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The term "homeopathy" was coined by the [[Saxony|Saxon]] physician [[Samuel Hahnemann]] ([[1755]]–[[1843]]) and first published in [[1796]].
The term "homeopathy" was coined by the [[Saxony|Saxon]] physician [[Samuel Hahnemann]] ([[1755]]–[[1843]]) and first published in [[1796]].
=== The 'Law of Similars' ===
Homeopathy is founded on the 'Law of Similars', first expressed by Hahnemann in the exhortation ''similia similibus curentur'' or 'let likes cure likes'. The law of similars is based on Hahnemann's conclusion that a given constellation of symptoms ellicited by a given homepathic remedy in a group of healthy individuals will cure an ill individual exhibiting a similar constellations of symptoms. Symptom patterns associated with various remedies are determined by 'provings', in which healthy volunteers are given remedies in homeopathic form, and the physical, mental and spiritual symptoms they develop are recorded and complied by observers. Homeopathic practitioners rely on two types of reference in prescribing. The Homeopathic [[Materia Medica]]e are organized by remedy, and describe symptom patterns associated with individual remedies. The [[Homeopathic repertory]] are organized by symptom, and list individual remedies associated with various symptoms.


Homeopathic remedies are prepared by dilution of a substence with succussion, or shaking, between dilutions. The remedies in homeopathy are often so dilute that they are statistically unlikely to contain any molecules of the original substance. At first, Hahnemann tested substances commonly used as medicines in his time and poisions in homeopathic provings. He recorded his findings in his ''[[Materia Medica Pura]]''. [[James Tyler Kent|Kent's]] ''Lectures on Homoeopathic Materia Medica'' ([[1905]]) lists 217 remedies, and new substances are being added continually to contemporary versions. Homeopathy uses many animal, plant, mineral, and chemical substances of natural or synthetic origin. Examples include ''Natrum muriaticum'' ([[sodium chloride]] or table salt), ''[[lachesis muta]]'' (the venom of the [[bushmaster (snake)|bushmaster]] [[snake]]), ''[[Opium]]'', and ''Thyroidinum'' ([[thyroid hormone]]). Other homeopathic remedies, ('isopathic' remedies) involve dilutions of the agent or the product of the disease. [[Rabies]] nosode, for example, is made by potentizing the saliva of a rabid dog. Some modern homeopaths are exploring the use of more esoteric substances, known as ''imponderables'' because they do not originate from a material substance but from electromagnetic or electrical energy presumed to have been captured by direct exposure (''[[X-ray]]'', ''Sol'' (sunlight), [http://www.hominf.org/posi/posiintr.htm ''Positronium''], and [http://homeoint.org/clarke/e/elect.htm ''Electricitas''] (electricity)) or through the use of a telescope (''[[Polaris]]''). Recent ventures by homeopaths into esoteric substances include [http://uk.geocities.com/veryscarymary/stormremedy1.html ''Tempesta''] (thunderstorm), and [http://www.biolumanetics.net/tantalus/Cases/BerlinWall.htm ''Berlin wall''].
== Basic principles ==
=== The law of similars ===
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.


Today, about 3000 remedies are used in homeopathy; about 300 are based on comprehensive Materia Medica information, about 1500 on relatively fragmentary knowledge, and the rest are used experimentally in difficult clinical situations based on the law of similars, either without knowledge of their homeopathic properties or through knowledge independent of the law of similars. Examples include: the use of an isopathic (disease causing) agent as a first prescription in a 'stuck' case, when the beginning of disease coincides with a specific event such as vaccination; the use of a chemically related substance when a remedy fails yet seems well-indicated; and more recently, the use of substances based on their natural classification (the [[periodic table]] or biological [[taxonomy]]). This last approach is considered to be promising by some in the homeopathic community, because it allows for grouping remedies and classifying the ever-burgeoning Materia Medica, but is rejected by many purists because it involves speculation about remedy action without proper provings.
==== Provings and pathogenesies ====
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''.


There are many methods for determining the most-similar remedy (the ''simillimum''), and homeopaths often disagree about the diagnosis. This is due in part to the complexity of the idea of 'totality of symptoms'; homeopaths do not use 'all' symptoms, but decide which are the most characteristic; this evaluation is the aspect of diagnosis requiring the most knowledge and experience. Finally, the remedy picture in the Materia Medica is always more comprehensive than the symptomatology that one individual ever exhibits. These factors mean that a homeopathic diagnosis remains presumptive until it is verified by testing the effect of the remedy on the patient.
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''".


The law of similars is not a 'scientific' law in the sense that it is not built on a hypothesis that can be [[falsifiability|falsified]] scientifically; a failure to cure homeopathically can always be attributed to incorrect selection of a remedy.{{fact}}
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.


''See also'': [[List of common homeopathic remedies]]
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.


=== The 'Theory of Infinitesimals' ===
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''.
The most characteristic—and controversial—principle of homeopathy is that the potency of a remedy can be enhanced (and the side-effects diminished) by dilution, in a procedure known as ''dynamization'' or ''potentization''. Liquids are successively diluted (with water, or alcohol for water-insoluble materials) and shaken by ten hard strikes against an elastic body (''succussion''). Insoluble solids are diluted by grinding them with [[lactose]] (''[[trituration]]''). Higher dilutions are considered to be stronger 'deep-acting' remedies.


