapse into this trap (''Hughes, Manual of Pharmacodynamics, 1893, p.28 ff.''). It is a matter of subjective judgement which symptoms are included into pathogeneses. Still, relevant or not, the chosen symptoms find their way into the homeopathic Materia Medica. |
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{{cite book |author=Hahnemann S |title=The organon of the healing art |publication-date=1921 |year=1842 |publisher=Keats Pub. |edition=6th |at=aphorism 270 |isbn=978-0-87983-228-5}}</ref> He gathered and published an overview of his new medical system in his book, ''[[The Organon of the Healing Art]]'' (1810), with a sixth edition published in 1921 that homeopaths still use today.<ref name="homhist1"> |
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{{cite web |title=History of Homeopathy |publisher=Creighton University Department of Pharmacology |url=http://altmed.creighton.edu/Homeopathy/history.htm |access-date=July 23, 2007 |date=July 2007 |archive-url=https://web.archive.org/web/20070705095116/http://altmed.creighton.edu/Homeopathy/history.htm |archive-date=July 5, 2007}}</ref> |
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====Miasms and disease==== |
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The very remedy that sparked in Hahnemann his unsolicited enlightenment, ''Cinchona bark'' is an example of the unreliability of pathogeneses. Whenever taken by healthy provers after Hahnemann, it never produced the symptom of fever. A plausible explanation of the fact was first proposed by ''Theodor von Bacody'', an '''advocate''' of homeopathy. He suggested that Hahnemann had contracted malaria germs which remained inactive in his spleen. The surmise found factual confirmation in Hahnemann's own words. Namely, he was delivered from a relapse of quartan fever with 6 drams of Cinchona extract (''Tischner R.: Geschichte der Homöopathie, T.II, p.163''). So, the symptom was indeed aroused by Cinchona, but it does not pertain to the physiological action of ''Cinchona'', to its ''pathogenesis''. |
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In the ''Organon'', Hahnemann introduced the concept of "miasms" as the "infectious principles" underlying chronic disease<ref name="ClarkeClarke2001">{{cite book |author=John Henry Clarke |title=Homeopathy explained |url=https://books.google.com/books?id=ZUGIWuo4qc8C&pg=PA22 |access-date=January 12, 2013 |date=January 1, 2001 |publisher=Nanopathy |pages=22–|id=GGKEY:JWCD56EF80T }}</ref> and as "peculiar morbid derangement[s] of vital force".<ref name="Grimes2012">{{cite journal |
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|author=Grimes, D. R. |
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|title=Proposed mechanisms for homeopathy are physically impossible |
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|journal=[[Focus on Alternative and Complementary Therapies]] |
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|date=2012 |
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|volume=17 |
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|issue=3 |
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|page=154|doi=10.1111/j.2042-7166.2012.01162.x |
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}}</ref> Hahnemann associated each miasm with specific diseases, and thought that initial exposure to miasms causes local symptoms, such as skin or venereal diseases. His assertion was that if these symptoms were suppressed by medication, the cause went deeper and began to manifest itself as diseases of the internal organs.<ref name="miasms" /> Homeopathy maintains that treating diseases by directly [[Symptomatic treatment|alleviating their symptoms]], as is sometimes done in conventional medicine, is ineffective because all "disease can generally be traced to some latent, deep-seated, underlying chronic, or inherited tendency".<ref> |
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{{cite journal |
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|url =http://homeoint.org/cazalet/ward/historycase.htm |
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|author =Ward JW |
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|title=Taking the history of the case |
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|journal=Pacific Coast Journal of Homeopathy |
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|date=July 1937 |
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|access-date =October 22, 2007 |
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}}</ref> The underlying imputed miasm still remains, and deep-seated ailments can be corrected only by removing the deeper disturbance of the vital force.<ref name="homphilo"> |
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{{cite web |
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|title=Cause of disease in homeopathy |
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|publisher=Creighton University Department of Pharmacology |
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|url=http://altmed.creighton.edu/Homeopathy/philosophy/cause.htm |
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|access-date=July 23, 2007 |
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|archive-url=https://web.archive.org/web/20091231160035/http://altmed.creighton.edu/Homeopathy/philosophy/cause.htm |
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|archive-date=December 31, 2009 |
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}}</ref> |
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Hahnemann's [[hypotheses]] for miasms originally presented only three local symptoms: psora (the itch), [[syphilis]] (venereal disease) or [[sycosis]] (fig-wart disease).<ref>{{cite EB1911 |wstitle=Homoeopathy |volume=13 |page=645 |first=William Tod |last=Helmuth}}</ref> Of these the most important was ''psora'', described as being related to any itching diseases of the skin and was claimed to be the foundation of many further disease conditions. Hahnemann believed it to be the cause of such diseases as [[epilepsy]], [[cancer]], [[jaundice]], [[deafness]], and [[cataracts]].<ref name="Hahnemann_Chronic"> |
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At first, Hahnemann proved substances known as poisons or as remedies in his time. Hahnemann's finding from provings were first recorded in his ''Materia Medica Pura''. Kent's ''Lectures on Homoeopathic Materia Medica'' (1905) lists 217 remedies. Modern drugs and chemicals are being added continually. As a result, homeopathy uses a variety of animal, plant, mineral, and chemical substances. But on a par with them, there are pathogeneses of non-existent and even magic substances, as [http://homeoint.org/clarke/g/galva.htm|''Galvanismus''] or [http://homeoint.org/clarke/e/elect.htm|''Electricitas''] introduced in XIX century, up to [http://www.hominf.org.uk/posiintr.htm|''Positronium''], [http://www.biolumanetics.net/tantalus/Cases/BerlinWall.htm|''Berlin Wall''], Sai Baba's magic dust ([http://www.homoeopathie-wichmann.de/Provings/vibhuti.htm|''Vibhuti'']), or thunderstorm ([http://uk.geocities.com/veryscarymary/stormremedy1.html|''Tempesta'']) introduced recently. |
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{{cite book |
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|author =Hahnemann S |
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|title =Die chronischen Krankheiten, ihre eigenthümliche Natur und homöopathische Heilung [The chronic diseases, their specific nature and homoeopathic treatment] |
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|url =https://books.google.com/books?id=Xfk3AAAAMAAJ |
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|location =[[Dresden]] and [[Leipzig]] |
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|publisher =Arnoldische Buchhandlung |
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|year =1828 |
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}}{{Page needed|date=March 2011}}</ref> Since Hahnemann's time, other miasms have been proposed, some replacing illnesses previously attributed to the psora, including [[tuberculosis]] and [[cancer]] miasms.<ref name="miasms"> |
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{{cite web |
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|work = Classical homeopathy |
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|title = Miasms in homeopathy |
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|url = http://homepage.ntlworld.com/homeopathy_advice/Theory/Intermediate/miasm.html |
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|author = King S |
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|access-date = March 25, 2009 |
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|archive-url = https://web.archive.org/web/20090307120146/http://homepage.ntlworld.com/homeopathy_advice/Theory/Intermediate/miasm.html |
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|archive-date = March 7, 2009 |
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}}</ref> |
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Hahnemann's miasm theory remains disputed and controversial within homeopathy even in modern times. The theory of miasms has been criticized as an explanation developed to preserve the system of homeopathy in the face of treatment failures, and for being inadequate to cover the many hundreds of sorts of diseases, as well as for failing to explain disease predispositions, as well as [[genetics]], environmental factors, and the unique disease history of each patient.<ref name="Shelton">{{cite book |last=Shelton |first=JW |year=2004 |title=Homeopathy: How it really works |url=https://archive.org/details/homeopathyhowitr0000shel |url-access=registration |location=Amherst, New York |publisher=[[Prometheus Books]] |isbn=978-1-59102-109-4}}</ref>{{rp|148–9|date=November 2012}} |
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Most homeopathic remedies lack solid provings. Among nearly 3000 remedies known today, approximately only 300 are used based upon comprehensive materia medica information. A further 1500-or-so are based on fragmentary knowledge, and the rest are used without empirical knowledge of their homeopathic properties at all. |
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===19th century: rise to popularity and early criticism=== |
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==== The choice of a remedy ==== |
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[[File:Beydeman Gomeopatiya vzir.jpg|thumb|left|''[[Homeopathy Looks at the Horrors of Allopathy]]'', an 1857 painting by Alexander Beydeman, showing historical figures and personifications of homeopathy observing the [[heroic medicine|brutality of medicine]] of the 19th century]]Homeopathy achieved its greatest popularity in the 19th century. It was introduced to the United States in 1825 by Hans Birch Gram, a student of Hahnemann.<ref name="Miller">{{cite book |last=Miller |first=Timothy |author-link=Timothy Miller |title=America's alternative religions |publisher=State University of New York Press, Albany |date=1995 |pages=[https://archive.org/details/americasalternat00mill/page/80 80] |isbn=978-0-7914-2397-4 |url=https://archive.org/details/americasalternat00mill/page/80 }}</ref> The first homeopathic school in the United States opened in 1835 and the [[American Institute of Homeopathy]] was established in 1844. Throughout the 19th century, dozens of homeopathic institutions appeared in Europe and the United States,<ref name="Julian">{{cite web |
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Another silent assumption in the homeopathic theory is an old belief which ''James I'' put as follows: "'''...I doubt not, but for every disease there is in nature a severall symple'''". However, "''there are many diseases which it would be absolutely impossible to reproduce in the human organism by artificial means'' (Hempel C.J., ''Organon of Specific Homeopathy'', p.114 ff.) - so there can be no homeopathic remedies for them. |
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|url = http://www.wholehealthnow.com/homeopathy_pro/homeopathy_1825_1849.html |
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|title = Homeopathy Timeline |
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|access-date = July 23, 2007 |
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|website= Whole Health Now |
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|archive-date = December 15, 2018 |
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|archive-url = https://web.archive.org/web/20181215122834/http://www.wholehealthnow.com/homeopathy_pro/homeopathy_1825_1849.html |
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}}</ref> and by 1900, there were 22 homeopathic colleges and 15,000 practitioners in the United States.<ref name="Time19951125" /> |
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Because medical practice of the time relied on treatments which were often ineffective and harmful, patients of homeopaths often had better outcomes than those being treated by medical practitioners.<ref name="pmid8885813">{{cite journal |last1=Ernst |first1=E. |last2=Kaptchuk |first2=TJ |title=Homeopathy revisited |journal=Archives of Internal Medicine |volume=156 |issue=19 |pages=2162–4 |year=1996 |pmid=8885813 |doi=10.1001/archinte.156.19.2162}}</ref> Though ineffective, homeopathic preparations are rarely detrimental, thus users are less likely to be harmed by the treatment that is supposed to be helping them.<ref name="homhist1" /> The relative success of homeopathy in the 19th century may have led to the abandonment of the ineffective and harmful treatments of [[bloodletting]] and purging and begun the move towards more effective, [[science-based medicine]].<ref name="kaufmanm"> |
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To explain away the preponderable cases where the simility principle did not work, the latter was re-defined, with requirements to simility becoming still wider (thus enabling explanations to the sense that "''the real simillimum''" was not found). There are two principal variants of this extension of the meaning of simillimum. The first one is illustrated by the definition included in the "''Eighteen Theses''". The latters were accepted in 1836 by the ''Central Association of Homoeopathic Physicians of Magdeburg'' as an explanation of the fundamental principle of homoeopathy, in contrast to more dogmatic views of Hahnemann himself, and remained the foundation of most homoeopathic doctors in Germany. On the issue in question, the fourth thesis says: "''The choice of the homoeopathic curative remedy is regulated by the totality of symptoms in the most comprehensive meaning of this term. It not only includes the complaints of the patient, and the result of the medical examinatiom, but all the pathological findings, from the termination of health, to the present condition in their sequel, duration and transitions.''" |
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{{cite book |
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|author =Kaufman M |
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|title =Homeopathy in America: The rise and fall of a medical heresy |
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|publisher =[[The Johns Hopkins University Press]] |
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|year =1971 |
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|isbn =978-0-8018-1238-5 |
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}}{{Page needed|date=March 2011}}</ref> One reason for the growing popularity of homeopathy was its apparent success in treating people suffering from infectious disease epidemics.<ref> |
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{{cite book |
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|author =Coulter HL |
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|year =1973 |
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|title =Divided Legacy |
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|pages =II:544–46; III:267–70, 298–305 |
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|location =Berkeley |
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|publisher =North Atlantic |
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|oclc =9538442 |
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}}</ref> During 19th-century epidemics of diseases such as [[cholera]], death rates in homeopathic hospitals were often lower than in conventional hospitals, where the treatments used at the time were often harmful and did little or nothing to combat the diseases.<ref>Death rates in conventional hospitals were typically two- to eight-fold higher than in homeopathic hospitals for patients with these infectious diseases; see |
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{{cite book |
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|title =The logic of figures or comparative results of homeopathic and other treatments |
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|author =Bradford TL |
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|publisher =Kessinger |
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|year =2007 |
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|orig-date =1900 |
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|isbn =978-1-4304-8892-7 |
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}}{{Page needed|date=March 2011}}</ref> |
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Even during its rise in popularity, homeopathy was criticized by scientists and physicians. [[John Forbes (physician)|Sir John Forbes]], physician to [[Victoria of the United Kingdom|Queen Victoria]], said in 1843 that the extremely small doses of homeopathy were regularly derided as useless and considered it "an outrage to human reason".<ref name="John_Forbes"> |
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The other way to extend the meaning of simillimum is represented by the '''constitutional treatment'''. This principle states that the simillimum should correspond to all characteristic features manifested by an individual, both pathological and constitutional. This stand can be traced back to Hahnemann. As he wrote in §5 of the ''Organon'': "''...the ascertainable physical constitution of the patient (especially when the disease is chronic), his moral and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age, sexual function, etc., are to be taken into consideration.''" |
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{{cite book |
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|author =Forbes J |
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|title =Homeopathy, allopathy and young physic |
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|location =London |
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|year =1846 |
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}}</ref> [[James Young Simpson]] said in 1853 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> |
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{{cite book |
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|author =Simpson JY |
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|title =Homoeopathy, its tenets and tendencies, theoretical, theological and therapeutical |
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|location =Edinburgh |
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|publisher =Sutherland & Knox |
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|year =1853 |
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|page =11 |
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}}</ref> Nineteenth-century American physician and author [[Oliver Wendell Holmes Sr.|Oliver Wendell Holmes]] was also a vocal critic of homeopathy and published an essay entitled ''[[Homœopathy and Its Kindred Delusions]]'' (1842).<ref name="Holmes" /> The members of the French Homeopathic Society observed in 1867 that some leading homeopaths of Europe not only were abandoning the practice of administering infinitesimal doses but were also no longer defending it.<ref> |
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{{cite journal |
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|title =Homœopathists vs homœopathy |
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|editor =Allen JA |
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|journal =Chic Med J |
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|pages =268–69 |
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|year =1867 |
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|volume =24 |
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|issue =6 |
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|pmid =37412875 |
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|pmc =9801777 |
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|url =https://books.google.com/books?id=R08VAAAAYAAJ&q=leading+europe+abandoning&pg=PA268 |
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}}</ref> The last school in the United States exclusively teaching homeopathy closed in 1920.<ref name="homhist1" /> |
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=== Revival in the 20th century === |
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Thus, the claim of clinical evidence is extended still further, and in a way recognised by a preponderable majority of homoeopaths. To wit, characteristic features (pathological or constitutional) of persons treated by remedies with apparent success may be included into remedial pathogenesies. Constitutional prescriptions are at least in part based upon prominent non-pathological features of the individual. These features cannot be based on provings in principle. |
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According to academics {{Interlanguage link|Paul U. Unschuld|lt=|de||WD=}} and [[Edzard Ernst]], the [[Nazi]] regime in Germany was fond of homeopathy, and spent large sums of money on researching its mechanisms, but without gaining a positive result.<ref>{{Cite news|last=Ernst|first=Edzard|title=Standing up for the truth about homeopathy and Nazi medicine|url=https://www.irishtimes.com/culture/books/standing-up-for-the-truth-about-homeopathy-and-nazi-medicine-1.2138835|access-date=2020-10-26|newspaper=The Irish Times|language=en}}</ref> Unschuld also states that homeopathy never subsequently took root in the [[United States]], but remained more deeply established in European thinking.<ref name="Unschuld2009">{{cite book|author=Paul Ulrich Unschuld|title=What Is Medicine?: Western and Eastern Approaches to Healing|url=https://books.google.com/books?id=bPMTlS1pzEUC&pg=PA171|access-date=September 7, 2013|date=August 9, 2009|publisher=University of California Press|isbn=978-0-520-94470-1|page=171}}</ref> In the United States, the ''[[Federal Food, Drug, and Cosmetic Act|Food, Drug, and Cosmetic Act]]'' of 1938 (sponsored by [[Royal S. Copeland|Royal Copeland]], a [[United States Senate|Senator]] from [[New York (state)|New York]] and homeopathic physician) recognized homeopathic preparations as drugs. In the 1950s, there were only 75 solely homeopathic practitioners in the U.S.<ref> |
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{{cite news |
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|title =Homeopathic Hassle |
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|url =http://www.time.com/time/magazine/article/0,9171,891760,00.html |
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|archive-url =https://web.archive.org/web/20081214115339/http://www.time.com/time/magazine/article/0,9171,891760,00.html |
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|archive-date =December 14, 2008 |
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|magazine =[[Time (magazine)|Time]] |
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|date =August 20, 1956 |
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}}</ref> By the mid to late 1970s, homeopathy made a significant comeback and the sales of some homeopathic companies increased tenfold.<ref name="rader"> |
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{{cite news |
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|date =March 1, 1985 |
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|publisher =FDA Consumer Magazine |
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|author =Rader WM |
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|url =http://www.homeowatch.org/history/fdac1.html |
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|title =Riding the coattails of homeopathy's revival |
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}}</ref> |
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Some homeopaths credit the revival to Greek homeopath [[George Vithoulkas]], who conducted a "great deal of research to update the scenarios and refine the theories and practice of homeopathy" in the 1970s,<ref name="pmid12614092">{{Cite journal |volume=138 |issue=5 |pages=393–99 |last=Jonas |first=WB |author2=TJ Kaptchuk |author3=K Linde |title=A critical overview of homeopathy |journal=Annals of Internal Medicine |year=2003 |doi=10.7326/0003-4819-138-5-200303040-00009|pmid=12614092 |s2cid=22787732 }}</ref><ref>{{cite book |first=Andrew |last=Lockie |title=Encyclopedia of Homeopathy |url=https://archive.org/details/encyclopediahome00lock_433 |url-access=limited |publisher=[[Dorling Kindersley]] |year=2000 |location=New York |edition=1st |page=[https://archive.org/details/encyclopediahome00lock_433/page/n20 19] |isbn=978-0-7566-1871-1 }}</ref> but Ernst and [[Simon Singh]] consider it to be linked to the rise of the [[New Age movement]].<ref name="isbn0-393-06661-4" /> [[Bruce Hood (psychologist)|Bruce Hood]] has argued that the increased popularity of homeopathy in recent times may be due to the comparatively long consultations practitioners are willing to give their patients, and to a [[appeal to nature|preference for "natural" products]], which people think are the basis of homeopathic preparations.<ref name="Hood2009">{{cite book|author=Bruce M. Hood|title=SuperSense|url=https://archive.org/details/supersensewhyweb00hood|url-access=registration|access-date=September 7, 2013|date=April 7, 2009|publisher=HarperCollins|isbn=978-0-06-186793-4|page=[https://archive.org/details/supersensewhyweb00hood/page/157 157]}}</ref> |
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The concept of constitutional prescribing was given a particular twist of meaning by '''Kent''', the second most influential homoeopath after Hahnemann. Kent, a devout Swedenborgianist, was of the opinion that it is the sick individual as a whole to be cured, rather than the totality of the characteristic symptoms, or the pathological condition of the diseased organs of the patient. Therefore, he gave highest or first rank to the general characteristic symptoms of the patient as a whole. Kent's understanding was anchored in his religious conceptions. According to his Swedenborgian view, any disease process starts at the level of ''will and understanding''. Since the mind is posited to be the deepest level in the hierarchy of the physical body, treating the symptoms expressed through the ''will and understanding'' will heal that level, and permit it in turn to heal the other levels. To treat "''constitutionally''" was to treat that level. |
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Towards the end of the century opposition to homeopathy began to increase again; with [[William T. Jarvis]], the President of the [[National Council Against Health Fraud]], saying that "Homeopathy is a fraud perpetrated on the public with the government's blessing, thanks to the abuse of political power of Sen. Royal S. Copeland."<ref>{{cite web|author=William T. Jarvis|author-link=William T. Jarvis|title=Response to Isadora Stehlin "Homeopathy: real medicine or empty promises?" (originally published in ''FDA Consumer'' April 1997)|date=December 15, 2001|url=http://www.homeowatch.org/articles/fdac2.html}}</ref> |
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This hierarchization of symptoms opens the door for yet another source of subjectivity in choosing the remedy. Obviously, if the ranking of symptoms is re-evaluated, the remedy chosen may be quite different. |
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===21st century: renewed criticism=== |
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In addition, the remedy picture (its array of symptoms) as found in entries of the Materia Medica is always more comprehensive than the symptomatology that a single individual can ever exhibit. To cope with this obstacle, an assistant tool for finding the simillimum was invented, namely, repertories. A homeopathic repertory is supposed to be an index of the materia medica. However, it is not so. In the overwhelming majority of cases, provings do not provide sufficient number of complete symptoms as prescribed by the homoeopathic theory. The way out was invented by Bönninghausen who first conceived the idea of completing the array of symptoms shuffling them so that modalities of a symptom might be associated with other symptoms. Perhaps, it was not especially embarrassing for Bönnighausen who was a professional lawyer. Thence, repertories are filled with constructed symptoms, without necessarily observing in the proving the very symptom resulting from the combination. |
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Since the beginning of the 21st century, a series of [[Meta-analysis|meta-analyses]] have further shown that the therapeutic claims of homeopathy lack scientific justification.<ref name="champe">{{cite journal |last1=Crockett |first1=Chambers |title=Death by homeopathy: issues for civil, criminal and coronial law and for health service policy |pmid=22558899 |journal=Journal of Law, Medicine & Ethics |volume=19 |issue=3 |pages=454–78 |year=2012 }}</ref> This had led to a decrease or suspension of funding by many governments. In a 2010 report, the [[Science and Technology Select Committee|Science and Technology Committee of the United Kingdom House of Commons]] recommended that homeopathy should no longer receive [[National Health Service]] (NHS) funding due its lack of scientific credibility;<ref name="champe" /> NHS funding for homeopathy ceased in 2017.<ref name="TNHS" /> They also asked the [[Department of Health and Social Care|Department of Health]] in the UK to add homeopathic remedies to the list of forbidden prescription items.<ref name="bbc-blacklist" /> |
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As a result, the simility principle remains ill-defined, or rather undefined. It was never stated clearly which symptoms shown by an individual should be matched by the simillimum, and which should not. In fact, most practitioners oscillate between mutually exclusive definitions in particular cases. The notorious difficulty and unreliability of homoeopathic prescription are manifestation of the dizziness of the concept. |
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In 2015, the [[National Health and Medical Research Council]] of Australia found that "there are no health conditions for which there is reliable evidence that homeopathy is effective".<ref>{{cite web |title=The Australian report |url=https://www.hri-research.org/resources/homeopathy-the-debate/the-australian-report-on-homeopathy/ |website=HRI Research |access-date=13 August 2018|date=April 6, 2017 }}</ref> The federal government only ended up accepting three of the 45 recommendations made by the 2018 review of Pharmacy Remuneration and Regulation.<ref>{{cite news|last1=Abusson|first1=Kate|date=3 May 2018|title=Pharmacies avoid homeopathy ban as government parks recommendations|work=Sydney Morning Herald|url=https://www.smh.com.au/national/pharmacies-avoid-homeopathy-ban-as-government-parks-recommendations-20180503-p4zd94.html|access-date=13 August 2018}}</ref> The same year the US [[Food and Drug Administration]] (FDA) held a hearing requesting public comment on the regulation of homeopathic drugs.<ref name="Science42115">{{cite news|author1=Kelly Servick|date=April 21, 2015|title=FDA takes new look at homeopathy|work=Science|url=https://www.science.org/content/article/fda-takes-new-look-homeopathy|access-date=April 23, 2015|quote=Under FDA guidelines issued in 1988, a company can sell homeopathic products over the counter without demonstrating their safety or efficacy, and―unlike dietary supplements―their packaging can include claims about treating specific conditions, as long as they are "self-limiting" and not chronic. Such conditions include sprains, colds, or allergies.}}</ref> In 2017 the FDA announced it would strengthen regulation of homeopathic products.<ref name="Frazier FDA to Reg">{{cite journal|last1=Frazier|first1=Kendrick|author-link=Kendrick Frazier|date=2018|title=FDA to Regulate Some Homeopathic Products; CFI Hails Move|journal=[[Skeptical Inquirer]]|volume=42|issue=2|page=12}}</ref> |
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There is no clear-cut, precise rule for choosing homeopathic remedies in particular cases. Thence, the law of similars cannot be called a "law". It is, rather, an act of faith that forms the foundation of the homeopathic system, and through the application of which homeopaths arrive at their diagnosis. As Kent put it in his "''Aphorisms and Precepts''", "''The Law of Similars is a Divine Law. So soon as you have accepted the Law of Similars, so soon have you accepted Providence, which is law and order.''" |
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The American non-profit [[Center for Inquiry]] (CFI) filed a lawsuit in 2018 against the [[CVS Pharmacy|CVS]] pharmacy for consumer fraud over its sale of homeopathic medicines.<ref name="CVS">{{cite press release|author=<!--Staff writer(s); no by-line.-->|title=CENTER FOR INQUIRY SUES CVS FOR FRAUD OVER SALE OF HOMEOPATHIC FAKE MEDICINE|url=https://centerforinquiry.org/press_releases/cfi-sues-cvs/|publisher=Center for Inquiry|date=9 July 2018|access-date=9 July 2018}}</ref> It claimed that CVS was selling homeopathic products on an easier-to-obtain basis than standard medication.<ref>{{cite web|last1=Bellamy|first1=Jann|title=CVS sued for deceiving consumers in sale of homeopathic remedies|url=https://sciencebasedmedicine.org/cvs-sued-for-deceiving-consumers-in-sale-of-homeopathic-remedies/|access-date=22 January 2019|website=Science Based Medicine|date=July 19, 2018}}</ref> In 2019, CFI brought a similar lawsuit against [[Walmart]] for "committing wide-scale consumer fraud and endangering the health of its customers through its sale and marketing of homeopathic medicines".<ref>{{cite magazine|last=Fidalgo|first=Paul|date=September 2019|title=CFI sues Walmart for fraud for selling homeopathic fake medicine|magazine=[[Skeptical Inquirer]]|location=Amherst, NY|publisher=Center for Inquiry}}</ref><ref>{{cite web|last1=Vyse|first1=Stuart|author-link=Stuart Vyse|title=What Should Become of a Monument to Pseudoscience?|url=https://skepticalinquirer.org/exclusive/what-should-become-of-a-monument-to-pseudoscience/|access-date=2 December 2019|website=Skeptical Inquirer|date=July 10, 2019|publisher=Center for Inquiry}}</ref> They also conducted a survey in which they found consumers felt ripped off when informed of the lack of evidence for the efficacy of homeopathic remedies, such as those sold by Walmart and CVS.<ref name="CFISurvey SI 2019">{{cite journal|last1=Frazier|first1=Kendrick|authorlink= Kendrick Frazier|date=2019|title=CFI survey on Homeopathy: Consumers feel scammed by Walmart and CVS|journal=Skeptical Inquirer|volume=43|issue=6|page=7}}</ref><ref name="CFI 2019 Survey">{{cite web|last1=Fidalgo|first1=Paul|title=CONSUMERS FEEL "SCAMMED" BY WALMART AND CVS OVER HOMEOPATHIC FAKE MEDICINE, SURVEY SHOWS|url=https://centerforinquiry.org/press_releases/consumers-feel-scammed-by-walmart-and-cvs-over-homeopathic-fake-medicine/|access-date=9 November 2019|website=Center for Inquiry|date=September 17, 2019}}</ref> |
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As so far the law of similars was neither proved nor disproved scientifically, its claimed justification is derived from anecdotal clinical cases of spectacular effectiveness. Such justification is not much convincing in view of such examples as effectiveness of [http://www.medicinegarden.com/Homeopathy/remedies1.html|''paper remedies'']. The latters are used by some homeopaths so that the name of a remedy is written upon a piece of paper, and this piece of paper is then used like the remedy itself (a kind of sympathetic magic). The link above recites the many positive results obtained after wearing for two weeks a paper inscribed ''"LOSE EXCESS WEIGHT 2 LBS. A WEEK 30C"''. |
