Homeopathy
Overview
Homeopathy is a form of alternative medicine
Alternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....

 in which practitioners claim to treat patients using highly diluted preparations that are believed to cause healthy people to exhibit symptoms that are similar to those exhibited by the patient. The collective weight of scientific
Scientific method
Scientific method refers to a body of techniques for investigating phenomena, acquiring new knowledge, or correcting and integrating previous knowledge. To be termed scientific, a method of inquiry must be based on gathering empirical and measurable evidence subject to specific principles of...

 evidence has found homeopathy to be no more effective than a placebo
Placebo
A placebo is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient...

.

In the context of homeopathy, the term remedy is used to refer to a substance which has been prepared with a particular procedure and intended for patient
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....

 use; it is not to be confused with the generally accepted use of the word, which means "a medicine or therapy that cures disease or relieves pain".

The basic principle of homeopathy, known as the "law of similars", is "let like be cured by like." It was first stated by German physician Samuel Hahnemann
Samuel Hahnemann
Christian Friedrich Samuel Hahnemann was a German physician, known for creating an alternative form of medicine called homeopathy.- Early life :Christian Friedrich Samuel Hahnemann was born in Meissen, Saxony near Dresden...

 in 1796.
Quotations

HOMOEOPATHIST, n. The humorist of the medical profession.

Ambrose Bierce, The Devil's Dictionary (1911), p. 139

HOMOEOPATHY, n. A school of medicine midway between Allopathy and Christian Science. To the last both the others are distinctly inferior, for Christian Science will cure imaginary diseases, and they can not.

Ambrose Bierce, The Devil's Dictionary (1911), p. 139

The National Health Service|NHS recently spent £10m refurbishing the London Homeopathic Hospital. The equivalent of 500 nurses' wages, blown on a handful of magic beans. That was your tax money. It was meant for saving lives.

Encyclopedia
Homeopathy is a form of alternative medicine
Alternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....

 in which practitioners claim to treat patients using highly diluted preparations that are believed to cause healthy people to exhibit symptoms that are similar to those exhibited by the patient. The collective weight of scientific
Scientific method
Scientific method refers to a body of techniques for investigating phenomena, acquiring new knowledge, or correcting and integrating previous knowledge. To be termed scientific, a method of inquiry must be based on gathering empirical and measurable evidence subject to specific principles of...

 evidence has found homeopathy to be no more effective than a placebo
Placebo
A placebo is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient...

.

In the context of homeopathy, the term remedy is used to refer to a substance which has been prepared with a particular procedure and intended for patient
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....

 use; it is not to be confused with the generally accepted use of the word, which means "a medicine or therapy that cures disease or relieves pain".

The basic principle of homeopathy, known as the "law of similars", is "let like be cured by like." It was first stated by German physician Samuel Hahnemann
Samuel Hahnemann
Christian Friedrich Samuel Hahnemann was a German physician, known for creating an alternative form of medicine called homeopathy.- Early life :Christian Friedrich Samuel Hahnemann was born in Meissen, Saxony near Dresden...

 in 1796. His "law of similars" is taken on his word
Ipse dixit
Ipse dixit is a Latin phrase meaning he himself said it. The term labels a dogmatic statement asserted but not proved, to be accepted on faith in the speaker....

 as an unproven assertion, and is not a true law of nature
Natural law
Natural law, or the law of nature , is any system of law which is purportedly determined by nature, and thus universal. Classically, natural law refers to the use of reason to analyze human nature and deduce binding rules of moral behavior. Natural law is contrasted with the positive law Natural...

 based on the scientific method
Scientific method
Scientific method refers to a body of techniques for investigating phenomena, acquiring new knowledge, or correcting and integrating previous knowledge. To be termed scientific, a method of inquiry must be based on gathering empirical and measurable evidence subject to specific principles of...

. Homeopathic remedies are prepared by serial dilution
Serial dilution
A serial dilution is the stepwise dilution of a substance in solution. Usually the dilution factor at each step is constant, resulting in a geometric progression of the concentration in a logarithmic fashion. A ten-fold serial dilution could be 1 M, 0.1 M, 0.01 M, 0.001 M.....

 with shaking by forceful striking on an elastic body, which homeopaths term succussion. Each dilution followed by succussion is assumed to increase the effectiveness. Homeopaths call this process potentization. Dilution often continues until none of the original substance remains.
Apart from the symptoms, homeopaths examine aspects of the patient's physical and psychological state, then homeopathic reference books known as repertories are consulted, and a remedy is selected based on the totality of symptoms.

While some individual studies have positive results, systematic review
Systematic review
A systematic review is a literature review focused on a research question that tries to identify, appraise, select and synthesize all high quality research evidence relevant to that question. Systematic reviews of high-quality randomized controlled trials are crucial to evidence-based medicine...

s of published trials fail to demonstrate efficacy. Furthermore, higher quality trials
Clinical trial
Clinical trials are a set of procedures in medical research and drug development that are conducted to allow safety and efficacy data to be collected for health interventions...

 tend to report results that are less positive, and most positive studies have not been replicated or show methodological problems that prevent them from being considered unambiguous evidence of homeopathy's efficacy.

Depending on the dilution, homeopathic remedies may not contain any pharmacologically active
Pharmacology
Pharmacology is the branch of medicine and biology concerned with the study of drug action. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function...

 molecules, and for such remedies to have pharmacological effect
Pharmacology
Pharmacology is the branch of medicine and biology concerned with the study of drug action. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function...

 would violate fundamental principles of science. Modern homeopaths have proposed that water has a memory
Water memory
Water memory is the claimed ability of water to retain a "memory" of substances previously dissolved in it to arbitrary dilution. No scientific evidence supports this claim. Shaking the water at each stage of a serial dilution is claimed to be necessary for an effect to occur...

 that allows homeopathic preparations to work without any of the original substance; however, there are no verified observations nor scientifically plausible physical mechanisms for such a phenomenon. The lack of convincing scientific evidence
Scientific evidence
Scientific evidence has no universally accepted definition but generally refers to evidence which serves to either support or counter a scientific theory or hypothesis. Such evidence is generally expected to be empirical and properly documented in accordance with scientific method such as is...

 to support homeopathy's efficacy and its use of remedies lacking active ingredients have caused homeopathy to be described as pseudoscience
Pseudoscience
Pseudoscience is a claim, belief, or practice which is presented as scientific, but which does not adhere to a valid scientific method, lacks supporting evidence or plausibility, cannot be reliably tested, or otherwise lacks scientific status...

, quackery
Quackery
Quackery is a derogatory term used to describe the promotion of unproven or fraudulent medical practices. Random House Dictionary describes a "quack" as a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, knowledge, or...

, and a "cruel deception".

Oral homeopathic remedies are safe at high dilutions recommended by Hahnemann, since they likely contain no molecules of the original substance, but they may not be safe at lower dilutions. If injected, homeopathic remedies may carry a risk of infection if they have not been prepared in a wholly sterile clinical environment. Homeopathy has been criticized for putting patients at risk due to advice against conventional medicine
Evidence-based medicine
Evidence-based medicine or evidence-based practice aims to apply the best available evidence gained from the scientific method to clinical decision making. It seeks to assess the strength of evidence of the risks and benefits of treatments and diagnostic tests...

 such as vaccination
Vaccination
Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...

s, anti-malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...

l drugs, and antibiotics.

The regulation and prevalence of homeopathy
Regulation and prevalence of homeopathy
Homeopathy is fairly common in some countries while being uncommon 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...

 is highly variable from country to country. There are no specific legal regulations concerning its use in some countries, while in others, licenses or degrees in conventional medicine from accredited universities are required. In several countries, homeopathy is covered by the national insurance to different extents, while in some it is fully integrated into the national healthcare system. In many countries, the laws that govern the regulation and testing of conventional drugs do not apply to homeopathic remedies.

Philosophy

Homeopathy is a vitalist
Vitalism
Vitalism, as defined by the Merriam-Webster dictionary, is#a doctrine that the functions of a living organism are due to a vital principle distinct from biochemical reactions...

 philosophy that interprets diseases and sickness as caused by disturbances in a hypothetical vital force or life force. It sees these disturbances as manifesting themselves as unique symptoms. Homeopathy maintains 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 implies that a negative state of mind can attract hypothetical disease entities called miasms to invade the body and produce symptoms of diseases. However, Hahnemann rejected the notion of a disease as a separate thing or invading entity and insisted that it was always part of the "living whole". Hahnemann proposed homeopathy in reaction to the state of traditional western medicine
History of medicine
All human societies have medical beliefs that provide explanations for birth, death, and disease. Throughout history, illness has been attributed to witchcraft, demons, astral influence, or the will of the gods...

 at that time, which often was brutal and more harmful than helpful. Hahnemann coined the expression "allopathic medicine
Allopathic medicine
Allopathic medicine refers to the practice of conventional medicine that uses pharmacologically active agents or physical interventions to treat or suppress symptoms or pathophysiologic processes of diseases or conditions. It was coined by Samuel Hahnemann , a homeopath, in 1810...

," which was used to pejoratively refer to traditional western medicine.