The dilution factor at each stage is traditionally 1:10 ('D' or 'X' potencies) or 1:100 ('C' potencies). Hahnemann advocated 30C dilutions for most purposes, i.e. dilution by a factor of 100<sup>30</sup> = 10<sup>60</sup>. As [[Avogadro's number]] is only 6.022 × 10<sup>23</sup> particles/mole, the chance of any molecule of the original substance being present in a 15C solution is small, and it is extremely unlikely that one molecule would be present in a 30C solution. For perspective on these numbers, there are under 10<sup>51</sup> atoms in the Earth, and on the order of 10<sup>32</sup> molecules of water in an [[Olympic size swimming pool]]; to expect to get one molecule of a 15C solution, one would need to take 1% of the volume of such a pool, or roughly 25 metric tons of water, comparable to the weight of a fully-loaded 18-wheeler. <!-- As per orders of magnitude (volume) article, there's over 2.5 Gg of water in a pool, or about 1.4E8 moles at 18 to the gram, or somewhat over 1E32 molecules -- Pakaran --> Thus homeopathic remedies that have a high "potency," with overwhelming probability, contain only water, but this water is believed by practitioners of homeopathy to retain some 'essential property' of the substance once present. A key criticism is that any water will, at some time in its history, have been in contact with many different substances. Thus, any drink may be considered to be an extreme dilution of almost any agent you care to mention. Thus, critics argue that almost everyone is almost always receiving homeopathic treatment for almost every condition. Proponents of homeopathy respond that the methodical dilution of a particular substance, beginning with a 10% solution and working downward, is different; exactly why this is different is not clear. Thus modern medicine rejects the possibility of highly diluted preparations having any medicinal action, but attributes claimed effects to the [[placebo effect|Placebo Effect]] and/or the [[Forer effect]].
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.


Later homeopaths advocated very high potencies, which could not be made by traditional methods, but required succussion without dilution (Jenichen), higher dilution factors (LM potencies are diluted by a factor of 50,000), or machines which integrate dilution and succussion into a continuous process (Korsakoff). The practitioner's choice of what potency is appropriate is subjective; it involves his or her opinion of how "deep-seated" the disease is; whether it is primarily physical or more mental/emotional; the patient's sensitivity based on the practitioner's intuitive assessment or previous reactions to remedies; and the desired dosing regimen (e.g. low potency repeated often, vs high potency repeated seldom). Generally, French and German homeopaths use lower potencies than their American counterparts. Most homeopaths believe that the choice of potency is secondary to the choice of remedy: i.e. that a well-chosen remedy will act in a variety of potencies, but an approximately matched remedy might act only in certain potencies.
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.


===Miasms===
==== The choice of a remedy ====
By 1816, Hahnemann was concerned at the failure of his homeopathic remedies to produce lasting cures for chronic diseases. He found that ''"...the non-venereal chronic diseases, after being time and again removed homoeopathically … always returned in a more or less varied form and with new symptoms."'' To explain this, Hahnemann introduced the miasmatic theory, that three fundamental "miasms" are behind all the chronic diseases of mankind: syphilis, sycosis, and psora. The miasm of psora, he concluded, was behind most of the chronic diseases known to medicine. Miasma, from the Greek for 'stain', was an old medical concept, used for "pestiferous exhalations". The sense of this is indicated by Hahnemann's Note 2 to §11 of the Organon:
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.
''"...a child with small-pox or measles communicates to a near, untouched healthy child in an invisible manner (dynamically) the small-pox or measles, … in the same way as the magnet communicated to the near needle the magnetic property..."''


According to Hahneman, miasmatic infection causes local symptoms, usually in the skin. If these are suppressed by external medication, the disease goes deeper, and manifests itself as organ pathologies. In §80 of the ''Organon'' he asserted psora to be the cause of such diseases as epilepsy, cyphosis, cancer, jaundice, deafness, and cataract.
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.''"


Even in his own time, many followers of Hahneman, including Hering, made almost no reference to Hahnemann’s concept of chronic diseases. Today, some homeopathic practitioners [http://www.homeopathy.ca/articles/interview-2001-2.html] accept that Hahnemann’s theory does not hold up in light of current knowledge in immunology, genetics, microbiology and pathology, and recognise that Hahnemann neglected to identify genetic, congenital, metabolic, nutritional, and degenerative diseases, and failed to differentiate the multitude of different infectious diseases. However, they believe that some elements of his theory are valid. For instance, they believe that the fundamental cause of disease is constitutional (i.e. the susceptibility to becoming ill), and that it is contrary to good health to suppress symptoms, especially skin eruptions and discharges. They also accept Hahneman's concept of ''latent psora'', the early signs of an organism’s imbalance that indicate that treatment is needed to prevent the development of more advanced disease.
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 &sect;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.''"

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.

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.

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.

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 B&ouml;nninghausen 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 B&ouml;nnighausen 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.

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.

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.''"

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"''.

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).

=== The theory of infinitesimals ===
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''.

==== Homeopathic aggravation ====
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 pl&ouml;tzlich geheilte Kolikodynie''; in "Archiv f&uuml;r die hom&ouml;opathische 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.

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.

==== The techniques of attenuation ====
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).

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''".

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''".

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.

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).

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 &times; 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 B&ouml;nninghausen 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 &sect;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''."

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.

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.

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.

=== The homoeopathic theory of disease ===
Homoeopaths' approach to treating diseases, and their evaluation of the results are guided by some distinctive theoretical principles.

==== Suppression ====
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"''.

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.

==== Direction of cure ====
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:

1) The improvement ''takes place from above downward'',
2) and ''from within outward'',
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''.

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.

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.

==== Miasms ====
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.

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 &sect;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...''".

The new conception was a short-circuited generalization of Hahnemann's understanding of syphilis (see above in "Suppression"). So, in a footnote to &sect;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.

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 &sect;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''".

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.

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.


== History ==
== History ==
=== Debut ===
=== Theory of disease ===
In Hahnemann's day, the conventional theory of disease was based on the [[four humours]]. Mainstream medicine focused on restoring the balance in the humours, either by attempting to remove an excess of a humour (by such methods as [[bloodletting]] and purging, [[laxative]]s, [[enema]]s and nauseous substances that made patients [[vomit]]) or by suppressing symptoms associated with the humours causing trouble, such as by lowering the body temperature of patients who were feverish. By contrast, Hahnemann promoted a view of '[[spirituality|spiritual]] factors' as the root cause of all disease. Some later homeopaths, in particular [[James Tyler Kent]], put even more emphasis on spiritual factors.[http://www.homeoint.org/morrell/articles/pm_kent.htm]
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.''"
''<blockquote>"...for it goes to the very primitive wrong of the human race, the very first sickness of the human race that is the spiritual sickness... which in turn laid the foundation for other diseases." </blockquote>''
[[Vitalism]] was a part of mainstream science in the [[18th century]]. In the twentieth century, medicine discarded vitalism in favour of the germ theory of disease, following the work of [[Louis Pasteur]], [[Alexander Fleming]], [[Joseph Lister]] and many others. Modern medicine sees [[bacterium|bacteria]] and [[virus]]es as [[Koch's postulates|the causes of many diseases]], but Kent, and some modern homeopaths regard them as effects, not causes, of disease. Others have adapted to the views of modern medicine by referring to disturbances in, and stimulation of, the immune system, rather than the vital force.