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In 2021, the French healthcare minister phased out social security reimbursements for homeopathic drugs.<ref name="GuardianFrance" /><ref name="FranceEndFunding2021" /> France has long had a stronger belief in the virtues of homeopathic drugs than many other countries and the world's biggest manufacturer of alternative medicine drugs, [[Boiron]], is located in that country.<ref>{{cite news |url=https://www.reuters.com/article/us-france-health-homeopathy/france-will-end-healthcare-refunds-for-homeopathic-drugs-idUSKCN1U42B6 |title=France will end healthcare refunds for homeopathic drugs |website=[[Reuters]] |date=July 9, 2019}}</ref> Spain has also announced moves to ban homeopathy and other pseudotherapies.<ref name="El Pais 2019-07-30" /> In 2016, the [[University of Barcelona]] cancelled its master's degree in Homeopathy citing "lack of scientific basis", after advice from the Spanish Ministry of Health.<ref>{{cite news|last1=Ansede|first1=Manuel|date=March 4, 2016|title=La Universidad de Barcelona fulmina su máster de homeopatía|newspaper=El País|url=http://elpais.com/elpais/2016/03/01/ciencia/1456856774_534268.html}}</ref> Shortly afterwards the [[University of Valencia]] announced the elimination of its Masters in Homeopathy.<ref>{{cite web|date=April 7, 2016|title=El Máster de Homeopatía de la Universidad de Valencia cancela su edición para el próximo curso.|url=http://www.abc.es/sociedad/abci-master-homeopatia-universidad-valencia-cancela-edicion-para-proximo-curso-201604072200_noticia.html|publisher=Diario ABC}}</ref> |
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Just as well, homeopaths' faith into apparent clinical results is compromised by cases confirming the efficacy of distant homeopathy. The latter, also a kind of sympathetic magic, uses things that once were in touch with the patient to transmit the action of a remedy over distances of thousands of miles (for instance, the remedy is applied to patients' uprooted hair whereas the patient himself is in another city). In a book on distant homeopathy (''Sahni B.: Transmission of Homeo Drug-Energy from a Distance, 1993, New Delhi, B.Jain Publishers''), the miraculous cures, some of them of cancer, are recited on about hundred pages (ibid., pp. 107-200). |
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==Preparations and treatment== |
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=== The theory of infinitesimals === |
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{{see also|List of homeopathic preparations}}[[File:Rep1.JPG|thumb|Homeopathic repertory by [[James Tyler Kent]]]] |
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In the eye of a layman, the most characteristic and controversial tenet of homeopathy is that the potency of a remedy can be enhanced (and side effects diminished) by attenuation through a particular procedure known as '''dynamization''' or '''potentization'''. In fact, it is not so. Homoeopathy can be practiced (and is practiced) with mother tinctures. The origin of the attenuation procedure is rooted in the phenomenon of ''homoeopathic aggravation''. |
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Homeopathic preparations are referred to as "homeopathic remedies".<ref name="Consumer Reports">{{cite news |date=December 21, 2015 |title=Homeopathic drugs: No better than placebos? |newspaper=[[The Washington Post]] |url=https://www.washingtonpost.com/national/health-science/homeopathic-drugs-no-better-than-placebos/2015/12/18/037b3976-7750-11e5-a958-d889faf561dc_story.html |access-date=December 22, 2015 }}</ref> Practitioners rely on two types of reference when prescribing: ''[[Materia medica]]'' and repertories. A homeopathic ''materia medica'' is a collection of "drug pictures", organized alphabetically. A homeopathic repertory is a quick reference version of the ''materia medica'' that indexes the symptoms and then the associated remedies for each. In both cases different compilers may dispute particular inclusions in the references.<ref>Jonas: Mosby's Dictionary of Complementary and Alternative Medicine. (c) 2005, Elsevier</ref> The first symptomatic homeopathic ''materia medica'' was arranged by Hahnemann. The first homeopathic repertory was Georg Jahr's ''Symptomenkodex'', published in German in 1835, and translated into English as the ''Repertory to the more Characteristic Symptoms of Materia Medica'' in 1838. This version was less focused on disease categories and was the forerunner to later works by [[James Tyler Kent]].<ref name="pmid16322800">{{cite journal|last1=Bellavite|first1=Paolo|last2=Conforti|first2=Anita|last3=Piasere|first3=Valeria|last4=Ortolani|first4=Riccardo|year=2005|title=Immunology and Homeopathy. 1. Historical Background|journal=Evidence-Based Complementary and Alternative Medicine|volume=2|issue=4|pages=441–52|doi=10.1093/ecam/neh141|pmc=1297514|pmid=16322800}}</ref><ref> |
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==== Homeopathic aggravation ==== |
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{{cite book|author=Mathur KN|title=Prinzipien der homöopathischen Verschreibung: Synopsis weltweiter klinischer Erfahrungen|publisher=Georg Thieme Verlag|year=2003|isbn=978-3-8304-9021-0|pages=122–23|language=de|oclc=76518035}}</ref> There are over 118 repertories published in English, with Kent's being one of the most used.<ref>{{Cite web|title=Repertories today and yesterday|url=http://www.homeopathycenter.org/homeopathy-today/repertories-today-and-yesterday|archive-url=https://web.archive.org/web/20170414063600/http://www.homeopathycenter.org/homeopathy-today/repertories-today-and-yesterday|archive-date=April 14, 2017|access-date=2020-08-31|website=National Center for Homeopathy}}</ref> |
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Expectedly, patient's symptoms may become worse in response to homeopathic treatment. This is termed ''homeopathic aggravation''. Hahnemann met with severe aggravations as early as in 1797 (''Eine plötzlich geheilte Kolikodynie''; in "Archiv für die homöopathische Heilkunst" 1829, 199-203; included in ''The Lesser Writings'', p.303-307.). To avoid them, he began lessening the dose of homoeopathic remedies through particular techniques known as attenuations. |
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=== Consultation === |
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By some reason, from the very start (by 1801) Hahnemann jumped from conventional doses to attenuations higher than 1:1,000,000. One could expect that, after some steps of attenuation, there should be a limit below which no medicinal influence of substances could be traced. And at any rate, one could expect that sufficiently diluted remedies would cause no further aggravations. But, since Hahnemann ascribed any change in the condition of the patient under treatment to the action of the intaken homoeopathic remedy, each time he met an adverse reaction he ascribed it to an exceeding dose. Thence, however mild acting, or however ineffective a remedy could be, there always should have been some cases of aggravation ascribed to remedial action. |
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Homeopaths generally begin with a consultation, which can be a 10–15 minute appointment or last for over an hour, where the patient describes their [[medical history]]. The patient describes the "modalities", or if their symptoms change depending on the weather and other external factors.<ref name="Vickers 1115–11182">{{Cite journal|last1=Vickers|first1=Andrew|last2=Zollman|first2=Catherine|date=1999-10-23|title=Homoeopathy|journal=BMJ: British Medical Journal|volume=319|issue=7217|pages=1115–1118|doi=10.1136/bmj.319.7217.1115|issn=0959-8138|pmc=1116906|pmid=10531108}}</ref> The practitioner also solicits information on mood, likes and dislikes, physical, mental and emotional states, life circumstances, and any physical or emotional illnesses.<ref name="Stehlin"> |
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{{cite web|author=Stehlin I|year=1996|title=Homeopathy: Real medicine or empty promises?|url=http://findarticles.com/p/articles/mi_m1370/is_n10_v30/ai_18979004/|archive-url=https://web.archive.org/web/20090924121418/http://findarticles.com/p/articles/mi_m1370/is_n10_v30/ai_18979004/|archive-date=September 24, 2009|access-date=October 1, 2007|publisher=U.S. [[Food and Drug Administration]]}}</ref> This information (also called the "symptom picture") is matched to the "drug picture" in the ''materia medica'' or repertory and used to determine the appropriate homeopathic remedies. In classical homeopathy, the practitioner attempts to match a single preparation to the totality of symptoms (the ''simlilum''), while "clinical homeopathy" involves combinations of preparations based on the illness's symptoms.<ref name="pmid12614092" /> |
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=== Preparation === |
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==== The techniques of attenuation ==== |
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[[File:Ambalaj Oscillococcinum.jpg|thumb|left|upright|''[[Oscillococcinum]]'', a homeopathic remedy in pill form]]Homeopathy uses animal, plant, mineral, and synthetic substances in its preparations, generally referring to them using [[Latin]] names.<ref name="WHO Safety">{{Cite web|title=Safety issues in the preparation of homeopathic medicines|url=https://www.who.int/medicines/areas/traditional/Homeopathy.pdf|website=World Health Organization}}</ref> Examples include ''[[arsenicum album]]'' (arsenic oxide), ''natrum muriaticum'' ([[sodium chloride]] or table salt), ''[[Lachesis muta]]'' (the venom of the [[Lachesis (genus)|bushmaster snake]]), ''[[opium]]'', and ''thyroidinum'' ([[thyroid hormone]]). Homeopaths say this is to ensure accuracy.<ref>{{Cite web|title=FAQs|url=https://www.theaahp.org/consumer-information/faqs/|access-date=2020-08-31|website=The American Association of Homeopathic Pharmacists|language=en}}</ref> In the USA the common name must be displayed, although the Latin one can also be present.<ref name="WHO Safety" /> Homeopathic pills are made from an inert substance (often sugars, typically lactose), upon which a drop of liquid homeopathic preparation is placed and allowed to evaporate.<ref name="Ernst2005">{{cite journal|last1=Ernst|first1=E|year=2005|title=Is homeopathy a clinically valuable approach?|url=http://www.dcscience.net/ernst-tips-sept-2005.pdf|journal=Trends in Pharmacological Sciences|volume=26|issue=11|pages=547–48|citeseerx=10.1.1.385.5505|doi=10.1016/j.tips.2005.09.003|pmid=16165225}}</ref><ref>{{cite journal|last1=Sagar|first1=SM|year=2007|title=Homeopathy: Does a teaspoon of honey help the medicine go down?|journal=Current Oncology|volume=14|issue=4|pages=126–27|doi=10.3747/co.2007.150|pmc=1948865|pmid=17710203}}</ref> |
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Attenuations are stepwise procedures, the concentration of the remedy being lessened at each step according to some ratio called the scale of attenuation (or potentization). For the centesimal scale (1:100), liquids are successively diluted (with water or occasionally alcohol) and shaken by 10 hard strikes against an elastic body, a process called '''succussion'''. Insoluble solids are diluted by grinding them with ''lactose'', which process is known as ''trituration''. There are also the decimal scale (1:10), and the fifty-millesimal or LM-scale (1:50,000). |
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Isopathy is a therapy derived from homeopathy in which the preparations come from diseased or pathological products such as fecal, urinary and respiratory discharges, blood, and tissue.<ref name="pmid16322800" /> They are called nosodes (from the Greek ''nosos'', disease) with preparations made from "healthy" specimens being termed "sarcodes". Many so-called "homeopathic vaccines" are a form of isopathy.<ref>{{cite book|author=Kayne SB|url=https://books.google.com/books?id=w2IFcHJYTSYC|title=Homeopathic pharmacy: theory and practice|publisher=Elsevier Health Sciences|year=2006|isbn=978-0-443-10160-1|edition=2|page=171}}</ref> Tautopathy is a form of isopathy where the preparations are composed of drugs or [[vaccine]]s that a person has consumed in the past, in the belief that this can reverse the supposed lingering damage caused by the initial use.<ref>{{Cite book|last=Owen|first=David|url=https://books.google.com/books?id=UZ72uQy385wC&q=Tautopathy&pg=PA56|title=Principles and Practice of Homeopathy: The Therapeutic and Healing Process|date=2007-01-01|publisher=Elsevier Health Sciences|isbn=978-0-443-10089-5|page=56|language=en}}</ref> There is no convincing scientific evidence for isopathy as an effective method of treatment.<ref>{{Cite book|last1=Lack|first1=Caleb W.|url=https://books.google.com/books?id=Miy2CwAAQBAJ&q=isopathy+pseudoscience&pg=PA206|title=Critical Thinking, Science, and Pseudoscience: Why We Can't Trust Our Brains|last2=Rousseau|first2=Jacques|date=2016-03-08|publisher=Springer Publishing Company|isbn=978-0-8261-9426-8|page=206|language=en}}</ref> |
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Sometimes, homeopaths use much more intriguing techniques of preparing potentized remedies. In 1832, ''Korsakov'' described the method known now as '''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 acquire the property to exert the influence of the initial remedy upon organism, "''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''". |
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Some modern homeopaths use preparations they call "imponderables" because they do not originate from a substance but some other phenomenon presumed to have been "captured" by alcohol or [[lactose]].<!--See next two sources, and the rest of the journal issue they came from for more information--> Examples include [[X-ray]]s<ref> |
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Hahnemann's explanation for increased strength of higher potencies was of mechanical nature. Apparently, it was suggested to him by his musings on the nature of friction. His argumentation proceeded along the following line: since cold steel contains a hidden store of caloric which can only be released by friction, thence friction should release '''any''' hidden power of substances, including the so-called curative power - '''understood substantially!''' - in case of medicinal substances. 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''". |
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{{cite journal |
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|vauthors=Lee J, Thompson E |title =X-ray drug picture |
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|journal =The Homeopath |
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|volume =26 |
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|issue =2 |
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|pages =43–48 |
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|year =2007 |
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|issn =0263-3256 |
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}}</ref> and [[sunlight]].<ref> |
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{{cite journal |
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|vauthors=Lee J, Thompson E |title =Postironium – the vastness of the universe knocks me off my feet |
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|journal =The Homeopath |
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|volume =26 |
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|issue =2 |
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|pages =49–54 |
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|year =2007 |
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|issn =0263-3256 |
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}}</ref> Another derivative is [[electrohomeopathy]], where an electric bio-energy of therapeutic value is supposedly extracted from plants. Popular in the late nineteenth century, electrohomeopathy is extremely pseudo-scientific.<ref>{{cite journal|last1=Kempf|first1=EJ|year=1906|title=European Medicine: A Résumé of Medical Progress During the Eighteenth and Nineteenth Centuries|journal=Medical Library and Historical Journal|volume=4|issue=1|pages=86–100|pmc=1692573|pmid=18340908}}</ref> In 2012, the Allahabad High Court in Uttar Pradesh, India, handed down a decree stating that electrohomeopathy was quackery and no longer recognized it as a system of medicine.<ref name="toie">{{cite news|date=5 March 2012|title=Electro-homeopathy clinics to be sealed after Holi|work=[[The Times of India]]|url=https://timesofindia.indiatimes.com/city/kanpur/Holi-Electro-homeopathy-clinics-to-be-sealed-after-the-festival/articleshow/12140070.cms|access-date=13 August 2018}}</ref> |
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Other minority practices include paper preparations, in which the terms for substances and dilutions are written on pieces of paper and either pinned to the patients' clothing, put in their pockets, or placed under glasses of water that are then given to the patients. [[Radionics]], the use of [[electromagnetic radiation]] such as [[radio wave]]s, can also be used to manufacture preparations. Such practices have been strongly criticized by classical homeopaths as unfounded, speculative, and verging upon magic and superstition.<ref> |
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The conception of succussions as the source of medicinal strength of potentized remedies was fully implemented in practice. Thus, if previously the number of succussions used at each step of dynamisation was 10, by the year 1833 Hahnemann cut them to 2, ''out of fear of too strong aggravations''. He warned homoeopaths against unintentional raise of potency through casual shaking: "''There are, however, homoeopathists who carry about with them on their visits to patients homoeopathic medicines in the fluid state, and who yet assert that they do not become more highly potentized in the course of time, but they thereby show their want of ability to observe correctly.''" By this reason, he recommended carrying remedies in the form of dry pellets - he considered that in this form the remedy cannot be further potentized. Accordingly, it is believed by many modern practitioners that the succussion just before administration activates the remedy, and makes it more powerful. |
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{{cite web |
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|url =http://www.askdrshah.com/images/lancet.pdf |
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|title=Call for introspection and awakening |
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|publisher =Life Force Center |
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|access-date =July 24, 2007 |
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|author =Shah R |
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|archive-url =https://web.archive.org/web/20070202082349/http://www.askdrshah.com/images/lancet.pdf |archive-date=February 2, 2007}}</ref><ref name="Barwell"> |
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{{cite journal |
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|url = http://www.homeopathy.ac.nz/editorials/2000/vol-20-no-3-june-2000-the-wo-wo-effect/ |
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|title = The wo-wo effect |
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|access-date = April 2, 2009 |
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|author = Barwell B |
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|journal = Homoeopathica |
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|volume = 20 |
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|issue = 3 |
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|year = 2000 |
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|archive-url = https://web.archive.org/web/20090726180731/http://www.homeopathy.ac.nz/editorials/2000/vol-20-no-3-june-2000-the-wo-wo-effect/ |
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|archive-date = July 26, 2009 |
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|df = mdy-all |
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}}</ref> Flower preparations are produced by placing flowers in water and exposing them to sunlight. The most famous of these are the [[Bach flower remedies]], which were developed by [[Edward Bach]].<ref>{{cite journal|last1=Vanhaselen|first1=R|year=1999|title=The relationship between homeopathy and the Dr Bach system of flower remedies: A critical appraisal|journal=British Homoeopathic Journal|volume=88|issue=3|pages=121–27|doi=10.1054/homp.1999.0308|pmid=10449052}}</ref> |
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=== Dilutions === |
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Drawn to its logical conclusion, the idea that succussion as such is sufficient to upgrade the potency of a remedy means that the potency of a liquid remedy can be counted merely by the number of succussions it was subjected to, without addition of new menstruum. This way the process of potentization was as if short-circuited, creating what is named '''succussion potencies'''. So with ''Jenichen's potencies'' - the first high potencies chronologically. Apparently, Jenichen counted some varying number (10, 12, or 30) of vigorous shakes as one potency. (His potencies also differed from the Hahnemannian ones in some other technical features). |
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{{Main|Homeopathic dilutions}} |
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[[File:Arnica montana homéopathie zoom.jpg|thumb|This bottle is labelled ''[[Arnica montana]]'' (wolf's bane) D6, i.e. the nominal dilution is one [[parts per million|part in a million]] (10<sup>'''-6'''</sup>).]]Hahnemann claimed that undiluted doses caused reactions, sometimes dangerous ones, and thus that preparations be given at the lowest possible dose.<ref name="Kayne 53"> |
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Until he introduced the LM-scale, Hahnemann advocated the use of 30C dilutions for most purposes, i.e. dilution by a factor of 100<sup>-30</sup> = 10<sup>-60</sup>. Since Avogadro's number is 6.022 × 10<sup>-23</sup> particles/mole, the chance that even one molecule of the original would be present in a 30C solution is vanishingly small. Still the homoeopathic theory did not bother much about considerations of physical presence of matter, which is well illustrated by the '''olfaction''' technique (used uptoday). It is a method of dispensing ''potentized'' homoeopathic remedies, introduced by Hahnemann. As he wrote to Bönninghausen in a letter of 28.04.1833: "''the homoeopathic physician ... could dispense his own remedies by simply applying the small bottle every fortnight to both nostrils of his chronic patient who comes to visit him, or at the bedside of the acute patient, without even allowing him to swallow the smallest amount of material medicine''. His conception of its mechanism of action can be seen from his wordings in the §288 of the 5<sup>th</sup> Edition of the ''Organon'' where he says that "''it is especially in the form of vapour, by olfaction and inhalation of the '''medicinal aura''' ''<emphasis added>'' that is always emanating from a globule impregnated with a medicinal fluid in a high development of power,... that the homoeopathic remedies act most surely and most powerfully''." |
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{{cite book|author=Kayne SB|url=https://books.google.com/books?id=w2IFcHJYTSYC&q=homeopathic%20proving%20method&pg=PA53|title=Homeopathic pharmacy: theory and practice|publisher=Elsevier Health Sciences|year=2006|isbn=978-0-443-10160-1|edition=2|page=53}}</ref> A solution that is more dilute is described as having a higher "potency", and thus are claimed to be stronger and deeper-acting.<ref> |
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{{cite web|title=Glossary of Homeopathic Terms|url=http://altmed.creighton.edu/Homeopathy/Glossary.htm|archive-url=https://web.archive.org/web/20121016234338/http://altmed.creighton.edu/Homeopathy/glossary.htm|archive-date=October 16, 2012|access-date=February 15, 2009|publisher=Creighton University Department of Pharmacology|df=mdy-all}}</ref> The general method of dilution is [[serial dilution]], where solvent is added to part of the previous mixture, but the "Korsakovian" method may also be used. In the Korsakovian method, the vessel in which the preparations are manufactured is emptied, refilled with solvent, with the volume of fluid adhering to the walls of the vessel deemed sufficient for the new batch.<ref name="Shelton" />{{rp|270|date=January 2015}} The Korsakovian method is sometimes referred to as K on the label of a homeopathic preparation.<ref>{{cite web|date=January 22, 2011|title=Homeopathy: Diluted out of existence?|url=http://www.scilogs.com/in_scientio_veritas/homeopathy-diluted-out-of-existence/|access-date=June 15, 2015|publisher=scilogs.com/in_scientio_veritas}}</ref><ref>{{cite web|title=Homeopathic Medicine Potency or Dilution|url=http://www.ritecare.com/homeopathic/guide_potency.asp|archive-url=https://web.archive.org/web/20150821064849/http://www.ritecare.com/homeopathic/guide_potency.asp|archive-date=August 21, 2015|access-date=June 15, 2015|publisher=ritecare.com}}</ref> Another method is Fluxion, which dilutes the substance by continuously passing water through the vial.<ref>{{Cite journal|last=Winston|first=Julian|date=1989-04-01|title=A brief history of potentizing machines|url=http://www.sciencedirect.com/science/article/pii/S000707858980050X|journal=British Homoeopathic Journal|language=en|volume=78|issue=2|pages=59–68|doi=10.1016/S0007-0785(89)80050-X|s2cid=71942187 |issn=0007-0785}}</ref> Insoluble solids, such as [[granite]], [[diamond]], and [[platinum]], are diluted by grinding them with lactose ("[[trituration]]").<ref name="Shelton" />{{rp|23}} |
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Three main [[Logarithmic scale|logarithmic]] dilution scales are in regular use in homeopathy. Hahnemann created the "centesimal" or "C scale", diluting a substance by a factor of 100 at each stage. There is also a decimal dilution scale (notated as "X" or "D") in which the preparation is diluted by a factor of 10 at each stage.<ref>{{cite web|url=http://www.ritecare.com/homeopathic/guide_potency.asp|title=Homeopathic Medicine Potency or Dilution|archive-url=https://web.archive.org/web/20150821064849/http://www.ritecare.com/homeopathic/guide_potency.asp|archive-date=August 21, 2015|access-date=June 15, 2015}}</ref> The centesimal scale was favoured by Hahnemann for most of his life, although in his last ten years Hahnemann developed a quintamillesimal (Q) scale which diluted the drug 1 part in 50,000.<ref>{{Cite journal|last1=Adler|first1=U. C.|last2=Adler|first2=M. S.|date=2006|title=Hahnemann's experiments with 50 millesimal potencies: a further review of his casebooks|journal=Homeopathy|volume=95|issue=3|pages=171–181|doi=10.1016/j.homp.2006.03.003|issn=1475-4916|pmid=16815521|s2cid=3760829 }}</ref> A 2C dilution works out to one part of the original substance in 10,000 parts of the solution. In standard chemistry, this produces a substance with a concentration of 0.01% ([[Concentration#Volume-volume percentage|volume-volume percentage]]). A 6C dilution ends up with the original substance diluted by a factor of 100<sup>−6</sup> (one part in one trillion). The end product is usually so diluted as to be indistinguishable from the diluent (pure water, sugar or alcohol).<ref name="Dynamization and Dilution" /><ref name="homsim"> |
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However, the use of infinitesimals should not be equalled with homeopathy. Critical view of ultra-molecular potencies was common among homeopaths in XIX century. In 1879, the American Institute of Homoeopathy even undertook the research known as the '''Milwaukee Test'''. Provers were given 10 vials, one containg a homeopathic remedy in 30C, and 9 containing placebo. At the end, only one person selected the remedy, while the other 8 selected the placebo. The AIH's conclusion was that the 30<sup>th</sup> potency is nothing other than placebo. |
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{{cite web |
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|title = Similia similibus curentur (Like cures like) |
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|publisher = Creighton University Department of Pharmacology |
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|url = http://altmed.creighton.edu/Homeopathy/philosophy/similia.htm |
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|access-date = August 20, 2007 |
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|archive-url = https://web.archive.org/web/20070808051756/http://altmed.creighton.edu/Homeopathy/philosophy/similia.htm |
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|archive-date = August 8, 2007 |
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|df = mdy-all |
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}}</ref> The greatest dilution reasonably likely to contain at least one molecule of the original substance is approximately 12C.<ref>{{cite web|last1=Page 3|title=Alternative Medicine: Homeopathy-A Review|url=http://www.ijopjournal.com/File_Folder/57-69.pdf|archive-url=https://web.archive.org/web/20150903231608/http://www.ijopjournal.com/File_Folder/57-69.pdf|archive-date=September 3, 2015|access-date=August 10, 2015|publisher=International Journal of Pharmacotherapy|df=mdy-all}}</ref> |
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Hahnemann advocated dilutions of 1 part to 10<sup>60</sup> or 30C.<ref name="Organon_6th_128"> |
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The use of high potencies prevailed mostly because of the influence the Swedenborgian lineage of homeopaths exerted upon American homeopathy. They advocated the use of ultra-high attenuations, such as 1M (1,000C), 10M (10,000C), and even CM (100,000C). Their manufacture could not be achieved by the traditional methods, and American homeopaths started inventing machines to automate the process of potentization. A new principle of potentization was introduced by Fincke, namely the '''fluxion process''' that consisted in constant flow of water through a vessel which originally contained some initial attenuation. |
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{{cite book |
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|author =Hahnemann S |
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|title =The Organon of the Healing Art |
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|year =1921 |
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|publisher =Keats Pub. |
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|edition =6th |
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|at =aphorism 128 |
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|isbn =978-0-87983-228-5 |
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}}</ref> Hahnemann regularly used dilutions of up to 30C but opined that "there must be a limit to the matter".<ref name="Haehl1922" />{{rp|322|date=January 2015}} To counter the reduced potency at high dilutions he formed the view that vigorous shaking by striking on an elastic surface – a process termed ''succussion'' – was necessary.<ref name="Kayne 53" /> Homeopaths are unable to agree on the number and force of strikes needed, and there is no way that the claimed results of succussion can be tested.<ref name="Shelton" />{{rp|67–69|date=January 2015}} |
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Critics of homeopathy commonly emphasize the dilutions involved in homeopathy, using analogies.<ref name="Appendix2">For further discussion of homeopathic dilutions and the mathematics involved, see [[Homeopathic dilutions]].</ref> One mathematically correct example is that a 12C solution is equivalent to "a pinch of salt in both the North and South Atlantic Oceans".<ref name="Bambridge"> |
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No abstract figures, be they CM or MM, will impress greater than a vivid presentment of the process itself. Fincke's potencies were made as follows. Tap water streamed through a tube into a dram vial containing an initial potency (3C, 30C, or some other) which had to be raised. The liquid in the vial was displaced by the running water and ultimately went down the drain. The potency was considered to be raised by one degree whenever one dram of water ran through the latter. To obtain one dram of CM, more than 400 litres of water should flow through the thimble-sized vial; to obtain one dram of MM - more than 4,000 litres. |
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{{cite book|author=Bambridge AD|title=Homeopathy investigated|publisher=Diasozo Trust|year=1989|isbn=978-0-948171-20-8|location=[[Kent, England|Kent]], England}}</ref><ref name="Andrews"> |
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{{cite web|author=Andrews P|year=1990|title=Homeopathy and Hinduism|url=http://www.watchman.org/na/homeopth.htm|publisher=[[Watchman Fellowship]]|periodical=The Watchman Expositor|volume=7|issue=3}}</ref><ref> |
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A 12C solution produced using [[sodium chloride]] (also called ''natrum muriaticum'' in homeopathy) is the equivalent of dissolving 0.36 mL of table salt, weighing about 0.77 g, into a volume of water the size of the Atlantic Ocean, since the volume of the Atlantic Ocean and its adjacent seas is 3.55×10<sup>8</sup> km<sup>3</sup> or 3.55×10<sup>20</sup> L : |
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{{cite book|url=https://books.google.com/books?id=6J0TAAAAYAAJ&q=355+x+106+km3+in+the+whole|title=The geology of the Atlantic Ocean|vauthors=Emery KO, Uchupi E|publisher=Springer|year=1984|isbn=978-0-387-96032-6}}</ref> One-third of a [[Drop (volume)|drop]] of some original substance diluted into all the water on Earth would produce a preparation with a concentration of about 13C.<ref name="Appendix2" /><ref>The volume of all water on earth is about 1.36×10<sup>9</sup> km<sup>3</sup>: |
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{{cite web |
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|url = http://ga.water.usgs.gov/edu/waterdistribution.html |
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|title = Earth's water distribution |
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|website= [[United States Geological Survey]] |
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|date = August 28, 2006 |
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|access-date = March 14, 2008 |
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|archive-date = June 29, 2012 |
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|archive-url = https://web.archive.org/web/20120629055146/http://ga.water.usgs.gov/edu/waterdistribution.html |
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}}</ref><ref>Gleick PH, ''Water resources'', In |
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{{cite book |
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|title =Encyclopedia of climate and weather |
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|editor1 =Schneider SH |
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|publisher =[[Oxford University Press]] |
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|location =New York |
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|volume =2 |
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|year =1996 |
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|pages =817–823 |
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}}</ref> [[Robert L. Park]] points out that a 200C dilution of duck liver, marketed under the name [[Oscillococcinum]], would require 10<sup>320</sup> universes worth of molecules to contain just one original molecule in the final substance.<ref>{{cite book |
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|title =Superstition: Belief in the Age of Science |
