Homeopathy
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[[WP:UNDO|Undid]] revision 226056844 by [[Special:Contributions/Vyx|Vyx]] ([[User talk:Vyx|talk]]) Please discuss new sources and the use of "sceptics" to gain consensus.
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[[Image:Homeopathic332.JPG|thumb|right|250px|Homeopathic remedies]]
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'''Homeopathy''' (also homœopathy or homoeopathy; from the Greek ''ὅμοιος'', ''hómoios'', "[[Similarity|similar]]" + ''πάθος'', ''páthos'', "[[suffering]]" or "[[disease]]") is a form of [[alternative medicine]] first defined by [[Samuel Hahnemann]] in the 18th century.<ref name="homhist1"/> Homeopathic practitioners contend that an ill person can be treated using a substance that can produce, in a healthy person, [[symptom]]s similar to those of the illness. According to homeopaths, [[serial dilution]], with shaking between each dilution, removes the [[Toxicity|toxic]] effects of the [[Medication|remedy]] while the qualities of the substance are retained by the [[diluent]] (water, sugar, or alcohol). The end product is often so diluted that it is indistinguishable from pure water, sugar or alcohol.<ref name="Dynamization and Dilution">{{cite news | title= Dynamization and Dilution | publisher= Creighton University Department of Pharmacology | url =http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm | accessdate = 2007-10-09 }}</ref><ref>Smith, Trevor. ''Homeopathic Medicine'' Healing Arts Press, 1989. 14-15</ref><ref name="homsim">{{cite news | title= Similia similibus curentur (Like cures like) | publisher= [[Creighton University]] Department of Pharmacology | url =http://altmed.creighton.edu/Homeopathy/philosophy/similia.htm | accessdate = 2007-08-20 }}</ref> Practitioners select treatments according to a patient consultation that explores the physical and psychological state<ref>Hahnemann, ''Organon of medicine,'' aphorism 217 [http://homeoint.org/books/hahorgan/organ200.htm#P217]</ref> of the patient, both of which are considered important to selecting the remedy.<ref>Hahnemann, ''Organon of medicine,'' aphorism 5[http://homeoint.org/books/hahorgan/organ001.htm#P5]</ref>
Claims for efficacy of homeopathic treatment beyond the [[placebo effect]] are unsupported by the collective weight of [[scientific method|scientific]] and [[clinical medicine|clinical]] evidence.<ref name="pmid12492603">{{cite journal |author=Ernst E |title=A systematic review of systematic reviews of homeopathy |journal=Br J Clin Pharmacol |volume=54 |issue=6 |pages=577–82 |year=2002 |pmid=12492603 |doi= |url= http://www.blackwell-synergy.com/links/doi/10.1046/j.1365-2125.2002.01699.x/full?cookieSet=1|accessdate=2008-02-12}}</ref><ref name="asthma">{{cite journal |author=McCarney RW, Linde K, Lasserson TJ |title=Homeopathy for chronic asthma |journal=Cochrane database of systematic reviews (Online) |issue=1 |pages=CD000353 |year=2004 |pmid=14973954 |doi=10.1002/14651858.CD000353.pub2 }}</ref><ref name="dementia">{{cite journal |author=McCarney R, Warner J, Fisher P, Van Haselen R |title=Homeopathy for dementia |journal=Cochrane database of systematic reviews (Online) |issue=1 |pages=CD003803 |year=2003 |pmid=12535487 |doi=10.1002/14651858.CD003803 }}<br/>{{cite web|url=http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=197§ionId=27 |title=Homeopathy results |accessdate=2007-07-25 |publisher=[[National Health Service]] }}</ref><ref>{{cite web |url=http://www.ama-assn.org/ama/pub/category/13638.html |title=Report 12 of the Council on Scientific Affairs (A–97) |accessdate=2007-07-25 |publisher=[[American Medical Association]]}}<br/>{{cite journal |author=Linde K, Jonas WB, Melchart D, Willich S |title=The methodological quality of randomized controlled trials of homeopathy, herbal medicines and acupuncture |journal=International journal of epidemiology |volume=30 |issue=3 |pages=526–531 |year=2001 |pmid=11416076 |doi=10.1093/ije/30.3.526 }}<br/>{{cite journal |title=Homeopathy for childhood and adolescence ailments: systematic review of randomized clinical trials |author=Altunç U, Pittler MH, Ernst E |journal=Mayo Clin Proc. |date=2007 |volume=82 |issue=1 |pages=69–75 |pmid= 17285788}}</ref> Common homeopathic preparations are diluted beyond the point where there is any likelihood that molecules from the original solution are present in the final product; the claim that these treatments still have any [[pharmacology|pharmacological effect]] is thus scientifically implausible<ref name="shang">{{cite journal |author=Shang A, Huwiler-Müntener K, Nartey L, ''et al'' |title=Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy |journal=Lancet |volume=366 |issue=9487 |pages=726–732 |year=2005 |pmid=16125589 |doi=10.1016/S0140-6736(05)67177-2}}</ref><ref name="Ernst2005"/> and violates fundamental principles of science,<ref name=NatureWhenToBelieve/> including the [[law of mass action]].<ref name=NatureWhenToBelieve>{{cite journal|title=When to believe the unbelievable|journal=Nature|volume=333|issue=30|pages=787|year=1988|doi=10.1038/333787a0}}</ref> While advocates point to positive results as evidence for its efficacy, the number of high-quality studies that support homeopathy is small, the conclusions are not definitive, and duplication of the results, a key test of scientific validity, has proven problematic at best.<ref>Toufexis, Anastasia [http://www.time.com/time/magazine/article/0,9171,983466-2,00.html Is Homeopathy Good Medicine?], [[Time (magazine)|Time]], Sep. 25, 1995, page 2 (page numbering given from online version, accessed 20 April 2008)</ref> The lack of convincing [[scientific evidence]] supporting its efficacy<ref name="Adler">Jerry Adler. [http://www.newsweek.com/id/105581 "No Way to Treat the Dying"] - ''[[Newsweek]]'', Feb 4, 2008</ref> and its use of remedies without active ingredients have caused homeopathy to be regarded as [[pseudoscience]];<ref>National Science Board (April 2002) ''Science and Engineering Indicators,'' Chapter 7, "Science and Technology: Public Attitudes and Public Understanding" - [http://www.nsf.gov/statistics/seind02/c7/c7s5.htm "Science Fiction and Pseudoscience"] (Arlington, Virginia: National Science Foundation Directorate for Social, Behavioral and Economic Sciences)</ref> [[quackery]];<ref>Wahlberg, A. (2007) [http://dx.doi.org/10.1016/j.socscimed.2007.07.024 "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 18080586</ref><ref>Atwood, K.C. (2003) [http://archotol.ama-assn.org/cgi/content/extract/129/12/1356 "Neurocranial Restructuring' and Homeopathy, Neither Complementary nor Alternative,"] ''Archives of Otolaryngology-Head and Neck Surgery'' '''129'''(12) pp. 1356-1357: PMID 14676179</ref><ref>Ndububa, V.I. (2007) [http://www.find-health-articles.com/rec_pub_18080586-medical-quackery-nigeria-silence.htm "Medical quackery in Nigeria; why the silence?"] ''Nigerian Journal of Medicine'' '''16'''(4) pp. 312-317: PMID 18080586</ref> or, in the words of a 1998 medical review, "placebo therapy at best and quackery at worst."<ref name=Ernst>{{cite journal |author=Ernst E, Pittler MH |title=Efficacy of homeopathic arnica: a systematic review of placebo-controlled clinical trials |journal=Archives of surgery (Chicago, Ill. : 1960) |volume=133 |issue=11 |pages=1187–90 |year=1998 | url = http://archsurg.ama-assn.org/cgi/content/full/133/11/1187 |pmid=9820349 |doi=10.1001/archsurg.133.11.1187}}</ref>
Homeopathic remedies are generally considered safe, with rare exceptions,<ref>{{cite web |url=http://www.onlinelawyersource.com/news/zicam-settlement.html |title=Zicam Settlement|accessdate=2007-10-25 |publisher=Online Lawyer Source}}</ref><ref>{{cite journal |author=Chakraborti, D; Mukherjee, SC; Saha, KC; Chowdhury, UK, ''et al'' |title= Arsenic Toxicity from Homeopathic Treatment|journal=Clinical Toxicology |volume=47 |issue=1 |pages=963–967 |year=2003 |doi=10.1081/CLT-120026518}}</ref> although homeopaths have been criticized for putting patients at risk by advising them to avoid [[Evidence-based medicine|conventional medicine]], such as [[vaccination]]s,<ref name="pmid8554846">{{cite journal |author=Ernst E, White AR |title=Homoeopathy and immunization |journal=The British journal of general practice: the journal of the Royal College of General Practitioners |volume=45 |issue=400 |pages=629–630 |year=1995 |pmid=8554846 }}</ref> anti-[[malaria]]l drugs<ref name=malaria2>{{cite news |first=Meirion |last=Jones |title=Malaria advice 'risks lives' |date=2006-07-14 |publisher=[[BBC News]] |url=http://news.bbc.co.uk/2/hi/programmes/newsnight/5178122.stm |accessdate=2007-07-25 }}</ref> and [[antibiotics]].<ref name = "minimum-67-4">[http://www.minimum.com/reviews/science-homeopathy.htm Critical review of ''The Science of Homeopathy''] from the ''British Homoeopathic Journal'' Volume 67, Number 4, October 1978</ref><!-- This is a sample of the refs found in the main section--> Regardless of whether homeopathic drugs are effective, they may make people feel better in an effect known as the [[placebo effect]]. Thus, like any placebo, such remedies may improve symptoms subject to psychological or behavioral influences such as chronic pain, fatigue, anxiety or depression.<ref name="pmid15749790">{{cite journal |author=McQuay HJ, Moore RA |title=Placebo |journal=Postgrad Med J. |volume=81 |issue=953 |pages=155-60 |year=2005 |pmid=15749790 }}</ref> In many countries, the laws that govern the regulation and testing of conventional drugs do not apply to homeopathic remedies.<ref name=WHO>{{cite web |url=http://whqlibdoc.who.int/hq/2001/WHO_EDM_TRM_2001.2.pdf |title=Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review |accessdate=2007-09-12 |date=2001 |format=PDF |work=World Health Organization |publisher=[[World Health Organization]]}}</ref><!-- This is the chief reference for the main section below.