Law of similars

Hahnemann observed from his experiments with cinchona
Cinchona
Cinchona or Quina is a genus of about 38 species in the family Rubiaceae, native to tropical South America. They are large shrubs or small trees growing 5–15 metres in height with evergreen foliage. The leaves are opposite, rounded to lanceolate and 10–40 cm long. The flowers are white, pink...

 bark, used as a treatment for malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...

, that the effects he experienced from ingesting the bark were similar to the symptoms of malaria. He therefore decided 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 "let like be cured by like" as a fundamental healing principle. He believed that by using drugs to induce symptoms, the artificial symptoms would stimulate the vital force, causing it to neutralise and expel the original disease and that this artificial disturbance would naturally subside when the dosing ceased. It is based on the belief that a substance that in large doses will produce symptoms of a specific disease will, in extremely small doses, cure it.

Hahnemann's law of similars is an ipse dixit
Ipse dixit
Ipse dixit is a Latin phrase meaning he himself said it. The term labels a dogmatic statement asserted but not proved, to be accepted on faith in the speaker....

axiom
Axiom
In traditional logic, an axiom or postulate is a proposition that is not proven or demonstrated but considered either to be self-evident or to define and delimit the realm of analysis. In other words, an axiom is a logical statement that is assumed to be true...

, in other words an unproven assertion made by Hahnemann, and not a true law of nature
Natural law
Natural law, or the law of nature , is any system of law which is purportedly determined by nature, and thus universal. Classically, natural law refers to the use of reason to analyze human nature and deduce binding rules of moral behavior. Natural law is contrasted with the positive law Natural...

.

Miasms and disease

In 1828, Hahnemann introduced the concept of miasms; underlying causes for many known diseases.
A miasm is often defined by homeopaths as an imputed "peculiar morbid derangement of [the] vital force".
Hahnemann associated each miasm with specific diseases, with each miasm seen as the root cause of several diseases. According to Hahnemann, initial exposure to miasms causes local symptoms, such as skin or venereal diseases, but if these symptoms are suppressed by medication, the cause goes deeper and begins to manifest itself as diseases of the internal organs. Homeopathy maintains that treating diseases by directly opposing their symptoms, as is sometimes done in conventional medicine, is ineffective because all "disease can generally be traced to some latent, deep-seated, underlying chronic, or inherited tendency". The underlying imputed miasm still remains, and deep-seated ailments can be corrected only by removing the deeper disturbance of the vital force.

Hahnemann originally presented only three miasms, of which the most important was "psora" (Greek for itch), described as being related to any itching diseases of the skin, supposed to be derived from suppressed scabies
Scabies
Scabies , known colloquially as the seven-year itch, is a contagious skin infection that occurs among humans and other animals. It is caused by a tiny and usually not directly visible parasite, the mite Sarcoptes scabiei, which burrows under the host's skin, causing intense allergic itching...

, and claimed to be the foundation of many further disease conditions. Hahnemann believed psora to be the cause of such diseases as epilepsy
Epilepsy
Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...

, cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

, jaundice
Jaundice
Jaundice is a yellowish pigmentation of the skin, the conjunctival membranes over the sclerae , and other mucous membranes caused by hyperbilirubinemia . This hyperbilirubinemia subsequently causes increased levels of bilirubin in the extracellular fluid...

, deafness, and cataracts. Since Hahnemann's time, other miasms have been proposed, some replacing one or more of psora's proposed functions, including tubercular
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

 miasms and cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

 miasms.

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
George Vithoulkas
George Vithoulkas is a teacher and practitioner of homeopathy.He studied homeopathy in South Africa and received a diploma in homeopathy from the Indian Institute of Homeopathy in 1966...

 claiming that syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital 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
Penicillin
Penicillin is a group of antibiotics derived from Penicillium fungi. They include penicillin G, procaine penicillin, benzathine penicillin, and penicillin V....

 treatment produces a complete cure of syphilis in more than 90% of cases.
Campbell described this as "a thoroughly irresponsible statement that could mislead an unfortunate layman into refusing orthodox treatment".

The theory of miasms has been criticized as an explanation developed by Hahnemann to preserve the system of homeopathy in the face of treatment failures, and for being inadequate to cover the many hundreds of sorts of diseases, as well as for failing to explain disease predispositions as well as genetics
Genetics
Genetics , a discipline of biology, is the science of genes, heredity, and variation in living organisms....

, environmental factors and the unique disease history of each patient.

Remedies

“Remedy” is a technical term in homeopathy that refers to a substance which has been prepared with a particular procedure and intended for patient use; it is not to be confused with the generally accepted use of the word, which means "a medicine or therapy that cures disease or relieves pain". Homeopathic practitioners rely on two types of reference when prescribing remedies: Materia medica
Materia medica
Materia medica is a Latin medical term for the body of collected knowledge about the therapeutic properties of any substance used for healing . The term 'materia medica' derived from the title of a work by the Ancient Greek physician Pedanius Dioscorides in the 1st century AD, De materia medica libre...

 and repertories. 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 repertory is an index of disease symptoms that lists remedies associated with specific symptoms.

Homeopathy uses many animal, plant, mineral, and synthetic substances in its remedies. Examples include Arsenicum album
Arsenicum album
Arsenicum album is a frequently-used homeopathic substance consisting of arsenic trioxide. It is used by homeopaths to treat a range of symptoms that include digestive disorders , insomnia, allergies, anxiety, depression, and obsessive–compulsive disorder, and it has been studied as a possible...

(arsenic oxide), Natrum muriaticum (sodium chloride
Sodium chloride
Sodium chloride, also known as salt, common salt, table salt or halite, is an inorganic compound with the formula NaCl. Sodium chloride is the salt most responsible for the salinity of the ocean and of the extracellular fluid of many multicellular organisms...

 or table salt), Lachesis muta
Lachesis muta
Lachesis muta is a venomous pitviper species found in South America. Two subspecies are currently recognized, including the nominate subspecies described here.-Description:...

(the venom of the bushmaster snake
Lachesis (genus)
Lachesis is a genus of venomous pitvipers found in remote forested areas of Central and South America. The generic name refers to one of the Three Fates in Greek mythology who determined the length of the thread of life...

), Opium
Opium
Opium is the dried latex obtained from the opium poppy . Opium contains up to 12% morphine, an alkaloid, which is frequently processed chemically to produce heroin for the illegal drug trade. The latex also includes codeine and non-narcotic alkaloids such as papaverine, thebaine and noscapine...

, and Thyroidinum (thyroid hormone
Thyroid hormone
The thyroid hormones, thyroxine and triiodothyronine , are tyrosine-based hormones produced by the thyroid gland primarily responsible for regulation of metabolism. An important component in the synthesis of thyroid hormones is iodine. The major form of thyroid hormone in the blood is thyroxine ,...

). Homeopaths also use treatments called nosodes (from the Greek nosos, disease) made from diseased or pathological products such as fecal, urinary, and respiratory discharges, blood, and tissue. Homeopathic remedies prepared from healthy specimens are called sarcodes.

Some modern homeopaths have considered more esoteric bases for remedies, 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
X-ray
X-radiation is a form of electromagnetic radiation. X-rays have a wavelength in the range of 0.01 to 10 nanometers, corresponding to frequencies in the range 30 petahertz to 30 exahertz and energies in the range 120 eV to 120 keV. They are shorter in wavelength than UV rays and longer than gamma...

s
and sunlight
Sunlight
Sunlight, in the broad sense, is the total frequency spectrum of electromagnetic radiation given off by the Sun. On Earth, sunlight is filtered through the Earth's atmosphere, and solar radiation is obvious as daylight when the Sun is above the horizon.When the direct solar radiation is not blocked...

.
Today there are about 3,000 different remedies commonly used in homeopathy.
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
Radionics
Radionics is the use of blood, hair, a signature, or other substances unique to the person as a focus to supposedly heal a patient from afar. The concept behind radionics originated in the early 1900s with Albert Abrams , who became a millionaire by leasing radionic machines which he designed...

 to prepare remedies. Such practices have been strongly criticised by classical homeopaths as unfounded, speculative, and verging upon magic and superstition.

Preparation

In producing remedies for diseases, homeopaths use a process called dynamisation or potentisation whereby a substance is diluted with alcohol or distilled water
Distilled water
Distilled water is water that has many of its impurities removed through distillation. Distillation involves boiling the water and then condensing the steam into a clean container.-History:...

 and then vigorously shaken by ten hard strikes against an elastic body in a process called succussion. Hahnemann advocated using substances that produce symptoms like those of the disease being treated, but found that material doses intensified the symptoms and exacerbated the condition, sometimes causing dangerous toxic reactions. He therefore specified that the substances be diluted. Hahnemann believed that the succussion activated the vital energy of the diluted substance and made it stronger. To facilitate succussion, Hahnemann had a saddle-maker construct a special wooden striking board covered in leather on one side and stuffed with horsehair. Insoluble solids, such as quartz
Quartz
Quartz is the second-most-abundant mineral in the Earth's continental crust, after feldspar. It is made up of a continuous framework of SiO4 silicon–oxygen tetrahedra, with each oxygen being shared between two tetrahedra, giving an overall formula SiO2. There are many different varieties of quartz,...

 and oyster
Oyster
The word oyster is used as a common name for a number of distinct groups of bivalve molluscs which live in marine or brackish habitats. The valves are highly calcified....

 shell, are diluted by grinding them with lactose
Lactose
Lactose is a disaccharide sugar that is found most notably in milk and is formed from galactose and glucose. Lactose makes up around 2~8% of milk , although the amount varies among species and individuals. It is extracted from sweet or sour whey. The name comes from or , the Latin word for milk,...

