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{{Short description|Pseudoscientific system of alternative medicine}}
{{Totally disputed}}
{{for|the journal|Homeopathy (journal){{!}}''Homeopathy'' (journal)}}
]
{{pp-vandalism|small=yes}}
'''Homeopathy''' (also spelled '''homœopathy''' or '''homoeopathy''') from the Greek words ''όμοιος, hómoios'' (similar) and ''πάθος, páthos'' (suffering), is a controversial system of ]. The model of homeopathy was developed by the ] physician ] (]–]) and first published in ].
{{good article}}
{{Use Oxford spelling|date=September 2016}}
{{Use mdy dates|date=August 2017}}
{{Infobox alternative medicine
| name = Homeopathy
| synonyms = Homoeopathy
| pronounce = {{IPAc-en|audio=En-uk-homeopathy.ogg|ˌ|h|oʊ|m|i|ˈ|ɒ|p|ə|θ|i}}
| image = Saxonia Museum fuer saechsische Vaterlandskunde III 19.jpg
| image_size = 250
| alt = Samuel Hahnemann
| caption = ], originator of homeopathy
| claims = "Like cures like", dilution increases potency, disease caused by ]s
| topics = ]
| orig-date = 1796
| origprop = ]
| laterprop = {{Plain list|
* ]
* ]
* ]
}}
| seealso = ], ]
| MeshID = D006705
}}
{{Alternative medical systems|fringe}}


'''Homeopathy''' or '''homoeopathy''' is a ]<ref>{{multiref
Homeopathy calls for treating "like with like", a doctrine referred to as the "Law of Similars". The practitioner considers the totality of symptoms of a given case, then chooses as a remedy a substance that has been reported in a ] to produce a similar set of symptoms in healthy subjects. The remedial substance is usually given in extremely low concentrations. Dilutions are performed according to a procedure known as ''potentization''.
|1=
|2={{cite book |author=Tuomela, R |title=Rational Changes in Science |chapter=Science, Protoscience, and Pseudoscience |publisher=Springer |year=1987 |isbn=978-94-010-8181-8 |veditors=Pitt JC, Marcello P |series=Boston Studies in the Philosophy of Science |volume=98 |pages=83–101 |doi=10.1007/978-94-009-3779-6_4 |author-link=Raimo Tuomela|issn = 0068-0346}}
<br /><br />
|3={{cite journal |vauthors=Mukerji N, Ernst E |title=Why homoeopathy is pseudoscience |journal=Synthese |date=14 September 2022 |volume=200 |issue=5 |eissn=1573-0964 |doi=10.1007/s11229-022-03882-w |pmid=|s2cid=252297716 |url= |doi-access=free}}
<br /><br />
|4={{cite book |vauthors=Baran GR, Kiana MF, Samuel SP |title=Healthcare and Biomedical Technology in the 21st Century |chapter=Science, Pseudoscience, and Not Science: How do They Differ? |publisher=Springer |year=2014 |pages=19–57 |doi=10.1007/978-1-4614-8541-4_2 |isbn=978-1-4614-8540-7 |quote=within the traditional medical community it is considered to be quackery }}
<br /><br />
|5={{cite book |author=Ladyman J |veditors=Pigliucci M, Boudry M |year=2013 |pages=48–49 |publisher=University of Chicago Press |chapter=Chapter 3: Towards a Demarcation of Science from Pseudoscience |title=Philosophy of Pseudoscience: Reconsidering the Demarcation Problem |quote=Yet homeopathy is a paradigmatic example of pseudoscience. It is neither simply bad science nor science fraud, but rather profoundly departs from scientific method and theories while being described as scientific by some of its adherents (often sincerely). |isbn=978-0-226-05196-3}}}}</ref> system of ]. It was conceived in 1796 by the German physician ]. Its practitioners, called '''homeopaths''' or homeopathic physicians,<ref>{{Cite web |title=Homeopathic Physician Licensure |url=https://www.cga.ct.gov/2010/rpt/2010-R-0315.htm |access-date=2023-11-25 |website=OLR Research Report}}</ref> believe that a substance that causes symptoms of a disease in healthy people can cure similar symptoms in sick people; this doctrine is called '']'', or "like cures like".<ref name="Hahnemann" /> Homeopathic preparations are termed ''remedies'' and are made using ]. In this process, the selected substance is repeatedly diluted until the final product is chemically indistinguishable from the ]. Often not even a single molecule of the original substance can be expected to remain in the product.<ref>{{Cite web |title=Homeopathy |url=https://www.rpharms.com/resources/quick-reference-guides/homeopathy |access-date=2019-11-17 |website=]}}</ref> Between each dilution homeopaths may hit and/or shake the product, claiming this makes the diluent "remember" the original substance after its removal. Practitioners claim that such preparations, upon oral intake, can treat or cure disease.<ref>{{Cite web |date=2017-10-18 |title=Homeopathy |url=https://www.nhs.uk/conditions/homeopathy/ |access-date=2019-11-10 |website=nhs.uk |language=en}}</ref>


All relevant scientific knowledge about physics, chemistry, biochemistry and biology contradicts homeopathy.<ref>{{multiref
Homeopathy is considered controversial because its hypotheses and claims have not been verified to, or are at odds with, the standards of modern ] and the ].