--> Current usage around the world varies from two percent of people in the [[United Kingdom]] and the [[United States]] using homeopathy in any one year<ref name=tindleprev>{{cite journal |author=Tindle HA, Davis RB, Phillips RS, Eisenberg DM |title=Trends in use of complementary and alternative medicine by US adults: 1997–2002 |journal=Alternative therapies in health and medicine |volume=11 |issue=1 |pages=42–9 |year=2005 |pmid=15712765}}</ref><ref>{{cite journal |author=Thomas K, Coleman P |title=Use of complementary or alternative medicine in a general population in Great Britain. Results from the National Omnibus survey |journal=Journal of public health (Oxford, England) |volume=26 |issue=2 |pages=152–7 |year=2004 |pmid=15284318 |url=http://jpubhealth.oxfordjournals.org/cgi/reprint/26/2/152 |doi=10.1093/pubmed/fdh139}}</ref> to 15 percent in [[India]], where it is considered part of Indian [[traditional medicine]].<ref name="Singh P">{{cite journal |author=Singh P, Yadav RJ, Pandey A |title=Utilization of indigenous systems of medicine & homoeopathy in India |journal=Indian J. Med. Res. |volume=122 |issue=2 |pages=137–42 |year=2005 |pmid=16177471}}</ref> In the UK, the [[National Health Service]] runs five homeopathic hospitals,<ref>[http://www.bmj.com/cgi/content/full/324/7337/565/a "Use of homeopathy in NHS not justified"], ''British Medical Journal'', March 9, 2002.</ref> and in the 1990s, between 5.9 and 7.5 percent of [[England|English]] family doctors are reported to have prescribed homeopathic remedies, a figure rising to at least 12 percent in Scotland.<ref>Ross, S; Simpson, C.R.; McLay, J.S. [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1885188 "Homoeopathic and herbal prescribing in general practice in Scotland"], ''British Journal of Clinical Pharmacology'', volume 62, issue 6, 2006, pp. 647-652, 645-646; Papers cited by Ross et al for the English figures are Perry R, Dowrick CF. [http://www.ncbi.nlm.nih.gov/pubmed/10859598 "Complementary medicine and general practice: an urban perspective"], ''Complement Ther Med''. 2000 Jun;8(2):71-5; Thomas KJ, Nicholl JP, Fall M. [http://www.ncbi.nlm.nih.gov/pubmed/11271869 "Access to complementary medicine via general practice"], Br J Gen Pract. 2001 Jan;51(462):25-30; White AR, Resch KL, Ernst E. [http://www.ncbi.nlm.nih.gov/pubmed/9283851 "Complementary medicine: use and attitudes among GPs"], ''Fam Pract''. 1997;14:302–6.</ref> In 2005, around 100,000 physicians used homeopathy worldwide, making it one of the most popular and widely used complementary therapies.<ref>{{cite web|url=http://news.bbc.co.uk/nolpda/ukfs_news/hi/newsid_4423000/4423303.stm|publisher=BBC|author=Jane Elliott|date=2005-04-10|title=Malaria row inspired homeopathy}}</ref>
{{Alternative medical systems}}
==History==
[[Image:Beydeman Gomeopatiya vzir.jpg|thumb|right|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 [[laxative]]s and [[enema]]s, and the administration of complex mixtures, such as [[Venice treacle]], which was made from 64 substances including opium, myrrh, and viper's flesh.<ref>* {{Harvard reference
| Author=Hodgson, Barbara
| Last=Hodgson
| First=Barbara
| Title=In the Arms of Morpheus: The Tragic History of Morphine, Laudanum and Patent Medicines
| Publisher=Firefly Books
| Year=2001
| ID=ISBN 1552975401
}} page 18</ref><ref>Griffin, J. P., [http://www.blackwell-synergy.com/doi/pdf/10.1111/j.1365-2125.2004.02147.x?cookieSet=1 ''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}}</ref> Such measures often worsened symptoms and sometimes proved fatal.<ref>[http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=2260507&pageindex=1#page British Medical Journal: Blood-letting], page 283, [[March 18]] [[1871]], retrieved on [[March 21]] [[2008]]</ref><ref name="kaufmanm"/> While the virtues of these treatments had been extolled for centuries,<ref> {{cite web|url=http://www.queens.cam.ac.uk/Queens/Record/1998/History/Shakespeare2.html |title=Shakespeare and Queens' (Part II) |accessdate=2007-10-14 |last=Wright |first=Iaian |publisher=Queens' College Cambridge }}</ref> Hahnemann rejected such methods as irrational and unadvisable.<ref name=Lasagna>{{cite book | last = Lasagna | first = Louis | authorlink = | coauthors = | title = The doctors' dilemmas | publisher = Collier Books | date = | location = | pages = 33 | url = http://books.google.com/books?id=CiLMdjrSFeEC&pg=PA33&lpg=PA33&dq=hahnemann+purge&source=web&ots=jFxu5xUDAo&sig=1PEUjXN-yruevcw--aZOvqpSJ_E#PPA35 | doi = | id = | isbn = }}</ref> Instead, he favored the use of single drugs at lower doses and promoted an immaterial, [[vitalism|vitalistic]] view of how living organisms function, believing that diseases have [[Spirituality|spiritual]], as well as physical causes.<ref name=PANicholls>{{cite book |last=Nicholls |first=Philip A.|title=Homeopathy and the Medical Profession |publisher=Croom Helm Ltd |date=March 1988 |isbn=978-0709918363 }}</ref><ref name=OrganonH>{{cite book |last=Hahnemann |first=Dr Samuel |authorlink=Samuel Hahnemann |title=Organon of medicine |publisher = <!--Supply one on all references please!! --> |date=1818 |location=Leipzig |url=http://homeoint.org/books/hahorgan/orgapref.htm}}</ref> (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]],<ref>{{cite journal |author=Baxter AG |title=Louis Pasteur's beer of revenge |journal=Nat. Rev. Immunol. |volume=1 |issue=3 |pages=229–32 |year=2001 |pmid=11905832 |doi=10.1038/35105083}}</ref> and advances in [[chemistry]].<ref>{{cite journal |author=Coley NG |title=Medical chemists and the origins of clinical chemistry in Britain (circa 1750–1850) |journal=Clin. Chem. |volume=50 |issue=5 |pages=961–72 |year=2004 |pmid=15105362 |url=http://www.clinchem.org/cgi/content/full/50/5/961 |doi=10.1373/clinchem.2003.029645}}</ref><ref>{{cite journal |author=Ramberg PJ |title=The death of vitalism and the birth of organic chemistry: Wohler's urea synthesis and the disciplinary identity of organic chemistry |journal=Ambix |volume=47 |issue=3 |pages=170–95 |year=2000 |pmid=11640223}}</ref>) Hahnemann also advocated various lifestyle improvements to his patients, including exercise, diet, and cleanliness.<ref name="Lasagna"/><ref>http://homeoint.org/books4/bradford/chapter35.htm Thomas L Bradford, ''The Life and Letters of Hahnemann,'' Ch.35</ref>
===Hahnemann's concept===
[[Image:Samuel Hahnemann.png|thumb|left|[[Samuel Hahnemann]], considered to be the father of homeopathy]]
[[Samuel Hahnemann]] conceived of homeopathy while translating a medical treatise by [[Scotland|Scottish]] physician and chemist [[William Cullen]] into [[German language|German]].<ref name="homhist1"/> 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".<ref>http://www.iavh.org/homeopathy/history/ ''History of Homeopathy,'' IAVH</ref> Upon ingesting the bark, he noticed few stomach symptoms, but did experience [[fever]], [[shivering]] and [[arthralgia|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.<ref name=homhist1>{{cite news |title=History of Homeopathy |publisher=[[Creighton University]] Department of Pharmacology |url=http://altmed.creighton.edu/Homeopathy/history.htm |accessdate=2007-07-23 }}</ref> 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.<ref>{{cite journal |title=Homeopathy and "the progress of science" |journal=History of science; an annual review of literature, research and teaching |date=2001 |first=Michael |last=Emmans Dean |volume=39 |issue=125 Pt 3 |pages=255–83 |pmid=11712570 |url=http://www.shpltd.co.uk/dean-homeopathy.pdf |format=PDF |accessdate=2007-10-02 }}</ref>
Hahnemann began to test what effects substances produced in humans, a procedure which would later become known as "homeopathic proving".<ref name=homproving>{{cite web |url=http://altmed.creighton.edu/Homeopathy/philosophy/provings.htm |title=Homeopathic Provings |accessdate=2007-10-02 |publisher=[[Creighton University]] School of Medicine }}</ref> 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.<ref name="homproving"/> 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.<ref>{{cite book |last=Kirschmann |first=Anne Taylor |title=A Vital Force: Women in American Homeopathy |publisher=Rutgers University Press |date=December 2003 |isbn=978-0813533209 }}</ref> 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,<ref name=homeodilut>{{cite web |url=http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm |title=Homeopathic Dynamization and Dilution |accessdate=2007-10-02 |publisher=[[Creighton University]] School of Medicine }}</ref> proposing that this process aroused and enhanced "spirit-like medicinal powers held within a drug".<ref>[http://www.hpathy.com/philosophy/hahnemann-organon261to270.asp ''Organon of Medicine,''] Samuel Hahnemann, combined 5th/6th edition</ref> 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.<ref name="homhist1"/>
===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]].<ref name=Julian>{{cite web|url=http://www.wholehealthnow.com/homeopathy_pro/homeopathy_1825_1849.html |title=Homeopathy Timeline |accessdate=2007-07-23 |last=Winston |first=Julian |date=2006 |work="The Faces of Homoeopathy" |publisher=Whole Health Now }}</ref> Because of medicine's reliance on unscientific [[blood-letting]] and other untested, often dangerous treatments, patients of homeopaths often had better outcomes than those of the doctors of the time.<ref name="pmid8885813">{{cite journal |author=Ernst E, Kaptchuk TJ |title=Homeopathy revisited |journal=Arch. Intern. Med. |volume=156 |issue=19 |pages=2162–4 |year=1996 |pmid=8885813 |doi=10.1001/archinte.156.19.2162 }}</ref> Homeopathic remedies, even if ineffective, would almost surely cause no harm, making the users of homeopathic remedies less likely to be killed by the treatment that was supposed to be helping them.<ref name="homhist1"/> 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, science based medicine.<ref name=kaufmanm>{{cite book |last = Kaufman |first=Martin |title = Homeopathy in America: The Rise and Fall of a Medical Heresy |publisher=[[The Johns Hopkins University Press]] |date=1971-10-01 |isbn=978-0801812385 }}</ref>