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|url =https://archive.org/details/superstitionbeli00park |
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|url-access =limited |
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|author =Robert L. Park |
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|author-link =Robert L. Park |
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|publisher =Princeton University Press |
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|year =2008 |
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|pages =[https://archive.org/details/superstitionbeli00park/page/n157 145]–46 |
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|isbn=978-0-691-13355-3}}</ref> The high dilutions characteristically used are often considered to be the most controversial and implausible aspect of homeopathy.<ref>{{cite journal |last1=Fisher |first1=P |title=The Memory of Water: a scientific heresy? |journal=Homeopathy |volume=96 |issue=3 |pages=141–2 |year=2007 |pmid=17678808 |doi=10.1016/j.homp.2007.05.008|s2cid=3737723 }}</ref> |
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===Provings=== |
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=== The homoeopathic theory of disease === |
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Homeopaths claim that they can determine the properties of their preparations by following a method which they call "proving".<ref>{{cite journal |last1=Dantas |first1=F |last2=Fisher |first2=P |last3=Walach |first3=H |last4=Wieland |first4=F |last5=Rastogi |first5=D |last6=Teixeira |first6=H |last7=Koster |first7=D |last8=Jansen |first8=J |last9=Eizayaga |first9=J |title=A systematic review of the quality of homeopathic pathogenetic trials published from 1945 to 1995 |journal=Homeopathy |volume=96 |issue=1 |pages=4–16 |year=2007 |pmid=17227742 |doi=10.1016/j.homp.2006.11.005|s2cid=3689226 }}</ref> As performed by Hahnemann, provings involved administering various preparations to healthy volunteers. The volunteers were then observed, often for months at a time. They were made to keep extensive journals detailing all of their symptoms at specific times throughout the day. They were forbidden from consuming coffee, tea, spices, or wine for the duration of the experiment; playing chess was also prohibited because Hahnemann considered it to be "too exciting", though they were allowed to drink beer and encouraged to exercise in moderation.<ref>{{cite book|last1=Bradford|first1=Thomas Lindsley|title=The Life and Letters of Dr. Samuel Hahnemann|date=1895|publisher=Boericke & Tafel|location=Philadelphia|isbn=978-1-330-00150-9|pages=[https://archive.org/details/lifelettersofdrs00brad/page/103 103]–04|url=https://archive.org/details/lifelettersofdrs00brad|access-date=August 27, 2015}}</ref> At first Hahnemann used undiluted doses for provings, but he later advocated provings with preparations at a 30C dilution,<ref name="Organon_6th_128" /> and most modern provings are carried out using ultra-dilute preparations.<ref> |
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Homoeopaths' approach to treating diseases, and their evaluation of the results are guided by some distinctive theoretical principles. |
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{{cite book|url=https://books.google.com/books?id=w2IFcHJYTSYC&q=homeopathic+proving+method&pg=PA52|title=Homeopathic pharmacy: theory and practice|author=Kayne SB|publisher=Elsevier Health Sciences|year=2006|isbn=978-0-443-10160-1|edition=2|page=52}}</ref> |
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Provings are claimed to have been important in the development of the [[clinical trial]], due to their early use of simple control groups, systematic and quantitative procedures, and some of the first application of [[statistics]] in medicine.<ref> |
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==== Suppression ==== |
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{{cite book |
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A prominent role in the homeopathic theory of disease belongs to the notion of suppression. Its initial meaning consisted in the belief that there are diseases whose external (in particular, skin) manifestations prevent development of inner symptoms of the same disease. This notion originated from erroneous intepretation of some clinical facts, which is well illustrated by Hahnemann's reasoning about the development of symptoms of syphilis{{fn|21}}. As known today (but not in Hahnemann's time), the untreated first stage of syphilis, the chancre, disappears spontaneously after a certain period, and just as regularly, the secondary stage manifests itself in due time. Some physicians tried stopping the disease by destroying the chancre, obviously in vain, without any influence upon further course of the disease. But Hahnemann beheld a non-existent causal relation between those events. Thus he wrote that syphilis ''"...can only proceed from the uncured indwelling venereal disease, whose external substitute and suppresser (the chancre, which, as long as it exists undisturbed, prevents the outbreak of the syphilis) has been destroyed locally by the physician, and can consequently no longer hinder its outbreak"''. |
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|author=Cassedy JH |
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|title=American Medicine and Statistical Thinking, 1800–1860 |
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|publisher=iUniverse |
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|year=1999 |
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|isbn=978-1-58348-428-9 |
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}}{{Page needed|date=March 2011}}</ref> The lengthy records of [[self-experimentation]] by homeopaths have occasionally proven useful in the development of modern drugs: For example, evidence that [[nitroglycerin]] might be useful as a treatment for [[angina pectoris|angina]] was discovered by looking through homeopathic provings, though homeopaths themselves never used it for that purpose at that time.<ref name="pmid2866851"> |
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{{cite journal |
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|author=Fye WB |
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|title=Nitroglycerin: a homeopathic remedy |
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|journal=Circulation |
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|volume=73 |
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|issue=1 |
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|pages=21–29 |
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|year=1986 |
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|pmid=2866851 |
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|doi=10.1161/01.CIR.73.1.21 |
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|doi-access=free |
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}}</ref> The first recorded provings were published by Hahnemann in his 1796 ''Essay on a New Principle''.<ref> |
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{{cite journal |
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|author=Hahnemann S |
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|title=Versuch über ein neues Prinzip zur Auffindung der Heilkräfte der Arzneisubstanzen, nebst einigen Blicken auf die bisherigen |
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|journal=[[Journal der Practischen Heilkunde]] |
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|editor=C. W. Hufelands |
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|language=de |
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|volume=II |
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|issue=3 |
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|year=1796 |
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}}</ref> His ''Fragmenta de Viribus'' (1805)<ref> |
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{{cite book |
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|title=Fragmenta de Viribus medicamentorum Positivis |
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|author=Hahnemann S |
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|language=la |
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|location=Leipzig |
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|year=1805 |
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}}</ref> contained the results of 27 provings, and his 1810 ''Materia Medica Pura'' contained 65.<ref> |
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{{cite book |
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|title=Materia medica pura; sive, Doctrina de medicamentorum viribus in corpore humano sano observatis; e Germanico sermone in Latinum conversa |
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|vauthors=Hahnemann S, Stapf E, Gross G, de Brunnow EG |language=la |
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|location=Dresden |
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|publisher=Arnold |
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|year=1826–1828 |
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|oclc=14840659 |
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}}</ref> For James Tyler Kent's 1905 ''Lectures on Homoeopathic Materia Medica'', 217 preparations underwent provings and newer substances are continually added to contemporary versions.<ref>{{Cite book|last=Kent|first=James Tyler|url=https://books.google.com/books?id=c-ArAQAAMAAJ|title=Lectures on Homoeopathic Materia Medica|date=1905|publisher=Boericke & Tafel|isbn=978-0-7222-9856-5|language=en}}</ref><ref>{{Cite book|last=Kent|first=James Tyler|url=https://books.google.com/books?id=RZtEPAAACAAJ|title=Lectures on Homoeopathic Materia Medica: Together With Kent's "New Remedies" Incorporated and Arranged in One Alphabetical Order|date=2020-03-31|publisher=B. Jain Publishers (P) Limited|isbn=978-81-319-0259-2|language=en}}</ref> |
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Though the proving process has superficial similarities with clinical trials, it is fundamentally different in that the process is subjective, not [[Blind test|blinded]], and modern provings are unlikely to use pharmacologically active levels of the substance under proving.<ref name="Creighton">{{cite web |url=http://altmed.creighton.edu/Homeopathy/science/validity.htm |title=Are the principles of Homeopathy scientifically valid? |publisher=Creighton University School of Medicine |archive-url=https://web.archive.org/web/20120816233729/http://altmed.creighton.edu/Homeopathy/science/validity.htm |archive-date=August 16, 2012 |df=mdy-all }}</ref> As early as 1842, Oliver Holmes had noted that provings were impossibly vague, and the purported effect was not repeatable among different subjects.<ref name="Holmes" /> |
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Yet present-day homeopaths still invoke this notion to state their belief that symptoms are not in themselves the disease, but rather represent an underlying disturbance of the organism's vitality, and it is this underlying disturbance that the homeopath needs to address. It is asserted that superficial manifestations of disease may disappear only to be replaced later on with more deep affections (e.g., respiratory complaints, organic heart disease, and mental illness). In such cases their original disappearance is considered to be suppressive, and their transient reappearance following homeopathic prescription is considered evidence in support of this notion. |
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== Evidence and efficacy == |
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{{main|Evidence and efficacy of homeopathy}} |
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The notion of suppression underlies the so-called ''Hering's Laws of Direction of Cure'', first set forth by ''Constantine Hering'' in 1845. In his formulation: |
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Outside of the [[alternative medicine]] community, scientists have long considered homeopathy a sham<ref name="aaci2">{{cite journal|last1=Caulfield|first1=Timothy|last2=Rachul|first2=Christen|year=2011|title=Supported by science?: What Canadian naturopaths advertise to the public|journal=Allergy, Asthma & Clinical Immunology|volume=7|issue=1 |page=14|doi=10.1186/1710-1492-7-14|pmc=3182944|pmid=21920039|quote=Within the non-CAM scientific community, homeopathy has long been viewed as a sham|author-link1=Timothy Caulfield |doi-access=free }}</ref> or a [[pseudoscience]],<ref name="Tuomela p83-101">{{cite book |author=Tuomela, R |title=Rational Changes in Science |chapter=Science, Protoscience, and Pseudoscience |publisher=Springer |year=1987 |isbn=978-94-010-8181-8 |veditors=Pitt JC, Marcello P |series=Boston Studies in the Philosophy of Science |volume=98 |pages=83–101 |doi=10.1007/978-94-009-3779-6_4 |author-link=Raimo Tuomela|issn = 0068-0346}}</ref><ref name="Why">{{cite journal |vauthors=Mukerji N, Ernst E |title=Why homoeopathy is pseudoscience |journal=Synthese |date=14 September 2022 |volume=200 |issue=5 |eissn=1573-0964 |doi=10.1007/s11229-022-03882-w |pmid=|s2cid=252297716 |url= |doi-access=free }}</ref><ref name="Baran20142">{{cite book|vauthors=Baran GR, Kiana MF, Samuel SP|title=Healthcare and Biomedical Technology in the 21st Century |chapter=Science, Pseudoscience, and Not Science: How do They Differ? |publisher=Springer|year=2014|isbn=978-1-4614-8540-7|pages=19–57|doi=10.1007/978-1-4614-8541-4_2|quote=within the traditional medical community it is considered to be quackery}}</ref><ref name="Ladyman2">{{cite book|author=Ladyman J|title=Philosophy of Pseudoscience: Reconsidering the Demarcation Problem|publisher=University of Chicago Press|year=2013|isbn=978-0-226-05196-3|veditors=Pigliucci M, Boudry M|pages=48–49|chapter=Chapter 3: Towards a Demarcation of Science from Pseudoscience|quote=Yet homeopathy is a paradigmatic example of pseudoscience. It is neither simply bad science nor science fraud, but rather profoundly departs from scientific method and theories while being described as scientific by some of its adherents (often sincerely).}}</ref> and the medical community regards it as [[quackery]].<ref name="Baran20142" /> There is an overall absence of sound [[statistical evidence]] of therapeutic efficacy, which is consistent with the lack of any [[Biological plausibility|biologically plausible]] pharmacological [[Active ingredient|agent]] or mechanism.<ref name="pmid124926032" /> Proponents argue that homeopathic medicines must work by some, as yet undefined, biophysical mechanism.<ref name="Vickers 1115–11182" /> No homeopathic preparation has been shown to be different from [[placebo]].<ref name="pmid124926032" /> |
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=== Lack of scientific evidence === |
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1) The improvement ''takes place from above downward'', |
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The lack of convincing scientific evidence supporting its efficacy<ref name="Adler2">{{Cite news|author=Adler J|date=February 4, 2004|title=No way to treat the dying|magazine=[[Newsweek]]|url=http://www.newsweek.com/id/105581}}</ref> and its use of preparations without active ingredients have led to characterizations of homeopathy as pseudoscience and quackery,<ref name="Dearden2">{{cite news|last=Dearden|first=Lizzie|date=February 7, 2017|title=Russian Academy of Sciences says homeopathy is dangerous 'pseudoscience' that does not work|newspaper=[[The Independent]]|url=https://www.independent.co.uk/news/world/europe/russia-academy-of-sciences-homeopathy-treaments-pseudoscience-does-not-work-par-magic-a7566406.html|access-date=February 7, 2017}}</ref><ref name="pmid146761792">{{cite journal|last1=Atwood|first1=KC|year=2003|title="Neurocranial restructuring" and homeopathy, neither complementary nor alternative|journal=Archives of Otolaryngology–Head & Neck Surgery|volume=129|issue=12|pages=1356–57|doi=10.1001/archotol.129.12.1356|pmid=14676179}}</ref><ref name="NdububaQuack2">{{cite journal|last1=Ndububa|first1=VI|year=2007|title=Medical quackery in Nigeria; why the silence?|journal=Nigerian Journal of Medicine|volume=16|issue=4|pages=312–17|doi=10.4314/njm.v16i4.37328|pmid=18080586|doi-access=free}}</ref> or, in the words of a 1998 medical review, "placebo therapy at best and quackery at worst".<ref name="Ernst2">{{cite journal|last1=Ernst|first1=E|last2=Pittler|first2=MH|year=1998|title=Efficacy of homeopathic arnica: a systematic review of placebo-controlled clinical trials|journal=Archives of Surgery|volume=133|issue=11|pages=1187–90|doi=10.1001/archsurg.133.11.1187|pmid=9820349|doi-access=free}}</ref> The [[Russian Academy of Sciences]] considers homeopathy a "dangerous 'pseudoscience' that does not work", and "urges people to treat homeopathy 'on a par with magic{{'"}}.<ref name="Dearden2" /> The Chief Medical Officer for England, [[Sally Davies (doctor)|Dame Sally Davies]], has stated that homeopathic preparations are "rubbish" and do not serve as anything more than placebos.<ref>{{cite news|last=Silverman|first=Rosa|title=Homeopathy is 'rubbish', says chief medical officer|work=[[The Daily Telegraph]]|location=London|url=https://www.telegraph.co.uk/health/healthnews/9822744/Homeopathy-is-rubbish-says-chief-medical-officer.html|archive-url=https://web.archive.org/web/20130126102237/http://www.telegraph.co.uk/health/healthnews/9822744/Homeopathy-is-rubbish-says-chief-medical-officer.html|archive-date=January 26, 2013|access-date=January 24, 2013|issn=0307-1235|oclc=49632006}}</ref> In 2013, [[Mark Walport]], the UK [[Government Chief Scientific Adviser]] and head of the [[Government Office for Science]] said "homeopathy is nonsense, it is non-science."<ref name="Collins2">{{cite news|author=Nick Collins|date=April 18, 2013|title=Homeopathy is nonsense, says new chief scientist|work=[[The Daily Telegraph]]|url=https://www.telegraph.co.uk/health/healthnews/10003680/Homeopathy-is-nonsense-says-new-chief-scientist.html|archive-url=https://web.archive.org/web/20130420234704/http://www.telegraph.co.uk/health/healthnews/10003680/Homeopathy-is-nonsense-says-new-chief-scientist.html|archive-date=April 20, 2013}}</ref> His predecessor, [[John Beddington]], also said that homeopathy "has no underpinning of scientific basis" and is being "fundamentally ignored" by the Government.<ref>{{Cite web|last=Gray|first=Richard|date=April 9, 2013|title=Homeopathy on the NHS is 'mad' says outgoing scientific adviser|url=https://www.telegraph.co.uk/news/health/news/9982234/Homeopathy-on-the-NHS-is-mad-says-outgoing-scientific-adviser.html |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/news/health/news/9982234/Homeopathy-on-the-NHS-is-mad-says-outgoing-scientific-adviser.html |archive-date=January 11, 2022 |url-access=subscription |url-status=live|access-date=2020-10-28|website=The Telegraph|language=en-GB}}{{cbignore}}</ref> |
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2) and ''from within outward'', |
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3) and ''the disease passes off in the order in which the organs had been affected, the more important being relieved first, the less important next, and the skin last''. |
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Jack Killen, acting deputy director of the [[National Center for Complementary and Alternative Medicine]], says homeopathy "goes beyond current understanding of chemistry and physics". He adds: "There is, to my knowledge, no condition for which homeopathy has been proven to be an effective treatment."<ref name="Adler2" /> [[Ben Goldacre]] says that homeopaths who misrepresent scientific evidence to a [[Scientific literacy|scientifically illiterate]] public, have "... walled themselves off from academic medicine, and critique has been all too often met with avoidance rather than argument".<ref name="Goldacre20072">{{cite journal|last1=Goldacre|first1=Ben|year=2007|title=Benefits and risks of homoeopathy|journal=The Lancet|volume=370|issue=9600|pages=1672–73|doi=10.1016/S0140-6736(07)61706-1|pmid=18022024|s2cid=43588927}}</ref> Homeopaths often prefer to ignore [[Meta-analysis|meta-analyses]] in favour of [[Cherry picking (fallacy)|cherry picked]] positive results, such as by promoting a particular [[observational study]] (one which Goldacre describes as "little more than a customer-satisfaction survey") as if it were more informative than a series of randomized controlled trials.<ref name="Goldacre20072" /> |
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An invented example: a patient originally treated with medicinal ointments for a body-wide rash, later became asthmatic, and now being treated homeopathically for suicidal depression, would tend first to recover emotionally while experiencing transient asthma symptoms and the reappearance of his skin rash, which would leave the core of his body first and his extremities last. |
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In an article entitled "Should We Maintain an Open Mind about Homeopathy?"<ref name="Baum_&_Ernst2">{{cite journal|last1=Baum|first1=Michael|last2=Ernst|first2=Edzard|year=2009|title=Should We Maintain an Open Mind about Homeopathy?|journal=The American Journal of Medicine|volume=122|issue=11|pages=973–74|doi=10.1016/j.amjmed.2009.03.038|pmid=19854319|quote=Homeopathy is among the worst examples of faith-based medicine... These axioms [of homeopathy] are not only out of line with scientific facts but also directly opposed to them. If homeopathy is correct, much of physics, chemistry, and pharmacology must be incorrect... To have an open mind about homeopathy or similarly implausible forms of alternative medicine (e.g., Bach Flower remedies, spiritual healing, crystal therapy) is, therefore, not an option}}</ref> published in the ''[[American Journal of Medicine]]'', [[Michael Baum (surgeon)|Michael Baum]] and [[Edzard Ernst]]{{spaced ndash}}writing to other physicians{{spaced ndash}}wrote that "Homeopathy is among the worst examples of faith-based medicine... These axioms [of homeopathy] are not only out of line with scientific facts but also directly opposed to them. If homeopathy is correct, much of physics, chemistry, and pharmacology must be incorrect...". |
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A good real example is that of syphilis. According to Herings' law, skin symptoms should be last to disappear, whereas in fact they are first to go away. At any case, homeopathic writers themselves note that cases when clinical manifestations change in compliance with Hering's laws are exceptionally rare. |
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=== Plausibility of dilutions === |
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[[File:LedumPalustre15CH.jpg|right|thumb|A homeopathic preparation made from [[marsh tea]]: the "15C" dilution shown here means the original solution was diluted to 1/10<sup>30</sup> of its original strength.]] |
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As early as in 1816, Hahnemann found "''...a continually repeated fact that the non-venereal chronic diseases, after being time and again removed homoeopathically by the remedies fully proved up to the present time, always returned in a more or less varied form and with new symptoms, or reappeared annually with an increase of complaints.''" After more than 10 years of struggling with the problem, the senile Hahnemann (he was 72 when he communicated the fruits of his musings to two of his pupils) introduced a new theory currently known as the ''miasmatic'' theory. He proclaimed that there are only three fundamental diseases - fundamental miasms - behind all the multitude of the chronic diseases of the mankind: '''syphilis''', '''sycosis''' (an outdated nosological unit confounding gonorrhoea and figwart disease), and '''psora'''. The latter - ''the miasm of psora'' - was said to be a single underlying miasm behind most part (assessed by him as seven eighths) of various diseases known to the medical science. |
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The exceedingly low concentration of homeopathic preparations, which often lack even a single [[molecule]] of the diluted substance,<ref name="Ernst2005" /> has been the basis of questions about the effects of the preparations since the 19th century.<ref name="GrimesFACT">{{cite journal|last1=Grimes|first1=D.R.|year=2012|title=Proposed mechanisms for homeopathy are physically impossible|journal=Focus on Alternative and Complementary Therapies|volume=17|issue=3|pages=149–55|doi=10.1111/j.2042-7166.2012.01162.x}}</ref> The laws of chemistry give this dilution limit, which is related to the [[Avogadro constant|Avogadro number]], as being roughly equal to 12C homeopathic dilutions (1 part in 10<sup>24</sup>).<ref name="Appendix2" /><ref name="Sbarrett2">{{cite web|author=Barrett S|date=December 28, 2004|title=Homeopathy: the ultimate fake|url=http://www.quackwatch.org/01QuackeryRelatedTopics/homeo.html|access-date=July 25, 2007|publisher=[[Quackwatch]]}}</ref><ref name="dynam2">{{cite web|author=Faziola L|title=Dynamization and dilution|url=http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm|access-date=July 24, 2007|work=Homeopathy Tutorial|publisher=Creighton University School of Medicine|archive-date=August 26, 2002|archive-url=https://web.archive.org/web/20020826082134/http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm}}</ref> [[James Randi]] and the [[10:23 campaign]] groups have highlighted the lack of [[active ingredient]]s by taking large 'overdoses'.<ref name="Jones2">Sam Jones, [https://www.theguardian.com/lifeandstyle/2010/jan/29/sceptics-homeopathy-mass-overdose-boots "Homeopathy protesters to take 'mass overdose' outside Boots"], ''[[The Guardian]]'', January 29, 2010</ref> None of the hundreds of demonstrators in the UK, Australia, New Zealand, Canada and the US were injured and "no one was cured of anything, either".<ref name="Jones2" /> |
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Modern advocates of homeopathy have proposed a concept of "[[water memory]]", according to which water "remembers" the substances mixed in it, and transmits the effect of those substances when consumed. This concept is inconsistent with the current understanding of matter, and water memory has never been demonstrated to have any detectable effect, biological or otherwise.<ref name="NatureWhenToBelieve2">{{cite journal|author=Maddox J|year=1988|title=When to believe the unbelievable|journal=Nature|type=editorial|volume=333|issue=6176|pages=1349–56|bibcode=1988Natur.333Q.787.|doi=10.1038/333787a0|pmid=<!--none-->|s2cid=4369459|doi-access=free}}</ref><ref name="delusion2">{{cite journal|last1=Maddox|first1=J|last2=Randi|first2=J|last3=Stewart|first3=W|year=1988|title="High-dilution" experiments a delusion|journal=Nature|volume=334|issue=6180|pages=287–91|bibcode=1988Natur.334..287M|doi=10.1038/334287a0|pmid=2455869|s2cid=9579433}}</ref> Existence of a [[Biological activity|pharmacological effect]] in the absence of any true active ingredient is inconsistent with the [[law of mass action]] and the observed [[dose-response relationship]]s characteristic of therapeutic drugs.<ref name="Levy2">{{cite journal|last1=Levy|first1=G|year=1986|title=Kinetics of drug action: An overview|journal=Journal of Allergy and Clinical Immunology|volume=78|issue=4 Pt 2|pages=754–61|doi=10.1016/0091-6749(86)90057-6|pmid=3534056}}</ref> Homeopaths contend that their methods produce a therapeutically active preparation, selectively including only the intended substance, though in reality any water will have been in contact with millions of different substances throughout its history, and homeopaths cannot account for the selected homeopathic substance being isolated as a special case in their process.<ref name="Smith20122">{{cite journal|author=Smith K|year=2012|title=Homeopathy is Unscientific and Unethical|journal=Bioethics|volume=26|issue=9|pages=508–12|doi=10.1111/j.1467-8519.2011.01956.x|s2cid=143067523|url=https://zenodo.org/record/1035885 }}</ref> |
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The basic notion of the new theory, that of ''miasma'', was not invented by Hahnemann; it was an old medical concept adopted by him. The main meaning of this Greek word was "stain", "stigma"; but in medicine the word came to be used in a specific sense of "pestiferous exhalations". Hahnemann's notion of miasm was of that kind as well. Thus, he wrote in ''Note 2'' to §11 of the Organon: "''...a child with small-pox or measles communicates to a near, untouched healthy child in an invisible manner (dynamically) the small-pox or measles, that is, infects it at a distance without anything material from the infective child going or capable of going to the one to be infected. A purely specific conceptual influence communicated to the near child small-pox or measles in the same way as the magnet communicated to the near needle the magnetic property...''". |
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Practitioners also hold that higher dilutions produce stronger medicinal effects. This idea is also inconsistent with observed dose-response relationships, where effects are dependent on the concentration of the active ingredient in the body.<ref name="Levy2" /> Some contend that the phenomenon of [[hormesis]] may support the idea of dilution increasing potency,<ref>{{cite journal|author1=Oberbaum, M|author2=Singer, SR|author3=Samuels, N.|date=Jul 2010|title=Hormesis and homeopathy: bridge over troubled waters|journal=Hum Exp Toxicol|volume=29|issue=7|pages=567–71|doi=10.1177/0960327110369777|pmid=20558608|s2cid=8107797|doi-access=free|bibcode=2010HETox..29..567O }}</ref><ref>{{cite journal|last1=Khuda-Bukhsh|first1=Anisur Rahman|date=2003|title=Towards understanding molecular mechanisms of action of homeopathic drugs: an overview|journal=Molecular and Cellular Biochemistry|volume=253|issue=1/2|pages=339–45|doi=10.1023/A:1026048907739|pmid=14619985|s2cid=10971539}}</ref> but the dose-response relationship outside the zone of hormesis declines with dilution as normal, and nonlinear pharmacological effects do not provide any credible support for homeopathy.<ref name="Smith20122" /> |
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The new conception was a short-circuited generalization of Hahnemann's understanding of syphilis (see above in "Suppression"). So, in a footnote to §282 he spoke of "''the three great miasms while they still effloresce on the skin, i.e., recently erupted itch, the untouched chancre (on the sexual organs, labia, mouth or lips, and so forth), and the figwarts''". Their development looked schematically as follows. Miasmatic infection causes local symptomatics in its place of intrusion, usually skin. If this local pathology is removed ("''suppressed''") by external medication, the disease goes deeper, and manifests itself by manifold organ pathologies. |
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===Efficacy=== |
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The fundamental miasm of ''psora'' was obtained by merely substituting itch for chancre in this speculative model. This imaginary inner disease - generalized itch - was promulgated to the range of all-pervading universal underlying pathology (in §80 of the ''Organon'' he asserted psora to be the only real fundamental cause and producer of such forms of disease among others as epilepsy, cyphosis, cancer, jaundice, deafness, and cataract). Its diagnosis presented no difficulty: "''even the first little pustule of itch with its unbearable voluptuous itching, forcing a man irresistibly to scratch, and with the following burning pain, is in every case and every time the proof of a universal itch-disease which has been previously developed in the interior of the whole organism''". |
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{| class="wikitable floatright" style="width:40%;" |
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|+ Explanations for efficacy of homeopathic preparations:<ref name="Shelton" />{{rp|155–167|date=November 2012}}<ref name="BrienRheumatology">{{cite journal |url= |title=Homeopathy has clinical benefits in rheumatoid arthritis patients that are attributable to the consultation process but not the homeopathic remedy: a randomized controlled clinical trial |author1=Brien S |author2=Lachance S |author3=Prescott P |author4=McDermott C |author5=Lewith G |journal=Rheumatology |date=June 2011 |volume=50 |issue=6 |pages=1070–82 |doi=10.1093/rheumatology/keq234 |pmid=21076131 |pmc=3093927}}</ref> |
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|- |
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| The [[placebo effect]] |
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| The intensive consultation process and expectations for the homeopathic preparations may cause the effect |
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|- |
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| Therapeutic effect of the consultation |
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| The care, concern, and reassurance a patient experiences when opening up to a compassionate caregiver can have a positive effect on the patient's well-being. |
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|- |
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| Unassisted [[healing|natural healing]] |
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| Time and the body's ability to heal without assistance can eliminate many diseases of their own accord. |
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|- |
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| Unrecognized treatments |
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| An unrelated food, exercise, environmental agent, or treatment for a different ailment, may have occurred. |
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|- |
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| [[Regression toward the mean|Regression towards the mean]] |
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| Since many diseases or conditions are cyclical, symptoms vary over time and patients tend to seek care when discomfort is greatest; they may feel better anyway but because of the timing of the visit to the homeopath they attribute improvement to the preparation taken. |
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|- |
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| Non-homeopathic treatment |
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| Patients may also receive standard medical care at the same time as homeopathic treatment, and the former is responsible for improvement. |
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|- |
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| Cessation of unpleasant treatment |
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| Often homeopaths recommend patients stop getting medical treatment such as surgery or drugs, which can cause unpleasant side-effects; improvements are attributed to homeopathy when the actual cause is the cessation of the treatment causing side-effects in the first place, but the underlying disease remains untreated and still dangerous to the patient. |
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|} |
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No individual homeopathic preparation has been unambiguously shown by research to be different from placebo.<ref name="pmid124926032" /> The [[Methodology|methodological]] quality of the early primary research was low, with problems such as weaknesses in [[study design]] and reporting, small [[sample size]], and [[selection bias]]. Since better quality trials have become available, the evidence for efficacy of homeopathy preparations has diminished; the highest-quality trials indicate that the preparations themselves exert no intrinsic effect.<ref name="Caulfield20053" /><ref name="Shelton2">{{cite book|last=Shelton|first=JW|url=https://archive.org/details/homeopathyhowitr0000shel|title=Homeopathy: How it really works|publisher=[[Prometheus Books]]|year=2004|isbn=978-1-59102-109-4|location=Amherst, New York|url-access=registration}}</ref>{{rp|206|date=November 2012}}<ref name="Linde19992">{{cite journal|last1=Linde|first1=K|last2=Scholz|first2=M|last3=Ramirez|first3=G|last4=Clausius|first4=N|last5=Melchart|first5=D|last6=Jonas|first6=WB|year=1999|title=Impact of study quality on outcome in placebo-controlled trials of homeopathy|journal=Journal of Clinical Epidemiology|volume=52|issue=7|pages=631–36|doi=10.1016/S0895-4356(99)00048-7|pmid=10391656}}</ref> A review conducted in 2010 of all the pertinent studies of "best evidence" produced by the [[Cochrane Collaboration]] concluded that this evidence "fails to demonstrate that homeopathic medicines have effects beyond placebo."<ref name="Ernst20102" /> |