Hahnemann developed homeopathy after coming upon the idea that 'like cures like' while translating a work on malaria. On reading that Cinchona bark (which contains [[quinine]]) was effective because it was bitter, Hahnemann felt this implausible because other substances were as bitter but had no therapeutic value. To understand the effects of Cinchona bark, he decided to take it himself, and saw that his reactions were similar to the symptoms of the disease it was used to treat. At least one writer has suggested that Hahnemann was hypersensitive to quinine, and that he may have had an allergic reaction[http://www.angelfire.com/mb2/quinine/allergy.html].
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.


For Hahnemann, the whole body and spirit was the focus of therapy, not just the localised disease. Hahnemann spent a lot of time with his patients, asking them not only about their symptoms or illness, but also about their daily lives. This gentle approach contrasted with the violent forms of [[heroic medicine]] common at the time, which included techniques such as bleeding as a matter of course.
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.


Homeopathy came to the USA in 1825 and rapidly gained popularity, partly because the excesses of conventional medicine were extreme there, and partly due to the efforts of Constantine Hering. Homeopathy reached a peak of popularity in 1865&ndash;1885 and thereafter declined due to a combination of the recognition by the establishment of the dangers of large doses of drugs and bleeding, and dissent between different schools of homeopathy.
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.


Nearly as important as Hahnemann to the development of homeopathy was [[James Tyler Kent]] ([[1849]] &ndash; [[1921]]). Kent's influence in the USA was limited, but in the UK, his ideas became the homeopathic orthodoxy by the end of the [[First World War]].<ref>A. Campbell, [http://www.accampbell.uklinux.net/homeopathy/homeopathy-html/chapter08.html ''Kentian Homeopathy''], Chapter 8 of ''Homeopathy in Perspective''</ref> His most important contribution may be his repertory, which is still used today. Kent's approach was authoritarian, emphasizing the metaphysical and clinical aspects of Hahnemann's teachings, in particular
Hahnemann's attitude to his brainchild contributed much toward such a d&eacute;nouement. 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.''"
* insistence on the doctrines of miasm and vitalism;
* emphasis on psychological symptoms (as opposed to physical pathology) in prescribing; and
* regular use of very high potencies.
Kent believed that illness had spiritual causes:
''<blockquote>"You cannot divorce medicine and theology. Man exists all the way down from his innermost spiritual, to his outermost natural." (Kent, 1926)</blockquote>''
and in the USA, homeopathy came to be associated closely with Swedenborgianism, (the Christian mystical sect of Emanuel [[Swedenborg]], who founded the [[New Jerusalem Church]])[http://www.homeoint.org/morrell/articles/pm_kent.htm]. All prominent American homoeopaths in the nineteenth century, from Hering to Kent, were members of the New Jerusalem Church; and the members of the Church were mostly supporters and followers of homoeopathy. In Russia, homoeopathy was similarly closely connected with the [[Russian Orthodox Church]], and the Missionary School of Medicine, founded in England in 1903, was closely associated with the Faculty of Homoeopathy in London in the early 1900's.


Today, the ease with which large [[database]]s can be manipulated has profoundly changed the way homeopathy is practised. Today, many homeopaths use computers to sift through thousands of provings and case studies. Because information about lesser-known remedies is more accessible, it is now more common for homeopaths to prescribe them, which has led to an increase in the number of new provings.
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 f&uuml;r die hom&ouml;opatische 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'''.


''See also:'' [[List of important homeopaths]]
=== In quest of allies ===
=== Homeopathy around the world ===
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.
There are estimated<ref>[http://www.dw-world.de/dw/article/0,1564,1575855,00.html Homeopathy Seeks More Acknowledgement] from Deutsche Welle</ref> to be more than 100,000 physicians practising homeopathy worldwide, with an estimated 500 million people receiving treatment. More than 12,000 medical doctors and licensed health care practitioners administer homeopathic treatment in the UK, [[France]], and [[Germany]]. Since 2001, homeopathy is regulated in the [[European Union]] by Directive 2001/83/EC; the latest amendments make it compulsory for member states to implement a simple registration procedure for homeopathic remedies.


<!--English speaking countries-->
==== Support by religious groups ====
In the UK, homeopathic remedies may be sold over the counter. The UK has five homeopathic hospitals where treatment, funded by the [[National Health Service]], is available and many regional clinics. Homeopathy is not practised by most of the medical profession, but there is a core of public support, including from the English royal family.
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.


In India, homeopathy has been practised since the middle of the [[19th century]], and is officially recognized. India has the largest homeopathic infrastructure in the world, with 300,000 qualified homeopaths, 180 colleges, 7500 government clinics, and 307 hospitals.<ref>Dr. Raj Kumar Manchanda & Dr. Mukul Kulashreshtha, ''[http://www.delhihomeo.com/paperberlin.html Cost Effectiveness and Efficacy of Homeopathy in Primary Health Care Units of Government of Delhi- A study]''</ref>
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.