 (trituration
Trituration
Trituration is the name of several different methods of processing materials. Trituration is also the name of the process for reducing the particle size of a substance by grinding, as by grinding of powders in a mortar with a pestle. Trituration additionally refers to the production of a...

).

Dilutions

Three logarithm
Logarithm
The logarithm of a number is the exponent by which another fixed value, the base, has to be raised to produce that number. For example, the logarithm of 1000 to base 10 is 3, because 1000 is 10 to the power 3: More generally, if x = by, then y is the logarithm of x to base b, and is written...

ic 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 diluted by a further factor of one hundred. This works out to one part of the original substance in 10,000 parts of the solution.
A 6C dilution repeats this process six times, ending up with the original material diluted by a factor of 100−6=10−12 (one part in one trillion or 1/1,000,000,000,000). Higher dilutions follow the same pattern. In homeopathy, a solution that is more dilute is described as having a higher potency, and more dilute substances are considered by homeopaths to be stronger and deeper-acting remedies. The end product is often so diluted that it is indistinguishable from the dilutant (pure water, sugar or alcohol).

Hahnemann advocated 30C dilutions for most purposes (that is, dilution by a factor of 1060). In Hahnemann's time it was reasonable to assume that remedies could be diluted indefinitely, as the concept of the atom or molecule as the smallest possible unit of a chemical substance was just beginning to be recognized. The greatest dilution that is reasonably likely to contain even one molecule of the original substance is 12C.

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, Constantine Hering
Constantine Hering
Constantine Hering was an early pioneer of homeopathy in the United States.-Biography:Hering was born in Oschatz, Saxony, and studied medicine at the University of Leipzig where his conversion to homeopathy occurred...

. 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. 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.
X Scale, D Scale C Scale Ratio Note
Ø Ø 1:1 mother tincture (undiluted)
1X, D1 1:10 described as low potency
2X, D2 1C 1:100 called higher potency than 1X by homeopaths
6X, D6 3C 10−6
8X, D8 4C 10−8 allowable concentration of arsenic in U.S. drinking water
12X, D12 6C 10−12
24X, D24 12C 10−24 Has a 60% probability of containing one molecule of original material if one mole
Mole (unit)
The mole is a unit of measurement used in chemistry to express amounts of a chemical substance, defined as an amount of a substance that contains as many elementary entities as there are atoms in 12 grams of pure carbon-12 , the isotope of carbon with atomic weight 12. This corresponds to a value...

 of the original substance was used.
60X, D60 30C 10−60 Dilution advocated by Hahnemann for most purposes; patient would need to consume 1041 pills (a billion times the mass of the Earth), or 1034 gallons of liquid remedy (10 billion times the volume of the Earth) to consume a single molecule of the original substance Moreover, since even in a 15C solution there would very likely be no molecules of the original substance left, the 30C solution would probably contain no molecules of water that had come into contact with the original substance.
400X, D400 200C 10−400 Dilution of popular homeopathic flu remedy Oscillococcinum
Oscillococcinum
Oscillococcinum is a homeopathic alternative medicine marketed to relieve influenza-like symptoms. It is one of the most popular homeopathic preparations, particularly in France. Oscillococcinum is manufactured by a French company, Boiron, its sole manufacturer. There are, however, other...

Note: the "X scale" is also called "D scale". 1X = D1, 2X = D2, etc.


Critics and advocates of homeopathy alike commonly attempt to illustrate the dilutions involved in homeopathy with analogies. 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
Lake Geneva
Lake Geneva or Lake Léman is a lake in Switzerland and France. It is one of the largest lakes in Western Europe. 59.53 % of it comes under the jurisdiction of Switzerland , and 40.47 % under France...

, if it could be succussed 60 times.
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", which is approximately correct.
One third of a drop of some original substance diluted into all the water on earth would produce a remedy with a concentration of about 13C. A popular homeopathic treatment for the flu
Influenza
Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae , that affects birds and mammals...

 is a 200C dilution of duck liver, marketed under the name Oscillococcinum
Oscillococcinum
Oscillococcinum is a homeopathic alternative medicine marketed to relieve influenza-like symptoms. It is one of the most popular homeopathic preparations, particularly in France. Oscillococcinum is manufactured by a French company, Boiron, its sole manufacturer. There are, however, other...

. As there are only about 1080 atoms in the entire observable universe
Observable universe
In Big Bang cosmology, the observable universe consists of the galaxies and other matter that we can in principle observe from Earth in the present day, because light from those objects has had time to reach us since the beginning of the cosmological expansion...

, a dilution of one molecule in the observable universe would be about 40C. Oscillococcinum would thus require 10320 more universes to simply have one molecule in the final substance.
The high dilutions characteristically used are often considered to be the most controversial and implausible aspect of homeopathy.

Dilution debate

Not all homeopaths advocate extremely high dilutions. Many of the early homeopaths were originally doctors and generally used lower dilutions such as "3X" or "6X", rarely going beyond "12X". The split between lower and higher dilutions followed ideological lines. Those favoring low dilutions stressed pathology
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....

 and a strong link to conventional medicine, while those favoring high dilutions emphasised vital force, miasms and a spiritual
Spirituality
Spirituality can refer to an ultimate or an alleged immaterial reality; an inner path enabling a person to discover the essence of his/her being; or the “deepest values and meanings by which people live.” Spiritual practices, including meditation, prayer and contemplation, are intended to develop...

 interpretation of disease.
Some products with such relatively lower dilutions continue to be sold, but like their counterparts, they have not been conclusively demonstrated to have any effect beyond that of a placebo
Placebo effect
Placebo effect may refer to:* Placebo effect, the tendency of any medication or treatment, even an inert or ineffective one, to exhibit results simply because the recipient believes that it will work...

.

Provings

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 word Prüfung, meaning "test". A homeopathic proving is the method by which the profile of a homeopathic remedy is determined.

At first Hahnemann used material doses for provings, but he later advocated proving with remedies at a 30C dilution, and most modern provings are carried out using ultradilute remedies in which it is highly unlikely that any of the original molecules remain. During the proving process, Hahnemann administered remedies to healthy volunteers, and the resulting symptoms were compiled by observers into a drug picture. The volunteers were observed for months at a time and made to keep extensive journals detailing all of their symptoms at specific times throughout the day. They were forbidden from consuming coffee, tea, spices, or wine for the duration of the experiment; playing chess was also prohibited because Hahnemann considered it to be "too exciting", though they were allowed to drink beer and encouraged to exercise in moderation. After the experiments were over, Hahnemann made the volunteers 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
Clinical trial
Clinical trials are a set of procedures in medical research and drug development that are conducted to allow safety and efficacy data to be collected for health interventions...

, due to their early use of simple control groups, systematic and quantitative procedures, and some of the first application of statistics
Statistics
Statistics is the study of the collection, organization, analysis, and interpretation of data. It deals with all aspects of this, including the planning of data collection in terms of the design of surveys and experiments....

 in medicine. The lengthy records of self-experimentation by homeopaths have occasionally proven useful in the development of modern drugs: For example, evidence that nitroglycerin might be useful as a treatment for angina was discovered by looking through homeopathic provings, though homeopaths themselves never used it for that purpose at that time.
The first recorded provings were published by Hahnemann in his 1796 Essay on a New Principle.
His Fragmenta de Viribus (1805) contained the results of 27 provings, and his 1810 Materia Medica Pura contained 65.
For James Tyler Kent
James Tyler Kent
James Tyler Kent, MD was an American physician best remembered as a forefather of the modern homeopathy movement. In 1897 Kent published a massive guidebook on human ailments and their associated homeopathic remedies which has been translated into a number of languages and remains in use by...

's 1905 Lectures on Homoeopathic Materia Medica, 217 remedies underwent provings and newer substances are continually added to contemporary versions.

Physical, mental, and emotional state examination; Repertories

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 or 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.

From these symptoms, the homeopath chooses how to treat the patient. A compilation of reports of many homeopathic provings, supplemented with clinical data, is known as a homeopathic materia medica. But because a practitioner first needs to explore the remedies for a particular symptom rather than looking up the symptoms for a particular remedy, the homeopathic repertory, which is an index of symptoms, lists after each symptom those remedies that are associated with it. Repertories are often very extensive and may include data extracted from multiple sources of materia medica. There is often lively debate among compilers of repertories and practitioners over the veracity of a particular inclusion.

The first symptomatic index of the homeopathic materia medica was arranged by Hahnemann. Soon after, one of his students Clemens von Bönninghausen
Clemens Maria Franz von Bönninghausen
Clemens Maria Franz Freiherr von Bönninghausen was a lawyer, agriculturalist and botanist, who also practised and researched homeopathy....