In the early 19th century, homeopathy began to be criticised. [[John Forbes (physician)|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".<ref>Sir John Forbes, ''Homeopathy, Allopathy and Young Physic'', London, 1846</ref> Professor Sir [[James Young Simpson]] said of the highly diluted drugs: "No poison, however strong or powerful, the billionth or decillionth of which would in the least degree affect a man or harm a fly."<ref>James Y Simpson, ''Homoeopathy, Its Tenets and Tendencies, Theoretical, Theological and Therapeutical'', Edinburgh: Sutherland & Knox, 1853, 11</ref> 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''.<ref>{{cite book|title=Homœopathy, and its Kindred Delusions; two lectures delivered before the Boston society for the diffusion of useful knowledge.| first=Oliver Wendell |last=Holmes |location=[[Boston, MA]] |publisher=William D. Ticknor |year=1842 |oclc=166600876}} Found online at,{{cite web|url=http://homeoint.org/cazalet/holmes/index.htm |title=Homeopathy and Its Kindred Delusions |accessdate=2007-07-25 |last=Holmes |first=Oliver Wendell}}</ref> The last school in the U.S. exclusively teaching homeopathy closed in 1920.<ref name="homhist1"/>
===Revival in the late 20th Century===
Attempts to outlaw alternative forms of medicine in the USA failed and the ''Food, Drug, and Cosmetic Act'' of 1938 recognized homeopathic remedies as drugs.<ref name=rader>{{citation|date=March 1985|publisher=FDA Consumer Magazine|author=William M. Rader|url=http://www.homeowatch.org/history/fdac1.html|title=Riding the Coattails of Homeopathy's Revival}}</ref> By the 1950s there were only 75 pure homeopaths practising in the USA.<ref>{{citation|url=http://www.time.com/time/magazine/article/0,9171,891760,00.html|publisher=Time|title=Homeopathic Hassle|date=1956-08-20}}</ref> However, in the mid to late 1970s, homeopathy made a significant comeback and sales of some homeopathic companies increased tenfold.<ref name=rader/> Homeopathy was also revived worldwide<ref>{{citation|url=http://annals.highwire.org/cgi/content/abstract/138/5/393|journal=Annals of Internal Medicine|title=A Critical Overview of Homeopathy|author=Wayne B. Jonas, Ted J. Kaptchuk, Klaus Linde|date=2003-04-04|volume=138|issue=5|pages=393–399|pmid=12614092}}</ref>; for example, Brazil in the 1970s and Germany in the 1980s.<ref>{{citation|url=http://www.igm-bosch.de/download/report/summaryinhh2.pdf|title=Homeopathy and Hospitals in History|publisher=International Network for the History of Homeopathy|date=2007-07-06|author=F. von Reiswitz}}</ref> The medical profession started to integrate such ideas in the 1990s<ref>{{citation|journal=Social Problems|title=From Quackery to Complementary Medicine: The American Medical Profession Confronts Alternative Therapies|date=February 2005|volume=52|number=1|pages=38–61|url=http://caliber.ucpress.net/doi/abs/10.1525/sp.2005.52.1.38|doi=10.1525/sp.2005.52.1.38|author=Winnick, TERRI A.}}</ref> and big mainstream pharmacies started competing for this business.<ref>{{citation|url=http://www.guardian.co.uk/money/2002/jan/05/lifeinsurance.jobsandmoney|title=A question of health or wealth?|author=Mary O'Hara|date=2002-01-05|publisher=The Guardian}}</ref>
==General philosophy==
Homeopathy is a [[vitalism|vitalist]] philosophy in that it regards diseases and sickness to be caused by disturbances in a hypothetical [[vital force]] or [[spiritual energy|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.<ref name="homhist1"/> However, Hahnemann rejected the notion of a disease as a separate thing or invading entity<ref>{{cite web|url=http://julianwinston.com/archives/articles/winston_organon_outline.php |title=Outline of the Organon |accessdate=2007-08-04 |last=Winston |first=Julian }}</ref> and insisted that it was always part of the "living whole".<ref>{{cite web |url=http://www.homeopathyhome.com/reference/organon/organon.html |title=Organon Of Medicine |accessdate=2007-08-04 |last=Hahnemann |first=Samuel }}</ref>
===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" ({{lang-la|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.<ref name="homhist1"/>
===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.<ref>{{cite web | url=http://www.lyghtforce.com/HomeopathyOnline/Issue2/educate.html |accessdate=2007-10-12 |author=David Little | title=The Classical View on Miasms | publisher = Homeopathy Online}}</ref> In 1828,<ref>The Chronic Diseases, their Nature and Homoeopathic Treatment, [[Dresden]] and Leipsic, Arnold. Vols. 1, 2, 3, 1828; vol. 4, 1830</ref> 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".<ref>{{cite web |url=http://www.homeopathyhome.com/reference/organon/10.html |author=Samuel Hahnemann |title=Organon, 5th edition, para 29 |publisher=Homeopathy Home.com. |accessdate=2007-10-22 }}</ref> 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.<ref name="ntlworld"/> 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".<ref>{{cite web |url=http://homeoint.org/cazalet/ward/historycase.htm |author=Dr J W Ward |title=Taking the History of the Case |publisher=Pacific Coast Jnl of Homeopathy, July 1937 |accessdate=2007-10-22}}</ref> The underlying imputed miasm still remains, and deep-seated ailments can only be corrected by removing the deeper disturbance of the vital force.<ref name=homphilo>{{cite news |title=Cause of Disease in homeopathy |date= |publisher=Creighton University Department of Pharmacology |url=http://altmed.creighton.edu/Homeopathy/philosophy/cause.htm |accessdate=2007-07-23 }}</ref>
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.<ref name="Birnbaum">{{cite journal |author=Birnbaum NR, Goldschmidt RH, Buffett WO |title=Resolving the common clinical dilemmas of syphilis |url=http://www.aafp.org/afp/990415ap/2233.html |journal=American family physician |volume=59 |issue=8 |pages=2233–40, 2245–6 |year=1999 |pmid=10221308}}</ref> Campbell described this as "a thoroughly irresponsible statement which could mislead an unfortunate layman into refusing orthodox treatment".<ref name = "minimum-67-4"/>
Originally Hahnemann presented only three miasms, of which the most important was "psora" ([[Greek language|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]].<ref name="OrganonH"/> Since Hahnemann's time, other miasms have been proposed, some replacing one or more of psora's proposed functions, including [[Tuberculosis|tubercular]] miasms and [[cancer]] miasms.<ref name=ntlworld>{{cite web|url=http://homepage.ntlworld.com/homeopathy_advice/Theory/Intermediate/miasm.html |title=Miasms in homeopathy |accessdate=2007-07-24 }}</ref>
==Preparation of remedies==
[[Image:Mortar2.jpg|thumb|right|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.<ref>{{cite web |url=http://www.igm-bosch.de/english/f10.htm |title= Online Museum |publisher=The Institute for the History of Medicine |accessdate=2007-10-22 }}</ref><ref name="Williams_2002">Williams, Nathan (2002-[[November 26|11-26]]) [http://www.bbc.co.uk/science/horizon/2002/homeopathy.shtml ''Homeopathy: The Test''], [[Horizon (BBC TV series)|Horizon (BBC)]] Retrieved on 2007-[[January 26|01–26]] ([http://www.bbc.co.uk/science/horizon/2002/homeopathytrans.shtml transcript])</ref> 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 created the centesimal or "C scale", diluting a substance by a factor of 100 at each stage. The centesimal scale was favored by Hahnemann for most of his life. A 2C dilution requires a substance to be diluted to one part in one hundred, and then some of that diluted solution is diluted by a further factor of one hundred. This works out to one part of the original solution mixed into 9,999 parts (100 × 100 −1) of the diluent.<ref>In standard chemistry, this produces a substance with a concentration of 0.01%, measured by the [[Concentration#Volume-volume_percentage|volume-volume percentage]] method.</ref> A 6C dilution repeats this process six times, ending up with the original material diluted by a factor of 1,000,000,000,000. (100 × 100 × 100 × 100 × 100 × 100, or 100<sup>6</sup>). Higher dilutions follow the same pattern. In homeopathy, a solution that is more dilute is described as having a higher ''potency''. Higher potencies (that is, more dilute substances) are considered by homeopaths to be stronger and deeper-acting remedies.
{| class="wikitable"
|-
! X Scale
! C Scale
! Ratio
! Note
|-
| 1X
| —
| 1:10
| described as low potency
|-
| 2X
| 1C
| 1:100
| called ''higher'' potency than 1X by homeopaths
|-
| 6X
| 3C
| 1:1,000,000
|
|-
| 8X
| 4C
| 1:100,000,000
| allowable concentration of arsenic in US drinking water<ref name = "Arsenic">''Arsenic in Drinking Water'', US Environmental Protection Agency [http://www.epa.gov/safewater/arsenic/index.html]</ref>
|-
| 12X
| 6C
| 1:1,000,000,000,000
|-
| 24X
| 12C
| 1:10<sup>24</sup>
| [[Avogadro's constant| Chemically unlikely to contain any molecules of original material]].
|-
| 400X
| 200C
| 1:10<sup>400</sup>
| Dilution of popular homeopathic flu remedy [[Oscillococcinum]]
|}
Hahnemann advocated 30C dilutions for most purposes (that is, dilution by a factor of 10<sup>60</sup>).<ref name = "Hahnemann-128">Hahnemann, ''Organon of medicine,'' aphorism 128 [http://homeoint.org/books/hahorgan/organ120.htm#P128E6]</ref> A popular homeopathic treatment for the [[influenza|flu]] is a 200C dilution of duck liver, marketed under the name ''[[Oscillococcinum]]''. Comparing these levels of dilution to [[Avogadro's number]], one liter of a 12C homeopathic remedy created from diluting 1 liter of 1 [[molar solution]] contains on average only about 0.602 molecules of the original substance per liter of the 12C remedy. Similarly, the chance of a single molecule of the original substance remaining in a liter of 15C remedy dose is about one in 1.7 million, and about one in 1.7 trillion trillion trillion (10<sup>36</sup>) for a 30C solution.
