Homeopathy

Homeopathic remedies

Homeopathy (also homœopathy or homoeopathy; from the Greek ὅμοιος, hómoios, "similar" + πάθος, páthos, "suffering" or "disease") is a form of alternative medicine first defined by Samuel Hahnemann in the 18th century. Homeopathic practitioners contend that an ill person can be treated using a substance that can produce, in a healthy person, symptoms similar to those of the illness. According to homeopaths, serial dilution, with shaking between each dilution, removes the toxic effects of the remedy while the qualities of the substance are retained by the diluent (water, sugar, or alcohol). The end product is often so diluted that materially it is indistinguishable from pure water, sugar or alcohol."Dynamization and Dilution", Creighton University Department of Pharmacology. Retrieved on 2007-10-09. Smith, Trevor. Homeopathic Medicine Healing Arts Press, 1989. 14-15"Similia similibus curentur (Like cures like)", Creighton University Department of Pharmacology. Retrieved on 2007-08-20.  Practitioners select treatments according to a patient consultation that explores the physical and psychological stateHahnemann, Organon of medicine, aphorism 217 [1] of the patient, both of which are considered important to selecting the remedy.Hahnemann, Organon of medicine, aphorism 5[2]

Claims for efficacy of homeopathic treatment beyond the placebo effect are unsupported by scientific and clinical studies,Ernst E (2002). "A systematic review of systematic reviews of homeopathy". Br J Clin Pharmacol 54 (6): 577–82. PMID 12492603. Retrieved on 2008-02-12. McCarney RW, Linde K, Lasserson TJ (2004). "Homeopathy for chronic asthma". Cochrane database of systematic reviews (Online) (1): CD000353. doi:10.1002/14651858.CD000353.pub2. PMID 14973954. McCarney R, Warner J, Fisher P, Van Haselen R (2003). "Homeopathy for dementia". Cochrane database of systematic reviews (Online) (1): CD003803. PMID 12535487. 
Homeopathy results. National Health Service. Retrieved on 2007-07-25.Report 12 of the Council on Scientific Affairs (A–97). American Medical Association. Retrieved on 2007-07-25.
Linde K, Jonas WB, Melchart D, Willich S (2001). "The methodological quality of randomized controlled trials of homeopathy, herbal medicines and acupuncture". International journal of epidemiology 30 (3): 526–531. PMID 11416076. 
Altunç U, Pittler MH, Ernst E (2007). "Homeopathy for childhood and adolescence ailments: systematic review of randomized clinical trials". Mayo Clin Proc. 82 (1): 69–75. PMID 17285788.  although meta-analyses of homeopathy, which compare the results of many studies, face difficulty in controlling for the combination of publication bias and the fact that most of these studies suffer from serious shortcomings in their methods.Linde K, Clausius N, Ramirez G, et al (1997). "Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials". Lancet 350 (9081): 834–43. PMID 9310601. 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.  The ideas behind homeopathy are scientifically implausible and "diametrically opposed to modern pharmaceutical knowledge".Shang A, Huwiler-Müntener K, Nartey L, et al (2005). "Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy". Lancet 366 (9487): 726–732. doi:10.1016/S0140-6736(05)67177-2. PMID 16125589. Johnson T, Boon H (2007). "Where does homeopathy fit in pharmacy practice?". American journal of pharmaceutical education 71 (1): 7. PMID 17429507.  The lack of convincing scientific evidence supporting its efficacy,Jerry Adler. "No Way to Treat the Dying" - Newsweek, Feb 4, 2008 and its contradiction of basic scientific principles, have caused homeopathy to be regarded as pseudoscience,National Science Board (April 2002) Science and Engineering Indicators, Chapter 7, "Science and Technology: Public Attitudes and Public Understanding" - "Science Fiction and Pseudoscience" (Arlington, Virginia: National Science Foundation Directorate for Social, Behavioral and Economic Sciences)Wahlberg, A. (2007) "A quackery with a difference—New medical pluralism and the problem of \'dangerous practitioners\' in the United Kingdom," Social Science & Medicine 65(11) pp. 2307-2316: PMID 18080586Atwood, K.C. (2003) "Neurocranial Restructuring\' and Homeopathy, Neither Complementary nor Alternative," Archives of Otolaryngology-Head and Neck Surgery 129(12) pp. 1356-1357: PMID 14676179Ndububa, V.I. (2007) "Medical quackery in Nigeria; why the silence?" Nigerian Journal of Medicine 16(4) pp. 312-317: PMID 18080586 or, in the words of a 1998 medical review, as "placebo therapy at best and quackery at worst".Ernst E, Pittler MH (1998). "Efficacy of homeopathic arnica: a systematic review of placebo-controlled clinical trials". Archives of surgery (Chicago, Ill. : 1960) 133 (11): 1187–90. PMID 9820349. 