In the USA, homeopathic remedies are, like all healthcare products, regulated by the [[Food and Drug Administration]]. However, the FDA treats homeopathic remedies very differently to conventional medicines. Homeopathic products do not have to be approved by the FDA before sale, they do not have to be proved to be either safe or effective, they do not have to be labeled with an expiration date, and they do not have to undergo finished product testing to verify contents and strength. Unlike conventional drugs, homeopathic remedies do not have to identify their active ingredients on the grounds that they have few or no active ingredients. In the USA, only homeopathic medicines that claim to treat self-limiting conditions may be sold over the counter; homeopathic medicines that claim to treat a serious disease can be sold only by prescription.
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.


<!--deutschsprachiger Raum-->
==== Under the Nazi patronage ====
In Germany, about 6,000 physicians specialize in homeopathy. In [[1978]] homeopathy, [[Anthroposophy|anthroposophically extended medicine]] and [[herbalism]], were recognized as "special forms of therapy", meaning that their medications are freed from the usual requirement of proving efficacy. Since [[January 1]], [[2004]] homeopathic medications, with some exceptions, are no longer covered by the country's public health insurance<ref>[http://www.dhu.de/wc_800/archiv/GMG.shtml Gesundheitssystem: Was bringt das neue Gesetz?] (in German)</ref>. Most private health insurers continue to cover homeopathy.
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.


In [[Switzerland]] homeopathic medications were formerly covered by the basic health insurance system, if prescribed by a physician. This ended in June 2005<ref>[http://www.kaufmann-net.ch/ Bundesratsentscheid über die Leistungen für Alternativmedizin: Information about Homeopathy in Switzerland by Vera Kaufmann, BHSc.Hom.] (in German)</ref>. The Swiss Government, after a 5-year trial, withdrew insurance coverage for homoeopathy and four other complementary treatments because they did not meet efficacy and cost-effectiveness criteria. This applies only to compulsory insurance; homeopathy and other complementary medicine is covered by additional insurance, if the treatment is provided by a medical doctor.
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 ''J&uuml;tte R.: Geschichte der Alternativen Medizin, M&uuml;nchen, 1996, pp.42-55''). Homoeopaths enthusiastically hailed the new ideology. Hans Wapler, the editor of the ''Allgemeine Hom&ouml;opathische Zeitung'', wrote about "''decisive importance which political utilization of Similia similibus by '''Hitler''' gained in Germany''" (''Allgemeine Hom&ouml;opathische 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, K&ouml;ln, M&uuml;nchen, N&uuml;rnberg, 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 ''Reichs&auml;rztef&uuml;hrer'' (''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.

==== Para-scientific underpinnings ====
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.

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''".

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.

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''".

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...''"


=== Classical versus non-classical homeopathy ===
=== Classical versus non-classical homeopathy ===
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.
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.


== The popularity of homeopathy ==
== Credibility ==
In the [[1930's]] the popularity of homeopathy waned, especially in [[Europe]] and the USA, partly due to advances in conventional medicine, to the [[Flexner Report]] (1910) which led (in the USA) to the closure of virtually all medical schools teaching alternative medicine. Homeopathy had a renaissance in the [[1970's]], largely because of [[George Vithoulkas]] in Europe and the USA, that continues to this day. In the USA, in 1995, retail sales of homeopathic medicines were estimated at US$201 million, and growing at 20% per year, according to the American Homeopathic Pharmaceutical Association, and the number of homeopathic practitioners increased from fewer than 200 in the 1970's to approximately 3,000 in 1996. The increased popularity of homeopathy since the 1970's accompanied a rise in interest in [[alternative medicine]].<ref>[http://www.thespiritofhomoeopathy.com/evolution.html The Evolution of Homoeopathy]</ref>
=== Laboratory research ===
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.


==Science and homeopathy==
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.
===Placebo effect===
There is no scientific basis for the actions of homeopathic remedies, although 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>.


====Lancet 2005 study====
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.

==== The Benveniste affaire ====
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.

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.

==== Contonian statistics ====
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.

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.: Th&eacute;orie des hautes dilutions et aspects exp&eacute;rimentaux; Paris, 1996'').

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.

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?

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.

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 naivet&eacute; 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.


=== Placebo effect ===
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>.

==== Lancet 2005 study ====
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
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
[http://www.hpathy.com/research/bhatia-lancet-homeopathy.asp]
[http://www.hpathy.com/research/bhatia-lancet-homeopathy.asp]
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[http://www.vithoulkas.com/library_EN/important_issues/imp_issue03.html]
[http://www.vithoulkas.com/library_EN/important_issues/imp_issue03.html]


=== Evidence based medicine ===
===Evidence based medicine===
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
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
[http://www.cochrane.org/cochrane/revabstr/ab000353.htm asthma],
[http://www.cochrane.org/cochrane/revabstr/ab000353.htm asthma],
Line 196: Line 97:
[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]
[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]


==== American Medical Association ====
====American Medical Association====

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]
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]
''<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>''
''<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>''


=== Regulatory decisions ===
===Regulatory decisions===
In 2006 Australia's [[Therapeutic Goods Advertising Code Council]] (TGACC) found that a homeopathic Hangover Relief Oral Spray marketed by Brauer Natural Medicine P/L was "in breach of section 4(1)(b) of the Therapeutic Goods Advertising Code 2005 ( the Code ), which states that an advertisement must contain correct and balanced statements only and claims which the sponsor has already verified , and section 4(2)(c) which prohibits misleading advertisements."[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"
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"


== Misconceptions about homeopathy ==
=== Safety of homeopathic treatment ===
=== Composition of homeopathic remedies ===
It is a common misconception that homeopathic remedies use only natural herbal components (akin to [[herbology]]). Herbs are used, but homeopathy also uses non-biological substances (such as [[salt]]s) and components of animal origin, such as [[duck]] [[liver]] in the remedy [[oscillococcinum]]. In herbology, measurable amounts of herbs are used, while in homeopathy the active ingredient is diluted to the point where it is no longer measurable. Homeopathy also uses substances of human origin, called ''[[nosode]]s''. Some people have the opposite misconception, that homeopathic remedies are only based on [[toxicity|toxic]] substances like [[snake venom]] or [[mercury (element)|mercury]].