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Later speculations produced more miasms, such as tuberculosis and cancer. Their definitions are no better than Hahnemann's. So, tuberculosis is said to be associated with the infection as well as with asthma or pneumonia and psychologically with constant dissatisfaction and desire for change. Cancer is associated with malignant states as well as with obsessive-compulsive disorder and psychological traits of perfectionism, and excessive responsibility or ambition. Similar speculations continue up to the present time, the list of miasms being steadily expanded. |
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In 2009, the United Kingdom's [[House of Commons of the United Kingdom|House of Commons]] Science and Technology Committee concluded that there was no compelling evidence of effect other than placebo.<ref name="inquiry_cfm">UK Parliamentary Committee Science and Technology Committee. [http://www.parliament.uk/business/committees/committees-a-z/commons-select/science-and-technology-committee/inquiries/homeopathy-/ "Evidence Check 2: Homeopathy"]</ref> The Australian [[National Health and Medical Research Council]] completed a comprehensive review of the effectiveness of homeopathic preparations in 2015, in which it concluded that "there were no health conditions for which there was reliable evidence that homeopathy was effective."<ref name="NHMRC2">{{cite book|author1=National Health and Medical Research Council|url=https://www.nhmrc.gov.au/guidelines-publications/cam02|title=NHMRC statement on homeopathy and NHMRC information paper – Evidence on the effectiveness of homeopathy for treating health conditions|date=2015|publisher=National Health and Medical Research Council|isbn=978-1-925129-29-8|location=Canberra|page=16|quote=There is no reliable evidence that homoeopathy is effective for treating health conditions.|author1-link=National Health and Medical Research Council|access-date=August 18, 2016|archive-url=https://web.archive.org/web/20170419065845/https://www.nhmrc.gov.au/guidelines-publications/cam02|archive-date=April 19, 2017|df=mdy-all}}</ref> The European Academies' Science Advisory Council (EASAC) published its official analysis in 2017 finding a lack of evidence that homeopathic products are effective, and raising concerns about quality control.<ref name="EASAC2017">{{cite web|date=September 2017|title=Homeopathic products and practices: assessing the evidence and ensuring consistency in regulating medical claims in the EU|url=http://www.easac.eu/fileadmin/PDF_s/reports_statements/EASAC_Homepathy_statement_web_final.pdf|access-date=1 October 2017|work=European Academies' Science Advisory Council|page=1|quote=... we agree with previous extensive evaluations concluding that there are no known diseases for which there is robust, reproducible evidence that homeopathy is effective beyond the placebo effect.}}</ref> In contrast a 2011 book was published, purportedly financed by the Swiss government, that concluded that homeopathy was effective and cost efficient.<ref>{{Cite book|last1=Bonhöft|first1=Gudrun|title=Homeopathy in healthcare: effectiveness, appropriateness, safety, costs.|last2=Matthiessen|first2=Peter|publisher=Springer|year=2012}}</ref> Although hailed by proponents as proof that homeopathy works,<ref name="ShawMisconduct2">{{cite journal|author=Shaw, David|date=May 2012|title=The Swiss report on homeopathy: a case study of research misconduct|journal=[[Swiss Medical Weekly]]|volume=142|pages=w13594|doi=10.4414/smw.2012.13594|pmid=22653406|doi-access=free}}</ref> it was found to be scientifically, logically and ethically flawed, with most authors having a [[conflict of interest]].<ref name="ShawMisconduct2" /> The [[Swiss Federal Office of Public Health]] later released a statement saying the book was published without the consent of the Swiss government.<ref>{{cite journal|author=Gurtner, Felix|date=December 2012|title=The report "Homeopathy in healthcare: effectiveness, appropriateness, safety, costs" is not a "Swiss report"|journal=[[Swiss Medical Weekly]]|volume=142|pages=w13723|doi=10.4414/smw.2012.13723|pmid=23255156|doi-access=free}}</ref> |
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Although the acceptance of miasms varied and varies within the homeopathic community, nowadays in some way or another the concept is used by a majority of homoeopaths. |
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[[Meta-analysis|Meta-analyses]], essential tools to summarize evidence of therapeutic efficacy,<ref name="PRISMA2">{{cite journal|last1=Liberati|first1=A|last2=Altman|first2=DG|last3=Tetzlaff|first3=J|last4=Mulrow|first4=C|last5=Gøtzsche|first5=PC|last6=Ioannidis|first6=J PA|last7=Clarke|first7=M|last8=Devereaux|first8=PJ|last9=Kleijnen|first9=J|last10=Moher|first10=D|year=2009|title=The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration|journal=PLOS Medicine|volume=6|issue=7|pages=e1000100|doi=10.1371/journal.pmed.1000100|pmc=2707010|pmid=19621070|doi-access=free}}</ref> and [[systematic review]]s have found that the methodological quality in the majority of randomized trials in homeopathy have shortcomings and that such trials were generally of lower quality than trials of conventional medicine.<ref>{{cite journal|last1=Jonas|first1=WB|last2=Anderson|first2=RL|last3=Crawford|first3=CC|last4=Lyons|first4=JS|date=2001|title=A systematic review of the quality of homeopathic clinical trials|journal=BMC Complementary and Alternative Medicine|volume=1|page=12|doi=10.1186/1472-6882-1-12|pmc=64638|pmid=11801202 |doi-access=free }}</ref><ref name="pmid114160762">{{cite journal|last1=Linde|first1=K|last2=Jonas|first2=WB|last3=Melchart|first3=D|last4=Willich|first4=S|year=2001|title=The methodological quality of randomized controlled trials of homeopathy, herbal medicines and acupuncture|journal=International Journal of Epidemiology|volume=30|issue=3|pages=526–31|doi=10.1093/ije/30.3.526|pmid=11416076|author-link1=Klaus Linde|doi-access=free}}</ref> A major issue has been [[publication bias]], where positive results are more likely to be published in journals.<ref>{{cite journal|author=Jeffrey D. Scargle|year=2000|title=Publication Bias: The "file-drawer problem" in scientific inference|url=http://www.scientificexploration.org/journal/jse_14_1_scargle.pdf|journal=[[Journal of Scientific Exploration]]|volume=14|issue=2|pages=94–106|arxiv=physics/9909033|bibcode=1999physics...9033S|access-date=January 19, 2011|archive-date=January 22, 2015|archive-url=https://web.archive.org/web/20150122021757/http://scientificexploration.org/journal/jse_14_1_scargle.pdf}}</ref>{{unreliable source?|date=February 2020}}<ref name="pmid160607222">{{cite journal|last1=Ioannidis|first1=John P. A.|year=2005|title=Why most published research findings are false|journal=PLOS Medicine|volume=2|issue=8|pages=e124|doi=10.1371/journal.pmed.0020124|pmc=1182327|pmid=16060722 |doi-access=free }}</ref><ref name="pmid18258002">{{cite journal|last1=Kleijnen|first1=J|last2=Knipschild|first2=P|last3=Ter Riet|first3=G|year=1991|title=Clinical trials of homoeopathy|journal=BMJ|volume=302|issue=6772|pages=316–23|doi=10.1136/bmj.302.6772.316|pmc=1668980|pmid=1825800}}</ref> This has been particularly marked in alternative medicine journals, where few of the published articles (just 5% during the year 2000) tend to report [[null result]]s.<ref name="Goldacre20072" /> A systematic review of the available systematic reviews confirmed in 2002 that higher-quality trials tended to have less positive results, and found no convincing evidence that any homeopathic preparation exerts clinical effects different from placebo.<ref name="pmid124926032" /> The same conclusion was also reached in 2005 in a meta-analysis published in ''The Lancet''. A 2017 systematic review and meta-analysis found that the most reliable evidence did not support the effectiveness of non-individualized homeopathy.<ref>{{Cite journal|last1=Mathie|first1=Robert T.|last2=Ramparsad|first2=Nitish|last3=Legg|first3=Lynn A.|last4=Clausen|first4=Jürgen|last5=Moss|first5=Sian|last6=Davidson|first6=Jonathan R. T.|last7=Messow|first7=Claudia-Martina|last8=McConnachie|first8=Alex|date=March 24, 2017|title=Randomised, double-blind, placebo-controlled trials of non-individualised homeopathic treatment: systematic review and meta-analysis|journal=Systematic Reviews|volume=6|issue=1|page=63|doi=10.1186/s13643-017-0445-3|issn=2046-4053|pmc=5366148|pmid=28340607 |doi-access=free }}</ref> |
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== History == |
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=== Debut === |
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By 1790 Samuel Hahnemann, the would-be founder of homoeopathy, made his living mainly by translations. This very year he was commissioned with translation of a then authoritative treatise on materia medica written by William Cullen, a famous physician from Edinburgh. Cullen introduced a new physiological theory closely akin to vitalism. Its pivotal notion was that of nervous force; the latter played the role of the vital force in vitalistic theories. The theory became a frame for a new system of medicine, and in his book Cullen classified remedies accordingly as increasing or decreasing the tone. In particular, there was considered, on twenty pages in the second volume, the medicinal effects of ''Peruvian, or china bark''. In Cullen's view, the remedy exerted its action on fever through its ''tonic effect'' on the stomach due to its bitter taste and astringent properties. This assertion struck Hahnemann as completely unfounded: "''By combining the strongest bitters and the strongest astringents we can obtain a compound which, in small doses, possesses much more of both these properties than the bark, and yet in all Eternity no fever specific can be made from such a compound.''" Exasperated, he decided to make an experiment with the remedy upon himself. "''I took, for several days, as an experiment, four drams of good china twice daily... To sum up: all those symptoms which to me are typical of intermittent fever... - all made their appearance. This paroxysm lasted from two to three hours every time, and recurred when I repeated the dose and not otherwise.''" With this observation, Hahnemann fell upon the idea that "''Peruvian bark, which is used as a remedy for intermittent fever, acts because it can produce symptoms similar to those of intermittent fever in healthy people.''" |
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Health organizations, including the UK's [[National Health Service]],<ref name="nhs_choices2">{{cite web|title=Health A-Z -- Homeopathy|url=http://www.nhs.uk/conditions/Homeopathy/Pages/Introduction.aspx|access-date=April 22, 2013|publisher=National Health Service}}</ref> the [[American Medical Association]],<ref name="amapseudo2">{{cite web|author=AMA Council on Scientific Affairs|year=1997|title=Alternative medicine: Report 12 of the Council on Scientific Affairs (A–97)|url=http://www.ama-assn.org/ama/no-index/about-ama/13638.shtml|archive-url=https://web.archive.org/web/20090614085504/http://www.ama-assn.org/ama/no-index/about-ama/13638.shtml|archive-date=June 14, 2009|access-date=March 25, 2009|publisher=[[American Medical Association]]}}</ref> the [[FASEB]],<ref name="Weissmann2">{{cite journal|last1=Weissmann|first1=G|year=2006|title=Homeopathy: Holmes, Hogwarts, and the Prince of Wales|journal=The FASEB Journal|volume=20|issue=11|pages=1755–58|doi=10.1096/fj.06-0901ufm|pmid=16940145|s2cid=9305843|doi-access=free}}</ref> and the [[National Health and Medical Research Council]] of Australia,<ref name="NHMRC2" /> have issued statements saying that there is no good-quality evidence that homeopathy is effective as a treatment for any health condition.<ref name="nhs_choices2" /> In 2009, [[World Health Organization]] official [[Mario Raviglione]] criticized the use of homeopathy to treat [[tuberculosis]]; similarly, another WHO spokesperson argued there was no evidence homeopathy would be an effective treatment for [[Diarrhea|diarrhoea]].<ref>{{cite news|date=August 20, 2009|title=Homeopathy not a cure, says WHO|work=BBC News|url=http://news.bbc.co.uk/2/hi/8211925.stm|access-date=October 20, 2014}}</ref> They warned against the use of homeopathy for serious conditions such as [[Major depressive disorder|depression]], [[HIV/AIDS|HIV]] and [[malaria]].<ref>{{cite journal|last=Mashta|first=O|date=August 24, 2009|title=WHO warns against using homoeopathy to treat serious diseases|journal=BMJ|volume=339|issue=aug24 2|pages=b3447|doi=10.1136/bmj.b3447|pmid=19703929|s2cid=9303173}}</ref> The [[American College of Medical Toxicology]] and the [[American Academy of Clinical Toxicology]] recommend that no one use homeopathic treatment for disease or as a preventive health measure.<ref name="toxicfive2">{{cite web|author1=American College of Medical Toxicology|author1-link=American College of Medical Toxicology|author2=American Academy of Clinical Toxicology|author2-link=American Academy of Clinical Toxicology|date=February 2013|title=Five things physicians and patients should question|url=http://www.choosingwisely.org/doctor-patient-lists/american-college-of-medical-toxicology-and-the-american-academy-of-clinical-toxicology/|access-date=December 5, 2013|work=[[Choosing Wisely]]: an initiative of the [[ABIM Foundation]]|publisher=American College of Medical Toxicology and American Academy of Clinical Toxicology}}, which cites {{cite journal|last1=Woodward|first1=KN|date=May 2005|title=The potential impact of the use of homeopathic and herbal remedies on monitoring the safety of prescription products|journal=Human & Experimental Toxicology|volume=24|issue=5|pages=219–33|doi=10.1191/0960327105ht529oa|pmid=16004184|bibcode=2005HETox..24..219W |s2cid=34767417}}</ref> These organizations report that no evidence exists that homeopathic treatment is effective, but that there is evidence that using these treatments produces harm and can bring indirect health risks by delaying conventional treatment.<ref name="toxicfive2" /> |
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It is a commonplace statement in ''homoeopathic'' literature that Hahnemann broke with contemporary medical practice moved by higher considerations, being disappointed by its inefficacy. The legend was invented by Hahnemann himself. He used to tell an edifying story in a lofty style, which now sounds somewhat comical: "''After I have discovered the weakness and errors of my teachers and books, I sank into a state of sorrowful indignation, which had nearly altogether disgusted me with the study of medicine. I was on the point of concluding that the whole art was vain and incapable of improvement. I gave myself up to solitary reflection, and resolved not to terminate my train of thought until I had arrived at a definite conclusion on the subject.''" But reality was that his main motive was pecuniary: he was not able to earn for his living. Thus, he wrote in a letter of 29.08.1790: "''I cannot reckon much on income from practice. This I know from fourteen years' experience''". And in another letter of the same date: "''I have entirely given up my practice for the past year, because it cost me more than it brought in...''" There is striking difference between these quotations from his private letters as opposed to his stilted public professions; they clearly show that his claim was disingenuous. |
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===Purported effects in other biological systems=== |
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Hahnemann's initial publication on the subject of homoeopathy met rather favourable reception. It is noteworthy, because it was not a rule for new ideas, which always had to overcome conservative opposition. A natural comparison is with Edward Jenner's discovery of vaccination, published at about the same time (in 1798). After some period of embittered struggle and resistance, vaccination was universally adopted. In a converse manner, after a short period of benevolent attitude, homoeopathy was repudiated. |
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While some articles have suggested that homeopathic solutions of high dilution can have statistically significant effects on organic processes including the growth of [[grain]]<ref>{{cite book |
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|author =Kolisko L |
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|trans-title =Physiological and physical evidence of the effectiveness of the smallest entities |title=Physiologischer und physikalischer Nachweis der Wirksamkeit kleinster Entitäten |
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|language =de |
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|location =Stuttgart |
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|year =1959 |
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}}</ref> and [[enzyme|enzyme reactions]], such evidence is disputed since attempts to replicate them have failed.<ref name="pmid11316508">{{cite journal |last1=Walach |first1=H |last2=Köster |first2=H |last3=Hennig |first3=T |last4=Haag |first4=G |title=The effects of homeopathic belladonna 30CH in healthy volunteers – a randomized, double-blind experiment |journal=Journal of Psychosomatic Research |volume=50 |issue=3 |pages=155–60 |year=2001 |pmid=11316508 |doi=10.1016/S0022-3999(00)00224-5}}</ref><ref name="pmid8255290">{{cite journal |last1=Hirst |first1=SJ |last2=Hayes |first2=NA |last3=Burridge |first3=J |last4=Pearce |first4=FL |last5=Foreman |first5=JC |title=Human basophil degranulation is not triggered by very dilute antiserum against human IgE |journal=Nature |volume=366 |issue=6455 |pages=525–27 |year=1993 |pmid=8255290 |doi=10.1038/366525a0|bibcode=1993Natur.366..525H |s2cid=4314547 }}</ref><ref name="pmid1376282">{{cite journal |last1=Ovelgönne |first1=J. H. |last2=Bol |first2=AWJM |last3=Hop |first3=WCJ |last4=Wijk |first4=R |title=Mechanical agitation of very dilute antiserum against IgE has no effect on basophil staining properties |journal=Experientia |volume=48 |issue=5 |pages=504–08 |year=1992 |pmid=1376282 |doi=10.1007/BF01928175|s2cid=32110713 }}</ref><ref name="pmid16722785">{{cite journal |last1=Witt |first1=Claudia M |last2=Bluth |first2=M |last3=Hinderlich |first3=S |last4=Albrecht |first4=H |last5=Ludtke |first5=R |last6=Weisshuhn |first6=Thorolf ER |last7=Willich |first7=Stefan N |title=Does potentized HgCl<sub>2</sub> (mercurius corrosivus) affect the activity of diastase and amylase? |journal=Journal of Alternative and Complementary Medicine |volume=12 |pages=359–65 |year=2006 |doi=10.1089/acm.2006.12.359 |pmid=16722785 |issue=4}}</ref><ref name="pmid16036166">{{cite journal |last1=Guggisberg |first1=A |last2=Baumgartner |first2=S |last3=Tschopp |first3=C |last4=Heusser |first4=P |title=Replication study concerning the effects of homeopathic dilutions of histamine on human basophil degranulation in vitro |journal=Complementary Therapies in Medicine |volume=13 |issue=2 |pages=91–100 |year=2005 |pmid=16036166 |doi=10.1016/j.ctim.2005.04.003}}</ref><ref>{{cite journal|last1=Vickers|first1=AJ|title=Independent replication of pre-clinical research in homeopathy: a systematic review.|journal=Forschende Komplementärmedizin|date=December 1999|volume=6|issue=6|pages=311–20|doi=10.1159/000021286|pmid=10649002|s2cid=22051466}}</ref> In 2001 and 2004, [[Madeleine Ennis]] published a number of studies that reported that homeopathic dilutions of [[histamine]] exerted an effect on the activity of [[basophil]]s.<ref>{{cite journal|last1=Brown|first1=V|last2=Ennis|first2=M|date=April 2001|title=Flow-cytometric analysis of basophil activation: inhibition by histamine at conventional and homeopathic concentrations|journal=Inflammation Research|volume=50|issue=Suppl 2|pages=S47–48|doi=10.1007/PL00022402|pmid=11411598|s2cid=10880180}}</ref><ref>{{cite journal|last1=Cumps|first1=J.|last2=Ennis|first2=M.|last3=Mannaioni|first3=P. F.|last4=Roberfroid|first4=M.|last5=Sainte-Laudy|first5=J.|last6=Wiegant|first6=F.A.C.|last7=Belon|first7=P.|date=April 1, 2004|title=Histamine dilutions modulate basophil activation|journal=Inflammation Research|volume=53|issue=5|pages=181–88|doi=10.1007/s00011-003-1242-0|pmid=15105967|s2cid=8682416}}</ref> In response to the first of these studies, ''[[Horizon (BBC TV series)|Horizon]]'' aired a programme in which British scientists attempted to replicate Ennis' results; they were unable to do so.<ref>{{cite web|title=Homeopathy: The Test|url=http://www.bbc.co.uk/science/horizon/2002/homeopathytrans.shtml|access-date=April 29, 2015|publisher=BBC}}</ref> A 2007 systematic review of high-dilution experiments found that none of the experiments with positive results could be reproduced by all investigators.<ref>{{cite journal|last1=Witt|first1=CM|last2=Bluth|first2=M|last3=Albrecht|first3=H|last4=Weisshuhn|first4=TE|last5=Baumgartner|first5=S|last6=Willich|first6=SN|title=The in vitro evidence for an effect of high homeopathic potencies--a systematic review of the literature|journal=Complementary Therapies in Medicine|date=June 2007|volume=15|issue=2|pages=128–38|pmid=17544864|doi=10.1016/j.ctim.2007.01.011}}</ref> |
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In 1988, French immunologist [[Jacques Benveniste]] published a paper in the journal ''[[Nature (journal)|Nature]]'' while working at [[INSERM]].<ref>{{Cite journal|last1=Davenas|first1=E.|last2=Beauvais|first2=F.|last3=Amara|first3=J.|last4=Oberbaum|first4=M.|last5=Robinzon|first5=B.|last6=Miadonnai|first6=A.|last7=Tedeschi|first7=A.|last8=Pomeranz|first8=B.|last9=Fortner|first9=P.|last10=Belon|first10=P.|last11=Sainte-Laudy|first11=J.|date=1988|title=Human basophil degranulation triggered by very dilute antiserum against IgE|url=http://www.nature.com/articles/333816a0|journal=Nature|language=en|volume=333|issue=6176|pages=816–818|doi=10.1038/333816a0|pmid=2455231|bibcode=1988Natur.333..816D|s2cid=12992106|issn=0028-0836}}</ref> The paper purported to have discovered that basophils released histamine when exposed to a homeopathic dilution of anti-immunoglobulin E antibody. Skeptical of the findings, ''Nature'' assembled an independent investigative team to determine the accuracy of the research. After investigation the team found that the experiments were "statistically ill-controlled", "interpretation has been clouded by the exclusion of measurements in conflict with the claim", and concluded, "We believe that experimental data have been uncritically assessed and their imperfections inadequately reported."<ref name="delusion"> |
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The household explanation consists in reference to well-established laws of physics and chemistry. However, this explanation may be valid only for later times, but not for that of Hahnemann's first publication. At the time when he was gradually introducing attenuations, concepts of modern molecular physics were either in cradle, or yet unborn. Dalton's law of aliquot proportions was proclaimed in 1801. Dalton's investigations lay foundation for modern atomic theory - and just by that reason, i.e. out of distrust to the atomic theory – they were accepted cautiously and gradually. Even in the scientifically advanced England, Davy used the term ''proportionate numbers'' instead of ''atomic weight'', and Wollaston used the term ''equivalents'' for the same purpose. In France, Gay-Lussac did not venture to derive from his own investigations a law establishing that equal volumes of simple gases contain equal number of atoms. Such was the state of affairs in leading scientific powers - in England and France, whereas Germany was still slowly freeing itself from the predominance of the phlogiston theory. Atomic theory was in possession of the top vanguard of scientists, but not of the bulk of educated strata; it could not be the cause of the violent opposition encountered by Hahnemann. The medical profession certainly was not in the vanguard of science. Rather, repudiation of Hahnemann's ideas was caused by everyday practical experience of physicians who did not see the results claimed by Hahnemann. |
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{{cite journal |last1=Maddox |first1=J |last2=Randi |first2=J |last3=Stewart |first3=W |title="High-dilution" experiments a delusion |journal=Nature |volume=334 |issue=6180 |pages=287–91 |year=1988 |pmid=2455869 |doi=10.1038/334287a0 |bibcode=1988Natur.334..287M |s2cid=9579433 }}</ref><ref name="Sullivan 1988-07-27"> |
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{{cite news |
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|author =Sullivan W |
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|title =Water that has a memory? Skeptics win second round |
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|date =July 27, 1988 |
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|work =[[The New York Times]] |
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|url =https://www.nytimes.com/1988/07/27/us/water-that-has-a-memory-skeptics-win-second-round.html |
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|access-date =October 3, 2007 |
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|author-link =Walter S. Sullivan |
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}}</ref><ref>Benveniste defended his results by comparing the inquiry to the Salem witch hunts and asserting that "It may be that all of us are wrong in good faith. This is no crime but science as usual and only the future knows."</ref> |
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== Ethics and safety == |
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Hahnemann's attitude to his brainchild contributed much toward such a dénouement. He proclaimed the simility principle as a universally applicable and infallible law of nature. He experienced a profound personality shift after hitting upon the principle of simility, and his assessment of the latter was very far from scientific objectivity. He completely discarded negative practical experiences of other professionals with his method. Judging by the fact that he never conceded any fact as an evidence against the validity of this principle, on subjective level it was a fixed idea, at best. His assessment of himself changed drastically as well. He came to consider himself as God's elect: "''When I burdened myself with the task of finding help for suffering humanity ... I was only carrying out that plan for which The Great Spirit gave me power and insight.''" |
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[[File:Rhustox.jpg|thumb|Homeopathic preparation ''Rhus toxicodendron'', derived from [[Toxicodendron radicans|poison ivy]]]]The provision of homeopathic preparations has been described as unethical.<ref name="unethical">{{cite journal |last1=Shaw |first1=DM |title=Homeopathy is where the harm is: Five unethical effects of funding unscientific 'remedies' |journal=Journal of Medical Ethics |volume=36 |issue=3 |pages=130–31 |year=2010 |pmid=20211989 |doi=10.1136/jme.2009.034959 |s2cid=206996446 |doi-access=free }}</ref><ref name="Shaw2010">{{cite journal |last=Shaw |first=David |title=Homeopathy and medical ethics |journal=Focus on Alternative and Complementary Therapies |publisher=Wiley |volume=16 |issue=1 |date=4 November 2010 |issn=1465-3753 |doi=10.1111/j.2042-7166.2010.01051.x |pages=17–21}}</ref> [[Michael Baum (surgeon)|Michael Baum]], professor emeritus of surgery and visiting professor of medical humanities at [[University College London]] (UCL), has described homeopathy as a "cruel deception".<ref name="Janes">{{cite news |author=Hilly Janes |url=http://www.timesonline.co.uk/tol/life_and_style/article4682309.ece |title=The Lifestyle 50: The top fifty people who influence the way we eat, exercise and think about ourselves |work=[[The Times]] |date=September 6, 2008 |archive-url=https://web.archive.org/web/20110727183929/http://www.timesonline.co.uk/tol/life_and_style/article4682309.ece |archive-date=July 27, 2011}}</ref> [[Edzard Ernst]], the first professor of [[alternative medicine|complementary medicine]] in the United Kingdom and a former homeopathic practitioner,<ref name="Ernst_memo">[https://publications.parliament.uk/pa/cm200910/cmselect/cmsctech/memo/homeopathy/ucm1602.htm Memorandum submitted by Edzard Ernst HO 16] to the [[House of Lords]]</ref><ref> |
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{{cite news |
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|title=The alternative professor |
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|url=https://www.theguardian.com/science/2003/sep/25/scienceinterviews.health |
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|author=Boseley S |
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|newspaper=[[The Guardian]] |
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|date=July 21, 2008 |
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|location=London |
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}}</ref><ref name="Con?">{{cite news |
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|url=https://www.independent.co.uk/life-style/health-and-wellbeing/features/complementary-therapies-the-big-con-813248.html |
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|title=Complementary therapies: The big con? |
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|work=The Independent |
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|access-date=May 4, 2010 |
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|location=London |
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|date=April 22, 2008 |
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|archive-url=https://web.archive.org/web/20090427070400/http://www.independent.co.uk/life-style/health-and-wellbeing/features/complementary-therapies-the-big-con-813248.html |
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|archive-date=April 27, 2009 |
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}}</ref> has expressed his concerns about [[pharmacist]]s who violate their ethical code by failing to provide customers with "necessary and relevant information" about the true nature of the homeopathic products they advertise and sell.<ref> |
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{{cite news |
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|title=Pharmacists urged to 'tell the truth' about homeopathic remedies |
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|url=https://www.theguardian.com/science/2008/jul/21/pharmacists.homeophathy |
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|author=Sample I |
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|newspaper=[[The Guardian]] |
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|date=July 21, 2008 |
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|location=London |
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}}</ref> In 2013 the [[Advertising Standards Authority (United Kingdom)|UK Advertising Standards Authority]] concluded that the [[Society of Homeopaths]] were targeting vulnerable ill people and discouraging the use of essential medical treatment while making misleading claims of efficacy for homeopathic products.<ref name="ASA">{{cite web|date=July 3, 2013|title=ASA adjudication on Society of Homeopaths|url=http://www.asa.org.uk/Rulings/Adjudications/2013/7/Society-of-Homeopaths/SHP_ADJ_157043.aspx|archive-url=https://web.archive.org/web/20130706020223/http://asa.org.uk/Rulings/Adjudications/2013/7/Society-of-Homeopaths/SHP_ADJ_157043.aspx|archive-date=July 6, 2013|access-date=July 4, 2013|publisher=ASA|df=mdy-all}}</ref> In 2015 the [[Federal Court of Australia]] imposed penalties on a homeopathic company for making false or misleading statements about the efficacy of the whooping cough vaccine and recommending homeopathic remedies as an alternative.<ref name="ACCC">{{cite web|title=Court imposes penalty for false or misleading claims by Homeopathy Plus and Ms Frances Sheffield |url=https://www.accc.gov.au/media-release/court-imposes-penalty-for-false-or-misleading-claims-by-homeopathy-plus-and-ms-frances-sheffield|publisher=ACCC|access-date=March 31, 2016|date=October 14, 2015}}</ref>[[File:1belladonna.jpg|thumb|Old homeopathic [[Deadly nightshade|belladonna]] preparation|alt=|left]]A 2000 review by homeopaths reported that homeopathic preparations are "unlikely to provoke severe adverse reactions".<ref>{{cite journal|last1=Dantas|first1=F|last2=Rampes|first2=H|year=2000|title=Do homeopathic medicines provoke adverse effects? A systematic review|journal=British Homoeopathic Journal|volume=89|pages=S35–S38|doi=10.1054/homp.1999.0378|pmid=10939781|s2cid=24738819}}</ref> In 2012, a systematic review evaluating evidence of homeopathy's possible [[adverse effect]]s concluded that "homeopathy has the potential to harm patients and consumers in both direct and indirect ways".<ref name="sr2012">{{cite journal|last1=Posadzki|first1=P|last2=Alotaibi|first2=A|last3=Ernst|first3=E|year=2012|title=Adverse effects of homeopathy: A systematic review of published case reports and case series|journal=International Journal of Clinical Practice|volume=66|issue=12|pages=1178–88|doi=10.1111/ijcp.12026|pmid=23163497|s2cid=2930768|doi-access=free}}</ref> A 2016 systematic review and meta-analysis found that, in homeopathic clinical trials, adverse effects were reported among the patients who received homeopathy about as often as they were reported among patients who received placebo or conventional medicine.<ref>{{cite journal|last1=Stub|first1=T|last2=Musial|first2=F|last3=Kristoffersen|first3=AA|last4=Alræk|first4=T|last5=Liu|first5=J|date=June 2016|title=Adverse effects of homeopathy, what do we know? A systematic review and meta-analysis of randomized controlled trials|url=https://munin.uit.no/bitstream/10037/10908/4/article.pdf|journal=Complementary Therapies in Medicine|volume=26|pages=146–63|doi=10.1016/j.ctim.2016.03.013|pmid=27261996|hdl=10037/10908}}</ref> |
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Some homeopathic preparations involve poisons such as [[Atropa belladonna|Belladonna]], [[arsenic]], and [[Toxicodendron radicans|poison ivy]]. In rare cases, the original ingredients are present at detectable levels. This may be due to improper preparation or intentional low dilution. Serious adverse effects such as seizures and death have been reported or associated with some homeopathic preparations.<ref name="sr2012" /> Instances of [[arsenic poisoning]] have occurred.<ref name="J Toxicology: Arsenic toxicity" /> In 2009, the FDA advised consumers to stop using three discontinued cold remedy [[Zicam]] products because it could cause permanent damage to users' sense of smell.<ref>Sources: |
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Hahnemann had all personal traits of a religious leader. And indeed, the atmosphere within the circle of his first followers was that of a newly founded religious sect. He did not tolerate differing views, was despotic in doctrinal matters, and extremely vindictive towards all dissidents. Some of his letters are really revealing in this aspect. He not only did not wish to consider any observations contrary to his opinions, he simply tried to suppress them. Thus, he wrote to Stapf, the editor of the ''Archiv für die homöopatische Heilkunst'', asking him to prevent any publications of clinical cases which could confirm the views contrary to his own: "''I pray of you to eliminate from your Archiv all superficial observations of pretended successful treatment.''" Homoeopathy survived; but it survived as a '''medical sect'''. |
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* {{cite news|author=Julianne Pepitone|date=June 16, 2009|title=Zicam may damage sense of smell – FDA|publisher=[[CNNMoney.com]]|url=https://money.cnn.com/2009/06/16/news/companies/zicam_sense_of_smell/index.htm?section=money_latest}} |
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=== In quest of allies === |