Current usage around the world varies from two percent of people in Britain and the United States using homeopathy in any one year,Thomas K, Coleman P (2004). "Use of complementary or alternative medicine in a general population in Great Britain. Results from the National Omnibus survey". Journal of public health (Oxford, England) 26 (2): 152–7. PMID 15284318.  to 15 percent in India, where homeopathy is now considered part of Indian traditional medicine.Singh P, Yadav RJ, Pandey A (2005). "Utilization of indigenous systems of medicine & homoeopathy in India". Indian J. Med. Res. 122 (2): 137–42. PMID 16177471.  Homeopathic remedies are generally considered safe, with rare exceptions;Zicam Settlement. Online Lawyer Source. Retrieved on 2007-10-25.Chakraborti, D; Mukherjee, SC; Saha, KC; Chowdhury, UK, et al (2003). "Arsenic Toxicity from Homeopathic Treatment". Clinical Toxicology 47 (1): 963-967. doi:10.1081/CLT-120026518.  however, homeopaths have been criticised for putting patients at risk by advising them to avoid conventional medicine, such as vaccinations,Ernst E, White AR (1995). "Homoeopathy and immunization". The British journal of general practice: the journal of the Royal College of General Practitioners 45 (400): 629–630. PMID 8554846.  anti-malarial drugsJones, Meirion. "Malaria advice \'risks lives\'", BBC News, 2006-07-14. Retrieved on 2007-07-25.  and antibiotics.Critical review of The Science of Homeopathy from the British Homoeopathic Journal Volume 67, Number 4, October 1978 In many countries, the laws that govern regulation and testing of conventional drugs often do not apply to homeopathic remedies.Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review (PDF). World Health Organization. World Health Organization (2001). Retrieved on 2007-09-12.

Alternative medical systems - edit
Ayurveda Chiropractic Homeopathy Naturopathic medicine Osteopathy Traditional Chinese medicine
NCCAM classifications
Category:Alternative medical systems Category:Mind-body interventions Biologically based therapy Manipulative and body-based methods Energy therapy
See also
Complementary and alternative medicine Alternative medicine Complementary medicine Glossary of alternative medicine

Contents 1 History 1.1 18th-century medicine 1.2 Hahnemann\'s concept 1.3 Rise to popularity and early criticism 2 General philosophy 2.1 Law of similars 2.2 Miasms and disease 3 Preparation of remedies 3.1 Dilution and succussion 3.1.1 Coverage in the mainstream press 3.2 Provings 3.3 Repertory 4 Treatments 4.1 Remedies 4.2 Isopathy 4.3 Tautopathy 4.4 Flower remedies 4.5 Veterinary use 5 Medical and scientific analysis 5.1 High dilutions 5.2 Research on medical effectiveness 6 Research on effects in other biological systems 6.1 Ethical and safety issues 7 Prevalence and legal trends 7.1 Outline of past prevalence in Great Britain 7.2 Contemporary prevalence 7.2.1 United Kingdom 7.2.2 Australia 7.2.3 Canada 7.2.4 South America 7.2.5 Mexico 7.2.6 United States 7.2.7 Asia 7.2.8 Africa 8 See also 9 Dilution calculation 10 Footnotes 11 External links

History

1857 painting by Alexander Beydeman showing historical figures and personifications of homeopathy observing the perceived brutality of medicine of the 19th century

18th-century medicine

At the time of the inception of homeopathy, the late 1700s, mainstream medicine employed such measures as bloodletting and purging, the use of laxatives and enemas, and the administration of complex mixtures, such as theriac, which was made from 64 substances including opium, myrrh, and viper\'s flesh.* Hodgson, Barbara (2001), In the Arms of Morpheus: The Tragic History of Morphine, Laudanum and Patent Medicines, Firefly Books, ISBN 1552975401 page 18Griffin, J. P., Venetian treacle and the foundation of medicines regulation (PDF), British Journal of Clinical Pharmacology 58:3, Page 317. doi:10.1111/j.1365-2125.2004.02147.x Such measures often worsened symptoms and sometimes proved fatal. While the virtues of these treatments had been extolled for centuries, Wright, Iaian. Shakespeare and Queens\' (Part II). Queens\' College Cambridge. Retrieved on 2007-10-14. Hahnemann rejected such methods as irrational and unadvisable.Lasagna, Louis. The doctors\' dilemmas. Collier Books, 33.  Instead, he favored the use of single drugs at lower doses and promoted an immaterial, vitalistic view of how living organisms function, believing that diseases have spiritual, as well as physical causes.Nicholls, Philip A. (March 1988). Homeopathy and the Medical Profession. Croom Helm Ltd. ISBN 978-0709918363. Hahnemann, Dr Samuel (1818). Organon of medicine. Hahnemann, Samuel (1831). Appeal to Thinking Philanthropist Respecting the Mode of Propagation of the Asiatic Choler. Retrieved on 2007-08-13. (At the time, vitalism was part of mainstream science; in the twentieth century, however, medicine discarded vitalism, with the development of microbiology, the germ theory of disease,Baxter AG (2001). "Louis Pasteur\'s beer of revenge". Nat. Rev. Immunol. 1 (3): 229–32. PMID 11905832.  and advances in chemistry.Coley NG (2004). "Medical chemists and the origins of clinical chemistry in Britain (circa 1750–1850)". Clin. Chem. 50 (5): 961–72. PMID 15105362. Ramberg PJ (2000). "The death of vitalism and the birth of organic chemistry: Wohler\'s urea synthesis and the disciplinary identity of organic chemistry". Ambix 47 (3): 170–95. PMID 11640223. ) Hahnemann also advocated various lifestyle improvements to his patients, including exercise, diet, and cleanliness.http://homeoint.org/books4/bradford/chapter35.htm Thomas L Bradford, The Life and Letters of Hahnemann, Ch.35