As the term homeopathy is well known and has good marketing value, the public can be confused by people who have adopted the term for other forms of therapy. For example, some companies combine homeopathic with non-homeopathic substances such as herbs or vitamins, and some preparations marketed as homeopathic contain no homeopathic preparations at all. Classical homeopaths argue that only remedies prepared and prescribed in accordance with the principles of Hahnemann can be called homeopathic. Many producers of homeopathic remedies also produce other types of alternative remedies under the same brand name, which can create confusion for the public.

===Homeopathy and vaccination===
To some, homeopathy, particularly the use of nosodes, resembles [[vaccination]], in that vaccines contain a small dose of the "disease" against which they are to protect. Hahnemann interpreted the introduction of vaccination by [[Edward Jenner]] in [[1798]] as a confirmation of the law of similars, but the two practices are fundamentally different. A vaccine is usually a [[bacterium]] or [[virus]] whose ability to produce symptoms has been deliberately weakened, while still providing enough information to the [[immune system]] to afford protection. By preparing the immune system of a healthy organism to meet a future attack by the [[pathogen]], vaccination hopes to prevent disease, in contrast to homeopathy's hope, which is to cure it. Another important difference between homeopathic preparations and vaccine, is that vaccine contains measurable amounts of the "disease," whereas homeopathic remedies have been so diluted as to contain no traces at all.

== Safety of homeopathic treatment ==
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]
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]



Revision as of 20:57, 7 May 2006

Template:Totally disputed

File:Samuel Hahnemann.png
Samuel Hahnemann, the father of homeopathy

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.

Although homeopathy is reported to be rapidly growing in popularity, it is controversial and does not satisfy the scientific standards of conventional evidence-based medicine.

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.

The term "homeopathy" was coined by the Saxon physician Samuel Hahnemann (17551843) and first published in 1796.

The 'Law of Similars'

Homeopathy is founded on the 'Law of Similars', first expressed by Hahnemann in the exhortation similia similibus curentur or 'let likes cure likes'. The law of similars is based on Hahnemann's conclusion that a given constellation of symptoms ellicited by a given homepathic remedy in a group of healthy individuals will cure an ill individual exhibiting a similar constellations of symptoms. Symptom patterns associated with various remedies are determined by 'provings', in which healthy volunteers are given remedies in homeopathic form, and the physical, mental and spiritual symptoms they develop are recorded and complied by observers. Homeopathic practitioners rely on two types of reference in prescribing. The Homeopathic Materia Medicae are organized by remedy, and describe symptom patterns associated with individual remedies. The Homeopathic repertory are organized by symptom, and list individual remedies associated with various symptoms.

Homeopathic remedies are prepared by dilution of a substence with succussion, or shaking, between dilutions. The remedies in homeopathy are often so dilute that they are statistically unlikely to contain any molecules of the original substance. At first, Hahnemann tested substances commonly used as medicines in his time and poisions in homeopathic provings. He recorded his findings in his Materia Medica Pura. Kent's Lectures on Homoeopathic Materia Medica (1905) lists 217 remedies, and new substances are being added continually to contemporary versions. Homeopathy uses many animal, plant, mineral, and chemical substances of natural or synthetic origin. Examples include Natrum muriaticum (sodium chloride or table salt), lachesis muta (the venom of the bushmaster snake), Opium, and Thyroidinum (thyroid hormone). Other homeopathic remedies, ('isopathic' remedies) involve dilutions of the agent or the product of the disease. Rabies nosode, for example, is made by potentizing the saliva of a rabid dog. Some modern homeopaths are exploring the use of more esoteric substances, known as imponderables because they do not originate from a material substance but from electromagnetic or electrical energy presumed to have been captured by direct exposure (X-ray, Sol (sunlight), Positronium, and Electricitas (electricity)) or through the use of a telescope (Polaris). Recent ventures by homeopaths into esoteric substances include Tempesta (thunderstorm), and Berlin wall.

Today, about 3000 remedies are used in homeopathy; about 300 are based on comprehensive Materia Medica information, about 1500 on relatively fragmentary knowledge, and the rest are used experimentally in difficult clinical situations based on the law of similars, either without knowledge of their homeopathic properties or through knowledge independent of the law of similars. Examples include: the use of an isopathic (disease causing) agent as a first prescription in a 'stuck' case, when the beginning of disease coincides with a specific event such as vaccination; the use of a chemically related substance when a remedy fails yet seems well-indicated; and more recently, the use of substances based on their natural classification (the periodic table or biological taxonomy). This last approach is considered to be promising by some in the homeopathic community, because it allows for grouping remedies and classifying the ever-burgeoning Materia Medica, but is rejected by many purists because it involves speculation about remedy action without proper provings.

There are many methods for determining the most-similar remedy (the simillimum), and homeopaths often disagree about the diagnosis. This is due in part to the complexity of the idea of 'totality of symptoms'; homeopaths do not use 'all' symptoms, but decide which are the most characteristic; this evaluation is the aspect of diagnosis requiring the most knowledge and experience. Finally, the remedy picture in the Materia Medica is always more comprehensive than the symptomatology that one individual ever exhibits. These factors mean that a homeopathic diagnosis remains presumptive until it is verified by testing the effect of the remedy on the patient.

The law of similars is not a 'scientific' law in the sense that it is not built on a hypothesis that can be falsified scientifically; a failure to cure homeopathically can always be attributed to incorrect selection of a remedy.[citation needed]

See also: List of common homeopathic remedies

The 'Theory of Infinitesimals'

The most characteristic—and controversial—principle of homeopathy is that the potency of a remedy can be enhanced (and the side-effects diminished) by dilution, in a procedure known as dynamization or potentization. Liquids are successively diluted (with water, or alcohol for water-insoluble materials) and shaken by ten hard strikes against an elastic body (succussion). Insoluble solids are diluted by grinding them with lactose (trituration). Higher dilutions are considered to be stronger 'deep-acting' remedies.