Commonly, critics of homeopathy, as well as homeopaths themselves, attempt to illustrate the dilutions involved in homeopathy with examples.<ref name="Appendix">For further discussion of homeopathic dilutions and the mathematics involved, see [[Homeopathy/Appendix: Dilutions]].</ref> Hahnemann is reported to have joked that a suitable procedure to deal with an epidemic would be to empty a bottle of poison into [[Lake Geneva]], if it could be succussed 60 times.<ref name=Bambridge>''Homeopathy Investigated'', A. D. Bambridge, Diasozo Trust, [[Kent, England]], 1989, ISBN 0948171200</ref><ref name=Andrews>[http://www.watchman.org/na/homeopth.htm ''Homeopathy and Hinduism''], Peter Andrews, The Watchman Expositor, Vol. 7, No. 3, 1990.</ref><ref>Pouring a 1 liter bottle of poison into [[Lake Geneva]] would only result in about a 7C remedy, since Lake Geneva has a volume of about 89 cubic kilometers of water ([http://links.jstor.org/sici?sici=0024-3590(200209)47%3A5%3C1355%3ATMOPAI%3E2.0.CO%3B2-J ''Temporal Mapping of Phytoplankton Assemblages in Lake Geneva: Annual and Interannual Changes in Their Patterns of Succession''], Orlane Anneville, Sami Souissi, Frederic Ibanez, Vincent Ginot, Jean Claude Druart, Nadine Angeli,
Limnology and Oceanography, Vol. 47, No. 5, Sep., 2002, pp. 1355–1366.)</ref> Another example given by a critic of homeopathy states that a 12C solution is equivalent to a "pinch of salt in both the North and South Atlantic Oceans",<ref name=Bambridge/><ref name=Andrews/> which is approximately correct.<ref>A 12C solution produced using [[sodium chloride]] (also called ''natrum muriaticum'' in homeopathy) is the equivalent of dissolving 0.36 milliters of table salt, weighing about 0.77 grams, into a volume of water the size of the [[Atlantic Ocean]], since the volume of the Atlantic Ocean and its adjacent seas is 3.55 × 10<sup>8</sup> cubic kilometers ([http://books.google.com/books?id=6J0TAAAAYAAJ&q=355+x+106+km3+in+the+whole&dq=355+x+106+km3+in+the+whole&ei=fAfTR7zHGIaUzAS6hpCbAg&pgis=1 ''The geology of the Atlantic Ocean''], Kenneth Orris Emery, Elazar Uchupi, Springer, 1984, ISBN 0387960325) or 3.55 × 10<sup>20</sup> liters.</ref> One third of a [[Drop (unit)|drop]] of some original substance diluted into all the water on earth would produce a remedy with a concentration of about 13C.<ref>The volume of all water on earth is about 1.36 billion cubic kilometers ([http://ga.water.usgs.gov/edu/waterdistribution.html ''Earth's water distribution''], Water Science for Schools, [[United States Geological Survey]] [[website]], 28-Aug-2006 ; ''Water resources'', P. H. Gleick, In ''Encyclopedia of Climate and Weather'', ed. by S. H. Schneider, [[Oxford University Press]], [[New York City|New York]], vol. 2, 1996 pp.817–823.).</ref><ref name="Appendix"/>
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]].<ref name=Dudgeon>{{cite book |last=Robert |first=Ellis Dudgeon |title=Lectures on the Theory & Practice of Homeopathy | date=1853 |location=London |pages=526–7 |url=http://books.google.com/books/pdf/Lectures_on_the_theory_and_practice_of_h.pdf?id=UKZ_lqlWPhUC&output=pdf&sig=X5aw7kl9oK-_8kXvc7022__2wVo |format=PDF |isbn=81-7021-311-8}}</ref> 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.<ref>{{cite web|url=http://www.simillimum.com/education/little-library/the-works-of-great-homoeopaths/ham/article04.php |title= Hahnemann's Advanced Methods |accessdate=2007-08-04 |last=Little |first=David |work=Simillimum.com }}</ref> A given dilution on the Q scale is roughly 2.35 times its designation on the C scale. For example a remedy described as "20Q" has about the same concentration as a "47C" remedy.<ref>If a dilution is designated as q on the Q scale, and c on the C scale, c/q=log<sub>10</sub>(50,000)/2=2.349485.</ref>
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 [[spirituality|spiritual]] interpretation of disease.<ref>{{cite book |last=Edwin Wheeler |first=Charles |title=Dr. Hughes: Recollections of Some Masters of Homeopathy |publisher=Health Through Homeopathy |date=1941 }}</ref><ref>{{cite book |last=Bodman |first=Frank |title=he Richard Hughes Memorial Lecture |publisher=BHJ |date=1970 |pages=179–193 }}</ref>
====Coverage in the mainstream press====
The [[BBC]]'s [[Horizon (BBC TV series)|''Horizon'']] and [[American Broadcasting Company|ABC's]] ''[[20/20]]'' broadcast programs described scientific testing of homeopathic dilutions that were unable to differentiate these dilutions from [[water]].<ref name="Williams_2002"/><ref name="Stossel">{{cite news | last = Stossel | first = John | authorlink=John Stossel|title = ''Homeopathic Remedies – Can Water Really Remember? | work = [[20/20]] | language = English | publisher = ABC News | year = 2008 | url = http://abcnews.go.com/print?id=124309 | accessdate = 2008-01-22}}</ref>
===Provings===
In order to determine which specific remedies could be used to treat which diseases, [[Samuel Hahnemann|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 these experiments. The method used for determining which remedies were suitable for specific diseases was called "proving", after the original [[German language|German]] word "Prüfung", meaning "test".) A homeopathic proving is the method by which the [[Profile (engineering)|profile]] of a [[homeopathic remedy]] is determined.<ref>{{cite journal |author=Dantas F, Fisher P, Walach H, ''et al'' |title=A systematic review of the quality of homeopathic pathogenetic trials published from 1945 to 1995 |journal=Homeopathy : the journal of the Faculty of Homeopathy |volume=96 |issue=1 |pages=4–16 |year=2007 |pmid=17227742}}</ref>
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 dilution,<ref name = "Hahnemann-128"/> 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.<ref>{{cite book |last =Cassedy |first=James H. |title=American Medicine and Statistical Thinking, 1800–1860 |publisher=iUniverse |date=June 1999 |isbn = 978-1583484289 }}</ref> 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 pectoris|angina]] was discovered by looking through homeopathic provings, though homeopaths themselves never used it for that purpose at that time.<ref name="pmid2866851">{{cite journal |author=Fye WB |title=Nitroglycerin: a homeopathic remedy |journal=Circulation |volume=73 |issue=1 |pages=21–9 |year=1986 |pmid=2866851 |url=http://circ.ahajournals.org/cgi/reprint/73/1/21.pdf|format=PDF}}</ref>
The first recorded provings were published by Hahnemann in his 1796 ''Essay on a New Principle''. His ''Fragmenta de viribus'' (1805)<ref> {{cite web|url=http://www.homeorizon.com/mainpagegeneral.asp?t=fragmenta.htm |title=''Fragmenta de Viribus Medicamentorum Positivis Sive in sano Corpore Humano Observatis''|accessdate=2007-10-16 |first=Homeorizon Team }}</ref> contained the results of 27 provings, and his 1810 ''[[Materia Medica Pura]]'' contained 65.<ref> {{cite web|url=http://www.hpathy.com/materiamedica/hahnemann-materia-pura/index.asp |title=Materia Medica Pura |accessdate=2007-10-16 |last=Hahnemann |first=Samuel |publisher=hpathy.com }}</ref> 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===
[[Image:Rep1.JPG|thumb|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 Maria Franz von Bönninghausen|Clemens von Bönninghausen]], created the ''Therapautic Pocket Book'', another homeopathic repertory.<ref>{{cite book |last=von Bönninghausen |first=Clemens |coauthors=Bradford TL, Boger, CM. |title=Boenninghausen's Characteristics and Repertory with Word Index |year=1999, Reprint Ed. |publisher=New Delhi : B. Jain |isbn=8-170-21207-3 }}</ref> The first such Homeopathic Repertory was Dr. George Jahr's Repertory, published in 1835 in [[German language|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.<ref name=Bellavite>{{cite journal |author=Bellavite P, Conforti A, Piasere V, Ortolani R |title=Immunology and homeopathy. 1. Historical background |journal=Evidence-based complementary and alternative medicine : eCAM |volume=2 |issue=4 |pages=441–52 |year=2005 |pmid=16322800 |url=http://ecam.oxfordjournals.org/cgi/content/full/2/4/441 |doi=10.1093/ecam/neh141}}</ref> It consisted of three large volumes. Such repertories increased in size and detail as time progressed.
==Treatments==
Homeopaths generally begin with detailed examinations of their patients' histories, including questions regarding their physical, mental and emotional states, their life circumstances and any physical/emotional illnesses. The homeopath then attempts to translate this information into a complex formula of mental and physical symptoms, including likes, dislikes, innate predispositions and even body type.<ref name=Stehlin>{{cite web |url=http://www.fda.gov/fdac/features/096_home.html |title=Homeopathy: Real Medicine or Empty Promises? |accessdate=2007-10-01 |last=Stehlin |first=Isadora |date=December 1996 |publisher=[[Food and Drug Administration]] }}</ref> The goal is to develop a comprehensive representation of each individual's overall health. This information can then be compared with similar lists 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 insurmountable complexity of the "totality of symptoms" concept. That is, homeopaths do not use all symptoms, but decide for themselves 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.<ref name=pmid12614092/>
===Remedies===
[[Image:Rhustox.jpg|thumb|right|160px|Homeopathic remedy ''Rhus toxicodendron'', derived from [[Toxicodendron radicans|poison ivy]].]]