Hahnemann\'s concept

Samuel Hahnemann, considered to be the father of homeopathy

Samuel Hahnemann conceived of homeopathy while translating a medical treatise by Scottish physician and chemist William Cullen into German. Being sceptical of Cullen’s theory concerning cinchona’s action in malaria, Hahnemann ingested some of the bark specifically to see if it cured fever "by virtue of its effect of strengthening the stomach". http://www.iavh.org/homeopathy/history/ History of Homeopathy, IAVH Upon ingesting the bark, he noticed few stomach symptoms, but did experience fever, shivering and joint pain, symptoms similar to some of the early symptoms of malaria, the disease that the bark was ordinarily used to treat. From this, Hahnemann came to believe that all effective drugs produce symptoms in healthy individuals similar to those of the diseases that they can treat. This later became known as the "law of similars", the most important concept of homeopathy."History of Homeopathy", Creighton University Department of Pharmacology. Retrieved on 2007-07-23.  The term "homeopathy" was coined by Hahnemann and first appeared in print in 1807, although he began outlining his theories of "medical similars" in a series of articles and monographs in 1796.Emmans Dean, Michael (2001). "Homeopathy and "the progress of science"" (PDF). History of science; an annual review of literature, research and teaching 39 (125 Pt 3): 255–83. PMID 11712570. Retrieved on 2007-10-02. 

Hahnemann began to test what effects substances produced in humans, a procedure which would later become known as "proving".Homeopathic Provings. Creighton University School of Medicine. Retrieved on 2007-10-02. These time-consuming tests required subjects to clearly record all of their symptoms as well as the ancillary conditions under which they appeared. Hahnemann saw this data as a way of identifying substances suitable for the treatment of particular diseases. The first collection of provings was published in 1805 and a second collection of 65 remedies appeared in his book, Materia Medica Pura, in 1810.Kirschmann, Anne Taylor (December 2003). A Vital Force: Women in American Homeopathy. Rutgers University Press. ISBN 978-0813533209.  Hahnemann believed that large doses of drugs that caused similar symptoms would only aggravate illness, and so he advocated extreme dilutions of the substances; he devised a technique for making dilutions that he believed would preserve a substance\'s therapeutic properties while removing its harmful effects,Homeopathic Dynamization and Dilution. Creighton University School of Medicine. Retrieved on 2007-10-02. proposing that this process aroused and enhanced "spirit-like medicinal powers held within a drug".Organon of Medicine, Samuel Hahnemann, combined 5th/6th edition He gathered and published a complete overview of his new medical system in his 1810 book, The Organon of the Healing Art, whose 6th edition, published in 1921, is still used by homeopaths today.

Rise to popularity and early criticism

During the 19th century homeopathy grew in popularity. In 1830, the first homeopathic schools opened, and throughout the 19th century dozens of homeopathic institutions appeared in Europe and the United States.Winston, Julian (2006). Homeopathy Timeline. "The Faces of Homoeopathy". Whole Health Now. Retrieved on 2007-07-23. Because of mainstream medicine\'s reliance on blood-letting and untested, often dangerous medicines, patients of homeopaths often had better outcomes than those of mainstream doctors.Ernst E, Kaptchuk TJ (1996). "Homeopathy revisited". Arch. Intern. Med. 156 (19): 2162–4. PMID 8885813.  Homeopathic treatments, even if ineffective, would almost surely cause no harm, making the users of homeopathic medicine less likely to be killed by the medicine that was supposed to be helping them. The relative success of homeopathy in the 18th century may have led to the abandonment of the ineffective and harmful treatments of bloodletting and purging and to have begun the move towards more effective, scientific medicine.Kaufman, Martin (1971-10-01). Homeopathy in America: The Rise and Fall of a Medical Heresy. The Johns Hopkins University Press. ISBN 978-0801812385. 