The dilution factor at each stage is traditionally 1:10 ('D' or 'X' potencies) or 1:100 ('C' potencies). Hahnemann advocated 30C dilutions for most purposes, i.e. dilution by a factor of 10030 = 1060. As Avogadro's number is only 6.022 × 1023 particles/mole, the chance of any molecule of the original substance being present in a 15C solution is small, and it is extremely unlikely that one molecule would be present in a 30C solution. For perspective on these numbers, there are under 1051 atoms in the Earth, and on the order of 1032 molecules of water in an Olympic size swimming pool; to expect to get one molecule of a 15C solution, one would need to take 1% of the volume of such a pool, or roughly 25 metric tons of water, comparable to the weight of a fully-loaded 18-wheeler. Thus homeopathic remedies that have a high "potency," with overwhelming probability, contain only water, but this water is believed by practitioners of homeopathy to retain some 'essential property' of the substance once present. A key criticism is that any water will, at some time in its history, have been in contact with many different substances. Thus, any drink may be considered to be an extreme dilution of almost any agent you care to mention. Thus, critics argue that almost everyone is almost always receiving homeopathic treatment for almost every condition. Proponents of homeopathy respond that the methodical dilution of a particular substance, beginning with a 10% solution and working downward, is different; exactly why this is different is not clear. Thus modern medicine rejects the possibility of highly diluted preparations having any medicinal action, but attributes claimed effects to the Placebo Effect and/or the Forer effect.

Later homeopaths advocated very high potencies, which could not be made by traditional methods, but required succussion without dilution (Jenichen), higher dilution factors (LM potencies are diluted by a factor of 50,000), or machines which integrate dilution and succussion into a continuous process (Korsakoff). The practitioner's choice of what potency is appropriate is subjective; it involves his or her opinion of how "deep-seated" the disease is; whether it is primarily physical or more mental/emotional; the patient's sensitivity based on the practitioner's intuitive assessment or previous reactions to remedies; and the desired dosing regimen (e.g. low potency repeated often, vs high potency repeated seldom). Generally, French and German homeopaths use lower potencies than their American counterparts. Most homeopaths believe that the choice of potency is secondary to the choice of remedy: i.e. that a well-chosen remedy will act in a variety of potencies, but an approximately matched remedy might act only in certain potencies.

Miasms

By 1816, Hahnemann was concerned at the failure of his homeopathic remedies to produce lasting cures for chronic diseases. He found that "...the non-venereal chronic diseases, after being time and again removed homoeopathically … always returned in a more or less varied form and with new symptoms." To explain this, Hahnemann introduced the miasmatic theory, that three fundamental "miasms" are behind all the chronic diseases of mankind: syphilis, sycosis, and psora. The miasm of psora, he concluded, was behind most of the chronic diseases known to medicine. Miasma, from the Greek for 'stain', was an old medical concept, used for "pestiferous exhalations". The sense of this is indicated by Hahnemann's Note 2 to §11 of the Organon: "...a child with small-pox or measles communicates to a near, untouched healthy child in an invisible manner (dynamically) the small-pox or measles, … in the same way as the magnet communicated to the near needle the magnetic property..."

According to Hahneman, miasmatic infection causes local symptoms, usually in the skin. If these are suppressed by external medication, the disease goes deeper, and manifests itself as organ pathologies. In §80 of the Organon he asserted psora to be the cause of such diseases as epilepsy, cyphosis, cancer, jaundice, deafness, and cataract.

Even in his own time, many followers of Hahneman, including Hering, made almost no reference to Hahnemann’s concept of chronic diseases. Today, some homeopathic practitioners [1] accept that Hahnemann’s theory does not hold up in light of current knowledge in immunology, genetics, microbiology and pathology, and recognise that Hahnemann neglected to identify genetic, congenital, metabolic, nutritional, and degenerative diseases, and failed to differentiate the multitude of different infectious diseases. However, they believe that some elements of his theory are valid. For instance, they believe that the fundamental cause of disease is constitutional (i.e. the susceptibility to becoming ill), and that it is contrary to good health to suppress symptoms, especially skin eruptions and discharges. They also accept Hahneman's concept of latent psora, the early signs of an organism’s imbalance that indicate that treatment is needed to prevent the development of more advanced disease.

History

Theory of disease

In Hahnemann's day, the conventional theory of disease was based on the four humours. Mainstream medicine focused on restoring the balance in the humours, either by attempting to remove an excess of a humour (by such methods as bloodletting and purging, laxatives, enemas and nauseous substances that made patients vomit) or by suppressing symptoms associated with the humours causing trouble, such as by lowering the body temperature of patients who were feverish. By contrast, Hahnemann promoted a view of 'spiritual factors' as the root cause of all disease. Some later homeopaths, in particular James Tyler Kent, put even more emphasis on spiritual factors.[2]

"...for it goes to the very primitive wrong of the human race, the very first sickness of the human race that is the spiritual sickness... which in turn laid the foundation for other diseases."

Vitalism was a part of mainstream science in the 18th century. In the twentieth century, medicine discarded vitalism in favour of the germ theory of disease, following the work of Louis Pasteur, Alexander Fleming, Joseph Lister and many others. Modern medicine sees bacteria and viruses as the causes of many diseases, but Kent, and some modern homeopaths regard them as effects, not causes, of disease. Others have adapted to the views of modern medicine by referring to disturbances in, and stimulation of, the immune system, rather than the vital force.

Hahnemann developed homeopathy after coming upon the idea that 'like cures like' while translating a work on malaria. On reading that Cinchona bark (which contains quinine) was effective because it was bitter, Hahnemann felt this implausible because other substances were as bitter but had no therapeutic value. To understand the effects of Cinchona bark, he decided to take it himself, and saw that his reactions were similar to the symptoms of the disease it was used to treat. At least one writer has suggested that Hahnemann was hypersensitive to quinine, and that he may have had an allergic reaction[3].

For Hahnemann, the whole body and spirit was the focus of therapy, not just the localised disease. Hahnemann spent a lot of time with his patients, asking them not only about their symptoms or illness, but also about their daily lives. This gentle approach contrasted with the violent forms of heroic medicine common at the time, which included techniques such as bleeding as a matter of course.