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* {{cite web|date=June 16, 2009|title=Information on Zicam Cold Remedy nasal gel, Zicam Cold Remedy nasal swabs, and Zicam Cold Remedy swabs, kids size|url=https://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm166834.htm|publisher=[[Food and Drug Administration (United States)|FDA]]}}</ref> In 2016 the FDA issued a safety alert to consumers<ref name="FDAconsumers">{{cite web |url=https://www.fda.gov/safety/medwatch/safetyinformation/safetyalertsforhumanmedicalproducts/ucm523435.htm |title=Homeopathic Teething Tablets and Gels: FDA Warning – Risk to Infants and Children |publisher=FDA |date=September 30, 2016 |access-date=October 17, 2016}}</ref> warning against the use of homeopathic teething gels and tablets following reports of adverse events after their use.<ref name="FDANewsRelease">{{cite web |url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm523468.htm |title=FDA warns against the use of homeopathic teething tablets and gels |publisher=FDA |date=September 30, 2016 |access-date=October 17, 2016}}</ref> A previous FDA investigation had found that these products were improperly diluted and contained "unsafe levels of belladonna" and that the reports of serious adverse events in children using this product were "consistent with belladonna toxicity".<ref name="arstechnicaFDA">{{cite web |url=http://arstechnica.co.uk/science/2016/10/fda-homeopathic-teething-gels-may-have-killed-10-babies-sickened-400/ |title=FDA: Homeopathic teething gels may have killed 10 babies, sickened 400 |publisher=Ars Technica UK |date=October 13, 2016 |access-date=October 17, 2016 |author=Mole, Beth}}</ref> |
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Homoeopathy proved to be capable of holding out. However, in European countries it never succeeded in gaining respectability with a majority, or even a considerable part of public opinion, to say nothing of the scientific circles. Consequently, homoeopaths had to use other means than conviction to promote their credo. |
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Patients who choose to use homeopathy rather than [[evidence-based medicine]] risk missing timely diagnosis and effective treatment, thereby worsening the outcomes of serious conditions such as cancer.<ref name="Mayo Clinic Proceedings: trials" /><ref name="pmid12974558">{{cite journal |last1=Malik |first1=IA |last2=Gopalan |first2=S |title=Use of CAM results in delay in seeking medical advice for breast cancer |journal=European Journal of Epidemiology |volume=18 |issue=8 |pages=817–22 |year=2002 |pmid=12974558 |doi=10.1023/A:1025343720564 |s2cid=19059757 |quote=CAM use [in the developing countries this study solely considered] was associated with delay in seeking medical advice (OR: 5.6; 95% CI: 2.3, 13.3) and presentation at an advanced stage of disease}}</ref><ref name="pmid8554846" /><ref name="BBC malaria" /> The Russian [[Commission on Pseudoscience]] has said homeopathy is not safe because "patients spend significant amounts of money, buying medicines that do not work and disregard already known effective treatment."<ref>{{Cite web|date=2017-02-07|title=Memorandum #2. Homeopathy as pseudoscience|url=http://klnran.ru/en/2017/02/memorandum02-homeopathy/|access-date=March 19, 2021|website=[[Commission on Pseudoscience]]}}</ref> Critics have cited cases of patients failing to receive proper treatment for diseases that could have been easily managed with conventional medicine and who have died as a result.<ref name="Baby_Gloria">Case of Baby Gloria, who died in 2002: |
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==== Support by religious groups ==== |
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*{{cite news |
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Homoeopaths always tended to rely upon lay persons and organizations invested with political power or at least with social influence to further the spread of homoeopathy. As a rule, allies were found among social powers of anti-scientific stand. The best known example is the connection of homoeopathy in the USA with Swedenborgianism. |
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|title = Homeopath Thomas Sam guilty of daughter Gloria's death |
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|newspaper = [[The Daily Telegraph (Sydney)|The Daily Telegraph]] |
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|location = Sydney |
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|date = June 5, 2009 |
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|url = http://www.dailytelegraph.com.au/news/homeopath-thomas-sam-guilty-of-daughter-glorias-death/story-e6freuy9-1225723018271 |
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|access-date = March 17, 2010 |
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|archive-date = November 18, 2012 |
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|archive-url = https://web.archive.org/web/20121118064506/http://www.dailytelegraph.com.au/news/homeopath-thomas-sam-guilty-of-daughter-glorias-death/story-e6freuy9-1225723018271 |
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}} |
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*{{cite news |
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|title = Parents guilty of manslaughter over daughter's eczema death |
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|newspaper = [[The Canberra Times]] |
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|date = June 5, 2009 |
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|url = http://www.canberratimes.com.au/news/national/national/general/parents-guilty-of-manslaughter-over-daughters-eczema-death/1533293.aspx |
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|archive-url = https://web.archive.org/web/20100625160931/http://www.canberratimes.com.au/news/national/national/general/parents-guilty-of-manslaughter-over-daughters-eczema-death/1533293.aspx |
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|archive-date = June 25, 2010 |
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|df = mdy-all |
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}}</ref><ref name="Dingle">{{cite web |author1=Alastair Neil Hope |author2=State Coroner |url=https://www.scribd.com/doc/68731728/Coroner-Dingle-Finding |title=Coroner's inquest into the death of Penelope Dingle. Ref No: 17/10 }}</ref> They have also condemned the "marketing practice" of criticizing and downplaying the effectiveness of medicine.<ref name="Goldacre20072" /><ref name="Dingle" /> Homeopaths claim that use of conventional medicines will "push the disease deeper" and cause more serious conditions, a process referred to as "suppression".<ref> |
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{{cite book |
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|author=Schmukler AV |
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|year=2006 |
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|url=https://books.google.com/books?id=E1fVzLCmk5gC&q=suppression+homeopathy&pg=PA16 |
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|title=Homeopathy: An A to Z Home Handbook |
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|publisher=Llewellyn Worldwide |
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|page=16 |
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|isbn=978-0-7387-0873-7 |
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}}</ref> In 1978, [[Anthony Campbell (physician)|Anthony Campbell]], a consultant physician at the Royal London Homeopathic Hospital, criticized statements by [[George Vithoulkas]] claiming that [[syphilis]], when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the [[central nervous system]].<ref>{{cite journal|author=Campbell A|date=October 1978|title=The science of homoeopathy, by G. Vithoulkas|journal=British Homoeopathic Journal|type=book review|volume=67|issue=4|pages=299–301|doi=10.1016/S0007-0785(78)80061-1|s2cid=69144584 }}</ref> Vithoulkas' claims echo the idea that treating a disease with external medication used to treat the symptoms would only drive it deeper into the body and conflict with scientific studies, which indicate that [[penicillin]] treatment produces a complete cure of syphilis in more than 90% of cases.<ref name="Birnbaum">{{cite journal|vauthors=Birnbaum NR, Goldschmidt RH, Buffett WO|year=1999|title=Resolving the common clinical dilemmas of syphilis|url=http://www.aafp.org/afp/990415ap/2233.html|journal=American Family Physician|volume=59|issue=8|pages=2233–40, 2245–46|pmid=10221308|access-date=September 3, 2007|archive-date=June 6, 2011|archive-url=https://web.archive.org/web/20110606033808/http://www.aafp.org/afp/990415ap/2233.html}}</ref> |
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The use of homeopathy as a preventive for serious infectious diseases, called [[homeoprophylaxis]], is especially controversial.<ref name="BBC-malaria">{{cite news|date=January 5, 2011|title=Is bad homeopathic advice putting travellers at risk?|work=Newsnight|agency=BBC|url=http://news.bbc.co.uk/1/hi/programmes/newsnight/9341713.stm|access-date=January 10, 2015}}</ref> Some homeopaths (particularly those who are non-physicians) advise their patients against [[vaccine|immunization]].<ref name="pmid8554846" /><ref name="pmid9243229">{{cite journal |last1=Ernst |first1=E. |title=The attitude against immunisation within some branches of complementary medicine |journal=European Journal of Pediatrics |volume=156 |issue=7 |pages=513–15 |year=1997 |pmid=9243229 |doi=10.1007/s004310050650|s2cid=25420567 |doi-access=free }}</ref><ref>{{cite journal |last1=Ernst |first1=E |title=Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination |journal=Vaccine |volume=20 |pages=S90–93; discussion S89 |year=2001 |doi=10.1016/S0264-410X(01)00290-0 |pmid=11587822}}</ref> Others have suggested that vaccines be replaced with homeopathic "nosodes".<ref> |
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All prominent American homoeopaths in XIX century, from Hering to Kent, were members of the New Jerusalem Church; and the members of the New Jerusalem Church were supporters and followers of homoeopathy almost to a man. With Kent, the Swedenborgian theosophy found its way into the homoeopathic doctrine, which fact is acknowledged by homoeopathic writers (see e.g. ''Winston J.: The Faces of Homoeopathy, Tawa, 1999; p.166-167''). In particular, the priority given to mental symptoms in choosing the remedy is dictated by theosophic fantasies. By the same token, Kent's Swedenborgian speculations dictate the potencies used in particular cases. Kent felt that potentization reduced a homeopathic remedy to its ''simple substance'', and this way the remedy itself entered into the Swedenborgian ''fourth state of matter''. It is maintained that high potency approaches the spirit, while low potency approaches matter. Then, going higher in potency means going deeper into causes. The high potencies are regarded as solely capable of reaching into the higher world and thus solely capable of destroying the true causes of disease. The low potencies are regarded as superficial and trifling, as too close to matter and not close enough to the nature of the vital force to be of much use. |
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{{cite journal |
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|author =Pray WS |
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|title =The challenge to professionalism presented by homeopathy |
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|journal =American Journal of Pharmaceutical Education |
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|volume =60 |
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|pages =198–204 |
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|year =1996 |
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|issue =2 |
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|doi =10.1016/S0002-9459(24)04582-0 |
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}}</ref> While Hahnemann was opposed to such preparations, modern homeopaths often use them although there is no evidence to indicate they have any beneficial effects.<ref> |
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{{cite journal |
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|title =A challenge to the credibility of homeopathy |
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|journal =American Journal of Pain Management |
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|year =1992 |
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|author =Pray WS |
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|issue =2 |
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|pages =63–71 |
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}}</ref><ref>{{cite journal |last1=English |first1=J |title=The issue of immunization |journal=British Homoeopathic Journal |volume=81 |pages=161–63 |year=1992 |doi=10.1016/S0007-0785(05)80171-1 |issue=4|s2cid=71502677 }}</ref> Promotion of homeopathic alternatives to vaccines has been characterized as dangerous, inappropriate and irresponsible.<ref name="CBC-Irresponsible">{{cite web|date=November 28, 2014|title=Vaccine alternatives offered by homeopaths 'irresponsible'|url=http://www.cbc.ca/news/health/vaccine-alternatives-offered-by-homeopaths-irresponsible-1.2852408|access-date=January 10, 2015|work=Marketplace|publisher=CBC}}</ref><ref name="BBC-Poling">{{cite news|author=Poling, Samantha|date=September 13, 2010|title=Doctors warn over homeopathic 'vaccines'|agency=BBC|url=https://www.bbc.co.uk/news/uk-scotland-11277990|access-date=January 10, 2015}}</ref> In December 2014, the Australian homeopathy supplier [[Homeopathy Plus!]] was found to have acted deceptively in promoting homeopathic alternatives to vaccines.<ref name="ACCC-HPlus">{{cite web|date=December 23, 2014|title=Court finds Homeopathy Plus! vaccine claims misleading|url=https://www.accc.gov.au/media-release/court-finds-homeopathy-plus-vaccine-claims-misleading|access-date=January 10, 2015|publisher=Australian Competition and Consumer Commission}}</ref> In 2019, an investigative journalism piece by the [[The Daily Telegraph|''Telegraph'']] revealed that homeopathy practitioners were actively discouraging patients from vaccinating their children.<ref>{{Cite news|last1=Rushton|first1=Katherine|last2=Foggo|first2=Daniel|last3=Barnes|first3=Sophie|date=2019-11-01|title=Homeopaths warning mothers not to have children vaccinated, investigation reveals|language=en-GB|work=[[The Daily Telegraph]]|url=https://www.telegraph.co.uk/news/2019/11/01/homeopaths-warning-mothers-not-have-children-vaccinated-investigation/ |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/news/2019/11/01/homeopaths-warning-mothers-not-have-children-vaccinated-investigation/ |archive-date=January 11, 2022 |url-access=subscription |url-status=live|access-date=2019-11-03|issn=0307-1235}}{{cbignore}}</ref> Cases of homeopaths advising against the use of anti-malarial drugs have also been identified,<ref name="BBC malaria" /><ref name="Guardian malaria" /><ref name="pmid11082104" /> putting visitors to the tropics in severe danger.<ref name="BBC malaria"> |
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{{cite news |
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|author =Jones M |
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|title =Malaria advice 'risks lives' |
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|date =July 14, 2006 |
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|periodical =[[Newsnight]] |
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|publisher =[[BBC Television]] |
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|url =http://news.bbc.co.uk/2/hi/programmes/newsnight/5178122.stm |
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|access-date =March 24, 2009 |
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}}</ref><ref name="Guardian malaria"> |
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{{cite news |
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|author =Jha A |
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|title =Homeopaths 'endangering lives' by offering malaria remedies |
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|date =July 14, 2006 |
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|url =https://www.theguardian.com/science/story/0,,1820103,00.html |
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|newspaper =[[The Guardian]] |
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|location =London |
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}}</ref><ref name="pmid11082104">{{cite journal |last1=Starr |first1=M. |title=Malaria affects children and pregnant women most |journal=BMJ |volume=321 |page=1288 |year=2000 |doi=10.1136/bmj.321.7271.1288 |issue=7271|pmc=1119021 |pmid=11082103}}</ref><ref name="Coffman">{{cite web|author=Coffman, Becky |url=https://www.cdc.gov/malaria/stories/homeopathic_drugs.html |url-status=dead |archive-url=https://web.archive.org/web/20140324180407/https://www.cdc.gov/malaria/stories/homeopathic_drugs.html |archive-date=March 24, 2014 |title=A cautionary tale: the risks of unproven antimalarials |publisher=[[Centers for Disease Control]] |date=January 28, 2019 }}{{cbignore}}</ref> |
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A 2006 review recommends that pharmacy colleges include a required course where ethical dilemmas inherent in recommending products lacking proven safety and efficacy data be discussed and that students should be taught where unproven systems such as homeopathy depart from evidence-based medicine.<ref> |
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A less known story is the connection of Russian homoeopathy with the Russian Orthodox Church (''Kotok A.: Homeopathy and the Russian Orthodox Clergy''; in: ''Medizin, Gesellschaft und Geschichte, 16, 1997, pp.171-193''). Yet another example is the role of the Missionary School of medicine, founded in England in 1903, and connected with the Faculty of Homoeopathy in London, in the spread of homoeopathy during the early part of the 1900's. |
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{{cite journal |
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|author=Pray WS |
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|title=Ethical, scientific, and educational concerns with unproven medications |
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|journal=American Journal of Pharmaceutical Education |
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|volume=70 |
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|issue=6 |
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|page=141 |
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|year=2006 |
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|pmid=17332867 |
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|pmc=1803699 |
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|doi=10.5688/aj7006141 |
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}}</ref> |
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==Regulation and prevalence== |
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==== Under the Nazi patronage ==== |
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{{Main|Regulation and prevalence of homeopathy}} |
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But only once in two centuries, their hour of triumph appeared to dawn upon homoeopaths. It happened in Germany in 1933, when Nazis came to power. |
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[[File:Bristol Homeopathic.jpg|thumb|Hampton House, the former site of [[Bristol Homeopathic Hospital]]]] |
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Homeopathy is fairly common in some countries while being uncommon in others; is highly regulated in some countries and mostly unregulated in others. It is practiced worldwide and professional qualifications and licences are needed in most countries.<ref name="Who Legal">{{Cite web|date=2001|title=Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review|url=http://apps.who.int/medicinedocs/pdf/h2943e/h2943e.pdf|archive-url=https://web.archive.org/web/20090927001352/http://apps.who.int/medicinedocs/pdf/h2943e/h2943e.pdf|archive-date=September 27, 2009|access-date=2020-09-01|website=World Health Organization}}</ref> A 2019 WHO report found that 100 out of 133 Member States surveyed in 2012 acknowledged that their population used homeopathy, with 22 saying the practice was regulated and 13 providing health insurance coverage.<ref name="WHO traditional">{{Cite web|date=4 June 2019|title=WHO global report on traditional and complementary medicine 2019|url=https://www.who.int/traditional-complementary-integrative-medicine/WhoGlobalReportOnTraditionalAndComplementaryMedicine2019.pdf?ua=1|access-date=2020-09-04|website=WHO|language=en}}</ref> In some countries, there are no specific legal regulations concerning the use of homeopathy, while in others, licences or degrees in conventional medicine from accredited universities are required. In 2001 homeopathy had been integrated into the national health care systems of many countries, including India, Mexico, Pakistan, Sri Lanka, and the United Kingdom.<ref name="Who Legal" /> |
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Nazis' position in respect of what was then called the school medicine was rather hostile. The same year they took power, they proclaimed a policy of support for all brands of alternative medicine (a review of their practical steps in this directions can be found in ''Jütte R.: Geschichte der Alternativen Medizin, München, 1996, pp.42-55''). Homoeopaths enthusiastically hailed the new ideology. Hans Wapler, the editor of the ''Allgemeine Homöopathische Zeitung'', wrote about "''decisive importance which political utilization of Similia similibus by '''Hitler''' gained in Germany''" (''Allgemeine Homöopathische Zeitung 181 (1933), p.317-319''). After being kind of cinderella in the Weimar Republic, homoeopathy (as all other brands of alternative medicine) suddenly became patronized and protected. Homoeopathic and naturopathic hospitals were functioning in Berlin, Bremen, Dresden, Gera, Hamburg, Köln, München, Nürnberg, Recklinghausen, Stuutgart, and Wuppertal. Not only could homoeopaths treat patients as they wanted, feeling behind them the benevolent attitude of the State. It was imposed upon regular doctors to use the methods of alternative medicine. As the ''Reichsärzteführer'' (''State's Chief Physician'') put it, "''each physician will be obliged to use, along with the medical procedures of the school medicine, the procedures which utilize natural forces and drugs''" (''Hippokrates'' 7, 1936, p.371). In fact, it was the biggest clinical trial of homoeopathy throughout its history; the miracle cures that fill up the pages of homoeopathic textbooks, could now be produced ''en masse''. Yet nothing came of it; homoeopaths showed no spectacular results. Then their patrons lost the war, and the things resumed their normal course. |
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=== Regulation === |
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Some homeopathic treatment is covered by the public health service of several European countries, including Scotland,<ref>{{cite news |last1=Green |first1=Chris |title=Scotland urged to stop funding homeopathy on NHS |url=https://inews.co.uk/news/health/scotland-urged-stop-funding-homeopathy-nhs-522057 |access-date=18 January 2020 |publisher=iNews |date=2 August 2017}}</ref> and [[Luxembourg]].<ref>{{cite web |last1=Clarinval |first1=France |title=Homeopathy to remain reimbursable in Luxembourg |url=https://today.rtl.lu/news/luxembourg/a/1393668.html |website=today.rt.lu |publisher=RTL Today |access-date=4 May 2020}}</ref> It used to be covered in France until 2021.<ref name="FranceEndFunding2021" /> In other countries, such as Belgium, homeopathy is not covered. In Austria, the public health service requires scientific proof of effectiveness in order to reimburse medical treatments and homeopathy is listed as not reimbursable,<ref> |
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Just as natural, homoeopaths readily saw an ally in every new para-scientific doctrine with pretensions of discovering hidden dimensions of the universe. The first such doctrine was mesmerism, and Hahnemann was an enthusiast of mesmerism throughout his life. By the middle of XIX century, the notions that originated from mesmerism found further development that influenced theoretical constructs of homoeopathy. In particular, it was the conception of ''odic forces'' developed by Carl von Reichenbach. Among homoeopaths, its main enthusiast was Adolf von Gerhardt. |
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{{cite web|author=[[Central Association of Austrian Social Insurance Authorities|Hauptverband der österreichischen Sozialversicherungsträger]]|date=March 31, 2004|title=Liste nicht erstattungsfähiger Arzneimittelkategorien gemäß § 351c Abs. 2 ASVG (List of treatments not reimbursable by social service providers in Austria)|url=https://www.avsv.at/avi/dokument/dokumentanzeige.xhtml?dokid=2004%3D34&dokStat=0&csrId=1736&tlId=1231413537940|archive-url=https://web.archive.org/web/20110706091417/https://www.avsv.at/avi/dokument/dokumentanzeige.xhtml?dokid=2004%3D34&dokStat=0&csrId=1736&tlId=1231413537940|archive-date=July 6, 2011|language=de|df=mdy-all}}</ref> but exceptions can be made;<ref> |
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{{cite court|litigants=Rechtssatz (legal rule)|court=Oberster Gerichtshof (Austrian supreme court)|opinion=RS0083796 {{in lang|de}}|date=February 28, 1994|url=http://www.ris.bka.gv.at/Dokumente/Justiz/JJR_19940228_OGH0002_010OBS00103_9300000_001/JJR_19940228_OGH0002_010OBS00103_9300000_001.pdf|format=PDF}}</ref> private health insurance policies sometimes include homeopathic treatments.<ref name="Who Legal" /> In 2018, Austria's [[Medical University of Vienna]] stopped teaching homeopathy.<ref name="Undark 2020-09-02">{{Cite web|date=2020-03-16|title=In Germany, a Heated Debate Over Homeopathy|url=https://undark.org/2020/03/16/homeopathy-globuli-germany/|access-date=2020-09-02|website=Undark Magazine|language=en-US}}</ref> The Swiss government withdrew coverage of homeopathy and four other complementary treatments in 2005, stating that they did not meet efficacy and cost-effectiveness criteria,<ref name="EndofHomeopathy">{{cite journal|author=<!-- No author listed -->|year=2005|title=The end of homoeopathy|journal=The Lancet|volume=366|issue=9487|page=690|doi=10.1016/S0140-6736(05)67149-8|pmid=16125567|s2cid=6115077|doi-access=free}}</ref> but following a referendum in 2009 the five therapies were reinstated for a further 6-year trial period.<ref>{{cite web|author=Dacey J|date=January 14, 2011|title=Alternative therapies are put to the test|url=http://www.swissinfo.ch/eng/swiss_news/Alternative_therapies_are_put_to_the_test.html?cid=29242484|access-date=January 17, 2011|publisher=swissinfo.ch|archive-date=April 22, 2014|archive-url=https://web.archive.org/web/20140422184705/http://www.swissinfo.ch/eng/swiss_news/Alternative_therapies_are_put_to_the_test.html?cid=29242484|url-status=dead}}</ref> In Germany, homeopathic treatments are covered by 70 percent of government medical plans, and available in almost every pharmacy.<ref name="Undark 2020-09-02" /> In January 2024, [[Federal Ministry of Health (Germany)|German health minister]] [[Karl Lauterbach]] announced plans to withdraw all statutory health insurance coverage for homeopathic and anthroposophic treatments, citing a lack of scientific evidence for their efficacy.<ref>{{cite web|author=Tagesschau|date=January 11, 2024|title="Homöopathie macht als Kassenleistung keinen Sinn"|url=https://www.tagesschau.de/inland/innenpolitik/lauterbach-homoeopathie-kassenleistung-100.html|access-date=January 18, 2024|publisher=tagesschau.de}}</ref> |
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The English NHS recommended against prescribing homeopathic preparations in 2017.<ref name="NHS Homeo" /> In 2018, prescriptions worth £55,000 were written in defiance of the guidelines, representing less than 0.001% of the total NHS prescribing budget.<ref>{{Cite web|date=2017-10-18|title=Homeopathy|url=https://www.nhs.uk/conditions/homeopathy/|access-date=2020-01-18|website=nhs.uk|language=en}}</ref><ref>{{Cite news|last1=Donnelly|first1=Laura|last2=Taylor|first2=Rosie|date=2019-04-05|title=NHS still spending £55,000 a year on homeopathy, despite ban|language=en-GB|work=The Telegraph|url=https://www.telegraph.co.uk/news/2019/04/05/nhs-still-spending-55000-year-homeopathy-despite-ban/ |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/news/2019/04/05/nhs-still-spending-55000-year-homeopathy-despite-ban/ |archive-date=January 11, 2022 |url-access=subscription |url-status=live|access-date=2020-01-18|issn=0307-1235}}{{cbignore}}</ref> In 2016 the UK's [[Committee of Advertising Practice]] compliance team wrote to homeopaths<ref name="NightingaleASA_CAP">{{cite web|date=September 29, 2016|title=Diluting misleading claims – ASA update|url=http://www.nightingale-collaboration.org/news/185-diluting-misleading-claims-asa-update.html|access-date=September 30, 2016|publisher=Nightingale Collaboration}}</ref> in the UK to "remind them of the rules that govern what they can and can't say in their marketing materials".<ref name="ASA_CAP">{{cite web|date=September 29, 2016|title=Advertising standards for homeopathy|url=https://www.asa.org.uk/News-resources/Media-Centre/2016/Advertising-standards-for-homeopathy.aspx|access-date=September 30, 2016|publisher=Advertising Standards Authority}}</ref> The letter told homeopaths to "ensure that they do not make any direct or implied claims that homeopathy can treat medical conditions" and asks them to review their marketing communications "including websites and social media pages" to ensure compliance.<ref name="LetterToHomeopaths">{{cite web|author=CAP Compliance Team|date=September 28, 2016|title=Advertising standsards for homeopaths|url=https://www.asa.org.uk/News-resources/Media-Centre/2016/~/media/Files/CAP/News/Letter%20to%20Homeopaths.pdf|archive-url=https://web.archive.org/web/20161003143347/https://www.asa.org.uk/News-resources/Media-Centre/2016/~/media/Files/CAP/News/Letter%20to%20Homeopaths.pdf|archive-date=October 3, 2016|access-date=September 30, 2016|publisher=Committee of Advertising Practice|df=mdy-all}}</ref> Homeopathic services offered at [[Bristol Homeopathic Hospital]] in the UK ceased in October 2015.<ref name="GoodThinking">{{cite web|date=June 5, 2015|title=Bristol Homeopathic Hospital To Cease Offering Homeopathic Treatments|url=http://goodthinkingsociety.org/bristol-homeopathic-hospital-cease-offering-homeopathic-treatments/|access-date=April 29, 2016|publisher=Good Thinking}}</ref><ref name="BristolPost-10-06-2015">{{cite news|last1=Cardwell|first1=Mark|date=June 10, 2015|title=Homeopathy services will no longer be available at Bristol NHS Trust hospitals|work=Bristol Post|url=http://www.bristolpost.co.uk/Homeopathy-services-longer-available-NHS-Bristol/story-26666377-detail/story.html|access-date=April 29, 2016|archive-url=https://web.archive.org/web/20150928025310/http://www.bristolpost.co.uk/Homeopathy-services-longer-available-NHS-Bristol/story-26666377-detail/story.html|archive-date=September 28, 2015|df=mdy-all}}</ref> |
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Much more damaging to the reputation of homoeopathy was the hasty support given by homoeopaths to the so-called "''electronic reactions of Abrams''" (ERA). Its scientific validity is demonstrated by the claim that the religion of a person can be determined through the method. In the September 1922 issue of his journal, ''Physico-Clinical Medicine'', Abrams printed a chart showing abdominal areas of dullness for Catholic, Seventh Day Adventist, Theosophist, Jew, Protestant, and Methodist - the last two quite some distance apart. The controversy about ERA prompted the well-known magazine ''Scientific American'' to bottom one's own inquiry. The final conclusion appeared in the September issue of 1924. It stated: "''...the so-called electronic reactions do not exist. They are either faked by the unscrupulous practitioner, or, when the practitioner is sincere, they are baffling products of his subconsciuos mind''". |
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Member states of the [[European Union]] are required to ensure that homeopathic products are registered, although this process does not require any proof of efficacy.<ref name="Commander Snake">{{Cite web|last=Commander|first=Emily|date=2018-10-01|title=Snake oil or science? Homeopathy in Europe|url=https://www.euronews.com/2018/10/01/snake-oil-or-science-homeopathy-in-europe|access-date=2020-09-04|website=euronews|language=en}}</ref> In Spain, the [[Association for the protection of patients from pseudo-scientific therapies]] is lobbying to get rid of the easy registration procedure for homeopathic remedies.<ref name="Commander Snake" /> In Bulgaria, Hungary, Latvia, Romania and Slovenia homeopathy, by law, can only be practiced by medical practitioners. However, in Slovenia if doctors practice homeopathy their medical license will be revoked.<ref name="Commander Snake" /> In Germany, to become a homeopathic physician, one must attend a three-year training program, while France, Austria and Denmark mandate licences to diagnose any illness or dispense of any product whose purpose is to treat any illness.<ref name="Who Legal" /> Homeopaths in the UK are under no legal regulations, meaning anyone can call themselves homeopaths and administer homeopathic remedies.<ref name="NHS Homeo">{{Cite web|date=2017-10-18|title=Homeopathy|url=https://www.nhs.uk/conditions/homeopathy/|access-date=2020-09-02|website=nhs.uk|language=en}}</ref>[[File:India - Varanasi pharmacy - 0830.jpg|left|thumb|Homeopathics at a homeopathic pharmacy in [[Varanasi]], India]] |
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The whole of facts related to the ERA undisputably demonstrates them to be a classic instance of charlatanism. Why should homoeopaths have been involved in the affaire? Because Abrams claimed to be capable of determining the "''vibratory rate''" of drugs, homoeopathic drugs included. He stated that not only homoeopathic potencies do have their "''vibratory rates''" (the evidence of their effectiveness), but also that higher potencies evince stronger effect than the lower ones. The long wished for confirmation of the reality of high potencies was there! It was enough to assure blind support of the International Hahnemannian Association (IHA) for Abrams and his followers, whatever negative evidence was produced against the ERA. |
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[[File:A local store of Homeopathic medicines at Jagadishpur Hat, West Bengal.jpg|thumb|Homeopathic medicines at a store in [[West Bengal]], India]] |
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The [[Indian government]] recognizes homeopathy as one of its national systems of medicine and they are sold with medical claims.<ref>{{cite web |
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|url = http://india.gov.in/citizen/health/healthcare_system.php |
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|title = Alternative System of Health Care |
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|publisher = Government of India |
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|access-date = January 15, 2010 |
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|archive-url = https://web.archive.org/web/20100102154756/http://india.gov.in/citizen/health/healthcare_system.php |
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|archive-date = January 2, 2010 |