, created the Therapeutic Pocket Book, another homeopathic repertory.
The first such homeopathic repertory was Georg Jahr's Symptomenkodex, published in German (1835), which was then first translated to English (1838) by Constantine Hering as the Repertory to the more Characteristic Symptoms of Materia Medica. This version was less focused on disease categories and would be the forerunner to Kent's later works.
It consisted of three large volumes. Such repertories increased in size and detail as time progressed.

Some diversity in approaches to treatments exists among homeopaths. 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.

Homeopathic pills

Homeopathic pills are made from an inert substance (often sugars, typically lactose), upon which a drop of liquid homeopathic preparation is placed.

"Active" ingredients

The list of ingredients seen on remedies may confuse consumers into believing that the product actually contains those ingredients. According to normal homeopathic practice, remedies are prepared starting with active ingredient
Active ingredient
An active ingredient is the substance of a pharmaceutical drug or a pharmaceutical ingredient and bulk active in medicine; in pesticide formulations active substance may be used. Some medications and pesticide products may contain more than one active ingredient...

s that are often serially diluted to the point where the finished product no longer contains any biologically "active ingredients" as that term is normally defined. The list of ingredients normally refers to the ingredients originally used in their preparation. Following is a demonstrative example:

Zicam Cold Remedy
Zicam
Zicam is a branded series of products marketed for cold and allergy relief whose original formulations included the element zinc. The Zicam name is derived from a combination of the words "zinc" and "ICAM-1" . It is marketed as an "unapproved homeopathic" product.Zicam was invented by Charles B...

is marketed as an "unapproved homeopathic" product. It contains a number of highly diluted ingredients that are listed as "inactive ingredients" on the label. Some of the homeopathic ingredients used in the preparation of Zicam are galphimia glauca, histamine dihydrochloride (homeopathic name, histaminum hydrochloricum), luffa operculata
Luffa operculata
Luffa operculata is a species of Luffa. It is cultivated for its fruit, which is used to make a bath sponge. Its fruit is a capsule with spikes and toxicity. The fruit is dark-brown when mature. It is also grown in gardens and yards as an ornamental plant...

, and sulfur
Sulfur
Sulfur or sulphur is the chemical element with atomic number 16. In the periodic table it is represented by the symbol S. It is an abundant, multivalent non-metal. Under normal conditions, sulfur atoms form cyclic octatomic molecules with chemical formula S8. Elemental sulfur is a bright yellow...

. Although the product is marked "homeopathic" it does contain two ingredients that are only "slightly" diluted: zinc acetate
Zinc acetate
Zinc acetate is the chemical compound with the formula Zn2, which commonly occurs as a dihydrate Zn22. Both the hydrate and the anhydrous forms are colorless solids that are commonly used in chemical synthesis and as dietary supplements. Zinc acetates are prepared by the action of acetic acid on...

 (2X = 1/100 dilution) and zinc gluconate
Zinc gluconate
Zinc gluconate is the zinc salt of gluconic acid. It is an ionic compound consisting of two moles of gluconate for each mole of zinc...

 (1X = 1/10 dilution), which means that both are present in a concentration that contains biologically active ingredients. In fact, they are strong enough to have caused some people to lose their sense of smell, a condition termed anosmia
Anosmia
Anosmia is a lack of functioning olfaction, or in other words, an inability to perceive odors. Anosmia may be either temporary or permanent. A related term, hyposmia, refers to a decreased ability to smell, while hyperosmia refers to an increased ability to smell. Some people may be anosmic for one...

. This illustrates why taking a product marked "homeopathic", especially an overdose
Drug overdose
The term drug overdose describes the ingestion or application of a drug or other substance in quantities greater than are recommended or generally practiced...

, can still be dangerous because it may contain biologically active ingredients.

Scientific skeptics highlight the lack of active ingredients in homeopathic products by taking large overdoses - examples include James Randi
James Randi
James Randi is a Canadian-American stage magician and scientific skeptic best known as a challenger of paranormal claims and pseudoscience. Randi is the founder of the James Randi Educational Foundation...

 and the 10:23 campaign
10:23 campaign
The 1023 Campaign is an awareness campaign & protest against homeopathy. The campaign is organised by The Merseyside Skeptics Society, a non-profit organisation of skeptics in the United Kingdom...

 groups. None of the hundreds of demonstrators in the UK, Australia, New Zealand, Canada and the US were injured and "no one was cured of anything, either". Some marketers of remedies state that one "cannot overdose on homeopathic medicines".

Isopathy

Isopathy is a therapy derived from homeopathy and was invented by Johann Joseph Wilhelm Lux in the 1830s. Isopathy differs from homeopathy in general in that the remedies, known as "nosodes", are made up either from things that cause the disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...

 or from products of the disease, such as pus
Pus
Pus is a viscous exudate, typically whitish-yellow, yellow, or yellow-brown, formed at the site of inflammatory during infection. An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collection of pus within or beneath the epidermis is known as a pustule or...

. Many so-called "homeopathic vaccines" are a form of isopathy.

Flower remedies

Flower remedies can be produced by placing flowers in water and exposing them to sunlight. The most famous of these are the Bach flower remedies
Bach flower remedies
Bach flower remedies are dilutions of flower material developed by Edward Bach, an English bacteriologist, pathologist and homeopath, in the 1930s. Bach believed that dew found on flower petals retain healing properties of that plant...

, which were developed by the physician and homeopath Edward Bach
Edward Bach
Edward Bach was a British physician, homeopath and spiritual writer, best known for developing his titular Bach flower remedies, a form of alternative medicine inspired by classical homeopathic traditions.-Biography:...

. Although the proponents of these remedies share homeopathy's vitalist world-view and the remedies are claimed to act through the same hypothetical "vital force" as homeopathy, the method of preparation is different. Bach flower remedies are prepared in "gentler" ways such as placing flowers in bowls of sunlit water, and the remedies are not succussed. There is no convincing scientific or clinical evidence for flower remedies being effective.

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. The FDA has not approved homeopathic products as veterinary medicine in the U.S. In the UK, veterinary surgeon
Veterinary surgeon
Veterinary surgeon is a term used to describe:*The full title of a vet, who treats disease, disorder and injury in animals, in the United Kingdom and several Commonwealth countries**See also Veterinary medicine in the United Kingdom...

s who use homeopathy belong to the Faculty of Homeopathy
Faculty of Homeopathy
The Faculty of Homeopathy was formed in 1944 from the old British Homeopathic Society . It was incorporated by the Faculty of Homeopathy Act 1950, which confers an educational function on the Faculty...

 and/or to the British Association of Homeopathic Veterinary Surgeons. Animals may be treated only 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. 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.

Electrohomeopathy

Electrohomeopathy
Electrohomeopathy
Electrohomoeopathy is a derivative of homeopathy that had its origins in the 19th century with the claims of Count Cesare Mattei. The name is derived from a combination of electro and homeopathy Electrohomoeopathy is a derivative of homeopathy that had its origins in the 19th century with the...

 was a 19th century practice combining homeopathy with electric treatment.

Evidence

Homeopathy's efficacy is unsupported by the collective weight of modern scientific research. The extreme dilutions used in homeopathic preparations usually leave none of the original material in the final product. The modern mechanism proposed by homeopaths, water memory
Water memory
Water memory is the claimed ability of water to retain a "memory" of substances previously dissolved in it to arbitrary dilution. No scientific evidence supports this claim. Shaking the water at each stage of a serial dilution is claimed to be necessary for an effect to occur...

, is considered implausible in that short-range order in water only persists for about 1 picosecond
Picosecond
A picosecond is 10−12 of a second. That is one trillionth, or one millionth of one millionth of a second, or 0.000 000 000 001 seconds. A picosecond is to one second as one second is to 31,700 years....

. Pharmacological effect
Pharmacology
Pharmacology is the branch of medicine and biology concerned with the study of drug action. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function...

 without active ingredients is inconsistent with the observed dose-response relationship
Dose-response relationship
The dose-response relationship, or exposure-response relationship, describes the change in effect on an organism caused by differing levels of exposure to a stressor after a certain exposure time...

s of conventional drugs, leaving only non-specific placebo effects
Placebo
A placebo is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient...

 or various novel explanations. The proposed rationale for these extreme dilutions – that the water contains the "memory
Water memory
Water memory is the claimed ability of water to retain a "memory" of substances previously dissolved in it to arbitrary dilution. No scientific evidence supports this claim. Shaking the water at each stage of a serial dilution is claimed to be necessary for an effect to occur...

" or "vibration" from the diluted ingredient – is counter to the laws of chemistry
Chemistry
Chemistry is the science of matter, especially its chemical reactions, but also its composition, structure and properties. Chemistry is concerned with atoms and their interactions with other atoms, and particularly with the properties of chemical bonds....

 and physics
Physics
Physics is a natural science that involves the study of matter and its motion through spacetime, along with related concepts such as energy and force. More broadly, it is the general analysis of nature, conducted in order to understand how the universe behaves.Physics is one of the oldest academic...