In the early 19th century, homeopathy began to be criticised. Sir John Forbes, physician to Queen Victoria, said the extremely small doses of homeopathy were regularly derided as useless, laughably ridiculous and "an outrage to human reason".Sir John Forbes, Homeopathy, Allopathy and Young Physic, London, 1846 Professor Sir James Young Simpson said of the highly diluted drugs: "No poison, however strong or powerful, the billionth or decillionth of which would in the least degree affect a man or harm a fly."James Y Simpson, Homoeopathy, Its Tenets and Tendencies, Theoretical, Theological and Therapeutical, Edinburgh: Sutherland & Knox, 1853, 11 Nineteenth century American physician and author Oliver Wendell Holmes, Sr. was also a vocal critic of homeopathy and published an essay in 1842 entitled Homœopathy, and its Kindred Delusions.Holmes, Oliver Wendell (1842). Homœopathy, and its Kindred Delusions; two lectures delivered before the Boston society for the diffusion of useful knowledge.. Boston, MA: William D. Ticknor. OCLC 166600876.  Found online at,Holmes, Oliver Wendell. Homeopathy and Its Kindred Delusions. Retrieved on 2007-07-25. The last school in the U.S. exclusively teaching homeopathy closed in 1920.

General philosophy

Homeopathy is a vitalist philosophy in that it regards diseases and sickness to be caused by disturbances in a hypothetical vital force or life force in humans and that these disturbances manifest themselves as unique symptoms. Homeopathy contends that the vital force has the ability to react and adapt to internal and external causes, which homeopaths refer to as the "law of susceptibility". The law of susceptibility states that a negative state of mind can attract hypothetical disease entities called "miasms" to invade the body and produce symptoms of diseases. However, Hahnemann rejected the notion of a disease as a separate thing or invading entityWinston, Julian. OUTLINE OF THE ORGANON. Retrieved on 2007-08-04. and insisted that it was always part of the "living whole".Hahnemann, Samuel. Organon Of Medicine. Retrieved on 2007-08-04.

Law of similars

Hahnemann observed from his experiments with cinchona bark, used as a treatment for malaria, that the effects he experienced from ingesting the bark were similar to the symptoms of malaria. He therefore reasoned that cure proceeds through similarity, and that treatments must be able to produce symptoms in healthy individuals similar to those of the disease being treated. Through further experiments with other substances, Hahnemann conceived of the "law of similars", otherwise known as "like cures like" (Latin: similia similibus curentur) as a fundamental healing principle. He believed that by inducing a disease through use of drugs, the artificial symptoms empowered the vital force to neutralise and expel the original disease and that this artificial disturbance would naturally subside when the dosing ceased.

Miasms and disease

Hahnemann found as early as 1816 that the patients he treated through homeopathy still suffered from chronic diseases that he was unable to cure.David Little. The Classical View on Miasms. Homeopathy Online. Retrieved on []. In 1828,The Chronic Diseases, their Nature and Homoeopathic Treatment, Dresden and Leipsic, Arnold. Vols. 1, 2, 3, 1828; vol. 4, 1830 he introduced the concept of miasms, which he regarded as underlying causes for many known diseases. A miasm is often defined by homeopaths as an imputed "peculiar morbid derangement of our vital force".Samuel Hahnemann. Organon, 5th edition, para 29. Homeopathy Home.com.. Retrieved on 2007-10-22. Hahnemann associated each miasm with specific diseases, with each miasm seen as the root cause of several diseases. According to Hahnemann, initial exposure to miasms causes local symptoms, such as skin or venereal diseases, but if these symptoms are suppressed by medication, the cause goes deeper and begins to manifest itself as diseases of the internal organs. Homeopathy contends that treating diseases by directly opposing their symptoms, as is sometimes done in conventional medicine, is not so effective because all "disease can generally be traced to some latent, deep-seated, underlying chronic, or inherited tendency".Dr J W Ward. Taking the History of the Case. Pacific Coast Jnl of Homeopathy, July 1937. Retrieved on 2007-10-22. The underlying imputed miasm still remains, and deep-seated ailments can only be corrected by removing the deeper disturbance of the vital force."Cause of Disease in homeopathy", Creighton University Department of Pharmacology. Retrieved on 2007-07-23. 

Hahnemann\'s miasm theory remains disputed and controversial within homeopathy even in modern times. In 1978, Anthony Campbell, then a consultant physician at The Royal London Homeopathic Hospital, criticised statements by George Vithoulkas claiming that syphilis, when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the central nervous system. This conflicts with scientific studies, which indicate that penicillin treatment produces a complete cure of syphilis in more than 90% of cases.Birnbaum NR, Goldschmidt RH, Buffett WO (1999). "Resolving the common clinical dilemmas of syphilis". American family physician 59 (8): 2233-40, 2245-6. PMID 10221308.  Campbell described this as "a thoroughly irresponsible statement which could mislead an unfortunate layman into refusing orthodox treatment".Critical review of The Science of Homeopathy from the British Homoeopathic Journal Volume 67, Number 4, October 1978

Originally Hahnemann presented only three miasms, of which the most important was "psora" (Greek for itch), described as being related to any itching diseases of the skin, supposed to be derived from suppressed scabies, and claimed to be the foundation of many further disease conditions. Hahnemann claimed psora to be the cause of such diseases as epilepsy, cancer, jaundice, deafness, and cataracts. Since Hahnemann\'s time, other miasms have been proposed, some replacing one or more of psora\'s proposed functions, including tubercular miasms and cancer miasms.Miasms in homeopathy. Retrieved on 2007-07-24.