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}}</ref><ref name="WHO traditional" /> It has established the [[Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy]] (AYUSH) under the [[Ministry of Health and Family Welfare (India)|Ministry of Health & Family Welfare]].<ref>{{cite news|url=http://indianmedicine.nic.in/index.asp?lang=1|title=AYUSH|publisher=[[Government of India]]. website|archive-url=https://archive.today/20130822171213/http://indianmedicine.nic.in/index.asp?lang=1|archive-date=August 22, 2013|df=mdy-all}}</ref> The south Indian state of [[Kerala]] also has a cabinet-level AYUSH department.<ref>{{cite web|url=http://www.homoeoscan.com/2015/06/Kerala-AYUSH-department-Final-nod.html|title=Kerala AYUSH department- Final nod|date=June 4, 2015|website=Homoeoscan|access-date=October 1, 2017}}</ref> The [[Central Council of Homoeopathy]] was established in 1973 to monitor higher education in homeopathy, and the [[National Institute of Homoeopathy]] in 1975.<ref>{{cite web|title=Professional Councils |url=http://www.ugc.ac.in/inside/pcouncil.html#CCH |publisher=[[University Grants Commission (India)|University Grants Commission]] (UGC) website |archive-url=https://web.archive.org/web/20100106075646/http://www.ugc.ac.in/inside/pcouncil.html |archive-date=January 6, 2010 }}</ref> Principals and standards for homeopathic products are covered by the ''[[Homoeopathic pharmacopoeia of India]]''.<ref name="WHO Safety" /> A minimum of a recognized diploma in homeopathy and registration on a state register or the Central Register of Homoeopathy is required to practice homeopathy in India.<ref>{{cite web |
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|url = http://www.cchindia.com/central_act3.htm |
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|title = The Homoeopathy Central Council Act, 1973, s. 15 and Sch. II |
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|publisher = Central Council of Homeopathy, India |
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|access-date = January 18, 2010 |
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|archive-url = https://web.archive.org/web/20091123105853/http://www.cchindia.com/central_act3.htm |
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|archive-date = November 23, 2009 |
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}}</ref> |
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Some [[medical school]]s in Pakistan,<ref>{{Cite web |url=https://www.thenews.com.pk/print/436504-govt-asked-to-set-up-university-to-promote-homoeopathy |title=Govt asked to set up university to promote homoeopathy}}</ref> India,<ref>{{cite news|last1=MANDHANI|first1=APOORVA|title=Gujarat HC Quashes Rules Permitting Common Counselling By State For Management Quota Seats in Ayurveda Colleges [Read Judgment]|url=http://www.livelaw.in/gujarat-hc-quashes-rules-permitting-common-counselling-state-management-quota-seats-ayurveda-colleges-read-judgment/|publisher=Live Law|date=August 8, 2017}}</ref><ref>{{cite news|title=Alternative Medicine: Emerging Careers|url=https://www.northeasttoday.in/alternative-medicine-emerging-careers/|publisher=northeasttoday.in|date=March 23, 2017|access-date=March 4, 2021|archive-date=January 8, 2018|archive-url=https://web.archive.org/web/20180108062819/https://www.northeasttoday.in/alternative-medicine-emerging-careers/}}</ref> and Bangladesh,<ref>{{Cite web |url=https://books.google.com/books?id=7u8QjjEwif4C&q=bachelor+of+homoeopathy+medicine+and+surgery+in+bangladesh |title=Statistical Yearbook of Bangladesh|year=2012}}</ref><ref>{{Cite web |url=https://www.homoeopathicboardbd.org/ |title=Bangladesh Homoeopathy Board – Bangladesh Homoeopathy Board}}</ref> offer an undergraduate degree programme in homeopathy.<ref>{{Cite book |url=https://books.google.com/books?id=3RYrDwAAQBAJ&q=Bachelor+of+Homoeopathy+Medicine+and+Surgery&pg=PT77 |title=Educational Equivalency Analysis: India & USA Degrees: 108 India Degrees and Equivalency to USA degrees |isbn=978-93-5278-117-1 |last1=Raghu Korrapati |first1=Dr |date=2017-07-06|publisher=Diamond Pocket Books Pvt }}</ref> Upon completion the college may award a ''{{visible anchor|Bachelor of Homoeopathy Medicine and Surgery}}'' (''B.H.M.S.''). |
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The IHA rushed to save the reputation of the ERA. It created its own committee under the heading of Stearns to re-investigate the affaire. The results of the endeavours of the committee submitted to the IHA in 1925 revealed their complete incompetence in such issues. Without disproving any of the numerous negative results of the tests done by the ''Scientific American'', they still claimed that there is enough evidence "''that Abrams's claims had at least some basis in fact''", rejecting the Scientific American report as biased and "''directed toward disproving''". |
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In the United States each state is responsible for the laws and licensing requirements for homeopathy.<ref>{{Cite web|title=Practicing & Studying Homeopathy|url=https://www.homeopathycenter.org/practicing-studying-homeopathy/|access-date=2020-09-02|website=The National Center for Homeopathy|language=en|archive-date=April 14, 2021|archive-url=https://web.archive.org/web/20210414135845/https://www.homeopathycenter.org/practicing-studying-homeopathy/}}</ref> In 2015, the FDA held a hearing on homeopathic product regulation.<ref>{{cite journal|last1=Frazier|first1=Kendrick|authorlink= Kendrick Frazier|year=2015|title=CFI testimony urges FDA to regulate homeopathic products|journal=Skeptical Inquirer|volume=39|issue=4|pages=6–7}}</ref> At the hearing, representatives from the [[Center for Inquiry]] and the [[Committee for Skeptical Inquiry]] summarized the harm that is done to the general public from homeopathics and proposed regulatory actions:<ref name="fdahearing">{{cite web|author=De Dora, Michael|date=April 20, 2015|title=Homeopathic product regulation: evaluating the Food and Drug Administration's regulatory framework after a quarter-century. Testimony of the Center for Inquiry to the Food and Drug Administration|url=https://www.fda.gov/downloads/Drugs/NewsEvents/UCM443495.pdf|publisher=FDA}}</ref> In 2016 the United States [[Federal Trade Commission]] (FTC) issued an "Enforcement Policy Statement Regarding Marketing Claims for Over-the-Counter Homeopathic Drugs" which specified that the FTC will apply the same standard to homeopathic drugs that it applies to other products claiming similar benefits.<ref name="FTC2016">{{cite web|title=FTC: Enforcement Policy Statement on Marketing Claims for OTC Homeopathic Drugs|url=https://www.ftc.gov/system/files/documents/public_statements/996984/p114505_otc_homeopathic_drug_enforcement_policy_statement.pdf|access-date=November 18, 2016|publisher=Federal Trade Commission}}</ref> A related report concluded that claims of homeopathy effectiveness "are not accepted by most modern medical experts and do not constitute competent and reliable scientific evidence that these products have the claimed treatment effects."<ref name="WSReport">{{cite web|title=Homeopathic Medicine & Advertising Workshop Report|url=https://www.ftc.gov/system/files/documents/reports/federal-trade-commission-staff-report-homeopathic-medicine-advertising-workshop/p114505_otc_homeopathic_medicine_and_advertising_workshop_report.pdf|access-date=November 18, 2016|publisher=Federal Trade Commission}}</ref> In 2019, the FDA removed an enforcement policy that permitted unapproved homeopathics to be sold.<ref>{{Cite web|title=FDA Toughens Enforcement of Homeopathic Products|url=https://www.natlawreview.com/article/fda-toughens-enforcement-homeopathic-products|access-date=2020-09-02|website=The National Law Review|language=en}}</ref> Currently no homeopathic products are approved by the FDA.<ref>{{Cite journal|last=Research|first=Center for Drug Evaluation and|date=2020-07-22|title=Homeopathic Products|url=https://www.fda.gov/drugs/information-drug-class/homeopathic-products|journal=FDA|language=en}}</ref> |
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With all that, it was impossible to put by the egregious inconsistencies in the internal arrangement of Abrams' devices. It is really enlightening to see how the matter was treated in a pamphlet written by Stearns much later, in 1942. He had to admit that "''the investigation of the AMA, undertaken by the ''Scientific American'', failed to obtain reliable and consistent evidence from the Abrams proponents.''" After that, the non-sequitur conclusion: "''The wonder was that despite his crudities of technique Abrams was able to discover so much that was fundamental...''" |
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Homeopathic remedies are regulated as natural health products in Canada.<ref name="WHO Safety" /> [[Ontario]] became the first province in the country to regulate the practice of homeopathy, a move that was widely criticized by scientists and doctors.<ref>{{Cite news|title='A pseudo-science': Outrage after Ontario government funds college program in homeopathy|url=https://nationalpost.com/news/canada/a-diploma-in-magical-thinking-critics-want-funding-pulled-for-ontario-colleges-homeopathy-course|access-date=2020-09-02|website=National Post|date=February 8, 2018|language=en-CA|last1=Kirkey|first1=Sharon}}</ref> [[Health Canada]] requires all products to have a licence before being sold and applicants have to submit evidence on "the safety, efficacy and quality of a homeopathic medicine".<ref>{{Cite web|last=Canada|first=Health|date=2006-10-26|title=Evidence for Homeopathic Medicines|url=https://www.canada.ca/en/health-canada/services/drugs-health-products/natural-non-prescription/legislation-guidelines/guidance-documents/evidence-homeopathic-medicines.html|access-date=2020-09-04|website=aem}}</ref> In 2015 the [[Canadian Broadcasting Corporation]] tested the system by applying for and then receiving a government approved licence for a made-up drug aimed at kids.<ref>{{Cite web|date=Mar 13, 2015|title=Drugstore remedies: Licence to Deceive|url=https://www.cbc.ca/marketplace/episodes/2014-2015/drugstore-remedies-licence-to-deceive|website=CBC}}</ref> |
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=== Classical versus non-classical homeopathy === |
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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. Occasionally single remedies are used in this way, but more often, mixtures of several remedies are used in a practice known as ''complex homeopathy''. 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 critera based on various diagostic 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 probably exceeds that of classical homeopathy, at least in places where over-the-counter preparations are popular and where many doctors use natural medicines in a conventional clinical setting. |
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In Australia, the sale of homeopathic products is regulated by the [[Therapeutic Goods Administration]].<ref>{{Cite web|date=2008-09-01|title=Regulation of homoeopathic and anthroposophic medicines in Australia|url=https://www.tga.gov.au/consultation/regulation-homoeopathic-and-anthroposophic-medicines-australia|access-date=2020-09-01|website=Therapeutic Goods Administration (TGA)|language=en}}</ref> In 2015, the [[National Health and Medical Research Council]] of Australia concluded that there is "no reliable evidence that homeopathy is effective and should not be used to treat health conditions that are chronic, serious, or could become serious". They recommended anyone considering using homeopathy should first get advice from a registered health practitioner.<ref name="NHMRC2" /> A 2017 review into Pharmacy Remuneration and Regulation recommended that products be banned from pharmacies;<ref>{{Cite web|date=2017|title=Review of Pharmacy Remuneration and Regulation Final Report|url=https://www1.health.gov.au/internet/main/publishing.nsf/content/7E5846EB2D7BA299CA257F5C007C0E21/$File/review-of-pharmacy-remuneration-and-regulation-final-report.pdf|access-date=September 1, 2020|archive-date=March 4, 2021|archive-url=https://web.archive.org/web/20210304103416/https://www1.health.gov.au/internet/main/publishing.nsf/content/7E5846EB2D7BA299CA257F5C007C0E21/$File/review-of-pharmacy-remuneration-and-regulation-final-report.pdf}}</ref> while noting the concerns the government did not adopt the recommendation.<ref>{{Cite web|date=2018|title=AUSTRALIAN GOVERNMENT RESPONSE TO THE REVIEW OF PHARMACY REMUNERATION AND REGULATION|url=https://www1.health.gov.au/internet/main/publishing.nsf/content/7E5846EB2D7BA299CA257F5C007C0E21/%24File/Pharmacy-Review-Aus-Gov-Response-3-May-2018.pdf|access-date=September 1, 2020|archive-date=March 3, 2021|archive-url=https://web.archive.org/web/20210303041051/https://www1.health.gov.au/internet/main/publishing.nsf/content/7E5846EB2D7BA299CA257F5C007C0E21/$File/Pharmacy-Review-Aus-Gov-Response-3-May-2018.pdf}}</ref> In New Zealand there are no regulations specific to homeopathy<ref>{{Cite web|title=Natural health products|url=https://www.health.govt.nz/our-work/regulation-health-and-disability-system/natural-health-products|access-date=2020-09-01|website=Ministry of Health NZ|language=en}}</ref> and the [[New Zealand Medical Association]] does not oppose the use of homeopathy,<ref>{{Cite web|date=2017|title=Doctors and CAM (complementary and alternative medicine)|url=https://www.mcnz.org.nz/assets/standards/7eb60db2d2/Doctors-and-CAM-Complementary-and-alternative-medicine.pdf|website=MEDICAL COUNCIL OF NEW ZEALAND|access-date=September 1, 2020|archive-date=January 29, 2021|archive-url=https://web.archive.org/web/20210129025723/https://www.mcnz.org.nz/assets/standards/7eb60db2d2/Doctors-and-CAM-Complementary-and-alternative-medicine.pdf}}</ref> a stance that has been called unethical by some doctors.<ref>{{cite journal|last=Holt|first=Shaun|author2=Gilbey, Andrew|author3=Colquhoun|author4=David|author5=Baum, Michael|author6=Ernst, Edzard|date=15 April 2011|title=Call for doctors not to practice homeopathy or refer to homeopaths|journal=New Zealand Medical Journal|volume=124|issue=1332|pages=87–88|pmid=21747430|issn=1175-8716}}</ref> |
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== Credibility == |
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=== Laboratory research === |
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Among homoeopathic posits, only one proved to be really fatal for serious consideration of homoeopathy - the concept of dynamisation. The concept of the vital force was not so damaging because, in fact, it is easily removable from the doctrine. |
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=== Prevalence === |
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Hahnemann’s claim was that the doctrine is vindicated by obvious and unquestionable efficacy of homoeopathic treatment. All later experience showed that this is not the case. Therefore, the need for physical underpinning, either experimental or theoretical, came to be felt by Hahnemann's contemporaries already. |
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Homeopathy is one of the most commonly used forms of alternative medicines and it has a large worldwide market.<ref name="WHO Safety" /> The exact size is uncertain, but information available on homeopathic sales suggests it forms a large share of the medical market.<ref name="WHO Safety" /> |
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At the first stage of attempted homoeopathic research, a number of physico-chemical parameters were measured without a preconceived hypothesis concerning the nature of the phenomenon, just in hope that something would be found out. Nothing was found. Yet if there is no means to demonstrate any distinctive physico-chemical feature of high dilutions versus pure solvent, there remains a possibility to demonstrate their particular physiological influence. The idea is simple enough to be first implemented rather long ago, in the researches of Persson at Leningrad. The latter involved stimulation and inhibition of enzyme activity by dilute substances, including dilutions well past the point where solute molecules theoretically disappear. |
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In 1999, about 1000 UK doctors practiced homeopathy, most being general practitioners who prescribe a limited number of remedies. A further 1500 homeopaths with no medical training are also thought to practice. Over ten thousand German and French doctors use homeopathy.<ref name="Vickers 1115–11182" /> In the United States a National Health Interview Survey estimated 5 million adults and 1 million children used homeopathy in 2011. An analysis of this survey concluded that most cases were self-prescribed for colds and musculoskeletal pain.<ref>{{Cite web|title=Homeopathy|url=https://www.nccih.nih.gov/health/homeopathy|access-date=2020-09-02|website=NCCIH|language=en}}</ref> Major retailers like [[Walmart]], [[CVS Pharmacy|CVS]], and [[Walgreens]] sell homeopathic products that are packaged to resemble conventional medicines.<ref name="Undark 2020-09-02" /> |
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==== The Benveniste affaire ==== |
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Essentially the same approach was worked out much later in laboratories of a homoeopathic pharmaceutical firm in Lyon. The most famed of the experiments concerned the action of anti-IgE antiserum. A working group in the INSERM 200 laboratory headed by Jaque Benveniste believed to have traced this specific action of the antiserum after the latter was attenuated according to the classical homoeopathic procedure up to rather high dilutions. The results of the experiments were submitted for publication to the prestigious magazine ''Nature'', and after some delay caused by vacillations the paper came out. |
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The homeopathic drug market in Germany is worth about 650 million euro with a 2014 survey finding that 60 percent of Germans reported trying homeopathy.<ref name="Undark 2020-09-02" /> A 2009 survey found that only 17 percent of respondents knew how homeopathic medicine was made.<ref name="Undark 2020-09-02" /> France spent more than US$408 million on homeopathic products in 2008.<ref name="WHO Safety" /> In the United States the homeopathic market is worth about $3 billion-a-year;<ref>{{Cite web|last=Fox|first=Maggie|date=2017|title=Homeopathic products useless and often even harmful, FDA says|url=https://www.nbcnews.com/health/health-news/fda-crack-down-snake-oil-homeopathy-n830756|access-date=2020-09-04|website=NBC News|language=en}}</ref> with 2.9 billion spent in 2007.<ref name="WHO Safety" /> Australia spent US$7.3 million on homeopathic medicines in 2008.<ref name="WHO Safety" /> |
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The publication caused uproar. ''The Nature'' had to organize an investigation to verify the reliability of the results of those experiments. The magazine created a committee consisting of three persons who passed a week in Benveniste's laboratory. The findings were revelatory (''Maddox J., Randi J., Stewart W.W.: "High-dilution" experiments a delusion. Nature 334 (1988), 6180, 287-290''). First of all, "''We were surprised to learn that the experiments do not always "work". There have been periods of several months at a time during which solutions at high dilution have not degranulated basophils. Indeed, the laboratory had just emerged from such a period.''" It means that the results were misrepresented in the original article, since there was no hint at such a circumstance. There was also quite a few of other technical blunders. But the decisive event was the experiment run by the committee itself in the laboratory. It was the only strictly double-blind experiment made in this affaire, and it proved to be a failure. The question was settled factually. Incidentally, later Benveniste made claims that he uncovered ''the language of molecules'', which led to his complete scientific ostracism. |
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In India, a 2014 national health survey found that homeopathy was used by about 3% of the population.<ref>{{cite journal |last1=Rudra |first1=Shalini |last2=Kalra |first2=Aakshi |last3=Kumar |first3=Abhishek |last4=Joe |first4=William |date=2017 |title=Utilization of alternative systems of medicine as health care services in India: Evidence on AYUSH care from NSS 2014 |journal=PLOS ONE |volume=12|issue=5 |pages=e0176916 |doi=10.1371/journal.pone.0176916 |pmid=28472197 |pmc=5417584 |bibcode=2017PLoSO..1276916R |doi-access=free }}</ref> Homeopathy is used in China, although it arrived a lot later than in many other countries, partly due to the restriction on foreigners that persisted until late in the nineteenth century.<ref>{{Cite journal|last=Lu|first=Di|date=2019-09-20|title='Homoeopathy flourishes in the far East': A forgotten history of homeopathy in late nineteenth-century China|url=https://royalsocietypublishing.org/doi/10.1098/rsnr.2018.0041|journal=Notes and Records: The Royal Society Journal of the History of Science|volume=73|issue=3|pages=329–351|doi=10.1098/rsnr.2018.0041|s2cid=80714173}}</ref> Throughout Africa there is a high reliance on traditional medicines, which can be attributed to the cost of modern medicines and the relative prevalence of practitioners. Many African countries do not have any official training facilities.<ref name="Who Legal" /> |
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==== Contonian statistics ==== |
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A remarkable fact: upon scrutiny, every investigation claiming to bear out physical existence of homoeopathic attenuations turned out to be unscrupulous. The latest among them came comparatively recently, also from Lyon. Its main author, Rolland Conte, moved later to Australia, to exploit his invention commercially. |
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==Veterinary use== |
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The gist of the approach did not consist in a new method of physical measurement of the properties of dilutions, but in an alleged new method of inferring results - by means of calculations - from results already obtained through available methods of measurement. The technique of the approach was first outlined in a paper published in 1994, then in a book published two years later (''Conte R.R., Berliocchi H., Lasne Y., Vernot G.: Théorie des hautes dilutions et aspects expérimentaux; Paris, 1996''). |
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[[File:Homeopathic cures for small animals.jpg|thumb|Homeopathic cures for small animals on the [[Isle of Man]]]] |
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Using homeopathy as a treatment for animals is termed "veterinary homeopathy" and dates back to the inception of homeopathy; Hahnemann himself wrote and spoke of the use of homeopathy in animals other than humans.<ref name="Saxton2007">{{cite journal|last1=Saxton|first1=J|year=2007|title=The diversity of veterinary homeopathy|journal=Homeopathy|volume=96|issue=1|page=3|doi=10.1016/j.homp.2006.11.010|pmid=17227741|s2cid=3715861}}</ref> The use of homeopathy in the [[organic farming]] industry is heavily promoted.<ref>{{Cite journal|last1=Doehring|first1=C.|last2=Sundrum|first2=A.|date=2016-12-17|title=Efficacy of homeopathy in livestock according to peer-reviewed publications from 1981 to 2014|journal=The Veterinary Record|volume=179|issue=24|page=628|doi=10.1136/vr.103779|issn=0042-4900|pmc=5256414|pmid=27956476}}</ref> Given that homeopathy's effects in humans are due to the placebo effect and the counseling aspects of the consultation, such treatments are even less effective in animals.<ref>{{Cite journal|last1=Lees|first1=P.|last2=Pelligand|first2=L.|last3=Whiting|first3=M.|last4=Chambers|first4=D.|last5=Toutain|first5=P-L.|last6=Whitehead|first6=M.L.|date=2017-08-19|title=Comparison of veterinary drugs and veterinary homeopathy: part 2|journal=[[The Veterinary Record]]|volume=181|issue=8|pages=198–207|doi=10.1136/vr.104279|issn=0042-4900|pmc=5738588|pmid=28821700|quote=In human medicine, there may be a place for the counselling/psychotherapeutic aspects of homeopathic consults and the placebo effects generated by homeopathic products in patients who believe in such treatments, but in veterinary medicine these factors are unlikely to benefit patients, and the use of homeopathic products in veterinary medicine is contrary to best evidence, irrational, and inconsistent with current scientific and medical knowledge}}</ref> Studies have also found that giving animals placebos can play active roles in influencing pet owners to believe in the effectiveness of the treatment when none exists.<ref name="Hektoen" /> This means that animals given homeopathic remedies will continue to suffer, resulting in [[animal welfare]] concerns.<ref>{{Cite journal|last1=Lees|first1=P.|last2=Pelligand|first2=L.|last3=Whiting|first3=M.|last4=Chambers|first4=D.|last5=Toutain|first5=P-L.|last6=Whitehead|first6=M. L.|date=2017-08-12|title=Comparison of veterinary drugs and veterinary homeopathy: part 1|journal=The Veterinary Record|volume=181|issue=7|pages=170–176|doi=10.1136/vr.104278|issn=0042-4900|pmc=5738587|pmid=28801498}}</ref><ref>{{Cite journal|last1=Whitehead|first1=M L|last2=Lees|first2=P|last3=Toutain|first3=P L|date=2018|title=Veterinary homeopathy regulation in the UK – a cause for concern.|url=https://www.researchgate.net/publication/329152074|journal=Regulatory Rapporteur|volume=15|pages=21–25}}</ref> |
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Little existing research on the subject is of a high enough scientific standard to provide reliable data on efficacy.<ref name="Hektoen">{{cite journal|last1=Hektoen|first1=L|year=2005|title=Review of the current involvement of homeopathy in veterinary practice and research|journal=[[Veterinary Record]]|volume=157|issue=8|pages=224–29|doi=10.1136/vr.157.8.224|pmid=16113167|s2cid=12525634}}</ref><ref>{{cite journal|last1=Mathie|first1=RT|last2=Clausen|first2=J|date=October 18, 2014|title=Veterinary homeopathy: systematic review of medical conditions studied by randomised placebo-controlled trials|journal=The Veterinary Record|volume=175|issue=15|pages=373–81|doi=10.1136/vr.101767|pmid=25324413|s2cid=22894207}}</ref><ref>{{cite journal|last1=Mathie|first1=RT|last2=Clausen|first2=J|date=September 15, 2015|title=Veterinary homeopathy: systematic review of medical conditions studied by randomised trials controlled by other than placebo.|journal=[[BMC Veterinary Research]]|volume=11|page=236|doi=10.1186/s12917-015-0542-2|pmc=4570221|pmid=26371366 |doi-access=free }}</ref> A 2016 review of peer-reviewed articles from 1981 to 2014 by scientists from the [[University of Kassel]], Germany, concluded that there is not enough evidence to support homeopathy as an effective treatment of infectious diseases in livestock.<ref>{{Cite journal|last1=Doehring|first1=C.|last2=Sundrum|first2=A.|date=December 12, 2016|title=Efficacy of homeopathy in livestock according to peer-reviewed publications from 1981 to 2014|journal=Veterinary Record|language=en|volume=179|issue=24|pages=vetrec–2016–103779|doi=10.1136/vr.103779|issn=2042-7670|pmc=5256414|pmid=27956476}}</ref> The UK's [[Department for Environment, Food and Rural Affairs]] (Defra) has adopted a robust position against use of "alternative" pet preparations including homeopathy.<ref>{{cite web |url=https://www.gov.uk/government/news/alternative-pet-remedies-government-clampdown |title=Alternative pet remedies: Government clampdown}}</ref> The British Veterinary Association's position statement on alternative medicines says that it "cannot endorse" homeopathy,<ref name="BVA">{{cite web|title=Veterinary medicines|url=http://www.bva.co.uk/News-campaigns-and-policy/Policy/Medicines/Veterinary-medicines/|access-date=January 5, 2015|publisher=British Veterinary Association}}</ref> and the Australian Veterinary Association includes it on its list of "ineffective therapies".<ref name="AVA">{{cite web|title=Ineffective therapies|url=http://www.ava.com.au/12057|archive-url=https://web.archive.org/web/20150207080041/http://www.ava.com.au/12057|archive-date=February 7, 2015|access-date=January 5, 2015|publisher=Australian veterinary association}}</ref> |
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The very layout of the text reveals much about credibility of the approach. First, the authors introduce summarily a number of notions from more involute areas of mathematics and quantum physics. Significantly, the notions are heaped upon the prospective reader (presumably, mainly lay homoeopaths and homoeopathic pharmacists, who are hardly at home with such terms) without appropriate explanation or at least definition. The terms are such as "the problem of the undecidable", "the axiom of choice", "the second quantification", "Feynmann's sample", and the like. But when the authors progress to the operational part of the work, that is, to inference of specific conclusions concerning particular experimental results, these notions are nowhere used. They emerge again only in the concluding part, where the authors interpret the experimental findings allegedly validated by the proposed method of calculations, and serve as a speculative explanation of the formers. They are not inherently connected with the operational core of the work, and only grandstand the presentation. |
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==See also== |
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The real value of the approach can be assessed through examination of its operational part, that is, the technique of calculation. The logical frame of the latter looks as follows. The premise is incontestable: so far all attempts to prove the physical reality of high potencies crashed because the experimental findings are not reproducible, not only those made in different laboratories, but also those made in serial experimentation within the same laboratory. And now Conte claims to have found a way to extract a reproducible parameter from experimental findings using a mathematical technique he introduced to develop a model of economics. The idea consists in representation of serial measurements by definite integrals over the whole series of measurements. Namely, for a quantitative attribute, one calculates the definite integral ''L(v) '', which the authors call Contonian lagrangian. The authors say that the form of the lagrangian should be nearly linear. More generally, the whole method is said to be applicable not to any kind of data, but only to a particular kind of data which represent what the authors call Contonian processes (characteristically, nowhere defined in the publication). However, the meaning of this notion becomes clear from its properties as described by the authors. Namely, the Contonian processes are just such sequences whose ''L(v) '' are nearly linear. What does it mean? |
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* [[Fringe science]] |
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* [[List of topics characterized as pseudoscience]] |
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* [[Scientific skepticism]] |
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==References== |
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If the subintegral area as a function of its upper limit has "linear appearance", the rate of increase of the subintegral area should be nearly constant. Under what condition measurements can give constant rate of increase of the subintegral area? When the average value of experimental findings remains approximately the same. But what meaning can be assigned to steady average value of a parameter indicative of a particular characteristic of homoeopathic attenuations? First of all, it means that the parameter does not change notably with increasing attenuation. The authors specifically stressed this condition, producing particular kind of calculations to demonstrate the property of self-similitude for Hahnemannian attenuations, that is, identity of properties of intervals of the range of attenuations divided by considerable distances. In particular, the authors adduce as practically identical Contonian frequency values for the intervals between 6CH and 7CH, and 49CH and 50CH, respectively. So, if Contonian statistics can prove something in this particular case, it is that the experimental data used are worthless, because they do not even reflect any difference between ''material'' and ''immaterial'' potencies. |
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{{Reflist| refs= |
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<ref name="Hahnemann">{{cite book |title=The homœopathic medical doctrine, or "Organon of the healing art" |publisher=W. F. Wakeman |author=Hahnemann, Samuel |author-link=Samuel Hahnemann |year=1833 |location=Dublin |pages=[https://books.google.com/books?id=EnEFAAAAQAAJ&pg=PR3 iii], [https://books.google.com/books?id=EnEFAAAAQAAJ&pg=PA48 48–49] |quote=Observation, reflection, and experience have unfolded to me that the best and true method of cure is founded on the principle, ''[[similia similibus curentur]]''. To cure in a mild, prompt, safe, and durable manner, it is necessary to choose in each case a medicine that will excite an affection similar (''{{lang|el|ὅμοιος πάθος}}'') to that against which it is employed.}} Translator: Charles H. Devrient, Esq.</ref> |
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<ref name="Holmes"> |
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{{cite book |
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|author=Oliver Wendell Holmes Sr. |
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|title=Homoeopathy and its kindred delusions: Two lectures delivered before the Boston Society for the Diffusion of Useful Knowledge |
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|url=https://archive.org/details/64340260R.nlm.nih.gov |
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|location=Boston |
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|year=1842 |
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|author-link=Oliver Wendell Holmes Sr |
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}} as reprinted in |
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{{cite book |
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|author=Oliver Wendell Holmes Sr. |
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|title=Currents and counter-currents in medical science |
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|year=1861 |
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|publisher=Ticknor and Fields |
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|pages=72–188 |
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|url=https://catalog.hathitrust.org/Record/011611362 |
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|oclc=1544161 |
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|ol=14731800M |
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|author-link=Oliver Wendell Holmes Sr |
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}}</ref> |
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<ref name="Time19951125">{{cite news |vauthors=Toufexis A, Cole W, Hallanan DB |url=http://www.time.com/time/magazine/article/0,9171,983466,00.html |archive-url=https://web.archive.org/web/20090614091356/http://www.time.com/time/magazine/article/0,9171,983466,00.html |archive-date=June 14, 2009 |title=Is homeopathy good medicine? |magazine=[[Time (magazine)|Time]] |date=September 25, 1995}}</ref> |
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<ref name="shang">{{cite journal |last1=Shang |first1=Aijing |last2=Huwiler-Müntener |first2=Karin |last3=Nartey |first3=Linda |last4=Jüni |first4=Peter |last5=Dörig |first5=Stephan |last6=Sterne |first6=Jonathan AC |last7=Pewsner |first7=Daniel |last8=Egger |first8=Matthias |title=Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy |journal=The Lancet |volume=366 |pages=726–32 |year=2005 |doi=10.1016/S0140-6736(05)67177-2 |pmid=16125589 |issue=9487|s2cid=17939264 }}</ref> |
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<ref name="J Toxicology: Arsenic toxicity">{{cite journal |last1=Chakraborti |first1=D |last2=Mukherjee |first2=SC |last3=Saha |first3=KC |last4=Chowdhury |first4=UK |last5=Rahman |first5=MM |last6=Sengupta |first6=MK |title=Arsenic toxicity from homeopathic treatment |journal=Journal of Toxicology. Clinical Toxicology |volume=41 |issue=7 |pages=963–67 |year=2003 |pmid=14705842 |doi=10.1081/CLT-120026518|s2cid=25453468 }}</ref> |
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<ref name="Mayo Clinic Proceedings: trials">{{cite journal |last1=Altunc |first1=U. |last2=Pittler |first2=M. H. |last3=Ernst |first3=E |title=Homeopathy for childhood and adolescence ailments: systematic review of randomized clinical trials |journal=Mayo Clinic Proceedings |volume=82 |issue=1 |pages=69–75 |year=2007 |pmid=17285788 |doi=10.4065/82.1.69 |quote=However, homeopathy is not totally devoid of risks... it may delay effective treatment or diagnosis|citeseerx=10.1.1.456.5352 }}</ref> |