, such as the law of mass action. The lack of convincing scientific evidence supporting its efficacy and its use of remedies without active ingredients have led to characterizations as pseudoscience and quackery, or, in the words of a 1998 medical review, "placebo therapy at best and quackery at worst." Use of homeopathy may delay or replace effective medical treatment, worsening outcomes or exposing the patients to increased risk.

Referring specifically to homeopathy, the British House of Commons Science and Technology Committee has stated:
The National Center for Complementary and Alternative Medicine of the United States' National Institutes of Health
National Institutes of Health
The National Institutes of Health are an agency of the United States Department of Health and Human Services and are the primary agency of the United States government responsible for biomedical and health-related research. Its science and engineering counterpart is the National Science Foundation...

 states:

High dilutions

The extremely high dilutions in homeopathy have been a main point of criticism. 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. Homeopaths contend 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.
Since even the longest-lived noncovalent
Noncovalent bonding
A noncovalent bond is a type of chemical bond, typically between macromolecules, that does not involve the sharing of pairs of electrons, but rather involves more dispersed variations of electromagnetic interactions. The noncovalent bond is the dominant type of bond between supermolecules in...

 structures in liquid water at room temperature are stable for only a few picosecond
Picosecond
A picosecond is 10−12 of a second. That is one trillionth, or one millionth of one millionth of a second, or 0.000 000 000 001 seconds. A picosecond is to one second as one second is to 31,700 years....

s, critics have concluded that any effect that might have been present from the original substance can no longer exist. No evidence of stable clusters of water molecules was found when homeopathic remedies were studied using NMR
NMR
NMR may refer to:Applications of Nuclear Magnetic Resonance:* Nuclear magnetic resonance* NMR spectroscopy* Solid-state nuclear magnetic resonance* Protein nuclear magnetic resonance spectroscopy* Proton NMR* Carbon-13 NMR...

.

Furthermore, since water will have been in contact with millions of different substances throughout its history, critics point out that water is therefore an extreme dilution of almost any conceivable substance. By drinking water one would, according to this interpretation, receive treatment for every imaginable condition.

Practitioners of homeopathy contend that higher dilutions produce stronger medicinal effects. This idea is inconsistent with the observed dose-response relationship
Dose-response relationship
The dose-response relationship, or exposure-response relationship, describes the change in effect on an organism caused by differing levels of exposure to a stressor after a certain exposure time...

s of conventional drugs, where the effects are dependent on the concentration of the active ingredient in the body. This dose-response relationship has been confirmed in myriad experiments on organisms as diverse as nematodes, rats, and humans.

Physicist Robert L. Park
Robert L. Park
Robert Lee Park , also known as Bob Park, is an emeritus professor of physics at the University of Maryland, College Park and a former Director of Public Information at the Washington office of the American Physical Society...

, former executive director of the American Physical Society
American Physical Society
The American Physical Society is the world's second largest organization of physicists, behind the Deutsche Physikalische Gesellschaft. The Society publishes more than a dozen scientific journals, including the world renowned Physical Review and Physical Review Letters, and organizes more than 20...

, has noted that:
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. This limit, which is related to Avogadro's number, is roughly equal to homeopathic potencies of 12C or 24X (1 part in 1024).

Scientific tests run by both the BBC
BBC
The British Broadcasting Corporation is a British public service broadcaster. Its headquarters is at Broadcasting House in the City of Westminster, London. It is the largest broadcaster in the world, with about 23,000 staff...

's Horizon and ABC's
American Broadcasting Company
The American Broadcasting Company is an American commercial broadcasting television network. Created in 1943 from the former NBC Blue radio network, ABC is owned by The Walt Disney Company and is part of Disney-ABC Television Group. Its first broadcast on television was in 1948...

 20/20 programs were unable to differentiate homeopathic dilutions from water
Water
Water is a chemical substance with the chemical formula H2O. A water molecule contains one oxygen and two hydrogen atoms connected by covalent bonds. Water is a liquid at ambient conditions, but it often co-exists on Earth with its solid state, ice, and gaseous state . Water also exists in a...

, even when using tests suggested by homeopaths themselves.

Effectiveness

The effectiveness of homeopathy has been in dispute since its inception. One of the earliest double blind 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. The methodological quality of the research base is generally low, with such problems as weaknesses in design or reporting, small sample size, and selection bias. No individual preparation has been unambiguously demonstrated to be different from a placebo
Placebo
A placebo is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient...

. Further, as the quality of the trials become better, the evidence for homeopathy preparations being effective diminishes, and the highest-quality trials show that the remedies themselves have no effect. Abstract concepts within theoretical physics have been invoked to suggest explanations of how or why remedies might work, including quantum entanglement
Quantum entanglement
Quantum entanglement occurs when electrons, molecules even as large as "buckyballs", photons, etc., interact physically and then become separated; the type of interaction is such that each resulting member of a pair is properly described by the same quantum mechanical description , which is...

, the theory of relativity
Theory of relativity
The theory of relativity, or simply relativity, encompasses two theories of Albert Einstein: special relativity and general relativity. However, the word relativity is sometimes used in reference to Galilean invariance....

 and chaos theory
Chaos theory
Chaos theory is a field of study in mathematics, with applications in several disciplines including physics, economics, biology, and philosophy. Chaos theory studies the behavior of dynamical systems that are highly sensitive to initial conditions, an effect which is popularly referred to as the...

. However, the explanations are offered by nonspecialists within the field, and often include speculations that are incorrect in their application of the concepts and not supported by actual experiments. A 2010 inquiry into the evidence base for homeopathy conducted by the United Kingdom's House of Commons Science and Technology Committee
Science and Technology Select Committee
The Science and Technology Select Committee is a select committee of the House of Commons in the Parliament of the United Kingdom.The original Science and Technology was abolished upon the creation of the Innovation, Universities, Science and Skills Committee on November 6, 2007...

 concluded that homeopathy is no more effective than placebo.

Meta-analyses

Meta-analyses
Meta-analysis
In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of effect size, for which a weighted average might be the output of a meta-analyses. Here the...

, in which large groups of studies are analysed 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
Publication bias
Publication bias is the tendency of researchers, editors, and pharmaceutical companies to handle the reporting of experimental results that are positive differently from results that are negative or inconclusive, leading to bias in the overall published literature...

 in the studies reviewed. One of the positive meta-analyses, by Linde, et al., was later qualified by the authors, who wrote:

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.


In 2001, a meta-analysis of clinical trials on the effectiveness of homeopathy concluded 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.

In 2002, a review of systematic reviews found that higher-quality trials tended to have less positive results, to the point that those results were clinically irrelevant. Also, when taking collectively all the systematic reviews, there was no convincing evidence that any homeopathic remedy had better effects than placebo, and current evidence did not allow to recommend its usage in clinical treatment.

In 2005, a systematic review of the representation of homeopathy in the medical literature suggested that mainstream journals had a publication bias
Publication bias
Publication bias is the tendency of researchers, editors, and pharmaceutical companies to handle the reporting of experimental results that are positive differently from results that are negative or inconclusive, leading to bias in the overall published literature...

 against clinical trials of homeopathy that showed positive results, and the opposite was the case for complementary and alternative medicine
Alternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....

 journals. The authors suggested that this could be due to an involuntary bias, or otherwise a submission bias, in which positive trials tend to be sent to CAM journals and negatives ones to mainstream journals. Reviews in all journals approached the subject in an apparently impartial manner, though most of the reviews published in CAM journals made no mention of the plausibility of homeopathy, whereas 9 out of 10 reviews in mainstream journals mentioned a lack of plausibility of homeopathy in the introduction.

In 2005, The Lancet
The Lancet
The Lancet is a weekly peer-reviewed general medical journal. It is one of the world's best known, oldest, and most respected general medical journals...

medical journal published a meta-analysis of 110 placebo-controlled homeopathy trials and 110 matched medical trials based upon the Swiss government
Swiss Federal Council
The Federal Council is the seven-member executive council which constitutes the federal government of Switzerland and serves as the Swiss collective head of state....

's Program for Evaluating Complementary Medicine
Program for Evaluating Complementary Medicine
In 1998, the Swiss government began a comprehensive Program for Evaluating Complementary Medicine to study the role and effectiveness of complementary medicine, which was playing an ever-increasing role in the Swiss medical system.According to the PEK Report, results of the evaluation were...

, 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.

A 2006 meta-analysis of six trials evaluating homeopathic treatments to reduce cancer therapy
Oncology
Oncology is a branch of medicine that deals with cancer...

 side-effects following radiotherapy and chemotherapy
Chemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....

 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".

A 2007 systematic review of homeopathy for children and adolescents found that the evidence for attention-deficit hyperactivity disorder and childhood diarrhea was mixed. No difference from placebo was found for adenoid vegetation, asthma, or upper respiratory tract infection. Evidence was not sufficient to recommend any therapeutic or preventative intervention.

The Cochrane Library
Cochrane Library
The Cochrane Library is a collection of databases in medicine and other healthcare specialties provided by the Cochrane Collaboration and other organisations. At its core is the collection of Cochrane Reviews, a database of systematic reviews and meta-analyses which summarize and interpret the...

 found insufficient clinical evidence to evaluate the efficacy of homeopathic treatments for asthma dementia, or for the use of homeopathy in induction of labor. Other researchers found no evidence that homeopathy is beneficial for osteoarthritis
Osteoarthritis
Osteoarthritis also known as degenerative arthritis or degenerative joint disease, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion...

