Homeopathy/PreviousVersion

Homeopathy is an Alternative Medicine system that tries to treat illnesses with extremely small specially prepared doses of the drugs that cause the similar syndrome of symptoms as the illness. Homeopathy is based on the ideas of Samuel Hahnemann, a 19th century physician who observed that medicines evoked symptoms similar to those of the illnesses for which they were prescribed. The underlying premise of homeopathy is that symptoms of illness are not simply the result of breakdown of the organism but are its defenses in an effort to fight infection, adapt to stress, and/or respond to toxic insult. Rather than inhibit symptoms or suppress disease, the homeopathic method of treating sick people is oriented towards mimicking the body's wisdom and augmenting immune response. The scientific evidence for homeopathy has both positive and negative results, though the mechanism of action of its extremely small doses remains a stumbling block to its acceptance from mainstream medicine and science.

Introduction

Homeopathic medicines treat an illness with an infinitesimally small dose of a substance that, at larger doses, can cause symptoms that are like those of the illness (treating 'like with like'). This "law of similars" is an ancient principle that has been acknowledged by different cultures (the Oracle at Delphi was known to say "That which makes sick shall heal"). The Golden Bough by Sir James George Frazier is a treatise on the history of religion and magic, and one of its early chapters (pages 12-42) is entitled "Sympathetic or Homeopathic Magic"). This principle of similars is used today in conventional medicine as witnessed in the use of vaccination and allergy treatments.

Two hundred years of clinical experience using this principle of similars has led its practitioners to discover that living organisms develop a hypersensitivity to the substance that causes similar symptoms as the sick person is experiencing. The homeopathic principle of similars may be a type of resonance, akin to the hypersensitivity experienced from a musical note on one instrument to the same note on another instrument.

Controversially, homeopaths believe that the 'potency' of a remedy can be increased by serial dilutions (repetatively adding water or alcohol) combined with vigorous shaking in-between each dilution, to the point where little or none of the original solution remains as part of the final prepared remedy. Homeopaths assert that this process of dilution and vigorous shaking changes the structure of the water Scientists at several universities and hospitals in France and Belgium have discovered that the vigorous shaking of the water in glass bottles causes extremely small amounts of silica fragments or “chips” to fall into the water . The interaction of these silica fragments with the medicinal solution may help to change the structure of the water in a way.

The word 'homeopathy' was first used by the German physician Christian Friedrich Samuel Hahnemann (1755-1843). Hahnemann was an eminent physician and a prominent public health reformer. He believed that his new system was more humane and effective than the conventional medicine of his time, but it was greeted by the establishment with derision and contempt. Today, homeopathy is not an accepted part of conventional medicine, and its theories are not generally regarded as scientifically credible, but nevertheless it has more than 100,000 practitioners worldwide, and 500 million users.

Homeopathy (from the Greek hómoios (similar) and páthos (suffering)) regards diseases as 'morbid derangements of the organism', that involve some disturbance in a 'vital force.' Today, most homeopaths still believe that the fundamental causes of disease are internal and constitutional and that it is contrary to good health to suppress symptoms. They also accept the concept of 'latent Psora', the early signs of an organism’s imbalance which indicate that treatment is needed.

The popularity of homeopathy

Homeopathy is popular in Europe and in India, but less so in the USA, where non-orthodox therapies are more tightly regulated. There are estimated to be more than 100,000 practitioners worldwide, and 500 million people receiving treatment. In Germany, homeopathy has been recognized as a 'special form of therapy' since 1978, meaning that its remedies do not have to have been shown to be efficacious, but since 2004, most are not covered by public health insurance. In Switzerland, homeopathic remedies were covered by the basic health insurance system, if prescribed by a physician, until June 2005, when the Government, after a 5-year trial, withdrew insurance coverage for homoeopathy and four other complementary treatments, as they did not meet efficacy and cost-effectiveness criteria. In the UK, homeopathic remedies are sold over the counter, and five homeopathic hospitals are funded by the National Health Service. Homeopathy is not practised by most of the medical profession, but is supported by the Prince of Wales and other members of the royal family.