Homeopathy came to the USA in 1825 and rapidly gained popularity, partly because the excesses of conventional medicine were extreme there, and partly due to the efforts of Constantine Hering. Homeopathy reached a peak of popularity in 1865–1885 and thereafter declined due to a combination of the recognition by the establishment of the dangers of large doses of drugs and bleeding, and dissent between different schools of homeopathy.

Nearly as important as Hahnemann to the development of homeopathy was James Tyler Kent (18491921). Kent's influence in the USA was limited, but in the UK, his ideas became the homeopathic orthodoxy by the end of the First World War.[1] His most important contribution may be his repertory, which is still used today. Kent's approach was authoritarian, emphasizing the metaphysical and clinical aspects of Hahnemann's teachings, in particular

  • insistence on the doctrines of miasm and vitalism;
  • emphasis on psychological symptoms (as opposed to physical pathology) in prescribing; and
  • regular use of very high potencies.

Kent believed that illness had spiritual causes:

"You cannot divorce medicine and theology. Man exists all the way down from his innermost spiritual, to his outermost natural." (Kent, 1926)

and in the USA, homeopathy came to be associated closely with Swedenborgianism, (the Christian mystical sect of Emanuel Swedenborg, who founded the New Jerusalem Church)[4]. All prominent American homoeopaths in the nineteenth century, from Hering to Kent, were members of the New Jerusalem Church; and the members of the Church were mostly supporters and followers of homoeopathy. In Russia, homoeopathy was similarly closely connected with the Russian Orthodox Church, and the Missionary School of Medicine, founded in England in 1903, was closely associated with the Faculty of Homoeopathy in London in the early 1900's.

Today, the ease with which large databases can be manipulated has profoundly changed the way homeopathy is practised. Today, many homeopaths use computers to sift through thousands of provings and case studies. Because information about lesser-known remedies is more accessible, it is now more common for homeopaths to prescribe them, which has led to an increase in the number of new provings.

See also: List of important homeopaths

Homeopathy around the world

There are estimated[2] to be more than 100,000 physicians practising homeopathy worldwide, with an estimated 500 million people receiving treatment. More than 12,000 medical doctors and licensed health care practitioners administer homeopathic treatment in the UK, France, and Germany. Since 2001, homeopathy is regulated in the European Union by Directive 2001/83/EC; the latest amendments make it compulsory for member states to implement a simple registration procedure for homeopathic remedies.

In the UK, homeopathic remedies may be sold over the counter. The UK has five homeopathic hospitals where treatment, funded by the National Health Service, is available and many regional clinics. Homeopathy is not practised by most of the medical profession, but there is a core of public support, including from the English royal family.

In India, homeopathy has been practised since the middle of the 19th century, and is officially recognized. India has the largest homeopathic infrastructure in the world, with 300,000 qualified homeopaths, 180 colleges, 7500 government clinics, and 307 hospitals.[3]

In the USA, homeopathic remedies are, like all healthcare products, regulated by the Food and Drug Administration. However, the FDA treats homeopathic remedies very differently to conventional medicines. Homeopathic products do not have to be approved by the FDA before sale, they do not have to be proved to be either safe or effective, they do not have to be labeled with an expiration date, and they do not have to undergo finished product testing to verify contents and strength. Unlike conventional drugs, homeopathic remedies do not have to identify their active ingredients on the grounds that they have few or no active ingredients. In the USA, only homeopathic medicines that claim to treat self-limiting conditions may be sold over the counter; homeopathic medicines that claim to treat a serious disease can be sold only by prescription.

In Germany, about 6,000 physicians specialize in homeopathy. In 1978 homeopathy, anthroposophically extended medicine and herbalism, were recognized as "special forms of therapy", meaning that their medications are freed from the usual requirement of proving efficacy. Since January 1, 2004 homeopathic medications, with some exceptions, are no longer covered by the country's public health insurance[4]. Most private health insurers continue to cover homeopathy.

In Switzerland homeopathic medications were formerly covered by the basic health insurance system, if prescribed by a physician. This ended in June 2005[5]. The Swiss Government, after a 5-year trial, withdrew insurance coverage for homoeopathy and four other complementary treatments because they did not meet efficacy and cost-effectiveness criteria. This applies only to compulsory insurance; homeopathy and other complementary medicine is covered by additional insurance, if the treatment is provided by a medical doctor.

Classical versus non-classical homeopathy

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.

The popularity of homeopathy

In the 1930's the popularity of homeopathy waned, especially in Europe and the USA, partly due to advances in conventional medicine, to the Flexner Report (1910) which led (in the USA) to the closure of virtually all medical schools teaching alternative medicine. Homeopathy had a renaissance in the 1970's, largely because of George Vithoulkas in Europe and the USA, that continues to this day. In the USA, in 1995, retail sales of homeopathic medicines were estimated at US$201 million, and growing at 20% per year, according to the American Homeopathic Pharmaceutical Association, and the number of homeopathic practitioners increased from fewer than 200 in the 1970's to approximately 3,000 in 1996. The increased popularity of homeopathy since the 1970's accompanied a rise in interest in alternative medicine.[6]

Science and homeopathy

Placebo effect

There is no scientific basis for the actions of homeopathic remedies, although some patients report benefits [5], 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[6]. However, many of the trials are open to technical criticism or involve samples that are too small to allow firm conclusions to be drawn[7].

Lancet 2005 study

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 [8]. 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 [7] [9] [8]

Evidence based medicine

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 publish such reviews. The Cochrane Collaboration found insufficient evidence that homeopathy is beneficial for asthma, dementia and induction of labor. They also found no evidence that homeopathic treatment can prevent influenza, but reported that it might shorten the duration of the disease. Bandolier found insufficient evidence that homeopathy is beneficial for osteoarthritis, migraine prophylaxis, flu, delayed-onset muscle soreness,migraine or symptoms of menopause

American Medical Association

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:[9]

"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."