[[Image:DoseOscillococcinum.jpg|thumb|right|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: Materia Medicae and Repetories. A Homeopathic Materia Medica is a collection of "drug pictures", organised alphabetically by remedy, that describes the symptom patterns associated with individual remedies. A Homeopathic Repetory is an index of disease symptoms that lists remedies associated with specific symptoms.<ref name=elixris>{{cite web |url=http://www.elixirs.com/medica.htm |title=Materia Medica: Remedy Information |accessdate=2007-07-24 |last=Jones |first=Kathryn }}</ref>
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)|bushmaster]] [[snake]]), ''[[Opium]]'', and ''Thyroidinum'' ([[thyroid hormone]]). Homeopaths also use treatments called ''nosodes'' (from the [[Greek language|Greek]] ''nosos'', disease) made from diseased or pathological products such as fecal, urinary, and respiratory discharges, blood, and tissue.<ref name="pmid16322800">{{cite journal |author=Bellavite P, Conforti A, Piasere V, Ortolani R |title=Immunology and homeopathy. 1. Historical background |journal=Evidence-based complementary and alternative medicine: eCAM |volume=2 |issue=4 |pages=441–452 |year=2005 |pmid=16322800 |doi=10.1093/ecam/neh141 }}</ref> 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-ray]]s, [[sunlight]],<ref>{{cite web|url=http://www.hominf.org/posi/posiintr.htm |title=The Homœopathic Proving of Positronium |accessdate=2007-07-24 |last=Norland |first=Misha |date=1998 }}</ref> and [[electricity]].<ref>{{cite web|url=http://homeoint.org/clarke/e/elect.htm |title=Materia Medica |accessdate=2007-07-24 |last=Clarke |first=John Henry }}</ref> Recent ventures by homeopaths into even more esoteric substances include [[thunderstorms]] (prepared from collected rainwater).<ref>{{cite web|url=http://uk.geocities.com/veryscarymary/stormremedy1.html |title=The Homeopathic proving of 'Tempesta' the Storm |accessdate=2007-07-24 |last=English |first=Mary }}</ref> Today there are about 3,000 different remedies commonly used in homeopathy.<ref>{{cite web|url=http://web.archive.org/web/20070118131256/http://www.medicinenet.com/script/main/art.asp?articlekey=63203 |title=Homeopathy: Natural Approach or All a Fake? |accessdate=2007-07-24 |last=Doheny |first=Kathleen }}</ref> 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.<ref>{{cite web |url=http://www.askdrshah.com/images/lancet.pdf|format=PDF |title=Call for Introspection and Awakening |publisher=Life Force Center |accessdate=2007-07-24 |last=Shah |first=Rajesh }}</ref><ref>{{cite web |url=http://www.homoeopathica.org.nz/editorial_00.htm |title=Homoeopathica: The Wo-wo Effect |publisher=New Zealand Homoeopathic Society |accessdate=2007-07-24 |last=Barwell |first=Bruce }}</ref>
===Isopathy===
Isopathy is a therapy derived from homeopathy and was invented by Johann Joseph Wilhelm Lux in the 1830s.<ref name=Bellavite/> 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.<ref>{{cite web |url=http://www.homeoinfo.com/08_non-classical_topics/is_it_homeopathy/isopathy.php |title=Isopathy |accessdate=2007-07-25 }}</ref>
===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.<ref>[http://www.hpathy.com/tautopathy/tautopathy.asp ''Tautopathy – An Introduction''], Manish Bhatia, Tautopathy, [http://www.hpathy.com/ Homeopathy for Everyone: Everything Homeopathic!]</ref>
===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.<ref>{{cite journal |author=van Haselen RA |title=The relationship between homeopathy and the Dr Bach system of flower remedies: a critical appraisal |journal=The British homoeopathic journal |volume=88 |issue=3 |pages=121–7 |year=1999 |pmid=10449052 |doi=10.1054/homp.1999.0308}}</ref> There is no convincing scientific or clinical evidence for flower remedies being effective.<ref>{{cite journal |author=Ernst E |title="Flower remedies": a systematic review of the clinical evidence |journal=Wien. Klin. Wochenschr. |volume=114 |issue=23–24 |pages=963–6 |year=2002 |pmid=12635462}}</ref>
===Veterinary use===
The idea of using homeopathy as a treatment for other animals, termed ''veterinary homeopathy'', dates back to the inception of homeopathy; Hahnemann himself wrote and spoke of the use of homeopathy in animals other than humans.<ref name=Saxton2007>{{cite journal| author = Saxton, J.| year = 2007| title = The diversity of veterinary homeopathy.| journal = Homeopathy| volume = 96| issue = 1| pages = 3| doi = 10.1016/j| doi_brokendate = 2008-06-24}}</ref> In the United States, veterinary homeopathy is used by [[veterinarian]] members of the Academy for Veterinary Homeopathy and/or the American Holistic Veterinary Medical Association.<ref>{{cite web|url=http://www.ahvma.org/displaycommon.cfm?an=1 |title=What is Holistic medicine? |accessdate=2007-10-18 |last=Tiekert |first=Dr. Carvel G. |work=American Holistic Veterinary Medical Association}}{{Dead link|date=December 2007}}</ref> The FDA has not approved homeopathic products as veterinary medicine in the US. In the [[UK]], [[veterinary surgeon]]s 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.<ref name=Hektoen>{{cite journal |author=Hektoen L |title=Review of the current involvement of homeopathy in veterinary practice and research |journal=Vet. Rec. |volume=157 |issue=8 |pages=224–9 |year=2005 |pmid=16113167}}</ref> 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.<ref name=Hektoen/>
== 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.<ref name=Teixeira>{{cite journal |author=Teixeira J |title=Can water possibly have a memory? A sceptical view |journal=Homeopathy : the journal of the Faculty of Homeopathy |volume=96 |issue=3 |pages=158–162 |year=2007 |doi=10.1016/j.homp.2007.05.001}}</ref><ref name=Milgrom/> The idea that any biological effects could be produced by these preparations is inconsistent with the observed [[dose-response relationship]]s of conventional drugs.<ref name=Levy>{{cite journal |author=Levy G |title=Kinetics of drug action: an overview |journal=J. Allergy Clin. Immunol. |volume=78 |issue=4 Pt 2 |pages=754–61 |year=1986 |pmid=3534056 |doi=10.1016/0091-6749(86)90057-6}}</ref> The proposed rationale for these extreme dilutions – that the water contains the "[[water memory|memory]]" or "vibration" from the diluted ingredient – is also counter to the laws of [[chemistry]] and [[physics]].<ref name=Teixeira/> Thus critics contend that any positive results obtained from homeopathic remedies are purely due to the [[placebo]] effect.<ref name=Sbarrett/><ref>{{cite journal |author=Ernst E |title=Placebo: new insights into an old enigma |journal=Drug Discov. Today |volume=12 |issue=9–10 |pages=413–8 |year=2007 |pmid=17467578 |doi=10.1016/j.drudis.2007.03.007}}</ref> 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.<ref name=Milgrom>{{cite journal |author=Milgrom LR |title=Conspicuous by its absence: the Memory of Water, macro-entanglement, and the possibility of homeopathy |journal=Homeopathy : the journal of the Faculty of Homeopathy |volume=96 |issue=3 |pages=209–19 |year=2007 |pmid=17678819 |doi=10.1016/j.homp.2007.05.002}}</ref> Since even the longest-lived [[Noncovalent bonding|noncovalent]] structures in liquid water at room temperature are only stable for a few [[picosecond]]s,<ref>{{cite journal |author=Teixeira1 J, Luzar A, Longeville S. |title=Dynamics of hydrogen bonds: how to probe their role in the unusual properties of liquid water |journal=J. Phys.: Condens. Matter |volume=18 |pages=S2353–S2362 |year=2006 |doi=10.1088/0953-8984/18/36/S09}}</ref> critics have concluded that any effect that might have been present from the original substance can no longer exist.<ref name="Weissmann">{{cite journal |author=Weissmann G |title=Homeopathy: Holmes, Hogwarts, and the Prince of Wales |journal=FASEB J. |volume=20 |issue=11 |pages=1755–8 |year=2006 |pmid=16940145 |url=http://www.fasebj.org/cgi/content/full/20/11/1755 |doi=10.1096/fj.06-0901ufm}}</ref> Furthermore, since water will have been in contact with millions of different substances throughout its history, critics point out that any glass of water is therefore an extreme dilution of almost any conceivable substance, and so by drinking water one would, according to homeopathic principles, receive treatment for every imaginable condition.<ref>{{cite web |title=Horizon's Homeopathic Coup, Cuzco's Altitude, More Funny Sites, The Clangers, Overdue, Orbito Nabbed in Padua, Randi A Zombie?, Stellar Guests at Amazing Meeting, and Great New Shermer Books! |work=Swift, Online Newsletter of the JREF, November 29, 2002, James Randi Educational Foundation |url=http://www.randi.org/jr/112902.html |accessdate=2006-09-20}}</ref>
Homeopathy contends that higher dilutions (fewer potential molecules in each dose) result in stronger medicinal effects. This idea is inconsistent with the observed [[dose-response relationship]]s of conventional drugs, where the effects are dependent on the concentration of the active ingredient in the body.<ref name=Levy>{{cite journal |author=Levy G |title=Kinetics of drug action: an overview |journal=J. Allergy Clin. Immunol. |volume=78 |issue=4 Pt 2 |pages=754–61 |year=1986 |pmid=3534056 |doi=10.1016/0091-6749(86)90057-6}}</ref> This dose-response relationship has been confirmed in multitudinous experiments on organisms as diverse as nematodes,<ref>{{cite journal |author=Boyd WA, Williams PL |title=Comparison of the sensitivity of three nematode species to copper and their utility in aquatic and soil toxicity tests |journal=Environ. Toxicol. Chem. |volume=22 |issue=11 |pages=2768–74 |year=2003 |pmid=14587920 |doi=}}</ref> rats,<ref>{{cite journal |author=Goldoni M, Vettori MV, Alinovi R, Caglieri A, Ceccatelli S, Mutti A |title=Models of neurotoxicity: extrapolation of benchmark doses ''in vitro'' |journal=Risk Anal. |volume=23 |issue=3 |pages=505–14 |year=2003 |pmid=12836843 |doi=}}</ref> and humans.<ref>{{cite journal |author = Yu HS, Liao WT, Chai CY |title=Arsenic carcinogenesis in the skin |journal=J. Biomed. Sci. |volume=13 |issue=5 |pages=657–66 |year=2006 |pmid=16807664 |doi=10.1007/s11373-006-9092-8}}</ref>
Physicist [[Robert L. Park]], former executive director of the [[American Physical Society]], has noted that <!--- Please do not change the following direct quote, even if you think it would be an improvement.