History

(see Main article History of Homeopathy)

For the early Greek physician Hippocrates of Cos, who lived at about 400 BCE [6], the four 'humours' (blood, black bile, yellow bile and phlegm) were the key to understanding disease. His ideas persisted through the writings of Galen (131-201 CE) until at least 1858, and Rudolf Virchow's theories of cellular pathology. Diseases, it was thought, were the result of some 'imbalance' of the humours, and physicians of the day focused on restoring that balance, either by trying to remove an excess of a humour, or by suppressing the symptoms. "Bloodletting, fever remedies, tepid baths, lowering drinks, weakening diet, blood cleansing and everlasting aperients and clysters (enemas) form the circle in which the ordinary German physician turns round unceasingly", wrote Hahnemann while translating into German the Treatise on Materia Medica (1789) by the Edinburgh physician William Cullen.

After 1783, disillusioned with medicine and the many toxic effects of its cures, Hahnemann began to use smaller and smaller doses of drugs, trying to minimise their toxic effects while retaining their efficacy. Cullen had written that Cinchona bark (which contains quinine) was effective because it was bitter, and Hahnemann pondered about this; he felt that this explanation was implausible because other substances that were as bitter had no therapeutic value. Accordingly, he took Cinchona bark himself, and saw that its effects were similar to the symptoms of the diseases that it was prescribed for. For Hahnemann, this was a breakthrough, and it led him to formulate the 'Principle of Similars' on which homeopathy is based, expressed by him as similia similibus curentur or 'let likes cure likes'.

He had concluded that diseases are caused by "spirit-like derangements of the spirit-like power that animates the human body", and was searching for a way to harness this power for healing.

Provings

(see main article homeopathic proving)

Homeopathic remedies are found by 'provings', in which volunteers are given substances, the effects of which are recorded as a 'Drug Picture', these drug pictures are subsequently used to compare with a patient's symptoms in order to select, as a remedy, the substance whose effects are closest to the patient's symptoms. Today, homeopaths use about 3000 different remedies from animal, plant, mineral, and synthetic substances, including 'Natrum muriaticum' (sodium chloride or table salt)[7], 'Oscillococcinum' (a 200C product made from duck heart and liver that is prescribed for colds and flu-like symptoms) 'Roadrunner' (Geococcyx californianus) [8] and 'Arnica' [9]. Other 'isopathic' remedies involve diluting the agent or product of the disease; for example, Rabies nosode is made from the saliva of a rabid dog. Some homeopaths use more esoteric substances, known as 'imponderables' because they originate from electromagnetic energy 'captured' by alcohol or lactose ('X-ray', 'Sol' (sunlight), 'Positronium', and http://homeoint.org/clarke/e/elect.htm 'Electricitas'](electricity), or with a telescope ('Polaris'). Recent ventures into more esoteric remedies include 'Tempesta' (thunderstorm), and 'Berlin wall'.

Preparation of similars

The most characteristic — and controversial — principle of homeopathy is that the efficacy of a remedy can be enhanced and its side-effects reduced by diluting it, in a process known as 'dynamization' or 'potentization'. Liquids are diluted (with water or alcohol) and shaken by ten hard strikes against an elastic body ('succussion'). For this, Hahnemann had a saddlemaker construct a special, wooden, 'striking board', covered in leather on one side and stuffed with horsehair (the board is displayed at the Hahnemann Museum in Stuttgart). When insoluble solids are used as the basis of remedies, such as quartz or oyster shell, they are diluted by grinding them with lactose ('trituration'). The original serial dilutions by Hahnemann used a 1 part in 100 (centesimal; 'C' potencies), or 1 part in 50,000 ( Quintamillesimal; 'LM' or 'Q' potencies). The dilution factor at each stage is 1:10 ('D' or 'X' potencies) or 1:100 ('C' potencies); Hahnemann advocated 30C dilutions for most purposes (i.e. dilution by a factor of 100³⁰ = 10⁶⁰). The number of molecules in a given weight of a substance can be calculated by Avogadro's number; the chance that there is even one molecule of the original substance in a 15C solution is small, and it is very unlikely that one molecule would be present in a 30C dilution. Thus, homeopathic remedies of a high 'potency' contain just water, but water that, according to homeopaths, retains some essential property of one of the substances that it has contacted in the past.