Preparation of remedies

Mortar and pestle used for grinding insoluble solids into homeopathic remedies including quartz and oyster shells.

Dilution and succussion

In producing treatments for diseases, homeopaths use a process called "dynamisation" or "potentisation" whereby the remedy is diluted with alcohol or water and then vigorously shaken by ten hard strikes against an elastic body in a process called "succussion". Hahnemann thought that the use of remedies which present symptoms similar to those of disease in healthy individuals would only intensify the symptoms and exacerbate the condition, so he advocated the dilution of the remedies. During the process of potentisation, homeopaths believe that the vital energy of the diluted substance is activated and its energy released by vigorous shaking of the substance. For this purpose, Hahnemann had a saddle maker construct a special wooden striking board covered in leather on one side and stuffed with horsehair.Online Museum. The Institute for the History of Medicine. Retrieved on 2007-10-22.Williams, Nathan (2002-11-26) Homeopathy: The Test, Horizon (BBC) Retrieved on 2007-01-26 (transcript) Insoluble solids, such as quartz and oyster shell, are diluted by grinding them with lactose (trituration).

Three potency scales are in regular use in homeopathy. Hahnemann pioneered and always favoured the centesimal or "C scale", diluting a substance 1 part in a hundred of diluent at each stage. A 2C dilution requires a substance to be diluted to one part in one hundred, then some of that diluted solution is diluted by one part in one hundred. This works out to one part of the original solution to ten thousand parts (100x100) of diluent. A 6C dilution repeats the process six times, ending up with one part in 1,000,000,000,000. (100 × 100 × 100 × 100 × 100 × 100, or 100⁶) Other dilutions follow the same pattern. In homeopathy, a solution is described as higher potency the more dilute it is. Higher potencies - that is more dilute substances - are considered to be stronger deep-acting remedies.

Hahnemann advocated carrying out provings of remedies using 30C dilutionsHahnemann, Organon of medicine, aphorism 128 [3](a dilution by a factor of 10⁶⁰) and a common homeopathic treatment for the flu is a 200C dilution of duck liver, called Oscillococcinum in homeopathy. Comparing these levels of dilution to the number of molecules present in the initial solution, 50 mL of a 12C solution of Natrum muriaticum (sodium chloride) contains on average only about one molecule of the original substance. The chances of a single molecule of the original substance remaining in a 15C dilution would be roughly 1 in 2 million, and less than one in a billion billion billion billion (10³⁶) for a 30C solution. For a perspective on these numbers, there are on the order of 10³² molecules of water in an Olympic-size swimming pool and if such a pool were filled with a 15C homeopathic remedy, to have a 63% chance of consuming at least one molecule from the original substance, one would need to swallow 1% of the volume of such a pool, or roughly 25 metric tons of water.Consuming a fraction r of N molecules would lead to a probability of approximately 1 − e^−nr of consuming at least one of the n molecules of the original substance, where N is assumed to be a large number.Dynamization and Dilution. Retrieved on 2007-07-24.^{[citation needed]}

For more perspective, 1 ml of a solution which has gone through a 30C dilution would have been diluted into a volume of water equal to that of a cube of 1,000,000,000,000,000,000 metres per side, or about 106 light years. Thus, homeopathic remedies of standard dilutions contain, with overwhelming probability, only water (or alcohol). Practitioners of homeopathy believe that this water retains some "essential property" of the original substance, due to the shaking after each dilution.Resch, G,; Gutmann, V (1987). Scientific Foundations of Homoeopathy. Barthel & Barthel Publishing.  Hahnemann believed that the dynamisation or shaking of the solution caused a "spirit-like" healing force to be released from within the substance. He thought that even after every molecule of the previous substance has been removed from the water, the spiritual healing force still remained.

Some homeopaths developed a decimal scale (D or X), diluting the substance to ten times its original volume each stage. The D or X scale dilution is therefore half that of the same value of the C scale; for example, "12X" is the same level of dilution as "6C". Hahnemann never used this scale but it was very popular throughout the 19th century and still is in Europe. This potency scale appears to have been introduced in the 1830s by the American homeopath, Dr. Constantine Hering.Robert, Ellis Dudgeon (1853). Lectures on the Theory & Practice of Homeopathy (PDF), 526–7. ISBN 81-7021-311-8.  In the last ten years of his life, Hahnemann also developed a quintamillesimal (Q) or LM scale diluting the drug 1 part in 50,000 parts of diluent.Little, David. Hahnemann\'s Advanced Methods. Simillimum.com. Retrieved on 2007-08-04. A Q scale dilution is 2.35 times that of a C scale one, for example "20Q" is the same potency as "47C".