, migraine
Migraine
Migraine is a chronic neurological disorder characterized by moderate to severe headaches, and nausea...

s or delayed-onset muscle soreness
Delayed onset muscle soreness
Delayed onset muscle soreness , also called muscle fever, is the pain and stiffness felt in muscles several hours to days after unaccustomed or strenuous exercise. The soreness is felt most strongly 24 to 72 hours after the exercise. It is caused by eccentric exercise...

.

Health organisations such as the UK's National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...

, the American Medical Association
American Medical Association
The American Medical Association , founded in 1847 and incorporated in 1897, is the largest association of medical doctors and medical students in the United States.-Scope and operations:...

, and the FASEB 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". There have, however, been a number of clinical trials that have tested individualized homeopathy. A 1998 review 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." Jay Shelton, author of a book on homeopathy, has stated that the claim assumes without evidence that classical, individualized homeopathy works better than nonclassical variations.

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."

Explanations of effects

Mainstream science offers a variety of explanations for how homeopathy, if the preparations themselves are ineffective, may appear to cure diseases or alleviate symptoms:
  • Unassisted natural healing — time and the body's ability to heal without assistance can eliminate many diseases of their own accord
  • Unrecognized treatments — an unrelated food, exercise, environmental agent or treatment for a different ailment, may have occurred
  • Regression toward the mean
    Regression toward the mean
    In statistics, regression toward the mean is the phenomenon that if a variable is extreme on its first measurement, it will tend to be closer to the average on a second measurement, and—a fact that may superficially seem paradoxical—if it is extreme on a second measurement, will tend...

     — since many diseases or conditions are cyclical, symptoms vary over time and patients tend to seek care when discomfort is greatest, they may feel better anyway but because the timing of the visit to the homeopath they attribute improvement to the remedy taken
  • Non-homeopathic treatment — patients may also receive non-homeopathic care simultaneous with homeopathic treatment, and this is responsible for improvement though a portion or all of the improvement may be attributed to the remedy
  • Cessation of unpleasant treatment — often homeopaths recommend patients stop getting conventional treatment such as surgery or drugs, which can cause unpleasant side-effects; improvements are attributed to homeopathy when the actual cause is the cessation of the treatment causing side-effects in the first place
  • Lifestyle changes — homeopaths often recommend diet and exercise, as well as limitations in alcohol or coffee consumption and stress
    Stress (biology)
    Stress is a term in psychology and biology, borrowed from physics and engineering and first used in the biological context in the 1930s, which has in more recent decades become commonly used in popular parlance...

     reduction, all of which can increase health and decrease symptoms
  • The placebo effect
    Placebo effect
    Placebo effect may refer to:* Placebo effect, the tendency of any medication or treatment, even an inert or ineffective one, to exhibit results simply because the recipient believes that it will work...

     — the intensive consultation process and expectations for the homeopathic preparations can result in the release of endorphin
    Endorphin
    Endorphins are endogenous opioid peptides that function as neurotransmitters. They are produced by the pituitary gland and the hypothalamus in vertebrates during exercise, excitement, pain, consumption of spicy food, love and orgasm, and they resemble the opiates in their abilities to produce...

    s or other body-effecting chemicals that alleviate pain or other symptoms, or otherwise affect an individual's biology
  • Psychological healing — the care, concern and reassurance provided by a homeopath as part of the consultation can assure the patient the symptoms are minor and easily treated, or alleviate tension that could exacerbate a preexisting condition. This caring engagement can prove particularly effective when conventional physicians have limited time with the patient or cannot provide a diagnosis or treatment.
  • Publishing standards, p-value - Even if something is not effective, the way publishing works means that you must still expect about 1 in 20 tests to show that it is effective. The standard to publish a “positive effect” is as follows - If something is assumed to be false, and then the outcome of the experiment has only about a 1 in 20 chance of happening, then you can publish that it is effective. This means that about 1 in 20 tests will show homeopathy works, even if it is in fact false.
  • Publication bias - If a believer in something conducts a test of homeopathy and the test says that something is wrong, they might not publish that there will be no effect, because that would mean they are wrong in their belief. But they would be expected to publish when there is a positive effect, because this means their belief is not wrong. So many of the “disproving” tests of that something may not get published. Even though something is false, since we already expect about 1 in 20 tests to erroneously show it is true, we get even more than about 1 in 20 publications showing that homeopathy is not false. This is called publication bias.
  • A meta-analysis
    Meta-analysis
    In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of effect size, for which a weighted average might be the output of a meta-analyses. Here the...

     combines the results of several studies. A systematic review is a literature review focused on a research question that tries to identify, appraise, select and synthesize all high quality research evidence relevant to that question.

Effects in other biological systems

While some articles have suggested that homeopathic solutions of high dilution can have statistically significant effects on organic processes including the growth of grain
GRAIN
GRAIN is a small international non-profit organisation that works to support small farmers and social movements in their struggles for community-controlled and biodiversity-based food systems. Our support takes the form of independent research and analysis, networking at local, regional and...

, histamine
Histamine
Histamine is an organic nitrogen compound involved in local immune responses as well as regulating physiological function in the gut and acting as a neurotransmitter. Histamine triggers the inflammatory response. As part of an immune response to foreign pathogens, histamine is produced by...

 release by leukocytes, and enzyme reactions
Enzyme
Enzymes are proteins that catalyze chemical reactions. In enzymatic reactions, the molecules at the beginning of the process, called substrates, are converted into different molecules, called products. Almost all chemical reactions in a biological cell need enzymes in order to occur at rates...

, such evidence is disputed since attempts to replicate them have failed.

In 1987, French immunologist Jacques Benveniste
Jacques Benveniste
Jacques Benveniste was a French immunologist. In 1979 he published a well-known paper on the structure of platelet-activating factor and its relationship with histamine...

 submitted a paper to the journal Nature
Nature (journal)
Nature, first published on 4 November 1869, is ranked the world's most cited interdisciplinary scientific journal by the Science Edition of the 2010 Journal Citation Reports...

while working at INSERM. The paper purported to have discovered that basophils, a type of white blood cell
White blood cell
White blood cells, or leukocytes , are cells of the immune system involved in defending the body against both infectious disease and foreign materials. Five different and diverse types of leukocytes exist, but they are all produced and derived from a multipotent cell in the bone marrow known as a...

, released histamine
Histamine
Histamine is an organic nitrogen compound involved in local immune responses as well as regulating physiological function in the gut and acting as a neurotransmitter. Histamine triggers the inflammatory response. As part of an immune response to foreign pathogens, histamine is produced by...

 when exposed to a homeopathic dilution of anti-immunoglobulin E antibody. 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
John Maddox
Sir John Royden Maddox, FRS was a British science writer. He was an editor of Nature for 22 years, from 1966–1973 and 1980-1995.-Career:...

, American scientific fraud investigator and chemist Walter Stewart, and sceptic and magician James Randi
James Randi
James Randi is a Canadian-American stage magician and scientific skeptic best known as a challenger of paranormal claims and pseudoscience. Randi is the founder of the James Randi Educational Foundation...

. 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." 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.

Methodological and publication issues

Ben Goldacre
Ben Goldacre
Ben Michael Goldacre born 1974 is a British science writer, doctor and psychiatrist. He is the author of The Guardian newspaper's weekly Bad Science column and a book of the same title, published by Fourth Estate in September 2008....

 published an article on homeopathy in The Lancet
The Lancet
The Lancet is a weekly peer-reviewed general medical journal. It is one of the world's best known, oldest, and most respected general medical journals...

, stating the research on homeopathy is problematic for a variety of reasons. These included the high publication bias
Publication bias
Publication bias is the tendency of researchers, editors, and pharmaceutical companies to handle the reporting of experimental results that are positive differently from results that are negative or inconclusive, leading to bias in the overall published literature...

es of alternative therapy journals, with very few articles reporting null result
Null result
In science, a null result is a result without the expected content: that is, the proposed result is absent. It is an experimental outcome which does not show an otherwise expected effect. This does not imply a result of zero or nothing, simply a result that does not support the hypothesis...

s; ignoring meta-analytic
Meta-analysis
In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of effect size, for which a weighted average might be the output of a meta-analyses. Here the...

 studies in favour of cherry picked positive results; and the promotion of an observational study
Observational study
In epidemiology and statistics, an observational study draws inferences about the possible effect of a treatment on subjects, where the assignment of subjects into a treated group versus a control group is outside the control of the investigator...

 (that Goldacre described as "little more than a customer-satisfaction survey") as if it were more informative than a series of randomized trials. Goldacre also states that homeopaths who misrepresent scientific evidence to a scientifically illiterate
Scientific literacy
Scientific literacy encompasses written, numerical, and digital literacy as they pertain to understanding science, its methodology, observations, and theories.-Definition:...

 public, have "...walled themselves off from academic medicine, and critique has been all too often met with avoidance rather than argument."