Hahnemann's explanation for how higher potencies could be more efficacious was that the friction involved in succussion might release some hidden curative power of substances. He wrote in 1825: "The effect of friction is so great, that not only the physical properties, such as caloric, odour, etc., are thereby called into life and developed by it, but also the dynamic medicinal powers of natural substances are thereby developed to an incredible degree".

The skeptical view of homeopathy

As I understand it, the claim is that the less you use Homeopathy, the better it works. Sounds plausible to me (David Deutsch, physicist) [10]

Homeopathy was developed at a time when many of the most important concepts of modern chemistry and biology, such as molecules and germs, were understood poorly if at all. While proponents may consider the mechanism of homeopathy to be an interesting side issue, skeptics consider the lack of any plausible mechanism to be a serious problem, raising the bar on the quality of evidence required before accepting the existence of the phenomenon under the motto 'Extraordinary claims require extraordinary proof'.

In Hahnemann's day, many chemists believed that matter was infinitely divisible, so that it was meaningful to talk about dilution to any degree. Although the hypothesis of atoms can be traced back to the ancient Greeks, their size was not calculated until 1865 (by Loschmidt). There are 6.02×1023 particles in a mole (Avogadro's number), so homeopathic dilutions greater than about 24X or 12C are virtually certain to contain not even a single molecule of the initial substance. This is recognized by advocates of homeopathy, who assert that the essential healing power of their preparations is not to be found in the chemical action of molecules, but perhaps in the arrangement of the water molecules, giving rise to the expression 'the memory of water'. This concept is closely related to the belief in a 'vital force', which was common in Hahnemann's day, but was discarded by the scientific community as more and more life processes came to be describable in purely materialistic terms, and as the medical model of disease came to be focused on the failure of particular organs and processes in the body. .

For critics, a closely related question is that of logical consistency of the theory. The theory assumes that water is imprinted by the properties of molecules that it once came in contact with, even when the molecules are diluted away. If so, then where did the pure water used in this process come from? The water that homeopaths use was once in contact with other chemicals, including chemical wastes, radioactive metals, dinosaur urine, and various poisons. According to this skeptical interpretation of homeopathic theory, all water in the world should remember its contact with millions of chemical substances and not just the properties of the chemicals that the homeopath claims will be useful. The answer of the homeopaths, that dynamization involves succussion as well as dilution, is unconvincing, because it seems improbable that one can amplify order in a solution by shaking it, and because a lot of shaking goes on in the natural world as well.

Scientific Research Testing Homeopathic Medicines

It is not a matter of theory or belief or opinion … Homoeopathy must rest upon facts (James Tyler Kent)

Some meta-analyses reviewing the broad field of homeopathy have found that the placebo response is an inadequate explanation for the positive responses that controlled trials have found, and several meta-analyses evaluating the homeopathic treatment of specific diseases has also found positive results. However, there are also several meta-analyses that have suggested that the effect from a homeopathic medicine was no better than a placebo

Many homeopathic medicines sold in health food stores and pharmacies today are "low potencies," that is, at doses in which there are molecular amounts of the original medicine, while homeopathic medicines at potencies higher than about 24X, D24, or 12C (10^-24) contain no detectable ingredients apart from the diluent (water, alcohol or sugar). There is scientific controversy on how these doses can have any biological or therapeutic effect, though some scientists insist that homeopathic doses are compatible with biomedical experiences. .

In 2005, The Lancet published a comparison of 110 placebo-controlled homoeopathy trials and 110 matched conventional-medicine trials. The researchers choose to only evaluate those studies that met certain criteria for “high quality” scientific investigations. Of the original 110 trials, they found that 21 of the homeopathic studies fit this definition but only 9 of the conventional studies did so. The researchers did not provide any analysis of these high quality studies but instead chose to reduce these numbers to only those trials that had a large number of patients, claiming that these larger trials had less bias inherent in them. The researcher then compared 8 homeopathic trials with 6 conventional medical trials, even though these trials were no longer matched in any way. The final results of this small number of trials was that there was no significant difference between patients given a homeopathic medicine and those given a placebo. The authors claim that no further research on homeopathy is necessary, while advocates of homeopathy assert that almost all of the 8 homeopathic trials lacked external validity, that is, they used only a single homeopathic medicine given to every subject without the typical individualization of treatment that is commonly used in homeopathic practice.