|1=
|2={{cite journal |last1=Shang |first1=Aijing |last2=Huwiler-Müntener |first2=Karin |last3=Nartey |first3=Linda |last4=Jüni |first4=Peter |last5=Dörig |first5=Stephan |last6=Sterne |first6=Jonathan AC |last7=Pewsner |first7=Daniel |last8=Egger |first8=Matthias |title=Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy |journal=The Lancet |volume=366 |pages=726–32 |year=2005 |doi=10.1016/S0140-6736(05)67177-2 |pmid=16125589 |issue=9487|s2cid=17939264 }}
<br /><br />
|3={{cite journal|last=Ernst|first=E.|date=December 2012|title=Homeopathy: a critique of current clinical research|url=http://www.csicop.org/si/show/homeopathy_a_critique_of_current_clinical_research|journal=]|volume=36|issue=6}}
<br /><br />
|4={{cite web|title=Homeopathy|url=http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/pharmacologicalandbiologicaltreatment/homeopathy|access-date=October 12, 2014|publisher=American Cancer Society|archive-date=March 16, 2013|archive-url=https://web.archive.org/web/20130316003948/http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/pharmacologicalandbiologicaltreatment/homeopathy}}
<br /><br />
|5=UK Parliamentary Committee Science and Technology Committee.
<br /><br />
|6={{cite journal|last1=Grimes|first1=D.R.|year=2012|title=Proposed mechanisms for homeopathy are physically impossible|journal=Focus on Alternative and Complementary Therapies|volume=17|issue=3|pages=149–55|doi=10.1111/j.2042-7166.2012.01162.x}}
<br /><br />
|7={{cite web|date=September 2017|title=Homeopathic products and practices: assessing the evidence and ensuring consistency in regulating medical claims in the EU|url=http://www.easac.eu/fileadmin/PDF_s/reports_statements/EASAC_Homepathy_statement_web_final.pdf|access-date=1 October 2017|work=European Academies' Science Advisory Council|page=1|quote=... we agree with previous extensive evaluations concluding that there are no known diseases for which there is robust, reproducible evidence that homeopathy is effective beyond the placebo effect.}}
<br /><br />
|8={{cite book
|author=Oliver Wendell Holmes Sr.
|title=Homoeopathy and its kindred delusions: Two lectures delivered before the Boston Society for the Diffusion of Useful Knowledge
|url=https://archive.org/details/64340260R.nlm.nih.gov
|location=Boston
|year=1842
|author-link=Oliver Wendell Holmes Sr
}} as reprinted in
{{cite book
|author=Oliver Wendell Holmes Sr.