Ethics and safety

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. This may be due to improper preparation or intentional low dilution. Instances of arsenic poisoning
Arsenic poisoning
Arsenic poisoning is a medical condition caused by increased levels of the element arsenic in the body. Arsenic interferes with cellular longevity by allosteric inhibition of an essential metabolic enzyme...

 have occurred after use of arsenic-containing homeopathic preparations. Zicam Cold remedy Nasal Gel, which contains 2X (1:100) zinc gluconate, reportedly caused a small percentage of users to lose their sense of smell; 340 cases were settled out of court in 2006 for . In 2009, the FDA advised consumers to stop using three discontinued cold remedy products manufactured by Zicam because it could cause permanent damage to users' sense of smell. Zicam was launched without a New Drug Application
New drug application
The New Drug Application is the vehicle in the United States through which drug sponsors formally propose that the Food and Drug Administration approve a new pharmaceutical for sale and marketing...

 (NDA) under a provision in the FDA’s Compliance Policy Guide called "Conditions Under Which Homeopathic Drugs May be Marketed" (CPG 7132.15), but the FDA warned Zicam via a Warning Letter
FDA Warning Letter
The United States Food and Drug Adminstration defines a Warning Letter as "...a correspondence that notifies regulated industry about violations that FDA has documented during its inspections or investigations...

 that this policy does not apply when there is a health risk to consumers.

Critics of homeopathy have cited other concerns over homeopathic medicine, most seriously cases of patients of homeopathy failing to receive proper treatment for diseases that could have been easily diagnosed and managed with conventional medicine and who have died as a result and the "marketing practice" of criticizing and downplaying the effectiveness of mainstream medicine. Homeopaths claim that use of conventional medicines will "push the disease deeper" and cause more serious conditions, a process referred to as "suppression". Some homeopaths (particularly those who are non-physicians) advise their patients against immunisation
Vaccine
A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe or its toxins...

. Some homeopaths suggest that vaccines be replaced with homeopathic "nosodes", created from biological material such as pus, diseased tissue, bacilli from sputum or (in the case of "bowel nosodes") feces. While Hahnemann was opposed to such preparations, modern homeopaths often use them although there is no evidence to indicate they have any beneficial effects. Cases of homeopaths advising against the use of anti-malarial drugs have been identified. This puts visitors to the tropics who take this advice in severe danger, since homeopathic remedies are completely ineffective against the malaria parasite. Also, in one case in 2004, a homeopath instructed one of her patients to stop taking conventional medication for a heart condition, advising her on 22 June 2004 to "Stop ALL medications including homeopathic", advising her on or around 20 August that she no longer needed to take her heart medication, and adding on 23 August, "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 was admitted to hospital the next day, and died eight days later, the final diagnosis being "acute heart failure due to treatment discontinuation".

In 1978, Anthony Campbell, then a consultant physician at The Royal London Homeopathic Hospital, criticised statements made by George Vithoulkas
George Vithoulkas
George Vithoulkas is a teacher and practitioner of homeopathy.He studied homeopathy in South Africa and received a diploma in homeopathy from the Indian Institute of Homeopathy in 1966...

 to promote his homeopathic treatments. Vithoulkas stated that syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...

, when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the central nervous system
Central nervous system
The central nervous system is the part of the nervous system that integrates the information that it receives from, and coordinates the activity of, all parts of the bodies of bilaterian animals—that is, all multicellular animals except sponges and radially symmetric animals such as jellyfish...

. Campbell described this as a thoroughly irresponsible statement that could mislead an unfortunate layperson into refusing conventional medical treatment. 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.

A 2006 review by W. Steven Pray of the College of Pharmacy at Southwestern Oklahoma State University
Southwestern Oklahoma State University
Southwestern Oklahoma State University is a public university in Weatherford and Sayre, Oklahoma. It is one of seven state regional universities in the state of Oklahoma.The current president of SWOSU is Randy Beutler.-History:...

 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.

Edzard Ernst
Edzard Ernst
Edzard Ernst is the first Professor of Complementary Medicine in the world, at the University of Exeter, England....

, the first Professor of Complementary Medicine
Alternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....

in the United Kingdom and a former homeopathic practitioner, has expressed his concerns about pharmacist
Pharmacist
Pharmacists are allied health professionals who practice in pharmacy, the field of health sciences focusing on safe and effective medication use...

s who violate their ethical code by failing to provide customers with "necessary and relevant information" about the true nature of the homeopathic products they advertise and sell:
"My plea is simply for honesty. Let people buy what they want, but tell them the truth about what they are buying. These treatments are biologically implausible and the clinical tests have shown they don't do anything at all in human beings. The argument that this information is not relevant or important for customers is quite simply ridiculous."


Michael Baum
Michael Baum
Professor Michael Baum, Professor Emeritus of Surgery and visiting Professor of Medical Humanities at University College London , is a leading British oncologist who specialises in breast cancer treatment. He is also notable for his contributions to the evaluation and support of patient quality of...

, Professor Emeritus of Surgery and visiting Professor of Medical Humanities at University College London
University College London
University College London is a public research university located in London, United Kingdom and the oldest and largest constituent college of the federal University of London...

 (UCL), has described homoeopathy as a “cruel deception”.

In an article entitled "Should We Maintain an Open Mind about Homeopathy?" published in the American Journal of Medicine
American Journal of Medicine
The American Journal of Medicine is the official medical journal of the Association of Professors of Medicine, publishing original clinical research in internal medicine of interest to physicians in academia and in community based practice...

, Michael Baum and Edzard Ernst—writing to other physicians—wrote that "Homeopathy is among the worst examples of faith-based medicine... These axioms [of homeopathy] are not only out of line with scientific facts but also directly opposed to them. If homeopathy is correct, much of physics, chemistry, and pharmacology must be incorrect…".

Regulation and prevalence

Homeopathy is fairly common in some countries while being uncommon in others; is highly regulated in some countries and mostly unregulated in others. It is practised worldwide and professional qualifications and licences are needed in most countries. 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, licences or degrees in conventional medicine from accredited universities are required. In Germany, no specific regulations exist, while France, Austria and Denmark mandate licences to diagnose any illness or dispense of any product whose purpose is to treat any illness. Some homeopathic treatment is covered by the public health service of several European countries, including France, the United Kingdom, Denmark, and Luxembourg
Luxembourg
Luxembourg , officially the Grand Duchy of Luxembourg , is a landlocked country in western Europe, bordered by Belgium, France, and Germany. It has two principal regions: the Oesling in the North as part of the Ardennes massif, and the Gutland in the south...

. In other countries, such as Belgium, homeopathy is not covered. In Austria, the public health service requires scientific proof of effectiveness in order to reimburse medical treatments and homeopathy is listed as not reimbursable but exceptions can be made; private health insurance policies sometimes include homeopathic treatment. The Swiss government, after a 5-year trial, withdrew homeopathy and four other complementary treatments in 2005, stating that they did not meet efficacy and cost-effectiveness criteria, but following a referendum in 2009 the five therapies are to be reinstated for a further 6-year trial period from 2012.
The Indian government recognises homeopathy as one of its national systems of medicine, and a minimum of a recognised diploma in homeopathy and registration on a state register or the Central Register of Homoeopathy is required to practice homeopathy in India.

In the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...

, MPs inquired into homeopathy to assess the Government's policy on the issue, including funding of homeopathy under the National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...

 and government policy for licensing homeopathic products. The decision by the House of Commons Science and Technology Committee follows a written explanation from the Government in which it told the select committee that the licensing regime was not formulated on the basis of scientific evidence. "The three elements of the licensing regime (for homeopathic products) probably lie outside the scope of the ... select committee inquiry, because government consideration of scientific evidence was not the basis for their establishment," the Committee said. The inquiry sought written evidence and submissions from concerned parties.

In February 2010 the House of Commons Science and Technology Committee concluded that:
The Committee also stated:
In July 2010 the newly appointed UK Secretary of State for Health
Secretary of State for Health
Secretary of State for Health is a UK cabinet position responsible for the Department of Health.The first Boards of Health were created by Orders in Council dated 21 June, 14 November, and 21 November 1831. In 1848 a General Board of Health was created with the First Commissioner of Woods and...

 deferred to local NHS on funding homeopathy. A nineteen page document details the Government´s response, and it states that "our continued position on the use of homeopathy within the NHS is that the local NHS and clinicians, rather than Whitehall, are best placed to make decisions on what treatment is appropriate for their patients - including complementary or alternative treatments such as homeopathy - and provide accordingly for those treatments." The response also stated that "the overriding reason for NHS provision is that homeopathy is available to provide patient choice". by February 2011 only one third of PCTs still funded homeopathy.