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The bulk of the text consists of trivial mathematical transformations that serve as mere embellishments. A gem of pseudo-scientific finesse deserves particular mention. Namely, to impart deductive force to their system, the authors make it axiomatic. They introduce an axiom (''Axiom 1, p.57'') that asserts: "''the process of dilution-dynamisation creates an effect directly measurable in physical and/or biological experiments''". That is, the most controversial part of the problem is solved just by postulating the wished answer. Such a ploy presumes an extraordinary naiveté on the part of prospected readers. The follow-up is obvious: however inconsistent be the results of an experimentation with homoeopathic dilutions, it is asserted that they really measure something, just by virtue of this ludicrous axiom. |
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<ref name="pmid8554846">{{cite journal |last1=Ernst |first1=E |author-link=Edzard Ernst |last2=White |first2=AR |title=Homoeopathy and immunization |journal=The British Journal of General Practice |volume=45 |issue=400 |pages=629–30 |year=1995 |pmid=8554846 |pmc=1239445}}</ref> |
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}} |
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==External links== |
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{{commons category}} |
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{{EB1911 poster|Homoeopathy}} |
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* [https://www.nhs.uk/conditions/homeopathy/ Homeopathy] ([[NHS Choices]], UK) |
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{{Homoeopathy}} |
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=== Placebo effect === |
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{{pseudoscience}} |
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Some patients report benefits [http://www.homeopathy-soh.org/whats-new/documents/Positivehomeopathy.PDF], which scientists might explain as [[placebo]] or the [[regression fallacy]]. The placebo effect can be large, so conventional drugs are tested in large, multi-centre, randomised, placebo-controlled [[double-blind]] [[clinical trials]], the object of which is to test whether the drug has an objectively-demonstrable effect that is significantly better than a placebo. Many clinical trials that partially meet these criteria have investigated homeopathy, and some have indicated efficacy above placebo[http://www.annals.org/cgi/reprint/138/5/393.pdf]. 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>. |
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{{Authority control}} |
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==== Lancet 2005 study ==== |
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In August 2005, The [[Lancet]] published a [[meta-analysis]] of trials of homeopathy, the largest and most rigorous analysis so far, involving 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>. The outcome of this suggested that the clinical effects of homeopathy are likely to be placebo effects. For reactions to this study from homeopaths, see |
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[http://www.hpathy.com/research/bhatia-lancet-homeopathy.asp] |
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<ref>{{cite journal | author=White A, Slade P, Hunt C, Hart A, Ernst E | title=Individualised homeopathy as an adjunct in the treatment of childhood asthma: a randomised placebo controlled trial | journal=Thorax | year=2003 | pages=317-21 | volume=58 | issue=4 | id=PMID 12668794}}</ref> |
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[http://www.vithoulkas.com/library_EN/important_issues/imp_issue03.html] |
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[[Category:Homeopathy| ]] |
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=== Evidence based medicine === |
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There is scientific agreement that [[evidence based medicine]] should be used in healthcare and that systematic reviews with strict protocols are essential. Organisations such as the [[Cochrane Collaboration]] and [[Bandolier (journal)|Bandolier]] publish such reviews. The [[Cochrane Collaboration]] found insufficient evidence that homeopathy is beneficial for |
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[http://www.cochrane.org/cochrane/revabstr/ab000353.htm asthma], |
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[http://www.cochrane.org/reviews/en/ab003803.html dementia] and |
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[http://www.cochrane.org/reviews/en/ab003399.html induction of labor]. They also found no evidence that homeopathic treatment can prevent [http://www.cochrane.org/reviews/en/ab001957.html influenza], but reported that it might shorten the duration of the disease. [[Bandolier (journal)|Bandolier]] found insufficient evidence that homeopathy is beneficial for [http://www.jr2.ox.ac.uk/bandolier/booth/alternat/homearth.html osteoarthritis], [http://www.jr2.ox.ac.uk/bandolier/booth/alternat/AT015.html migraine prophylaxis], [http://www.jr2.ox.ac.uk/bandolier/booth/alternat/AT017.html flu], [http://www.jr2.ox.ac.uk/bandolier/booth/alternat/AT011.html delayed-onset muscle soreness],[http://www.jr2.ox.ac.uk/bandolier/booth/alternat/AT015.html migraine] or [http://www.jr2.ox.ac.uk/bandolier/band56/b_6-3.html symptoms of menopause] |
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==== American Medical Association ==== |
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In 1997, the following statement was adopted as policy of the [[American Medical Association]] (AMA) after a report on a number of alternative therapies including homeopathy:[http://www.ama-assn.org/ama/pub/category/13638.html] |
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''<blockquote>"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>'' |
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=== Regulatory decisions === |
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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."[http://www.tgacc.com.au/complaintSingle.cfm?id=657] 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" |
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=== Safety of homeopathic treatment === |
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The FDA considers that there is no real concern over the safety of homeopathic products "because they have little or no pharmacologically active ingredients". There have been a few reports of illness associated with the use of homeopathic products, which may be because some homeopathic remedies are prepared by serial dilution of [[toxicity|toxic]] substances, presenting a risk that by accident they might contain undiluted toxic substances. The medical literature contains several case reports of poisoning by heavy metals such as [[Arsenic|arsenic]]<ref>{{cite journal | author=Chakraborti D, Mukherjee SC, Saha KC, Chowdhury UK, Rahman MM, Sengupta MK | title=Arsenic toxicity from homeopathic treatment | journal=J Toxicol Clin Toxicol | year=2003 | pages=963-7 | volume=41 | issue=7 | id=PMID 14705842}}</ref> and [[mercury (element)|mercury]]<ref>{{cite journal | author=Montoya-Cabrera MA, Rubio-Rodriguez S, Velazquez-Gonzalez E, Avila Montoya S | title=[Mercury poisoning caused by a homeopathic drug] | journal=Gac Med Mex | year=1991 | pages=267-70 | volume=127 | issue=3 | id=PMID 1839288}} Article in Spanish.</ref><ref>{{cite journal | author=Audicana M, Bernedo N, Gonzalez I, Munoz D, Fernandez E, Gastaminza G | title=An unusual case of baboon syndrome due to mercury present in a homeopathic medicine | journal=Contact Dermatitis | year=2001 | pages=185 | volume=45 | issue=3 | id=PMID 11553159}}</ref><ref>{{cite journal | author=Wiesmuller GA, Weishoff-Houben M, Brolsch O, Dott W, Schulze-Robbecke R | title=Environmental agents as cause of health disorders in children presented at an outpatient unit of environmental medicine | journal=Int J Hyg Environ Health | year=2002 | pages=329-35 | volume=205 | issue=5 | id=PMID 12173530}}</ref> found in homeopathic remedies. However, in cases that they reviewed, the FDA discounted the homeopathic product involved as 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. Perhaps 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.[http://www.publications.parliament.uk/pa/ld199900/ldselect/ldsctech/123/12301.htm] |
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== References == |
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<references/> |
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== Sources == |
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*[http://www.findarticles.com/p/articles/mi_m2843/is_6_25/ai_79794372 Magical Thinking in Complementary and Alternative Medicine] from the Skeptical Enquirer |
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*[http://www.bbc.co.uk/science/horizon/2002/homeopathy.shtml Homeopathy: The Test - programme summary] from BBC |
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*{{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}} |
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*{{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}} |
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*Walach H "Unspezifische Therapie-Effekte. Das Beispiel Homöopathie" [PhD Thesis]. Freiburg, Germany: Psychologische Institut, Albert-Ludwigs-Universität Freiburg, (1997) |
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*Ernst E. "Classical homeopathy versus conventional treaments: a [[systematic review]]" ''Perfusion'', (1999); '''12''': 13-15 |
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*{{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}} |
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*{{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}} |
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*{{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}} |
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*Bandolier Homeopathy - dilute information and little knowledge [http://www.jr2.ox.ac.uk/bandolier/aboutus.html] |
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*{{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}} |
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*James Randi Educational Foundation. "The JREF Million Dollar Paranormal Challenge 'FAQ'". [http://www.randi.org/research/faq.html] Retrieved 13 September, 2005. |
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*footnote to pp.12-13, ''Hahnemann's Chronic Diseases'', ed. P. Dudley, ''B. Jain Publishers'', 1998 reprint |
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== External links == |
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* Online etext of Hahnemann's ''Organon der Heilkunst'': [http://www.homeoint.org/books4/organon/ German original] and [http://www.homeopathyhome.com/reference/organon/organon.html English translation] |
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=== Neutral === |
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*A recent article on homeopathy testing from the [http://www.annals.org/cgi/content/full/138/5/393/ Annals of Internal Medicine] |
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* [http://www.bbc.co.uk/science/horizon/2002/homeopathy.shtml BBC's ''Horizon'' on homeopathy] (transcripts, discussion, etc.) |
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* [http://www.acampbell.org.uk/homeopathy/index.html Homeopathy In Perspective] — critical online book, covering the history and present state of homeopathy |
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* [http://www.fda.gov/fdac/features/096_home.html FDA's view of homeopathy] |
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* [http://www.lsbu.ac.uk/water/ Water Structure and Behaviour]— balanced and up-to-date references to current scientific understanding of water, with specific entries on "memory effects" and homeopathy |
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* [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] |
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=== Supportive === |
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* [http://www.hpathy.com/ Extensive Homeopathy Information and Discussion Forum] |
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* [http://www.homeopathy.org/ North American Society of Homeopaths] |
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* [http://www.homeopathy-soh.org/ The Society of Homeopaths - UK Organisation Representing Professional Homeopaths] |
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* [http://www.holisticmed.com/www/homeopathy.html Homeopathy Links from The Holistic Medicine Resource Center] |
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* [http://www.arnica.com/homeo/homeo.html Introduction and Information on Homeopathy] |
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* [http://www.homeocurecenter.com/ Homeo Cure Center] - Forum discussing health issues, homeopathic remedies, and veterinary homeopathy. |
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* [http://www.bbc.co.uk/health/healthy_living/complementary_medicine/therapies_homeopathy.shtml Complementary Medicine - Therapies: Homeopathy] BBC's "Complementary Medicine" article on Homeopathy |
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*[http://www.homeopathy-cures.com/html/referrals_to_homeopaths.html Referrals to Certified Classical Homeopaths] |
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* [http://www.a-r-h.org Alliance of Registered Homeopaths] |
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* [http://www.homeoint.org/english/index.htm Homéopathe International] — The English language version of ''Homéopathe International'' |
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* [http://www.wholehealthnow.com/homeopathy_pro/homeopathy_1825_1849.html Homeopathy Timeline] with a wealth of historical and biographical information |
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* Adjuvant homeopathic treatment in Breastcancer, a pilot study [http://www.thieme-connect.de/ejournals/abstract/ahz/doi/10.1055/s-2005-862573] (in German) |
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=== Critical === |
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* [http://www.randi.org/jr/02-02-2001.html A skeptic's view of homeopathy] |
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* [http://www.csicop.org/si/2001-11/alternative.html Magical Thinking in Complementary and Alternative Medicine] |
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* [http://www.quackwatch.org/01QuackeryRelatedTopics/homeo.html Homeopathy: The Ultimate Fake] - [[Stephen Barrett]], M.D. |
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* [http://www.homeowatch.org/ HomeoWatch (Homeopathy Watch)] — A Skeptical Guide to Homeopathic History, Theories, and Current Practices, operated by [[Stephen Barrett]], M.D. (founder of [[Quackwatch]]) |
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* [http://www.bbc.co.uk/dna/h2g2/alabaster/A954740 H2G2 entry on homeopathy]. |
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* [http://www.skepdic.com/homeo.html The Skeptics Dictionary] |
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* [http://www.acsh.org/search/txtQuickSearch.homeopathy/health_result.asp "The Scientific Evidence on Homeopathy"] - American Council on Science and Health |
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*[http://www.skepticreport.com/health/hahnemann.htm A close look at homeopathy] |
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*[http://www.skepticreport.com/health/dilutiondelusion.htm Dilution or Delusion?] |
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*[http://www.ncahf.org/pp/homeop.html National Council Against Health Fraud Position Paper on Homeopathy] |
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*[http://www.farmaciasfrancesco.it/Lancet_Omeopatia.pdf Are the clinical effects of homoeopathy placebo effects?].pdf. A 2005 study published in [[The Lancet]]. |
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[[Category:Alternative medicine]] |
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[[Category:Homeopathy|*]] |
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[[Category:Medicine]] |
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[[Category:Pseudoscience]] |
[[Category:Pseudoscience]] |
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[[Category:Obsolete medical theories]] |
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[[Category:1796 introductions]] |
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[[Category:Health fraud]] |
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[[bg:Хомеопатия]] |
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[[ca:Homeopatia]] |
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[[de:Homöopathie]] |
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[[el:Ομοιοπαθητική]] |
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[[eo:Homeopatio]] |
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[[es:Homeopatía]] |
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[[fr:Homéopathie]] |
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[[he:הומאופתיה]] |
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[[hr:Homeopatija]] |
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[[ja:ホメオパシー]] |
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[[zh:顺势疗法]] |
Latest revision as of 15:58, 28 November 2024
Alternative medicine | |
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Homoeopathy | |
Pronunciation | |
Claims | "Like cures like", dilution increases potency, disease caused by miasms |
Related fields | Alternative medicine |
Original proponents | Samuel Hahnemann |
Subsequent proponents | |
MeSH | D006705 |
See also | Humorism, heroic medicine |
Part of a series on |
Alternative medicine |
---|
Homeopathy or homoeopathy is a pseudoscientific[1] system of alternative medicine. It was conceived in 1796 by the German physician Samuel Hahnemann. Its practitioners, called homeopaths or homeopathic physicians,[2] believe that a substance that causes symptoms of a disease in healthy people can cure similar symptoms in sick people; this doctrine is called similia similibus curentur, or "like cures like".[3] Homeopathic preparations are termed remedies and are made using homeopathic dilution. In this process, the selected substance is repeatedly diluted until the final product is chemically indistinguishable from the diluent. Often not even a single molecule of the original substance can be expected to remain in the product.[4] Between each dilution homeopaths may hit and/or shake the product, claiming this makes the diluent "remember" the original substance after its removal. Practitioners claim that such preparations, upon oral intake, can treat or cure disease.[5]
All relevant scientific knowledge about physics, chemistry, biochemistry and biology contradicts homeopathy.[6] Homeopathic remedies are typically biochemically inert, and have no effect on any known disease.[7][8][9] Its theory of disease, centered around principles Hahnemann termed miasms, is inconsistent with subsequent identification of viruses and bacteria as causes of disease. Clinical trials have been conducted and generally demonstrated no objective effect from homeopathic preparations.[10][11][12]: 206 [13] The fundamental implausibility of homeopathy as well as a lack of demonstrable effectiveness has led to it being characterized within the scientific and medical communities as quackery and fraud.[14][15][16]
Homeopathy achieved its greatest popularity in the 19th century. It was introduced to the United States in 1825, and the first American homeopathic school opened in 1835. Throughout the 19th century, dozens of homeopathic institutions appeared in Europe and the United States. During this period, homeopathy was able to appear relatively successful, as other forms of treatment could be harmful and ineffective. By the end of the century the practice began to wane, with the last exclusively homeopathic medical school in the United States closing in 1920. During the 1970s, homeopathy made a significant comeback, with sales of some homeopathic products increasing tenfold. The trend corresponded with the rise of the New Age movement, and may be in part due to chemophobia, an irrational aversion to synthetic chemicals, and the longer consultation times homeopathic practitioners provided.
In the 21st century, a series of meta-analyses have shown that the therapeutic claims of homeopathy lack scientific justification. As a result, national and international bodies have recommended the withdrawal of government funding for homeopathy in healthcare. National bodies from Australia, the United Kingdom, Switzerland and France, as well as the European Academies' Science Advisory Council and the Russian Academy of Sciences have all concluded that homeopathy is ineffective, and recommended against the practice receiving any further funding.[17][18][19][20] The National Health Service in England no longer provides funding for homeopathic remedies and asked the Department of Health to add homeopathic remedies to the list of forbidden prescription items.[21][22][23] France removed funding in 2021,[24][25] while Spain has also announced moves to ban homeopathy and other pseudotherapies from health centers.[26]
History
Homeopathy was created in 1796 by Samuel Hahnemann.[27] Hahnemann rejected the mainstream medicine of the late 18th century as irrational and inadvisable, because it was largely ineffective and often harmful.[28][29] He advocated the use of single drugs at lower doses and promoted an immaterial, vitalistic view of how living organisms function.[30] The term homeopathy was coined by Hahnemann and first appeared in print in 1807.[31] He also coined the expression "allopathic medicine", which was used to pejoratively refer to traditional Western medicine.[32]
Concept
Hahnemann conceived of homeopathy while translating a medical treatise by the Scottish physician and chemist William Cullen into German. Being sceptical of Cullen's theory that cinchona cured malaria because it was bitter, Hahnemann ingested some bark specifically to investigate what would happen. He experienced fever, shivering and joint pain: symptoms similar to those of malaria itself. From this, Hahnemann came to believe that all effective drugs produce symptoms in healthy individuals similar to those of the diseases that they treat.[33] This led to the name "homeopathy", which comes from the Ancient Greek: ὅμοιος hómoios, "-like" and πάθος páthos, "suffering".[34]
The doctrine that those drugs are effective which produce symptoms similar to the symptoms caused by the diseases they treat, called "the law of similars", was expressed by Hahnemann with the Latin phrase similia similibus curentur, or "like cures like".[3] Hahnemann's law of similars is unproven and does not derive from the scientific method.[35] An account of the effects of eating cinchona bark noted by Oliver Wendell Holmes, published in 1861, failed to reproduce the symptoms Hahnemann reported.[36]: 128 Subsequent scientific work showed that cinchona cures malaria because it contains quinine, which kills the Plasmodium falciparum parasite that causes the disease; the mechanism of action is unrelated to Hahnemann's ideas.[37]
Provings
Hahnemann began to test what effects various substances may produce in humans, a procedure later called "homeopathic proving". These tests required subjects to test the effects of ingesting substances by recording all their symptoms as well as the ancillary conditions under which they appeared.[38] He published a collection of provings in 1805, and a second collection of 65 preparations appeared in his book, Materia Medica Pura (1810).[39]
As Hahnemann believed that large doses of drugs that caused similar symptoms would only aggravate illness, he advocated for extreme dilutions. A technique was devised for making dilutions that Hahnemann claimed would preserve the substance's therapeutic properties while removing its harmful effects.[40] Hahnemann believed that this process enhanced "the spirit-like medicinal powers of the crude substances".[41] He gathered and published an overview of his new medical system in his book, The Organon of the Healing Art (1810), with a sixth edition published in 1921 that homeopaths still use today.[42]
Miasms and disease
In the Organon, Hahnemann introduced the concept of "miasms" as the "infectious principles" underlying chronic disease[43] and as "peculiar morbid derangement[s] of vital force".[44] Hahnemann associated each miasm with specific diseases, and thought that initial exposure to miasms causes local symptoms, such as skin or venereal diseases. His assertion was that if these symptoms were suppressed by medication, the cause went deeper and began to manifest itself as diseases of the internal organs.[45] Homeopathy maintains that treating diseases by directly alleviating their symptoms, as is sometimes done in conventional medicine, is ineffective because all "disease can generally be traced to some latent, deep-seated, underlying chronic, or inherited tendency".[46] The underlying imputed miasm still remains, and deep-seated ailments can be corrected only by removing the deeper disturbance of the vital force.[47]
Hahnemann's hypotheses for miasms originally presented only three local symptoms: psora (the itch), syphilis (venereal disease) or sycosis (fig-wart disease).[48] Of these the most important was psora, described as being related to any itching diseases of the skin and was claimed to be the foundation of many further disease conditions. Hahnemann believed it to be the cause of such diseases as epilepsy, cancer, jaundice, deafness, and cataracts.[49] Since Hahnemann's time, other miasms have been proposed, some replacing illnesses previously attributed to the psora, including tuberculosis and cancer miasms.[45]
Hahnemann's miasm theory remains disputed and controversial within homeopathy even in modern times. The theory of miasms has been criticized as an explanation developed to preserve the system of homeopathy in the face of treatment failures, and for being inadequate to cover the many hundreds of sorts of diseases, as well as for failing to explain disease predispositions, as well as genetics, environmental factors, and the unique disease history of each patient.[12]: 148–9
19th century: rise to popularity and early criticism
Homeopathy achieved its greatest popularity in the 19th century. It was introduced to the United States in 1825 by Hans Birch Gram, a student of Hahnemann.[50] The first homeopathic school in the United States opened in 1835 and the American Institute of Homeopathy was established in 1844. Throughout the 19th century, dozens of homeopathic institutions appeared in Europe and the United States,[51] and by 1900, there were 22 homeopathic colleges and 15,000 practitioners in the United States.[52]
Because medical practice of the time relied on treatments which were often ineffective and harmful, patients of homeopaths often had better outcomes than those being treated by medical practitioners.[53] Though ineffective, homeopathic preparations are rarely detrimental, thus users are less likely to be harmed by the treatment that is supposed to be helping them.[42] The relative success of homeopathy in the 19th century may have led to the abandonment of the ineffective and harmful treatments of bloodletting and purging and begun the move towards more effective, science-based medicine.[54] One reason for the growing popularity of homeopathy was its apparent success in treating people suffering from infectious disease epidemics.[55] During 19th-century epidemics of diseases such as cholera, death rates in homeopathic hospitals were often lower than in conventional hospitals, where the treatments used at the time were often harmful and did little or nothing to combat the diseases.[56]
Even during its rise in popularity, homeopathy was criticized by scientists and physicians. Sir John Forbes, physician to Queen Victoria, said in 1843 that the extremely small doses of homeopathy were regularly derided as useless and considered it "an outrage to human reason".[57] James Young Simpson said in 1853 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."[58] Nineteenth-century American physician and author Oliver Wendell Holmes was also a vocal critic of homeopathy and published an essay entitled Homœopathy and Its Kindred Delusions (1842).[36] The members of the French Homeopathic Society observed in 1867 that some leading homeopaths of Europe not only were abandoning the practice of administering infinitesimal doses but were also no longer defending it.[59] The last school in the United States exclusively teaching homeopathy closed in 1920.[42]
Revival in the 20th century
According to academics Paul U. Unschuld and Edzard Ernst, the Nazi regime in Germany was fond of homeopathy, and spent large sums of money on researching its mechanisms, but without gaining a positive result.[60] Unschuld also states that homeopathy never subsequently took root in the United States, but remained more deeply established in European thinking.[61] In the United States, the Food, Drug, and Cosmetic Act of 1938 (sponsored by Royal Copeland, a Senator from New York and homeopathic physician) recognized homeopathic preparations as drugs. In the 1950s, there were only 75 solely homeopathic practitioners in the U.S.[62] By the mid to late 1970s, homeopathy made a significant comeback and the sales of some homeopathic companies increased tenfold.[63]
Some homeopaths credit the revival to Greek homeopath George Vithoulkas, who conducted a "great deal of research to update the scenarios and refine the theories and practice of homeopathy" in the 1970s,[64][65] but Ernst and Simon Singh consider it to be linked to the rise of the New Age movement.[29] Bruce Hood has argued that the increased popularity of homeopathy in recent times may be due to the comparatively long consultations practitioners are willing to give their patients, and to a preference for "natural" products, which people think are the basis of homeopathic preparations.[66]
Towards the end of the century opposition to homeopathy began to increase again; with William T. Jarvis, the President of the National Council Against Health Fraud, saying that "Homeopathy is a fraud perpetrated on the public with the government's blessing, thanks to the abuse of political power of Sen. Royal S. Copeland."[67]
21st century: renewed criticism
Since the beginning of the 21st century, a series of meta-analyses have further shown that the therapeutic claims of homeopathy lack scientific justification.[68] This had led to a decrease or suspension of funding by many governments. In a 2010 report, the Science and Technology Committee of the United Kingdom House of Commons recommended that homeopathy should no longer receive National Health Service (NHS) funding due its lack of scientific credibility;[68] NHS funding for homeopathy ceased in 2017.[22] They also asked the Department of Health in the UK to add homeopathic remedies to the list of forbidden prescription items.[23]
In 2015, the National Health and Medical Research Council of Australia found that "there are no health conditions for which there is reliable evidence that homeopathy is effective".[69] The federal government only ended up accepting three of the 45 recommendations made by the 2018 review of Pharmacy Remuneration and Regulation.[70] The same year the US Food and Drug Administration (FDA) held a hearing requesting public comment on the regulation of homeopathic drugs.[71] In 2017 the FDA announced it would strengthen regulation of homeopathic products.[72]
The American non-profit Center for Inquiry (CFI) filed a lawsuit in 2018 against the CVS pharmacy for consumer fraud over its sale of homeopathic medicines.[73] It claimed that CVS was selling homeopathic products on an easier-to-obtain basis than standard medication.[74] In 2019, CFI brought a similar lawsuit against Walmart for "committing wide-scale consumer fraud and endangering the health of its customers through its sale and marketing of homeopathic medicines".[75][76] They also conducted a survey in which they found consumers felt ripped off when informed of the lack of evidence for the efficacy of homeopathic remedies, such as those sold by Walmart and CVS.[77][78]
In 2021, the French healthcare minister phased out social security reimbursements for homeopathic drugs.[24][25] France has long had a stronger belief in the virtues of homeopathic drugs than many other countries and the world's biggest manufacturer of alternative medicine drugs, Boiron, is located in that country.[79] Spain has also announced moves to ban homeopathy and other pseudotherapies.[26] In 2016, the University of Barcelona cancelled its master's degree in Homeopathy citing "lack of scientific basis", after advice from the Spanish Ministry of Health.[80] Shortly afterwards the University of Valencia announced the elimination of its Masters in Homeopathy.[81]
Preparations and treatment
Homeopathic preparations are referred to as "homeopathic remedies".[82] Practitioners rely on two types of reference when prescribing: Materia medica and repertories. A homeopathic materia medica is a collection of "drug pictures", organized alphabetically. A homeopathic repertory is a quick reference version of the materia medica that indexes the symptoms and then the associated remedies for each. In both cases different compilers may dispute particular inclusions in the references.[83] The first symptomatic homeopathic materia medica was arranged by Hahnemann. The first homeopathic repertory was Georg Jahr's Symptomenkodex, published in German in 1835, and translated into English as the Repertory to the more Characteristic Symptoms of Materia Medica in 1838. This version was less focused on disease categories and was the forerunner to later works by James Tyler Kent.[84][85] There are over 118 repertories published in English, with Kent's being one of the most used.[86]
Consultation
Homeopaths generally begin with a consultation, which can be a 10–15 minute appointment or last for over an hour, where the patient describes their medical history. The patient describes the "modalities", or if their symptoms change depending on the weather and other external factors.[87] The practitioner also solicits information on mood, likes and dislikes, physical, mental and emotional states, life circumstances, and any physical or emotional illnesses.[88] This information (also called the "symptom picture") is matched to the "drug picture" in the materia medica or repertory and used to determine the appropriate homeopathic remedies. In classical homeopathy, the practitioner attempts to match a single preparation to the totality of symptoms (the simlilum), while "clinical homeopathy" involves combinations of preparations based on the illness's symptoms.[64]
Preparation
Homeopathy uses animal, plant, mineral, and synthetic substances in its preparations, generally referring to them using Latin names.[89] Examples include arsenicum album (arsenic oxide), natrum muriaticum (sodium chloride or table salt), Lachesis muta (the venom of the bushmaster snake), opium, and thyroidinum (thyroid hormone). Homeopaths say this is to ensure accuracy.[90] In the USA the common name must be displayed, although the Latin one can also be present.[89] Homeopathic pills are made from an inert substance (often sugars, typically lactose), upon which a drop of liquid homeopathic preparation is placed and allowed to evaporate.[91][92]
Isopathy is a therapy derived from homeopathy in which the preparations come from diseased or pathological products such as fecal, urinary and respiratory discharges, blood, and tissue.[84] They are called nosodes (from the Greek nosos, disease) with preparations made from "healthy" specimens being termed "sarcodes". Many so-called "homeopathic vaccines" are a form of isopathy.[93] Tautopathy is a form of isopathy where the preparations are composed of drugs or vaccines that a person has consumed in the past, in the belief that this can reverse the supposed lingering damage caused by the initial use.[94] There is no convincing scientific evidence for isopathy as an effective method of treatment.[95]