BEGIN DIRECT QUOTE -->{{cquote|since the least amount of a substance in a solution is one molecule, a 30C solution would have to have at least one molecule of the original substance dissolved in a minimum of 1,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000 molecules of water. This would require a container more than 30,000,000,000 times the size of the Earth.}}<!-- END DIRECT QUOTE -->
Park has also noted that "to expect to get even one molecule of the 'medicinal' substance allegedly present in 30X pills, it would be necessary to take some two billion of them, which would total about a thousand tons of lactose plus whatever impurities the lactose contained". The laws of chemistry state that there is a limit to the dilution that can be made without losing the original substance altogether.<ref name="Ernst2005">{{cite journal |author=Ernst E |title=Is homeopathy a clinically valuable approach? |journal=Trends Pharmacol. Sci. |volume=26 |issue=11 |pages=547–8 |year=2005 |pmid=16165225 |doi=10.1016/j.tips.2005.09.003}}</ref> This limit, which is related to [[Avogadro constant|Avogadro's number]], is roughly equal to homeopathic potencies of 12C or 24X (1 part in 10<sup>24</sup>).<ref name=Sbarrett>{{cite web |url=http://www.quackwatch.org/01QuackeryRelatedTopics/homeo.html |title=Homeopathy: The Ultimate Fake |accessdate=2007-07-25 |last=Barrett |first=Stephen |date=2004-12-28 |work=Quackwatch |publisher=[[Quackwatch]]}}</ref><ref name=dynam>{{cite web|url=http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm|title=Dynamization and Dilution |accessdate=2007-07-24 }}</ref><ref name="Appendix"/>
=== Research on medical effectiveness ===
[[Image:Hepar.jpg|thumb|Old bottle of ''Hepar sulph'' made from [[calcium sulfide]]]]
The effectiveness of homeopathy has been a point of contention since its inception, and researchers have subjected the system to close scrutiny. One of the earliest studies concerning homeopathy was sponsored by the British government during World War II in which volunteers tested the effectiveness of homeopathic remedies against diluted mustard gas burns.<ref name="Mustard">{{citejournal|publisher=British Homoeopathic Society |journal=British Homoeopathic Journal|year=1943|title= Report on mustard gas experiments |pages= 1–12 |volume=33 |url=http://www.jameslindlibrary.org/trial_records/20th_Century/1940s/brit_homeo_soc/brit_homeo_soc_kp.html}}</ref> More recent controlled clinical trials on homeopathy are not particularly convincing. For example NCCAM says:
{{quote|1=In sum, systematic reviews have not found homeopathy to be a definitively proven treatment for any medical condition. Two groups of authors listed in Appendix II found some positive evidence in the groups of studies they examined, and they did not find this evidence to be explainable completely as placebo effects (a third group found 1 out of 16 trials to have some added effect relative to placebo). Each author or group of authors criticized the quality of evidence in the studies. Examples of problems they noted include weaknesses in design and/or reporting, choice of measuring techniques, small numbers of participants, and difficulties in replicating results. A common theme in the reviews of homeopathy trials is that because of these problems and others, it is difficult or impossible to draw firm conclusions about whether homeopathy is effective for any single clinical condition.<ref name="nccamnih">{{cite web |url = http://nccam.nih.gov/health/homeopathy/ | title = Questions and Answers About Homeopathy (NCCAM Research Report) | accessdate = 2008-02-08 | format= | work= }}</ref>}}
Positive results have been reported, but no single model has been sufficiently widely replicated, local models proposed are far from convincing, and the nonlocal models proposed would predict that it is impossible to nail down homeopathic effects with direct experimental testing. <ref>{{cite journal | author = Walach H, Jonas WB, Ives J, van Wijk R, Weingärtner O | title = Research on homeopathy: state of the art | journal = J Altern Complement Med | volume = 11 | issue = 5 | pages = 813–29 | year = 2005 | month = October | pmid = 16296915 | doi = 10.1089/acm.2005.11.813 }}</ref> For example, while some reports presented data that suggested hoemopathic treatment of [[allergy]] was more effective than placebo,<ref>{{cite journal |author=Reilly DT, Taylor MA, McSharry C, Aitchison T |title=Is homoeopathy a placebo response? Controlled trial of homoeopathic potency, with pollen in hayfever as model |journal=Lancet |volume=2 |issue=8512 |pages=881–6 |year=1986 |month=October |pmid=2876326 |doi=10.1016/S0140-6736(86)90410-1}}</ref><ref>{{cite journal |author=Taylor MA, Reilly D, Llewellyn-Jones RH, McSharry C, Aitchison TC |title=Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series |journal=BMJ |volume=321 |issue=7259 |pages=471–6 |year=2000 |pmid=10948025 |url=http://bmj.com/cgi/pmidlookup?view=long&pmid=10948025 |doi=10.1136/bmj.321.7259.471}}</ref> subsequent studies have questioned the conclusions.<ref>{{cite journal |author=Brien S, Lewith G, Bryant T |title=Ultramolecular homeopathy has no observable clinical effects. A randomized, double-blind, placebo-controlled proving trial of Belladonna 30C |journal=Br J Clin Pharmacol |volume=56 |issue=5 |pages=562–8 |year=2003 |month=November |pmid=14651731 |url=http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0306-5251&date=2003&volume=56&issue=5&spage=562 |doi=10.1046/j.1365-2125.2003.01900.x}}</ref><ref>{{cite journal |author=Lewith GT, Watkins AD, Hyland ME, ''et al'' |title=Use of ultramolecular potencies of allergen to treat asthmatic people allergic to house dust mite: double blind randomised controlled clinical trial |journal=BMJ |volume=324 |issue=7336 |pages=520 |year=2002 |month=March |pmid=11872551 |url=http://bmj.com/cgi/pmidlookup?view=long&pmid=11872551 |doi=10.1136/bmj.324.7336.520}}</ref>
[[meta-analysis|Meta-analyses]], in which large groups of studies are analyse and conclusions drawn based on the results as a whole, have been used to evaluate the effectiveness of homeopathy. Early meta-analyses investigating homeopathic remedies showed slightly positive results among the studies examined, but such studies have warned that it was impossible to draw firm conclusions due to low methodological quality and difficulty in controlling for [[publication bias]] in the studies reviewed.<ref name="pmid1825800">{{cite journal |author=Kleijnen J, Knipschild P, ter Riet G |title=Clinical trials of homoeopathy |journal=BMJ |volume=302 |issue=6772 |pages=316–323 |year=1991 |pmid=1825800 }}</ref><ref name="pmid11416076"/><ref name=pmid9310601>{{cite journal |author=Linde K, Clausius N, Ramirez G, ''et al'' |title=Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials |journal=Lancet |volume=350 |issue=9081 |pages=834–43 |year=1997 |pmid=9310601 |doi=10.1016/S0140-6736(97)02293-9}}</ref> One of the positive meta-analyses, by Linde, et al,<ref name=pmid9310601 /> was later corrected by the authors, who wrote:
<blockquote>The evidence of bias [in homeopathic trials] weakens the findings of our original meta-analysis. Since we completed our literature search in 1995, a considerable number of new homeopathy trials have been published. The fact that a number of the new high-quality trials... have negative results, and a recent update of our review for the most “original” subtype of homeopathy (classical or individualized homeopathy), seem to confirm the finding that more rigorous trials have less-promising results. It seems, therefore, likely that our meta-analysis at least overestimated the effects of homeopathic treatments.<ref name=Linde1999>Linde et al, ''Impact of Study Quality on Outcome in Placebo-Controlled Trials of Homeopathy'', J Clin Epidemiol Vol. 52, No. 7, pp. 631–636, 1999, {{doi|10.1016/S0895-4356(99)00048-7}}</ref><ref name="shang"/></blockquote>
A recent meta-analysis of clinical trials on the effectiveness of homeopathy has shown that earlier clinical trials showed signs of major weakness in methodology and reporting, and that homeopathy trials were less randomized and reported less on dropouts than other types of trials.<ref name="pmid11416076">{{cite journal |author=Linde K, Jonas WB, Melchart D, Willich S |title=The methodological quality of randomized controlled trials of homeopathy, herbal medicines and acupuncture |journal=International journal of epidemiology |volume=30 |issue=3 |pages=526–531 |year=2001 |pmid=11416076 |doi=10.1093/ije/30.3.526 }}</ref>
In 2005, ''[[The Lancet]]'' medical journal published a meta-analysis of 110 placebo-controlled homeopathy trials and 110 matched conventional-medicine trials based upon the [[Swiss Federal Council|Swiss government]]'s [[Program for Evaluating Complementary Medicine]], or PEK. The study concluded that its findings were compatible with the notion that the clinical effects of homeopathy are nothing more than placebo effects.<ref name="shang" />.