|title=Currents and counter-currents in medical science
|year=1861
|publisher=Ticknor and Fields
|pages=72–188
|url=https://catalog.hathitrust.org/Record/011611362
|oclc=1544161
|ol=14731800M
|author-link=Oliver Wendell Holmes Sr
}}
}}</ref> Homeopathic remedies are typically ] inert, and have no effect on any known disease.<ref name="shang" /><ref name="pmid124926032">{{cite journal|last1=Ernst|first1=E.|author-link=Edzard Ernst|year=2002|title=A systematic review of systematic reviews of homeopathy|journal=British Journal of Clinical Pharmacology|volume=54|issue=6|pages=577–82|doi=10.1046/j.1365-2125.2002.01699.x|pmc=1874503|pmid=12492603}}</ref><ref name="inquiry_4504">{{cite web|date=February 22, 2010|title=Evidence Check 2: Homeopathy – Science and Technology Committee|url=https://publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/4504.htm|access-date=April 5, 2014|publisher=] Science and Technology Committee}}</ref> Its theory of disease, centered around principles Hahnemann termed ], is inconsistent with subsequent identification of viruses and bacteria as ]. Clinical trials have been conducted and generally demonstrated no objective effect from homeopathic preparations.<ref name="Caulfield20053">{{cite journal|last1=Caulfield|first1=Timothy|author-link=Timothy Caulfield|last2=Debow|first2=Suzanne|year=2005|title=A systematic review of how homeopathy is represented in conventional and CAM peer reviewed journals|journal=BMC Complementary and Alternative Medicine|volume=5|page=12|doi=10.1186/1472-6882-5-12|pmc=1177924|pmid=15955254 |doi-access=free }}</ref><ref name="sbm-fun">{{Cite news|last=Gorski|first=David|authorlink= David Gorski|date=October 13, 2008|title=Fun with homeopaths and meta-analyses of homeopathy trials|language=en-US|website=Science-Based Medicine|url=https://sciencebasedmedicine.org/fun-with-homeopaths-and-meta-analyses-of-homeopathy-trials/|access-date=2019-11-09}}</ref><ref name="Shelton" />{{rp|206|date=November 2012}}<ref name="Ernst20102">{{cite journal|last1=Ernst|first1=E.|author-link1=Edzard Ernst|year=2010|title=Homeopathy: What does the "best" evidence tell us?|url=https://www.mja.com.au/journal/2010/192/8/homeopathy-what-does-best-evidence-tell-us|journal=Medical Journal of Australia|volume=192|issue=8|pages=458–60|doi=10.5694/j.1326-5377.2010.tb03585.x|pmid=20402610|s2cid=42180344}}</ref> The fundamental ] has led to it being characterized within the scientific and medical communities as ] and ].<ref name="Baran2014">{{cite book |vauthors=Baran GR, Kiana MF, Samuel SP |title=Healthcare and Biomedical Technology in the 21st Century |chapter=Science, Pseudoscience, and Not Science: How do They Differ? |publisher=Springer |year=2014 |pages=19–57 |doi=10.1007/978-1-4614-8541-4_2 |isbn=978-1-4614-8540-7 |quote=within the traditional medical community it is considered to be quackery }}</ref><ref name="Walport-Nonsense">{{cite news|last1=Collins|first1=Nick|date=April 18, 2013|title=Homeopathy is nonsense, says new chief scientist|work=]|url=https://www.telegraph.co.uk/health/healthnews/10003680/Homeopathy-is-nonsense-says-new-chief-scientist.html|access-date=September 9, 2013|archive-url=https://web.archive.org/web/20130420234704/http://www.telegraph.co.uk/health/healthnews/10003680/Homeopathy-is-nonsense-says-new-chief-scientist.html|archive-date=April 20, 2013}}</ref><ref name="oxcompus">{{cite book|author=Paul S. Boyer|url=https://archive.org/details/oxfordcompaniont00paul_0|title=The Oxford companion to United States history|year=2001|isbn=978-0-19-508209-8|page=|publisher=Oxford University Press |quote=After 1847, when regular doctors organized the American Medical Association (AMA), that body led the war on "quackery", especially targeting dissenting medical groups such as homeopaths, who prescribed infinitesimally small doses of medicine. Ironically, even as the AMA attacked all homeopathy as quackery, educated homeopathic physicians were expelling untrained quacks from their ranks.|access-date=January 15, 2013|url-access=registration}}</ref>


Homeopathy achieved its greatest popularity in the 19th century. It was introduced to the United States in 1825, and the first American homeopathic school opened in 1835. Throughout the 19th century, dozens of homeopathic institutions appeared in Europe and the United States. During this period, homeopathy was able to appear relatively successful, as other forms of treatment could be harmful and ineffective. By the end of the century the practice began to wane, with the last exclusively homeopathic medical school in the United States closing in 1920. During the 1970s, homeopathy made a significant comeback, with sales of some homeopathic products increasing tenfold. The trend corresponded with the rise of the ], and may be in part due to ], an irrational aversion to synthetic chemicals, and the longer consultation times homeopathic practitioners provided.