Medical organizations' attitudes towards homeopathy

People use homeopathy because they believe it works. Although homeopathy, like other placebos, does not work in a clinical sense, it can induce physiological changes. It can also coincide with getting better anyway. (Sense About Science)

In the USA, the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health, funds research into homeopathy. According to its statement on homeopathy, controlled clinical trials of homeopathy had produced mixed results; in some, homeopathy appeared to be no more helpful than a placebo, but in others, more benefits were seen than expected from a placebo. Despite the lack of clear empirical support for homeopathy, the statement concluded that "Some people feel that if homeopathy appears to be helpful and safe, then scientifically valid explanations or proofs of this alternative system of medicine are not necessary."

According to The UK National Health Service there have been about 200 randomised controlled trials evaluating homeopathy, many of which suggest that any effectiveness that homeopathy may have is due to the placebo effect. In 1997, the American Medical Association(AMA) adopted the following policy statement after a report on several alternative therapies including homeopathy: "There is little evidence to confirm the safety or efficacy of most alternative therapies. Much of the information currently known about these therapies makes it clear that many have not been shown to be efficacious. Well-designed, stringently controlled research should be done to evaluate the efficacy of alternative therapies"

According to the Indian Ministry of Health and Family Welfare, homeopathy is one of the National Systems of Medicine in India, and it plays an important role in health care for many people. "Its strength lies in its evident effectiveness as it takes a holistic approach towards the sick individual through promotion of inner balance at mental, emotional, spiritual and physical levels."

Safety of homeopathic remedies

The highest ideal of cure is the speedy, gentle, and enduring restoration of health by the most trustworthy and least harmful way (Samuel Hahnemann)

The U.S. Food & Drug Administration's view of homeopathy is that there is no real concern about the safety of most homeopathic products, as they "have little or no pharmacologically active ingredients". There have been some reports of illness associated with the use of homeopathic products, but in cases that they reviewed, the FDA concluded that the homeopathic product was not the cause of the adverse reactions. The main concern about the safety of homeopathy arises not from the products themselves, but from the possible withholding of more efficacious treatment, or from misdiagnosis of dangerous conditions by a non-medically qualified homeopath. For example, a 2006 survey by the UK charitable trust 'Sense About Science' revealed that homeopaths were advising travelers against taking conventional anti-malarial drugs, instead providing them with a homeopathic dilution of quinine. Even the director of the The Royal London Homeopathic Hospital condemned this:

"I'm very angry about it because people are going to get malaria - there is absolutely no reason to think that homeopathy works to prevent malaria and you won't find that in any textbook or journal of homeopathy so people will get malaria, people may even die of malaria if they follow this advice." [11].

Professor Pasvol, a tropical medicine expert at Imperial College, London was reported as saying "Medical practitioners would be sued, taken to court and found guilty for far less. What this investigation has unearthed is appalling."

A particular concern is that homeopaths discourage the use of vaccines. This attitude dates back to Hahnemann, who said "...to use a human morbific matter (a Psorin taken from the itch in man) as a remedy for the same itch or for evils arisen therefrom, stay away from it! Nothing can result from this but trouble and aggravation of the disease." Homeopathy is superficially like vaccination, in that vaccines contain a small dose of the 'disease' against which they offer protection (a vaccine is usually made from a bacterium or virus that is either dead or weakened so that it cannot produce symptoms, while still providing enough information to the immune system to generate antibody production). However, most homeopaths believe that vaccination has serious health consequences, and might arouse latent inherited and constitutional weaknesses.

External links

• 'Complementary Medicine - Therapies: Homeopathy'[12] BBC's 'Complementary Medicine' article on Homeopathy
• 'Homeopathy In Perspective' — critical online book, covering the history and present state of homeopathy