A 2006 meta-analysis of six trials evaluating homeopathic treatments to reduce [[Oncology|cancer therapy]] side effects following [[radiotherapy]] and [[chemotherapy]] found "encouraging but not convincing" evidence in support of homeopathic treatment. Their analysis concluded that there was "insufficient evidence to support clinical efficacy of homeopathic therapy in cancer care".<ref name="pmid16376071">{{cite journal |author=Milazzo S, Russell N, Ernst E |title=Efficacy of homeopathic therapy in cancer treatment |journal=Eur. J. Cancer |volume=42 |issue=3 |pages=282–289 |year=2006 |pmid=16376071 |doi=10.1016/j.ejca.2005.09.025 }}</ref>
The [[Cochrane Library]] found insufficient clinical evidence to evaluate the efficacy of homeopathic treatments for asthma<ref name="asthma"/> or dementia,<ref name="dementia"/> or for the use of homeopathy in induction of labor.<ref name="pmid14583972">{{cite journal |author=Smith CA |title=Homoeopathy for induction of labour |journal=Cochrane database of systematic reviews (Online) |issue=4 |pages=CD003399 |year=2003 |pmid=14583972 |doi=10.1002/14651858.CD003399 }}</ref> Other researchers found no evidence that homeopathy is beneficial for [[osteoarthritis]],<ref name="pmid11212088">{{cite journal |author=Long L, Ernst E |title=Homeopathic remedies for the treatment of osteoarthritis: a systematic review |journal=The British homoeopathic journal |volume=90 |issue=1 |pages=37–43 |year=2001 |pmid=11212088 |doi=10.1054/homp.1999.0449 }}</ref> [[migraine]]s<ref name="pmid9251877">{{cite journal |author=Whitmarsh TE, Coleston-Shields DM, Steiner TJ |title=Double-blind randomized placebo-controlled study of homoeopathic prophylaxis of migraine |journal=Cephalalgia: an international journal of headache |volume=17 |issue=5 |pages=600–604 |year=1997 |pmid=9251877 |doi=10.1046/j.1468-2982.1997.1705600.x }}</ref> or [[Delayed onset muscle soreness|delayed-onset muscle soreness]].<ref name="pmid12614092">{{cite journal |author=Jonas WB, Kaptchuk TJ, Linde K |title=A critical overview of homeopathy |journal=Ann. Intern. Med. |volume=138 |issue=5 |pages=393–399 |year=2003 |pmid=12614092 }}</ref>
Health organisations such as UK's [[National Health Service]],<ref name=nhspseudo>{{cite web|url=http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=197§ionId=27 |title=Homeopathy results |accessdate=2007-07-25 |publisher=[[National Health Service]] }}</ref> the [[American Medical Association]],<ref name=amapseudo>{{cite web |url=http://www.ama-assn.org/ama/pub/category/13638.html |title=Report 12 of the Council on Scientific Affairs (A–97) |accessdate=2007-07-25 |publisher=[[American Medical Association]] }}</ref> and the [[FASEB]]<ref name="Weissmann"/> have issued statements of their conclusion that there is no convincing scientific evidence to support the use of homeopathic treatments in medicine.
Clinical studies of the medical efficacy of homeopathy have been criticised by some homeopaths as being irrelevant because they do not test "classical homeopathy".<ref>[http://www.vithoulkas.com/index.php?option=com_content&task=view&id=247&Itemid=9 Another point of view for the homeopathic trials and meta-analyses] by [[George Vithoulkas]]</ref><ref>[http://news.bbc.co.uk/2/hi/health/4183916.stm Homoeopathy's benefit questioned] from [[BBC]] News web site</ref> There have, however, been a number of clinical trials that have tested individualized homeopathy. A 1998 review<ref>[http://www.liebertonline.com/doi/abs/10.1089/acm.1998.4.371?journalCode=acm Randomized Controlled Trials of Individualized Homeopathy: A State-of-the-Art Review], Klaus Linde, Dieter Melchart. ''[[The Journal of Alternative and Complementary Medicine]]''. [[December 1]], [[1998]], 4(4): 371–388. doi:10.1089/acm.1998.4.371.</ref>
found 32 trials that met their inclusion criteria, 19 of which were placebo-controlled and provided enough data for meta-analysis. These 19 studies showed a pooled odds ratio of 1.17 to 2.23 in favor of individualized homeopathy over the placebo, but no difference was seen when the analysis was restricted to the methodologically best trials. The authors concluded "that the results of the available randomized trials suggest that individualized homeopathy has an effect over placebo. The evidence, however, is not convincing because of methodological shortcomings and inconsistencies."
Dr. Jack Killen, acting deputy director of the [[National Center for Complementary and Alternative Medicine]], says homeopathy "goes beyond current understanding of chemistry and physics". He adds, "There is, to my knowledge, no condition for which homeopathy has been proven to be an effective treatment."<ref name="Adler"/>
== Research on effects in other biological systems ==
[[Image:1belladonna.jpg|thumb|right|160px|Old homeopathic [[Deadly nightshade|belladonna]] remedy.]]
While some articles have suggested that homeopathic solutions of high dilution can have statistically significant effects on organic processes including the growth of [[grain]],<ref>Kolisko, Lily, ''Physiologischer und physikalischer Nachweis der Wirksamkeit kleinster Entitäten'', Stuttgart (1959), Junker, H. ''Biologisches Zentralblatt'', 45. Nr. 1 (1925), p. 26 and ''Plügers Arhiv f. ges. Phys. 219B Nr. 5/6 (1928)</ref> [[histamine]] release by [[leukocytes]],<ref name="pmid16813505">{{cite journal |author=Wälchli C, Baumgartner S, Bastide M |title=Effect of low doses and high homeopathic potencies in normal and cancerous human lymphocytes: an ''in vitro'' isopathic study |journal=Journal of alternative and complementary medicine (New York, N.Y.) |volume=12 |issue=5 |pages=421–427 |year=2006 |pmid=16813505 |doi=10.1089/acm.2006.12.421 }}</ref> and [[enzyme|enzyme reactions]], such evidence is disputed since attempts to replicate them have failed.<ref name="pmid11316508">{{cite journal |author=Walach H, Köster H, Hennig T, Haag G |title=The effects of homeopathic belladonna 30CH in healthy volunteers — a randomized, double-blind experiment |journal=Journal of psychosomatic research |volume=50 |issue=3 |pages=155–160 |year=2001 |pmid=11316508 |doi=10.1016/S0022-3999(00)00224-5 }}</ref><ref name="pmid8255290">{{cite journal |author=Hirst SJ, Hayes NA, Burridge J, Pearce FL, Foreman JC |title=Human basophil degranulation is not triggered by very dilute antiserum against human IgE |journal=Nature |volume=366 |issue=6455 |pages=525–527 |year=1993 |pmid=8255290 |doi=10.1038/366525a0 }}</ref><ref name="pmid1376282">{{cite journal |author=Ovelgönne JH, Bol AW, Hop WC, van Wijk R |title=Mechanical agitation of very dilute antiserum against IgE has no effect on basophil staining properties |journal=Experientia |volume=48 |issue=5 |pages=504–508 |year=1992 |pmid=1376282 |doi=10.1007/BF01928175 }}</ref><ref name="pmid16722785">{{cite journal |author=Witt CM, Bluth M, Hinderlich S, ''et al'' |title=Does potentized HgCl2 (Mercurius corrosivus) affect the activity of diastase and alpha-amylase? |journal=Journal of alternative and complementary medicine (New York, N.Y.) |volume=12 |issue=4 |pages=359–365 |year=2006 |pmid=16722785 |doi=10.1089/acm.2006.12.359 }}</ref><ref name="pmid16036166">{{cite journal |author=Guggisberg AG, Baumgartner SM, Tschopp CM, Heusser P |title=Replication study concerning the effects of homeopathic dilutions of histamine on human basophil degranulation ''in vitro'' |journal=Complementary therapies in medicine |volume=13 |issue=2 |pages=91–100 |year=2005 |pmid=16036166 |doi=10.1016/j.ctim.2005.04.003 }}</ref>
In 1987, French immunologist [[Jacques Benveniste]] submitted a paper to the journal ''[[Nature (journal)|Nature]]'' while working at [[INSERM]]. The paper purported to have discovered that [[basophils]] released [[histamine]] when exposed to a homeopathic dilution of anti-immunoglobulin E, a type of [[white blood cell]]. The journal editors, sceptical of the results, requested that the study be replicated in a separate laboratory. Upon replication in four separate laboratories the study was published. Still sceptical of the findings, ''Nature'' assembled an independent investigative team to determine the accuracy of the research, consisting of ''Nature'' editor and physicist Sir [[John Maddox]], American scientific fraud investigator and chemist Walter Stewart, and sceptic and magician [[James Randi]]. After investigating the findings and methodology of the experiment, the team found that the experiments were "statistically ill-controlled", "interpretation has been clouded by the exclusion of measurements in conflict with the claim", and concluded, "We believe that experimental data have been uncritically assessed and their imperfections inadequately reported."<ref>{{cite journal |last=Maddox |first=John |authorlink=John Maddox |coauthors=James Randi and Walter W. Stewart |title='High-dilution' experiments a delusion |journal=Nature |volume=334 |pages=287–290 |date=1988-07-28 |url=http://br.geocities.com/criticandokardec/benveniste02.pdf |format=PDF |doi=10.1038/334287a0}}</ref><ref name=wsullivan>{{cite news | first=Walter | last=Sullivan | coauthors= | title= Water That Has a Memory? Skeptics Win Second Round | date=[[1988-07-27]] | publisher=nytimes.com | url =http://query.nytimes.com/gst/fullpage.html?res=940DE7DC1139F934A15754C0A96E948260 | work =The New York Times | pages = | accessdate = 2007-10-03}}</ref><ref> Beneveniste defended his results, however, comparing the inquiry to the Salem witch hunts and asserting that "It may be that all of us are wrong in good faith. This is no crime but science as usual and only the future knows."</ref> James Randi stated that he doubted that there had been any conscious fraud, but that the researchers had allowed "wishful thinking" to influence their interpretation of the data.<ref name="wsullivan"/>
=== Ethical and safety issues ===
As homeopathic remedies usually contain only water and/or alcohol, they are thought to be generally safe. Only in rare cases are the original ingredients present at detectable levels. In one such case, an unusually undiluted (1:100 or "2X") solution of [[zinc gluconate]], marketed as [[Zinc gluconate#Safety Concerns|Zicam Nasal Spray]], allegedly caused a small percentage of users to lose their sense of smell.<ref>{{cite web |url=http://www.homeowatch.org/legal/zicam.html |title=Zicam Marketers Sued |accessdate=2007-10-25 |publisher=Homeowatch.org }}</ref> There were 340 cases settled out of court for {{nowrap|12 million U.S. dollars}}.<ref>{{cite web |url=http://www.washingtonpost.com/wp-dyn/content/article/2006/01/30/AR2006013001240.html |title=Paying through the Nose |accessdate=2007-10-25 |last=Boodman |first=Sandra |date=[[January 31]], [[2006]] |publisher=[[Washington Post]]}}</ref>