Regulatory decisions

In 2006 Australia's Therapeutic Goods Advertising Code Council (TGACC) found that a homeopathic Hangover Relief Oral Spray marketed by Brauer Natural Medicine P/L was "in breach of section 4(1)(b) of the Therapeutic Goods Advertising Code 2005 ( the Code ), which states that an advertisement must contain correct and balanced statements only and claims which the sponsor has already verified , and section 4(2)(c) which prohibits misleading advertisements."[10] The TGACC is established under Australian law and the Therapeutic Goods Advertising Code is generally consistent with the World Health Organisation's "Ethical Criteria For Medicinal Drug Promotion 1988"

Misconceptions about homeopathy

Composition of homeopathic remedies

It is a common misconception that homeopathic remedies use only natural herbal components (akin to herbology). Herbs are used, but homeopathy also uses non-biological substances (such as salts) and components of animal origin, such as duck liver in the remedy oscillococcinum. In herbology, measurable amounts of herbs are used, while in homeopathy the active ingredient is diluted to the point where it is no longer measurable. Homeopathy also uses substances of human origin, called nosodes. Some people have the opposite misconception, that homeopathic remedies are only based on toxic substances like snake venom or mercury.

As the term homeopathy is well known and has good marketing value, the public can be confused by people who have adopted the term for other forms of therapy. For example, some companies combine homeopathic with non-homeopathic substances such as herbs or vitamins, and some preparations marketed as homeopathic contain no homeopathic preparations at all. Classical homeopaths argue that only remedies prepared and prescribed in accordance with the principles of Hahnemann can be called homeopathic. Many producers of homeopathic remedies also produce other types of alternative remedies under the same brand name, which can create confusion for the public.

Homeopathy and vaccination

To some, homeopathy, particularly the use of nosodes, resembles vaccination, in that vaccines contain a small dose of the "disease" against which they are to protect. Hahnemann interpreted the introduction of vaccination by Edward Jenner in 1798 as a confirmation of the law of similars, but the two practices are fundamentally different. A vaccine is usually a bacterium or virus whose ability to produce symptoms has been deliberately weakened, while still providing enough information to the immune system to afford protection. By preparing the immune system of a healthy organism to meet a future attack by the pathogen, vaccination hopes to prevent disease, in contrast to homeopathy's hope, which is to cure it. Another important difference between homeopathic preparations and vaccine, is that vaccine contains measurable amounts of the "disease," whereas homeopathic remedies have been so diluted as to contain no traces at all.

Safety of homeopathic treatment

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 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[10] and mercury[11][12][13] 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.[11]

References

  1. ^ A. Campbell, Kentian Homeopathy, Chapter 8 of Homeopathy in Perspective
  2. ^ Homeopathy Seeks More Acknowledgement from Deutsche Welle
  3. ^ Dr. Raj Kumar Manchanda & Dr. Mukul Kulashreshtha, Cost Effectiveness and Efficacy of Homeopathy in Primary Health Care Units of Government of Delhi- A study
  4. ^ Gesundheitssystem: Was bringt das neue Gesetz? (in German)
  5. ^ Bundesratsentscheid über die Leistungen für Alternativmedizin: Information about Homeopathy in Switzerland by Vera Kaufmann, BHSc.Hom. (in German)
  6. ^ The Evolution of Homoeopathy
  7. ^ Jonas WB, Anderson RL, Crawford CC, Lyons JS (2001). "A systematic review of the quality of homeopathic clinical trials". BMC Complement Altern Med. 1: 12. PMID 11801202.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  8. ^ Shang A, Huwiler-Muntener K, Nartey L, Juni P, Dorig S, Sterne JA, Pewsner D, Egger M (2005). "Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy". Lancet. 366 (9487): 726–32. PMID 16125589.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  9. ^ White A, Slade P, Hunt C, Hart A, Ernst E (2003). "Individualised homeopathy as an adjunct in the treatment of childhood asthma: a randomised placebo controlled trial". Thorax. 58 (4): 317–21. PMID 12668794.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  10. ^ Chakraborti D, Mukherjee SC, Saha KC, Chowdhury UK, Rahman MM, Sengupta MK (2003). "Arsenic toxicity from homeopathic treatment". J Toxicol Clin Toxicol. 41 (7): 963–7. PMID 14705842.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  11. ^ Montoya-Cabrera MA, Rubio-Rodriguez S, Velazquez-Gonzalez E, Avila Montoya S (1991). "[Mercury poisoning caused by a homeopathic drug]". Gac Med Mex. 127 (3): 267–70. PMID 1839288.{{cite journal}}: CS1 maint: multiple names: authors list (link) Article in Spanish.
  12. ^ Audicana M, Bernedo N, Gonzalez I, Munoz D, Fernandez E, Gastaminza G (2001). "An unusual case of baboon syndrome due to mercury present in a homeopathic medicine". Contact Dermatitis. 45 (3): 185. PMID 11553159.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  13. ^ Wiesmuller GA, Weishoff-Houben M, Brolsch O, Dott W, Schulze-Robbecke R (2002). "Environmental agents as cause of health disorders in children presented at an outpatient unit of environmental medicine". Int J Hyg Environ Health. 205 (5): 329–35. PMID 12173530.{{cite journal}}: CS1 maint: multiple names: authors list (link)

Sources

  • Magical Thinking in Complementary and Alternative Medicine from the Skeptical Enquirer
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  • Kleijnen J, Knipschild P, ter Riet G (1991). "Trials of homeopathy". BMJ. 302 (6782): 960. PMID 1827743.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  • Bandolier Homeopathy - dilute information and little knowledge [12]
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  • James Randi Educational Foundation. "The JREF Million Dollar Paranormal Challenge 'FAQ'". [13] Retrieved 13 September, 2005.
  • footnote to pp.12-13, Hahnemann's Chronic Diseases, ed. P. Dudley, B. Jain Publishers, 1998 reprint

Neutral

Supportive

Critical