Not all homeopaths advocate extremely high dilutions. Many of the early homeopaths were originally doctors and generally tended to use lower dilutions such as "3X" or "6X", rarely going beyond "12X". The split between lower and higher dilutions followed ideological lines with the former stressing pathology and a strong link to conventional medicine, while the latter emphasised vital force, miasms and a spiritual interpretation of disease.Edwin Wheeler, Charles (1941). Dr. Hughes: Recollections of Some Masters of Homeopathy. Health Through Homeopathy. Bodman, Frank (1970). he Richard Hughes Memorial Lecture. BHJ, 179–193. 

Coverage in the mainstream press

The BBC\'s Horizon and ABC\'s 20/20 broadcast programs described scientific testing of homeopathic dilutions that were unable to differentiate these dilutions from water.Stossel, John. "Homeopathic Remedies - Can Water Really Remember?", 20/20, ABC News. Retrieved on 2008-01-22. (English) 

Provings

In order to determine which specific remedies could be used to treat which diseases, Hahnemann experimented on himself and others for several years, before using remedies on patients. His experiments did not initially consist of giving remedies to the sick, because he thought that the most similar remedy, by virtue of its ability to induce symptoms similar to the disease itself, would make it impossible to determine which symptoms came from the remedy and which from the disease itself. Therefore, sick people were excluded from the provings. The method used for determining which remedies were suitable for specific diseases was called "proving". A homeopathic proving is the method by which the profile of a homeopathic remedy is determined.Dantas F, Fisher P, Walach H, et al (2007). "A systematic review of the quality of homeopathic pathogenetic trials published from 1945 to 1995". Homeopathy : the journal of the Faculty of Homeopathy 96 (1): 4–16. PMID 17227742.  The word "proving" derives from the German word "Prüfung" meaning "test".

During the process of proving, Hahnemann used healthy volunteers who were given remedies, often in molecular doses, although he later advocated proving with remedies at a 30C dilutionHahnemann, Organon of medicine, aphorism 128 [4], and the resulting symptoms were compiled by observers into a "Drug Picture". During the process the volunteers were observed for months at a time and were made to keep extensive journals detailing all of their symptoms at specific times during the day. During the tests volunteers were forbidden from consuming coffee, tea, spices, or wine. They were also not allowed to play chess, because Hahnemann considered it to be "too exciting", though they were allowed to drink beer and were encouraged to moderately exercise. After the experiments were over, Hahnemann made the volunteers offer their hands and take an oath swearing that what they reported in their journals was the truth, at which time he would interrogate them extensively concerning their symptoms.

Provings have been described as important in the development of the clinical trial, due to their early use of simple control groups, systematic and quantitative procedures, and some of the first application of statistics in medicine.Cassedy, James H. (June 1999). American Medicine and Statistical Thinking, 1800–1860. iUniverse. ISBN 978-1583484289.  The lengthy records of self-experimentation by homeopaths have occasionally proven useful in the development of modern drugs: For example, evidence nitroglycerin might be useful as a treatment for angina was discovered by looking through homeopathic provings, though homeopaths themselves never used it for that purpose at that time.Fye WB (1986). "Nitroglycerin: a homeopathic remedy" (PDF). Circulation 73 (1): 21–9. PMID 2866851.  The first recorded provings were published by Hahnemann in his 1796 Essay on a New Principle. His Fragmenta de viribus (1805) Fragmenta de Viribus Medicamentorum Positivis Sive in sano Corpore Humano Observatis. Retrieved on 2007-10-16. contained the results of 27 provings, and his 1810 Materia Medica Pura contained 65. Hahnemann, Samuel. Materia Medica Pura. hpathy.com. Retrieved on 2007-10-16. 217 remedies underwent provings for James Tyler Kent\'s 1905 Lectures on Homoeopathic Materia Medica, and newer substances are continually added to contemporary versions.

Repertory

Homeopathic repertory by James Tyler Kent.

A compilation of reports of many homeopathic provings is known as a homeopathic materia medica. In practice the usefulness of such a compilation is limited because a practitioner does not need to look up the symptoms for a particular remedy, but rather to explore the remedies for a particular symptom. This need is filled by the homeopathic repertory, which is an index of symptoms, listing after each symptom those remedies that are associated with it. Repertories are often very extensive and may include data from clinical experience in addition to provings. There is often lively debate among the compilers of a repertory and interested practitioners over the veracity of a particular inclusion. The first symptomatic index of the homeopathic materia medica was arranged by Hahnemann. Soon after, one of his students Clemens von Bönninghausen, created the Therapautic Pocket Book, another homeopathic repertory.von Bönninghausen, Clemens; Bradford TL, Boger, CM. (1999, Reprint Ed.). Boenninghausen\'s Characteristics and Repertory with Word Index. New Delhi : B. Jain. ISBN 8-170-21207-3.  The first such Homeopathic Repertory was Dr. George Jahr\'s Repertory, published in 1835 in German and then again in 1838 in English and edited by Dr. Constantine Hering. This version was less focused on disease categories and would be the forerunner to Kent\'s later works.Bellavite P, Conforti A, Piasere V, Ortolani R (2005). "Immunology and homeopathy. 1. Historical background". Evidence-based complementary and alternative medicine : eCAM 2 (4): 441–52. PMID 16322800.  It consisted of three large volumes. Such repertories increased in size and detail as time progressed.