Critics of homeopathy have cited other concerns over homeopathic remedies, most seriously, cases of patients of homeopathy failing to receive proper treatment for diseases that it is claimed could have been diagnosed or cured with conventional medicine. Several surveys demonstrate that some (particularly non-physician) homeopaths advise their patients against [[vaccine|immunisation]].<ref name="pmid9243229">{{cite journal |author=Ernst E |title=The attitude against immunisation within some branches of complementary medicine |journal=Eur. J. Pediatr. |volume=156 |issue=7 |pages=513–515 |year=1997 |pmid=9243229 |doi=10.1007/s004310050650 }}</ref><ref name="pmid8554846">{{cite journal |author=Ernst E, White AR |title=Homoeopathy and immunization |journal=The British journal of general practice: the journal of the Royal College of General Practitioners |volume=45 |issue=400 |pages=629–630 |year=1995 |pmid=8554846 }}</ref><ref>{{cite journal |author=Ernst E |title=Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination |journal=Vaccine |volume=20 Suppl 1 |issue= |pages=S90–3; discussion S89 |year=2001 |pmid=11587822 |doi=10.1016/S0264-410X(01)00290-0}}</ref> Some homeopaths suggest that vaccines be replaced with homeopathically diluted "[[nosode]]s", created from dilutions of biological agents – including material such as vomit, feces or infected human tissues. While Hahnemann was opposed to such preparations, modern homeopaths often use them and there is no evidence to indicate they have any beneficial effects.<ref>{{cite journal |title=A challenge to the credibility of homeopathy |journal=Am. J. Pain Mangmnt., |date=1992 |first=W.S. |last=Pray |issue=2 |pages=63–71 }}</ref><ref>{{cite journal |title=The issue of immunization |journal=British Homoeopathic journal |date=October 1992 |first=John |last=English |volume=81 |issue=4 |pages=161–163 |doi= 10.1016/S0007-0785(05)80171-1 |unused_data=|doi }}</ref> Cases of homeopaths advising against the use of anti-malarial drugs have been identified.<ref name=malaria1 /><ref name="pmid11082104"/><ref name=malaria2/> This puts visitors to the tropics who take this advice in severe danger, since homeopathic remedies are completely ineffective against the malaria parasite.<ref name=malaria1>{{cite news |first=Alok |last=Jha |title=Homeopaths 'endangering lives' by offering malaria remedies |date=2006-07-14 |url=http://www.guardian.co.uk/science/story/0,,1820103,00.html |work Guardian Unlimited |accessdate=2007-07-25 }}</ref><ref name="pmid11082104">{{cite journal |author=Delaunay P, Cua E, Lucas P, Marty P |title=Homoeopathy may not be effective in preventing malaria |journal=BMJ |volume=321 |issue=7271 |pages=1288 |year=2000 |pmid=11082104}}</ref><ref name=malaria2>{{cite news |first=Meirion |last=Jones |title=Malaria advice 'risks lives' |date=2006-07-14 |publisher=[[BBC News]] |url=http://news.bbc.co.uk/2/hi/programmes/newsnight/5178122.stm |accessdate=2007-07-25 }}</ref> Also, in one case in 2004, a homeopath instructed one of his patients to stop taking conventional medication for a heart condition, writing in his advice, "She just cannot take ANY drugs – I have suggested some homeopathic remedies. I feel confident that if she follows the advice she will regain her health." The patient suffered a fatal heart attack four months later, caused by this stoppage of her medication.<ref>{{cite web |url=http://www.telegraph.co.uk/connected/main.jhtml;jsessionid=1SDVYZIIKRQCDQFIQMFSFFOAVCBQ0IV0?xml=/connected/2007/03/22/nhealth122.xml |title= Patient died after being told to stop heart medicine |accessdate=2007-10-15 |last=Bunyan |first=Nigel |date=2007-03-22 |publisher=Daily Telegraph}}</ref><ref>{{cite web |url=http://www.gmc-uk.org/concerns/hearings_and_decisions/ftp/20070628_ftp_panel_viegas.asp |title=Fitness to PractiSe Panel hearing on Dr Marisa Viegas |accessdate=2007-10-15 |date=June 2007 |publisher=General Medical Council}}</ref>
In 1978, [[Anthony Campbell]], then a consultant physician at The Royal London Homeopathic Hospital, criticised statements made by [[George Vithoulkas]] to promote his homeopathic treatments. Vithoulkas stated that [[syphilis]], when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the [[central nervous system]]. Campbell described this as a thoroughly irresponsible statement which could mislead an unfortunate layman into refusing conventional medical treatment.<ref name = "minimum-67-4"/> This claim echoes the idea that treating a disease with external medication used to treat the symptoms would only drive it deeper into the body and conflicts with scientific studies, which indicate that penicillin treatment produces a complete cure of syphilis in more than 90% of cases.<ref name="Birnbaum"/>
A 2006 review by W. Steven Pray of the College of Pharmacy at [[Southwestern Oklahoma State University]] recommends that pharmacy colleges include a required course in unproven medications and therapies, that ethical dilemmas inherent in recommending products lacking proven safety and efficacy data be discussed, and that students should be taught where unproven systems such as homeopathy depart from evidence-based medicine.<ref>{{cite journal |author=Pray WS |title=Ethical, scientific, and educational concerns with unproven medications |journal=American journal of pharmaceutical education |volume=70 |issue=6 |pages=141 |year=2006 |pmid=17332867 |url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17332867}}</ref>
==Prevalence and legal trends==
{{main|Regulation and prevalence of homeopathy}}
[[Image:WomanHomeopathy.jpg|thumb|Woman looking at homeopathic remedies]]
Homeopathy is fairly common in some countries while being uncommon in others; is highly regulated in some countries and mostly unregulated in others. Regulations vary in Europe depending on the country. In some countries, there are no specific legal regulations concerning the use of homeopathy, while in others, licenses or degrees in conventional medicine from accredited universities are required. In [[Austria]] and [[Germany]], no specific regulations exist, while [[France]] and [[Denmark]] mandate licenses to diagnose any illness or dispense of any product whose purpose is to treat any illness.<ref name=WHO>{{cite web |url=http://whqlibdoc.who.int/hq/2001/WHO_EDM_TRM_2001.2.pdf |title=Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review |accessdate=2007-09-12 |date=2001 |format=PDF |work=World Health Organization |publisher=[[World Health Organization]] }}</ref> Some homeopathic treatment is covered by the public health service of several European countries, including France, the [[United Kingdom]], Denmark, and [[Luxembourg]]. In other countries, such as [[Belgium]], homeopathy is not covered. In [[Austria]], the public health service requires scientific proof of effectiveness in order to reimburse medical treatments, but exceptions are made for homeopathy.<ref name="WHO"/> Two countries which formerly offered homeopathy under their public health services have withdrawn this privilege. At the start of 2004, homeopathic medications, with some exceptions, were no longer covered by the German public health service, and in June 2005, the [[Swiss]] Government, after a 5-year trial, withdrew homeopathy and four other complementary treatments, stating that they did not meet efficacy and cost-effectiveness criteria, though insurance can be bought to cover such treatments provided by a medical doctor.<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>
==See also==
*[[Alternative medicine]]
*[[Arndt-Schulz law]]
*[[Complementary medicine]]
*[[Drug dynamization]]
*[[Homeopathy and allopathy]]
*[[Hormesis]]
*[[List of homeopathic preparations]]
*[[List of homeopaths]]
*[[Regulation and prevalence of homeopathy]]
*[[Samuel Hahnemann]]
*[[Homeopathy/Appendix: Dilutions]]
== External links ==
=== Associations and regulatory bodies ===
* [http://www.homeopathic.org National Center for Homeopathy (NCH)]
* [[British Homeopathic Association]] (BHA) [http://www.trusthomeopathy.org]
* [[European Committee for Homeopathy]] (ECH) [http://www.homeopathyeurope.org]
* [http://www.homeopathy-ecch.org European Council for Classical Homeopathy(ECCH)]
=== Other links ===
* [http://www.fda.gov/fdac/features/096_home.html Homeopathy: Real Medicine or Empty Promises?] – [[Food and Drug Administration]] report
* [http://nccam.nih.gov/health/homeopathy/ Questions and Answers About Homeopathy] [[National Center for Complementary and Alternative Medicine]] (NCCAM) ˑ [[National Institutes of Health]] Research Report
* [http://www.homeowatch.org/ HomeoWatch: Your Skeptical Guide to Homeopathic History, Theories, and Current Practices] – [[Stephen Barrett]]
* [http://www.acsh.org/healthissues/newsID.632/healthissue_detail.asp The Scientific Evidence on Homeopathy] – January 2000 article from the [[American Council on Science and Health]]
* [http://homeoint.org/seror/ameke/index.htm Wilhelm Ameke, ''History of Homœopathy, with an appendix on the present state of University medicine,''] translated by A. E. Drysdale, edited by R. E. Dudgeon, London: E. Gould & Son, 1885
* [http://video.google.ca/videoplay?docid=2785985155605802136&q=James+Randi Homeopathy Explained – Video (14 min 34 sec)] – Portion of [[James Randi]]'s 2001 [[Princeton University|Princeton]] lecture. ([http://video.google.ca/videoplay?docid=4665376168764022836 Complete 2 hr 10 min 43 sec lecture.])
*{{cite news|url=http://www.time.com/time/magazine/article/0,9171,985153,00.html|title=Challenging the mainstream|author=John Langone|publisher=[[Time Magazine]]|date=1996-09-18}}
* Does Homeopathy work? [http://www.nhm.ac.uk/nature-online/life/plants-fungi/301106homeopathy/does-homeopathy-work.html] A debate on the evidence on both sides with Dr Peter Fisher, Clinical Director of the Royal London Homeopathic Hospital and Dr Ben Goldacre, medical writer and broadcaster.
== Further reading ==
{{Expand-section|date=April 2008}}
== Notes and references ==
{{Reflist|2}}
{{Homoeopathy}}
[[Category:Alternative medical systems]]
[[Category:Alternative medicine]]
[[Category:Homeopathy|*]]
[[Category:Pseudoscience]]
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