History

Historical context

An early assertion that like cures like was made by Hippocrates about 400 BC, when he prescribed mandrake root, which produced mania, to treat mania, by prescribing a dose smaller than what would produce mania. In the 16th century the pioneer of pharmacology Paracelsus
Paracelsus
Paracelsus was a German-Swiss Renaissance physician, botanist, alchemist, astrologer, and general occultist....

 declared that small doses of “what makes a man ill also cures him." but it was Hahnemann who gave it a name and laid out its principles in the late 18th century. At that time, mainstream medicine employed such measures as bloodletting
Bloodletting
Bloodletting is the withdrawal of often little quantities of blood from a patient to cure or prevent illness and disease. Bloodletting was based on an ancient system of medicine in which blood and other bodily fluid were considered to be "humors" the proper balance of which maintained health...

 and purging, used laxative
Laxative
Laxatives are foods, compounds, or drugs taken to induce bowel movements or to loosen the stool, most often taken to treat constipation. Certain stimulant, lubricant, and saline laxatives are used to evacuate the colon for rectal and/or bowel examinations, and may be supplemented by enemas under...

s and enema
Enema
An enema is the procedure of introducing liquids into the rectum and colon via the anus. The increasing volume of the liquid causes rapid expansion of the lower intestinal tract, often resulting in very uncomfortable bloating, cramping, powerful peristalsis, a feeling of extreme urgency and...

s, and administered complex mixtures, such as Venice treacle, which was made from 64 substances including opium, myrrh, and viper's flesh. Such measures often worsened symptoms and sometimes proved fatal.
While the virtues of these treatments had been extolled for centuries,
Hahnemann rejected such methods as irrational and inadvisable.
Instead, he favored the use of single drugs at lower doses and promoted an immaterial, vitalistic
Vitalism
Vitalism, as defined by the Merriam-Webster dictionary, is#a doctrine that the functions of a living organism are due to a vital principle distinct from biochemical reactions...

 view of how living organisms function, believing that diseases have spiritual
Spirituality
Spirituality can refer to an ultimate or an alleged immaterial reality; an inner path enabling a person to discover the essence of his/her being; or the “deepest values and meanings by which people live.” Spiritual practices, including meditation, prayer and contemplation, are intended to develop...

, as well as physical causes.
(At the time, vitalism
Vitalism
Vitalism, as defined by the Merriam-Webster dictionary, is#a doctrine that the functions of a living organism are due to a vital principle distinct from biochemical reactions...

 was part of mainstream science; it wasn't completely discarded until the 20th century, with the development of microbiology
Microbiology
Microbiology is the study of microorganisms, which are defined as any microscopic organism that comprises either a single cell , cell clusters or no cell at all . This includes eukaryotes, such as fungi and protists, and prokaryotes...

, the germ theory of disease
Germ theory of disease
The germ theory of disease, also called the pathogenic theory of medicine, is a theory that proposes that microorganisms are the cause of many diseases...

,
and advances in chemistry
Chemistry
Chemistry is the science of matter, especially its chemical reactions, but also its composition, structure and properties. Chemistry is concerned with atoms and their interactions with other atoms, and particularly with the properties of chemical bonds....

.)
Hahnemann also advocated various lifestyle improvements to his patients, including exercise, diet, and cleanliness.

Hahnemann's concept

Hahnemann conceived of homeopathy while translating a medical treatise by Scottish physician and chemist William Cullen
William Cullen
William Cullen FRS FRSE FRCPE FPSG was a Scottish physician, chemist and agriculturalist, and one of the most important professors at the Edinburgh Medical School, during its heyday as the leading center of medical education in the English-speaking world.Cullen was also a central figure in the...

 into German. Being skeptical of Cullen's theory concerning cinchona
Cinchona
Cinchona or Quina is a genus of about 38 species in the family Rubiaceae, native to tropical South America. They are large shrubs or small trees growing 5–15 metres in height with evergreen foliage. The leaves are opposite, rounded to lanceolate and 10–40 cm long. The flowers are white, pink...

's action in intermittent fever, Hahnemann ingested some of the bark specifically to see if it cured fever "by virtue of its effect of strengthening the stomach".
Upon ingesting the bark, he noticed few stomach symptoms, but did experience fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...

, shivering
Shivering
Shivering is a bodily function in response to early hypothermia in warm-blooded animals. When the core body temperature drops, the shivering reflex is triggered to maintain homeostasis. Muscle groups around the vital organs begin to shake in small movements in an attempt to create warmth by...

 and joint pain
Arthralgia
Arthralgia literally means joint pain; it is a symptom of injury, infection, illnesses or an allergic reaction to medication....

, symptoms similar to some of the early symptoms of intermittent fever, 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 treat. This later became known as the "law of similars", the most important concept of homeopathy. The term "homeopathy" was coined by Hahnemann and first appeared in print in 1807, although he began outlining his theories of "medical similars" or the "doctrine of specifics" in a series of articles and monographs in 1796.

Hahnemann began to test what effects substances produced in humans, a procedure that would later become known as "homeopathic proving".
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 these data as a way of identifying substances suitable for the treatment of particular diseases. The first collection of provings was published in 1805 and a second collection of 65 remedies appeared in his book, Materia Medica Pura, in 1810.
Hahnemann believed that large doses of drugs that caused similar symptoms would only aggravate illness, 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, proposing that this process aroused and enhanced "the spirit-like medicinal powers of the crude substances".
He gathered and published a complete overview of his new medical system in his 1810 book, The Organon of the Healing Art
The Organon of the Healing Art
The Organon of the Healing Art by Samuel Hahnemann, 1810, laid the foundations of all theory and method of homeopathy...

, whose 6th edition, published in 1921, is still used by homeopaths today.

19th century: rise to popularity and early criticism

Homeopathy achieved its greatest popularity in the 19th century. Dr. John Franklin Gray
John Franklin Gray
John Franklin Gray was an American educator and physician a pioneer in the field of and the first practitioner of homoeopathy in the United States...

 (1804–1882) was the first practitioner of Homeopathy in the United States, beginning in 1828 in New York City. The first homeopathic schools opened in 1830, and throughout the 19th century dozens of homeopathic institutions appeared in Europe and the United States. By 1900, there were 22 homeopathic colleges and 15,000 practitioners in the United States. Because medical practice of the time relied on ineffective and often dangerous treatments, patients of homeopaths often had better outcomes than those of the doctors of the time. 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. The relative success of homeopathy in the 19th century may have led to the abandonment of the ineffective and harmful treatments of bloodletting and purging and to have begun the move towards more effective, science-based medicine.
One reason for the growing popularity of homeopathy was its apparent success in treating people suffering from infectious disease epidemics.
During 19th century epidemics of diseases such as cholera
Cholera
Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse watery diarrhea and vomiting. Transmission occurs primarily by drinking or eating water or food that has been contaminated by the diarrhea of an infected person or the feces...

, death rates in homeopathic hospitals were often lower than in conventional hospitals, where the treatments used at the time were often harmful and did little or nothing to combat the diseases.

From its inception, however, homeopathy was criticized by mainstream science. Sir John Forbes
John Forbes (physician)
Sir John Forbes FRCP FRS was a distinguished Scottish physician, famous for his translation of the classic French medical text, De L'Auscultation Mediate by René Laennec, the inventor of the stethoscope...

, physician to Queen Victoria
Victoria of the United Kingdom
Victoria was the monarch of the United Kingdom of Great Britain and Ireland from 20 June 1837 until her death. From 1 May 1876, she used the additional title of Empress of India....

, said in 1843 that the extremely small doses of homeopathy were regularly derided as useless, "an outrage to human reason". James Young Simpson
James Young Simpson
Sir James Young Simpson was a Scottish doctor and an important figure in the history of medicine. Simpson discovered the anaesthetic properties of chloroform and successfully introduced it for general medical use....

 said in 1853 of the highly diluted drugs: "No poison, however strong or powerful, the billionth or decillionth of which would in the least degree affect a man or harm a fly."
19th century American physician and author Oliver Wendell Holmes, Sr.
Oliver Wendell Holmes, Sr.
Oliver Wendell Holmes, Sr. was an American physician, professor, lecturer, and author. Regarded by his peers as one of the best writers of the 19th century, he is considered a member of the Fireside Poets. His most famous prose works are the "Breakfast-Table" series, which began with The Autocrat...

 was also a vocal critic of homeopathy and published an essay in 1842 entitled Homœopathy, and its kindred delusions.
The members of the French Homeopathic Society observed in 1867 that some of the leading homeopathists of Europe not only were abandoning the practice of administering infinitesimal doses but were also no longer defending it. The last school in the U.S. exclusively teaching homeopathy closed in 1920.

Revival in the late 20th century

The Food, Drug, and Cosmetic Act of 1938 (sponsored by New York Senator and Homeopathic Physician Royal Copeland) recognized homeopathic remedies as drugs. By the 1950s, there were only 75 pure homeopaths practicing in the U.S. However, in the mid to late 1970s, homeopathy made a significant comeback and sales of some homeopathic companies increased tenfold. Greek homeopath George Vithoulkas
George Vithoulkas
George Vithoulkas is a teacher and practitioner of homeopathy.He studied homeopathy in South Africa and received a diploma in homeopathy from the Indian Institute of Homeopathy in 1966...

performed a "great deal of research to update the scenarios and refine the theories and practice of homeopathy" beginning in the 1970s, and it was revived worldwide;
in Brazil during the 1970s and in Germany during the 1980s. The medical profession started to integrate such ideas in the 1990s and mainstream pharmacy chains recognized the business potential of selling homeopathic remedies.

External links

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