Treatments

Homeopathic treatments generally begin with a detailed examinations of their patients\' histories, including questions regarding their physical, mental and emotional states, their one\'s life circumstances and any physical/emotional illnesses. The homeopath then translates this information into a complex formula of mental and physical symptoms, including likes, dislikes, innate predispositions and even body type.Stehlin, Isadora (1996-12-XX). Homeopathy: Real Medicine or Empty Promises?. Food and Drug Administration. Retrieved on 2007-10-01. The goal is to develop a comprehensive representation of each individual\'s overall health. This information can then be compared with similar established data in the drug provings found in the homeopathic materia medica. Assisted by further dialogues with the patient, the homeopath then aims to find the one drug most closely matching the "symptom totality" of the patient. There are many methods for determining the most-similar remedy (the simillimum), and homeopaths sometimes disagree. This is partly due to the complexity of the "totality of symptoms" concept. That is, homeopaths do not use all symptoms, but decide which are the most characteristic. This subjective evaluation of case analysis relies on knowledge and experience of the homeopath doing the diagnosis.

Some diversity in approaches to treatments exists among homeopaths. So called "classical" homeopathy generally involves detailed examinations of a patient\'s history and infrequent doses of a single remedy as the patient is monitored for improvements in symptoms. While "clinical" homeopathy involves combinations of remedies to address the various symptoms of an illness.

Remedies

Homeopathic remedy Rhus toxicodendron, derived from poison ivy.

Homeopathic remedy Oscillococcinum

"Remedy" is a technical term used in homeopathy to refer to a substance prepared with a particular procedure and intended for treating patients. Homeopathic practitioners rely on two types of reference when prescribing remedies. The Homeopathic Materia Medicae which is comprised of alphabetical indexes of "drug pictures" organised by remedy and describe the symptom patterns associated with individual remedies. They also rely on homeopathic repertories which consist of indexes of symptoms of diseases and listing remedies associated with specific symptoms.Jones, Kathryn. Materia Medica: Remedy Information. Retrieved on 2007-07-24.

Homeopathy uses many animal, plant, mineral, and synthetic substances in its remedies. Examples include Natrum muriaticum (sodium chloride or table salt), Lachesis muta (the venom of the bushmaster snake), Opium, and Thyroidinum (thyroid hormone). Homeopaths also use treatments called nosodes (from the Greek nosos, disease) made from diseased or pathological products such as fecal, urinary, and respiratory discharges, blood, and tissue.Bellavite P, Conforti A, Piasere V, Ortolani R (2005). "Immunology and homeopathy. 1. Historical background". Evidence-based complementary and alternative medicine: eCAM 2 (4): 441–452. doi:10.1093/ecam/neh141. PMID 16322800.  Homeopathic remedies prepared from healthy specimens are called Sarcodes.

Some modern homeopaths have considered more esoteric substances, known as "imponderables" because they do not originate from a material but from electromagnetic energy presumed to have been "captured" by alcohol or lactose. Examples include X-rays, sunlight,Norland, Misha (1998). The Homœopathic Proving of Positronium. Retrieved on 2007-07-24. and electricity.CLARKE, John Henry. MATERIA MEDICA. Retrieved on 2007-07-24. Recent ventures by homeopaths into even more esoteric substances include thunderstorms (prepared from collected rainwater).English, Mary. The Homeopathic proving of \'Tempesta\' the Storm. Retrieved on 2007-07-24. Today there are about 3,000 different remedies commonly used in homeopathy.Doheny, Kathleen. Homeopathy: Natural Approach or All a Fake?. Retrieved on 2007-07-24. Some homeopaths also use techniques that are regarded by other practitioners as controversial. These include paper remedies, where the substance and dilution are written on a piece of paper and either pinned to the patient\'s clothing, put in their pocket, or placed under a glass of water that is then given to the patient, as well as the use of radionics to prepare remedies. Such practices have been strongly criticised by classical homeopaths as unfounded, speculative and verging upon magic and superstition.Shah, Rajesh. Call for Introspection and Awakening (PDF). Life Force Center. Retrieved on 2007-07-24.Barwell, Bruce. Homoeopathica: The Wo-wo Effect. New Zealand Homoeopathic Society. Retrieved on 2007-07-24.

Isopathy

Isopathy is a therapy derived from homeopathy and was invented by Johann Joseph Wilhelm Lux in the 1830s. Isopathy differs from homeopathy in general in that the remedies are made up either from things that cause the disease, or from products of the disease, such as pus. Many so-called "homeopathic vaccines" are a form of isopathy.Isopathy. Retrieved on 2007-07-25.