Some modern homeopaths use preparations they call "imponderables" because they do not originate from a substance but some other phenomenon presumed to have been "captured" by alcohol or lactose. Examples include X-rays[96] and sunlight.[97] Another derivative is electrohomeopathy, where an electric bio-energy of therapeutic value is supposedly extracted from plants. Popular in the late nineteenth century, electrohomeopathy is extremely pseudo-scientific.[98] In 2012, the Allahabad High Court in Uttar Pradesh, India, handed down a decree stating that electrohomeopathy was quackery and no longer recognized it as a system of medicine.[99]
Other minority practices include paper preparations, in which the terms for substances and dilutions are written on pieces of paper and either pinned to the patients' clothing, put in their pockets, or placed under glasses of water that are then given to the patients. Radionics, the use of electromagnetic radiation such as radio waves, can also be used to manufacture preparations. Such practices have been strongly criticized by classical homeopaths as unfounded, speculative, and verging upon magic and superstition.[100][101] Flower preparations are produced by placing flowers in water and exposing them to sunlight. The most famous of these are the Bach flower remedies, which were developed by Edward Bach.[102]
Dilutions
Hahnemann claimed that undiluted doses caused reactions, sometimes dangerous ones, and thus that preparations be given at the lowest possible dose.[103] A solution that is more dilute is described as having a higher "potency", and thus are claimed to be stronger and deeper-acting.[104] The general method of dilution is serial dilution, where solvent is added to part of the previous mixture, but the "Korsakovian" method may also be used. In the Korsakovian method, the vessel in which the preparations are manufactured is emptied, refilled with solvent, with the volume of fluid adhering to the walls of the vessel deemed sufficient for the new batch.[12]: 270 The Korsakovian method is sometimes referred to as K on the label of a homeopathic preparation.[105][106] Another method is Fluxion, which dilutes the substance by continuously passing water through the vial.[107] Insoluble solids, such as granite, diamond, and platinum, are diluted by grinding them with lactose ("trituration").[12]: 23
Three main logarithmic dilution scales are in regular use in homeopathy. Hahnemann created the "centesimal" or "C scale", diluting a substance by a factor of 100 at each stage. There is also a decimal dilution scale (notated as "X" or "D") in which the preparation is diluted by a factor of 10 at each stage.[108] The centesimal scale was favoured by Hahnemann for most of his life, although in his last ten years Hahnemann developed a quintamillesimal (Q) scale which diluted the drug 1 part in 50,000.[109] A 2C dilution works out to one part of the original substance in 10,000 parts of the solution. In standard chemistry, this produces a substance with a concentration of 0.01% (volume-volume percentage). A 6C dilution ends up with the original substance diluted by a factor of 100−6 (one part in one trillion). The end product is usually so diluted as to be indistinguishable from the diluent (pure water, sugar or alcohol).[40][110] The greatest dilution reasonably likely to contain at least one molecule of the original substance is approximately 12C.[111]
Hahnemann advocated dilutions of 1 part to 1060 or 30C.[112] Hahnemann regularly used dilutions of up to 30C but opined that "there must be a limit to the matter".[38]: 322 To counter the reduced potency at high dilutions he formed the view that vigorous shaking by striking on an elastic surface – a process termed succussion – was necessary.[103] Homeopaths are unable to agree on the number and force of strikes needed, and there is no way that the claimed results of succussion can be tested.[12]: 67–69
Critics of homeopathy commonly emphasize the dilutions involved in homeopathy, using analogies.[113] One mathematically correct example is that a 12C solution is equivalent to "a pinch of salt in both the North and South Atlantic Oceans".[114][115][116] One-third of a drop of some original substance diluted into all the water on Earth would produce a preparation with a concentration of about 13C.[113][117][118] Robert L. Park points out that a 200C dilution of duck liver, marketed under the name Oscillococcinum, would require 10320 universes worth of molecules to contain just one original molecule in the final substance.[119] The high dilutions characteristically used are often considered to be the most controversial and implausible aspect of homeopathy.[120]
Provings
Homeopaths claim that they can determine the properties of their preparations by following a method which they call "proving".[121] As performed by Hahnemann, provings involved administering various preparations to healthy volunteers. The volunteers were then observed, often for months at a time. They were made to keep extensive journals detailing all of their symptoms at specific times throughout the day. They were forbidden from consuming coffee, tea, spices, or wine for the duration of the experiment; playing chess was also prohibited because Hahnemann considered it to be "too exciting", though they were allowed to drink beer and encouraged to exercise in moderation.[122] At first Hahnemann used undiluted doses for provings, but he later advocated provings with preparations at a 30C dilution,[112] and most modern provings are carried out using ultra-dilute preparations.[123]
Provings are claimed to have been important in the development of the clinical trial, due to their early use of simple control groups, systematic and quantitative procedures, and some of the first application of statistics in medicine.[124] The lengthy records of self-experimentation by homeopaths have occasionally proven useful in the development of modern drugs: For example, evidence that nitroglycerin might be useful as a treatment for angina was discovered by looking through homeopathic provings, though homeopaths themselves never used it for that purpose at that time.[125] The first recorded provings were published by Hahnemann in his 1796 Essay on a New Principle.[126] His Fragmenta de Viribus (1805)[127] contained the results of 27 provings, and his 1810 Materia Medica Pura contained 65.[128] For James Tyler Kent's 1905 Lectures on Homoeopathic Materia Medica, 217 preparations underwent provings and newer substances are continually added to contemporary versions.[129][130]
Though the proving process has superficial similarities with clinical trials, it is fundamentally different in that the process is subjective, not blinded, and modern provings are unlikely to use pharmacologically active levels of the substance under proving.[131] As early as 1842, Oliver Holmes had noted that provings were impossibly vague, and the purported effect was not repeatable among different subjects.[36]
Evidence and efficacy
Outside of the alternative medicine community, scientists have long considered homeopathy a sham[132] or a pseudoscience,[133][134][135][136] and the medical community regards it as quackery.[135] There is an overall absence of sound statistical evidence of therapeutic efficacy, which is consistent with the lack of any biologically plausible pharmacological agent or mechanism.[8] Proponents argue that homeopathic medicines must work by some, as yet undefined, biophysical mechanism.[87] No homeopathic preparation has been shown to be different from placebo.[8]
Lack of scientific evidence
The lack of convincing scientific evidence supporting its efficacy[137] and its use of preparations without active ingredients have led to characterizations of homeopathy as pseudoscience and quackery,[138][139][140] or, in the words of a 1998 medical review, "placebo therapy at best and quackery at worst".[141] The Russian Academy of Sciences considers homeopathy a "dangerous 'pseudoscience' that does not work", and "urges people to treat homeopathy 'on a par with magic'".[138] The Chief Medical Officer for England, Dame Sally Davies, has stated that homeopathic preparations are "rubbish" and do not serve as anything more than placebos.[142] In 2013, Mark Walport, the UK Government Chief Scientific Adviser and head of the Government Office for Science said "homeopathy is nonsense, it is non-science."[143] His predecessor, John Beddington, also said that homeopathy "has no underpinning of scientific basis" and is being "fundamentally ignored" by the Government.[144]
Jack Killen, acting deputy director of the National Center for Complementary and Alternative Medicine, says homeopathy "goes beyond current understanding of chemistry and physics". He adds: "There is, to my knowledge, no condition for which homeopathy has been proven to be an effective treatment."[137] Ben Goldacre says that homeopaths who misrepresent scientific evidence to a scientifically illiterate public, have "... walled themselves off from academic medicine, and critique has been all too often met with avoidance rather than argument".[145] Homeopaths often prefer to ignore meta-analyses in favour of cherry picked positive results, such as by promoting a particular observational study (one which Goldacre describes as "little more than a customer-satisfaction survey") as if it were more informative than a series of randomized controlled trials.[145]
In an article entitled "Should We Maintain an Open Mind about Homeopathy?"[146] published in the American Journal of Medicine, Michael Baum and Edzard Ernst – writing to other physicians – wrote that "Homeopathy is among the worst examples of faith-based medicine... These axioms [of homeopathy] are not only out of line with scientific facts but also directly opposed to them. If homeopathy is correct, much of physics, chemistry, and pharmacology must be incorrect...".
Plausibility of dilutions
The exceedingly low concentration of homeopathic preparations, which often lack even a single molecule of the diluted substance,[91] has been the basis of questions about the effects of the preparations since the 19th century.[147] The laws of chemistry give this dilution limit, which is related to the Avogadro number, as being roughly equal to 12C homeopathic dilutions (1 part in 1024).[113][148][149] James Randi and the 10:23 campaign groups have highlighted the lack of active ingredients by taking large 'overdoses'.[150] None of the hundreds of demonstrators in the UK, Australia, New Zealand, Canada and the US were injured and "no one was cured of anything, either".[150]
Modern advocates of homeopathy have proposed a concept of "water memory", according to which water "remembers" the substances mixed in it, and transmits the effect of those substances when consumed. This concept is inconsistent with the current understanding of matter, and water memory has never been demonstrated to have any detectable effect, biological or otherwise.[151][152] Existence of a pharmacological effect in the absence of any true active ingredient is inconsistent with the law of mass action and the observed dose-response relationships characteristic of therapeutic drugs.[153] Homeopaths contend that their methods produce a therapeutically active preparation, selectively including only the intended substance, though in reality any water will have been in contact with millions of different substances throughout its history, and homeopaths cannot account for the selected homeopathic substance being isolated as a special case in their process.[154]
Practitioners also hold that higher dilutions produce stronger medicinal effects. This idea is also inconsistent with observed dose-response relationships, where effects are dependent on the concentration of the active ingredient in the body.[153] Some contend that the phenomenon of hormesis may support the idea of dilution increasing potency,[155][156] but the dose-response relationship outside the zone of hormesis declines with dilution as normal, and nonlinear pharmacological effects do not provide any credible support for homeopathy.[154]
Efficacy
The placebo effect | The intensive consultation process and expectations for the homeopathic preparations may cause the effect |
Therapeutic effect of the consultation | The care, concern, and reassurance a patient experiences when opening up to a compassionate caregiver can have a positive effect on the patient's well-being. |
Unassisted natural healing | Time and the body's ability to heal without assistance can eliminate many diseases of their own accord. |
Unrecognized treatments | An unrelated food, exercise, environmental agent, or treatment for a different ailment, may have occurred. |
Regression towards the mean | Since many diseases or conditions are cyclical, symptoms vary over time and patients tend to seek care when discomfort is greatest; they may feel better anyway but because of the timing of the visit to the homeopath they attribute improvement to the preparation taken. |
Non-homeopathic treatment | Patients may also receive standard medical care at the same time as homeopathic treatment, and the former is responsible for improvement. |
Cessation of unpleasant treatment | Often homeopaths recommend patients stop getting medical treatment such as surgery or drugs, which can cause unpleasant side-effects; improvements are attributed to homeopathy when the actual cause is the cessation of the treatment causing side-effects in the first place, but the underlying disease remains untreated and still dangerous to the patient. |
No individual homeopathic preparation has been unambiguously shown by research to be different from placebo.[8] The methodological quality of the early primary research was low, with problems such as weaknesses in study design and reporting, small sample size, and selection bias. Since better quality trials have become available, the evidence for efficacy of homeopathy preparations has diminished; the highest-quality trials indicate that the preparations themselves exert no intrinsic effect.[10][158]: 206 [159] A review conducted in 2010 of all the pertinent studies of "best evidence" produced by the Cochrane Collaboration concluded that this evidence "fails to demonstrate that homeopathic medicines have effects beyond placebo."[13]
In 2009, the United Kingdom's House of Commons Science and Technology Committee concluded that there was no compelling evidence of effect other than placebo.[160] The Australian National Health and Medical Research Council completed a comprehensive review of the effectiveness of homeopathic preparations in 2015, in which it concluded that "there were no health conditions for which there was reliable evidence that homeopathy was effective."[161] The European Academies' Science Advisory Council (EASAC) published its official analysis in 2017 finding a lack of evidence that homeopathic products are effective, and raising concerns about quality control.[162] In contrast a 2011 book was published, purportedly financed by the Swiss government, that concluded that homeopathy was effective and cost efficient.[163] Although hailed by proponents as proof that homeopathy works,[164] it was found to be scientifically, logically and ethically flawed, with most authors having a conflict of interest.[164] The Swiss Federal Office of Public Health later released a statement saying the book was published without the consent of the Swiss government.[165]
Meta-analyses, essential tools to summarize evidence of therapeutic efficacy,[166] and systematic reviews have found that the methodological quality in the majority of randomized trials in homeopathy have shortcomings and that such trials were generally of lower quality than trials of conventional medicine.[167][168] A major issue has been publication bias, where positive results are more likely to be published in journals.[169][unreliable source?][170][171] This has been particularly marked in alternative medicine journals, where few of the published articles (just 5% during the year 2000) tend to report null results.[145] A systematic review of the available systematic reviews confirmed in 2002 that higher-quality trials tended to have less positive results, and found no convincing evidence that any homeopathic preparation exerts clinical effects different from placebo.[8] The same conclusion was also reached in 2005 in a meta-analysis published in The Lancet. A 2017 systematic review and meta-analysis found that the most reliable evidence did not support the effectiveness of non-individualized homeopathy.[172]
Health organizations, including the UK's National Health Service,[173] the American Medical Association,[174] the FASEB,[175] and the National Health and Medical Research Council of Australia,[161] have issued statements saying that there is no good-quality evidence that homeopathy is effective as a treatment for any health condition.[173] In 2009, World Health Organization official Mario Raviglione criticized the use of homeopathy to treat tuberculosis; similarly, another WHO spokesperson argued there was no evidence homeopathy would be an effective treatment for diarrhoea.[176] They warned against the use of homeopathy for serious conditions such as depression, HIV and malaria.[177] The American College of Medical Toxicology and the American Academy of Clinical Toxicology recommend that no one use homeopathic treatment for disease or as a preventive health measure.[178] These organizations report that no evidence exists that homeopathic treatment is effective, but that there is evidence that using these treatments produces harm and can bring indirect health risks by delaying conventional treatment.[178]
Purported effects in other biological systems
While some articles have suggested that homeopathic solutions of high dilution can have statistically significant effects on organic processes including the growth of grain[179] and enzyme reactions, such evidence is disputed since attempts to replicate them have failed.[180][181][182][183][184][185] In 2001 and 2004, Madeleine Ennis published a number of studies that reported that homeopathic dilutions of histamine exerted an effect on the activity of basophils.[186][187] In response to the first of these studies, Horizon aired a programme in which British scientists attempted to replicate Ennis' results; they were unable to do so.[188] A 2007 systematic review of high-dilution experiments found that none of the experiments with positive results could be reproduced by all investigators.[189]
In 1988, French immunologist Jacques Benveniste published a paper in the journal Nature while working at INSERM.[190] The paper purported to have discovered that basophils released histamine when exposed to a homeopathic dilution of anti-immunoglobulin E antibody. Skeptical of the findings, Nature assembled an independent investigative team to determine the accuracy of the research. After investigation the team found that the experiments were "statistically ill-controlled", "interpretation has been clouded by the exclusion of measurements in conflict with the claim", and concluded, "We believe that experimental data have been uncritically assessed and their imperfections inadequately reported."[191][192][193]
Ethics and safety
The provision of homeopathic preparations has been described as unethical.[194][195] Michael Baum, professor emeritus of surgery and visiting professor of medical humanities at University College London (UCL), has described homeopathy as a "cruel deception".[196] Edzard Ernst, the first professor of complementary medicine in the United Kingdom and a former homeopathic practitioner,[197][198][199] has expressed his concerns about pharmacists who violate their ethical code by failing to provide customers with "necessary and relevant information" about the true nature of the homeopathic products they advertise and sell.[200] In 2013 the UK Advertising Standards Authority concluded that the Society of Homeopaths were targeting vulnerable ill people and discouraging the use of essential medical treatment while making misleading claims of efficacy for homeopathic products.[201] In 2015 the Federal Court of Australia imposed penalties on a homeopathic company for making false or misleading statements about the efficacy of the whooping cough vaccine and recommending homeopathic remedies as an alternative.[202]
A 2000 review by homeopaths reported that homeopathic preparations are "unlikely to provoke severe adverse reactions".[203] In 2012, a systematic review evaluating evidence of homeopathy's possible adverse effects concluded that "homeopathy has the potential to harm patients and consumers in both direct and indirect ways".[204] A 2016 systematic review and meta-analysis found that, in homeopathic clinical trials, adverse effects were reported among the patients who received homeopathy about as often as they were reported among patients who received placebo or conventional medicine.[205]
Some homeopathic preparations involve poisons such as Belladonna, arsenic, and poison ivy. In rare cases, the original ingredients are present at detectable levels. This may be due to improper preparation or intentional low dilution. Serious adverse effects such as seizures and death have been reported or associated with some homeopathic preparations.[204] Instances of arsenic poisoning have occurred.[206] In 2009, the FDA advised consumers to stop using three discontinued cold remedy Zicam products because it could cause permanent damage to users' sense of smell.[207] In 2016 the FDA issued a safety alert to consumers[208] warning against the use of homeopathic teething gels and tablets following reports of adverse events after their use.[209] A previous FDA investigation had found that these products were improperly diluted and contained "unsafe levels of belladonna" and that the reports of serious adverse events in children using this product were "consistent with belladonna toxicity".[210]
Patients who choose to use homeopathy rather than evidence-based medicine risk missing timely diagnosis and effective treatment, thereby worsening the outcomes of serious conditions such as cancer.[211][212][213][214] The Russian Commission on Pseudoscience has said homeopathy is not safe because "patients spend significant amounts of money, buying medicines that do not work and disregard already known effective treatment."[215] Critics have cited cases of patients failing to receive proper treatment for diseases that could have been easily managed with conventional medicine and who have died as a result.[216][217] They have also condemned the "marketing practice" of criticizing and downplaying the effectiveness of medicine.[145][217] Homeopaths claim that use of conventional medicines will "push the disease deeper" and cause more serious conditions, a process referred to as "suppression".[218] In 1978, Anthony Campbell, a consultant physician at the Royal London Homeopathic Hospital, criticized statements by George Vithoulkas claiming that syphilis, when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the central nervous system.[219] Vithoulkas' claims echo the idea that treating a disease with external medication used to treat the symptoms would only drive it deeper into the body and conflict with scientific studies, which indicate that penicillin treatment produces a complete cure of syphilis in more than 90% of cases.[220]
The use of homeopathy as a preventive for serious infectious diseases, called homeoprophylaxis, is especially controversial.[221] Some homeopaths (particularly those who are non-physicians) advise their patients against immunization.[213][222][223] Others have suggested that vaccines be replaced with homeopathic "nosodes".[224] While Hahnemann was opposed to such preparations, modern homeopaths often use them although there is no evidence to indicate they have any beneficial effects.[225][226] Promotion of homeopathic alternatives to vaccines has been characterized as dangerous, inappropriate and irresponsible.[227][228] In December 2014, the Australian homeopathy supplier Homeopathy Plus! was found to have acted deceptively in promoting homeopathic alternatives to vaccines.[229] In 2019, an investigative journalism piece by the Telegraph revealed that homeopathy practitioners were actively discouraging patients from vaccinating their children.[230] Cases of homeopaths advising against the use of anti-malarial drugs have also been identified,[214][231][232] putting visitors to the tropics in severe danger.[214][231][232][233]
A 2006 review recommends that pharmacy colleges include a required course where ethical dilemmas inherent in recommending products lacking proven safety and efficacy data be discussed and that students should be taught where unproven systems such as homeopathy depart from evidence-based medicine.[234]
Regulation and prevalence
Homeopathy is fairly common in some countries while being uncommon in others; is highly regulated in some countries and mostly unregulated in others. It is practiced worldwide and professional qualifications and licences are needed in most countries.[235] A 2019 WHO report found that 100 out of 133 Member States surveyed in 2012 acknowledged that their population used homeopathy, with 22 saying the practice was regulated and 13 providing health insurance coverage.[236] In some countries, there are no specific legal regulations concerning the use of homeopathy, while in others, licences or degrees in conventional medicine from accredited universities are required. In 2001 homeopathy had been integrated into the national health care systems of many countries, including India, Mexico, Pakistan, Sri Lanka, and the United Kingdom.[235]
Regulation
Some homeopathic treatment is covered by the public health service of several European countries, including Scotland,[237] and Luxembourg.[238] It used to be covered in France until 2021.[25] In other countries, such as Belgium, homeopathy is not covered. In Austria, the public health service requires scientific proof of effectiveness in order to reimburse medical treatments and homeopathy is listed as not reimbursable,[239] but exceptions can be made;[240] private health insurance policies sometimes include homeopathic treatments.[235] In 2018, Austria's Medical University of Vienna stopped teaching homeopathy.[241] The Swiss government withdrew coverage of homeopathy and four other complementary treatments in 2005, stating that they did not meet efficacy and cost-effectiveness criteria,[242] but following a referendum in 2009 the five therapies were reinstated for a further 6-year trial period.[243] In Germany, homeopathic treatments are covered by 70 percent of government medical plans, and available in almost every pharmacy.[241] In January 2024, German health minister Karl Lauterbach announced plans to withdraw all statutory health insurance coverage for homeopathic and anthroposophic treatments, citing a lack of scientific evidence for their efficacy.[244]
The English NHS recommended against prescribing homeopathic preparations in 2017.[245] In 2018, prescriptions worth £55,000 were written in defiance of the guidelines, representing less than 0.001% of the total NHS prescribing budget.[246][247] In 2016 the UK's Committee of Advertising Practice compliance team wrote to homeopaths[248] in the UK to "remind them of the rules that govern what they can and can't say in their marketing materials".[249] The letter told homeopaths to "ensure that they do not make any direct or implied claims that homeopathy can treat medical conditions" and asks them to review their marketing communications "including websites and social media pages" to ensure compliance.[250] Homeopathic services offered at Bristol Homeopathic Hospital in the UK ceased in October 2015.[251][252]
Member states of the European Union are required to ensure that homeopathic products are registered, although this process does not require any proof of efficacy.[253] In Spain, the Association for the protection of patients from pseudo-scientific therapies is lobbying to get rid of the easy registration procedure for homeopathic remedies.[253] In Bulgaria, Hungary, Latvia, Romania and Slovenia homeopathy, by law, can only be practiced by medical practitioners. However, in Slovenia if doctors practice homeopathy their medical license will be revoked.[253] In Germany, to become a homeopathic physician, one must attend a three-year training program, while France, Austria and Denmark mandate licences to diagnose any illness or dispense of any product whose purpose is to treat any illness.[235] Homeopaths in the UK are under no legal regulations, meaning anyone can call themselves homeopaths and administer homeopathic remedies.[245]
The Indian government recognizes homeopathy as one of its national systems of medicine and they are sold with medical claims.[254][236] It has established the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) under the Ministry of Health & Family Welfare.[255] The south Indian state of Kerala also has a cabinet-level AYUSH department.[256] The Central Council of Homoeopathy was established in 1973 to monitor higher education in homeopathy, and the National Institute of Homoeopathy in 1975.[257] Principals and standards for homeopathic products are covered by the Homoeopathic pharmacopoeia of India.[89] A minimum of a recognized diploma in homeopathy and registration on a state register or the Central Register of Homoeopathy is required to practice homeopathy in India.[258]
Some medical schools in Pakistan,[259] India,[260][261] and Bangladesh,[262][263] offer an undergraduate degree programme in homeopathy.[264] Upon completion the college may award a Bachelor of Homoeopathy Medicine and Surgery (B.H.M.S.).
In the United States each state is responsible for the laws and licensing requirements for homeopathy.[265] In 2015, the FDA held a hearing on homeopathic product regulation.[266] At the hearing, representatives from the Center for Inquiry and the Committee for Skeptical Inquiry summarized the harm that is done to the general public from homeopathics and proposed regulatory actions:[267] In 2016 the United States Federal Trade Commission (FTC) issued an "Enforcement Policy Statement Regarding Marketing Claims for Over-the-Counter Homeopathic Drugs" which specified that the FTC will apply the same standard to homeopathic drugs that it applies to other products claiming similar benefits.[268] A related report concluded that claims of homeopathy effectiveness "are not accepted by most modern medical experts and do not constitute competent and reliable scientific evidence that these products have the claimed treatment effects."[269] In 2019, the FDA removed an enforcement policy that permitted unapproved homeopathics to be sold.[270] Currently no homeopathic products are approved by the FDA.[271]
Homeopathic remedies are regulated as natural health products in Canada.[89] Ontario became the first province in the country to regulate the practice of homeopathy, a move that was widely criticized by scientists and doctors.[272] Health Canada requires all products to have a licence before being sold and applicants have to submit evidence on "the safety, efficacy and quality of a homeopathic medicine".[273] In 2015 the Canadian Broadcasting Corporation tested the system by applying for and then receiving a government approved licence for a made-up drug aimed at kids.[274]
In Australia, the sale of homeopathic products is regulated by the Therapeutic Goods Administration.[275] In 2015, the National Health and Medical Research Council of Australia concluded that there is "no reliable evidence that homeopathy is effective and should not be used to treat health conditions that are chronic, serious, or could become serious". They recommended anyone considering using homeopathy should first get advice from a registered health practitioner.[161] A 2017 review into Pharmacy Remuneration and Regulation recommended that products be banned from pharmacies;[276] while noting the concerns the government did not adopt the recommendation.[277] In New Zealand there are no regulations specific to homeopathy[278] and the New Zealand Medical Association does not oppose the use of homeopathy,[279] a stance that has been called unethical by some doctors.[280]
Prevalence
Homeopathy is one of the most commonly used forms of alternative medicines and it has a large worldwide market.[89] The exact size is uncertain, but information available on homeopathic sales suggests it forms a large share of the medical market.[89]
In 1999, about 1000 UK doctors practiced homeopathy, most being general practitioners who prescribe a limited number of remedies. A further 1500 homeopaths with no medical training are also thought to practice. Over ten thousand German and French doctors use homeopathy.[87] In the United States a National Health Interview Survey estimated 5 million adults and 1 million children used homeopathy in 2011. An analysis of this survey concluded that most cases were self-prescribed for colds and musculoskeletal pain.[281] Major retailers like Walmart, CVS, and Walgreens sell homeopathic products that are packaged to resemble conventional medicines.[241]
The homeopathic drug market in Germany is worth about 650 million euro with a 2014 survey finding that 60 percent of Germans reported trying homeopathy.[241] A 2009 survey found that only 17 percent of respondents knew how homeopathic medicine was made.[241] France spent more than US$408 million on homeopathic products in 2008.[89] In the United States the homeopathic market is worth about $3 billion-a-year;[282] with 2.9 billion spent in 2007.[89] Australia spent US$7.3 million on homeopathic medicines in 2008.[89]
In India, a 2014 national health survey found that homeopathy was used by about 3% of the population.[283] Homeopathy is used in China, although it arrived a lot later than in many other countries, partly due to the restriction on foreigners that persisted until late in the nineteenth century.[284] Throughout Africa there is a high reliance on traditional medicines, which can be attributed to the cost of modern medicines and the relative prevalence of practitioners. Many African countries do not have any official training facilities.[235]
Veterinary use
Using homeopathy as a treatment for animals is termed "veterinary homeopathy" and dates back to the inception of homeopathy; Hahnemann himself wrote and spoke of the use of homeopathy in animals other than humans.[285] The use of homeopathy in the organic farming industry is heavily promoted.[286] Given that homeopathy's effects in humans are due to the placebo effect and the counseling aspects of the consultation, such treatments are even less effective in animals.[287] Studies have also found that giving animals placebos can play active roles in influencing pet owners to believe in the effectiveness of the treatment when none exists.[288] This means that animals given homeopathic remedies will continue to suffer, resulting in animal welfare concerns.[289][290]
Little existing research on the subject is of a high enough scientific standard to provide reliable data on efficacy.[288][291][292] A 2016 review of peer-reviewed articles from 1981 to 2014 by scientists from the University of Kassel, Germany, concluded that there is not enough evidence to support homeopathy as an effective treatment of infectious diseases in livestock.[293] The UK's Department for Environment, Food and Rural Affairs (Defra) has adopted a robust position against use of "alternative" pet preparations including homeopathy.[294] The British Veterinary Association's position statement on alternative medicines says that it "cannot endorse" homeopathy,[295] and the Australian Veterinary Association includes it on its list of "ineffective therapies".[296]
See also
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{{cite book}}
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In human medicine, there may be a place for the counselling/psychotherapeutic aspects of homeopathic consults and the placebo effects generated by homeopathic products in patients who believe in such treatments, but in veterinary medicine these factors are unlikely to benefit patients, and the use of homeopathic products in veterinary medicine is contrary to best evidence, irrational, and inconsistent with current scientific and medical knowledge
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External links
- Homeopathy (NHS Choices, UK)