Tautopathy

Tautopathy is a practice of alternative medicine that is similar to homeopathy in that it uses very diluted substances to treat illness. However, tautopathy does not rely on the "law of similars", as homeopathy does. According to practitioners of Tautopathy, dilute solutions of lead and arsenic can cause the body to secrete excess amounts of these toxic metals.Tautopathy – An Introduction, Manish Bhatia, Tautopathy, Homeopathy for Everyone: Everything Homeopathic!

Flower remedies

Flower remedies are produced by placing flowers in water and exposing them to sunlight. The most famous of these are the Bach flower remedies, which were developed by the homeopath Edward Bach. The relationship between these remedies and homeopathy is controversial. On the one hand, the proponents of these remedies share homeopathy\'s vitalist world-view and the remedies are claimed to act through the same hypothetical "vital force". However, although many of the same plants are used as in homeopathy, the method of preparation is somewhat different, with Bach flower therapies supposedly being prepared in "gentler" ways, such as placing flowers in bowls of sunlit water, and so on.van Haselen RA (1999). "The relationship between homeopathy and the Dr Bach system of flower remedies: a critical appraisal". The British homoeopathic journal 88 (3): 121–7. PMID 10449052.  There is no convincing scientific or clinical evidence for flower remedies being effective.Ernst E (2002). ""Flower remedies": a systematic review of the clinical evidence". Wien. Klin. Wochenschr. 114 (23-24): 963–6. PMID 12635462. 

Veterinary use

The idea of using homeopathy as a treatment for other animals, termed veterinary homeopathy, dates back to the inception of homeopathy as Hahnemann himself wrote and spoke of the use of homeopathy in animals other than humans.Saxton, J. (2007). "The diversity of veterinary homeopathy.". Homeopathy 96 (1): 3. doi:10.1016/j.  In the USA veterinary homeopathy is used by veterinarian members of the Academy for Veterinary Homeopathy and/or the American Holistic Veterinary Medical Association. Tiekert, Dr. Carvel G.. What is Holistic medicine?. American Holistic Veterinary Medical Association. Retrieved on 2007-10-18.^{[dead link]} The FDA has not approved homeopathic products as veterinary medicine in the US. In the UK, veterinary surgeons who use homeopathy belong to the Faculty of Homeopathy and/or to the British Association of Homeopathic Veterinary Surgeons. Animals may only be treated by qualified veterinary surgeons in the UK and some other countries. Internationally, the body that supports and represents homeopathic veterinarians is the International Association for Veterinary Homeopathy. The use of homeopathy in veterinary medicine is controversial, as there has been little scientific investigation and current research in the field is not of a high enough standard to provide reliable data.Hektoen L (2005). "Review of the current involvement of homeopathy in veterinary practice and research". Vet. Rec. 157 (8): 224–9. PMID 16113167.  Other studies have also found that giving animals placebos can play active roles in influencing pet owners to believe in the effectiveness of the treatment when none exists.

Medical and scientific analysis

Homeopathy is unsupported by modern scientific research. The extreme dilutions used in homeopathic preparations usually leave none of the active ingredient (atoms, ions or molecules) in the final product.Teixeira J (2007). "Can water possibly have a memory? A sceptical view". Homeopathy : the journal of the Faculty of Homeopathy 96 (3): 158-162. doi:10.1016/j.homp.2007.05.001.  The idea that any biological effects could be produced by these preparations is inconsistent with the observed dose-response relationships of conventional drugs.Levy G (1986). "Kinetics of drug action: an overview". J. Allergy Clin. Immunol. 78 (4 Pt 2): 754–61. PMID 3534056.  The proposed rationale for these extreme dilutions - that the water contains the "memory" or "vibration" from the diluted ingredient - is also counter to the laws of chemistry and physics. Thus critics contend that any positive results obtained from homeopathic remedies are purely due to the placebo effect.Ernst E (2007). "Placebo: new insights into an old enigma". Drug Discov. Today 12 (9-10): 413–8. PMID 17467578.  Critics cite the lack of viable scientific studies for the effectiveness of homeopathic remedies as evidence that they are not effective and that any positive effects are due to the placebo effect. Critics also contend that homeopathy is inherently dangerous, because homeopaths offer a false hope that may discourage or delay proper treatment.

High dilutions

The extremely high dilutions in homeopathy have been a main point of criticism. Homeopaths believe that the methodical dilution of a substance, beginning with a 10% or lower solution and working downwards, with shaking after each dilution, produces a therapeutically active "remedy", in contrast to therapeutically inert water. However, homeopathic remedies are usually diluted to the point where there are no molecules from the original solution left in a dose of the final remedy.Milgrom LR (2007). "Conspicuous by its absence: the Memory of Water, macro-entanglement, and the possibility of homeopathy". Homeopathy : the journal of the Faculty of Homeopathy 96 (3): 209–19. doi:10.1016/j.homp.2007.05.002. PMID 17678819.  Since even the longest-lived noncovalent structures in liquid water at room temperature are only stable for a few pico