== Basic principles ==
=== Theory of disease ===
The conventional theory of disease in Hahnemann's time was based on the ]. Mainstream medicine focused on restoring the balance in the humours, either by attempting to remove an excess of a humour (by such methods as ] and purging, the use of ]s, ]s and nauseous substances that made patients ]) or by suppressing symptoms associated with the humours causing trouble, such as giving feverish (and so hot and wet) patients substances associated with cold and dry.


In the 21st century, a series of ] have shown that the therapeutic claims of homeopathy lack scientific justification. As a result, national and international bodies have recommended the withdrawal of government funding for homeopathy in healthcare. National bodies from Australia, the United Kingdom, Switzerland and France, as well as the ] and the ] have all concluded that homeopathy is ineffective, and recommended against the practice receiving any further funding.<ref name="Conversation-NHMRC">{{cite news |url=http://theconversation.com/no-evidence-homeopathy-is-effective-nhmrc-review-25368 |title=No evidence homeopathy is effective: NHMRC review |work=The Conversation |date=April 8, 2014 |last=Musgrave|first=I |access-date=January 10, 2015 }}</ref><ref>{{Cite web|title=Swiss make New Year's regulations |date=January 2012 |url=http://www.swissinfo.ch/eng/swiss-make-new-year-s-regulations/31867422 |publisher=Swiss Info |access-date=December 16, 2015}}</ref><ref>{{cite news|title=Homeopathic remedies are 'nonsense and risk significant harm' say 29 European scientific bodies|url=https://www.independent.co.uk/news/uk/home-news/homeopathy-nonsense-risk-harm-29-european-academies-science-advisory-council-remedies-a7963786.html|access-date=October 10, 2017|newspaper=The Independent|date=September 23, 2017}}</ref><ref>{{Cite web|date=2017-02-07|title=Memorandum #2. Homeopathy as pseudoscience|url=http://klnran.ru/en/2017/02/memorandum02-homeopathy/|access-date=June 25, 2019|website=]}}</ref> The ] no longer provides funding for homeopathic remedies and asked the ] to add homeopathic remedies to the list of forbidden prescription items.<ref>{{cite news|date=July 21, 2017|title=NHS to ban homeopathy and herbal medicine, as 'misuse of resources'|newspaper=Daily Telegraph|url=https://www.telegraph.co.uk/news/2017/07/21/nhs-ban-homeopathy-herbal-medicine-misuse-resources/ |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/news/2017/07/21/nhs-ban-homeopathy-herbal-medicine-misuse-resources/ |archive-date=January 11, 2022 |url-access=subscription |url-status=live|access-date=July 21, 2017}}{{cbignore}}</ref><ref name="TNHS">{{cite news|last1=Donnelly|first1=Laura|date=5 June 2018|title=High Court backs NHS decision to stop funding homeopathy|newspaper=Daily Telegraph|url=https://www.telegraph.co.uk/science/2018/06/05/high-court-backs-nhs-decision-stop-funding-homeopathy/ |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/science/2018/06/05/high-court-backs-nhs-decision-stop-funding-homeopathy/ |archive-date=January 11, 2022 |url-access=subscription |url-status=live|access-date=26 August 2018}}{{cbignore}}</ref><ref name="bbc-blacklist">{{Cite news |url=https://www.bbc.co.uk/news/health-34744858 |title=Homeopathy 'could be blacklisted' |last=Gallagher |first=James |date=2015-11-13 |work=BBC News |access-date=2017-12-05 |language=en-GB}}</ref> France removed funding in 2021,<ref name="GuardianFrance">{{Cite news |url=https://www.theguardian.com/world/2019/jul/10/france-to-stop-reimbursing-patients-for-homeopathic-treatment |title=France to stop reimbursing patients for homeopathy |agency=Agence France-Presse |date=2019-07-10 |work=The Guardian |access-date=2019-07-30 |language=en-GB |issn=0261-3077}}</ref><ref name="FranceEndFunding2021">{{cite web |url=https://www.francetvinfo.fr/sante/medicament/homeopathie/homeopathie-2021-signe-la-fin-du-remboursement_4240961.html |title=Homéopathie: 2021 signe la fin du remboursement |publisher=France Info | date=January 2021 | access-date=18 November 2023 }}</ref> while Spain has also announced moves to ban homeopathy and other pseudotherapies from health centers.<ref name="El Pais 2019-07-30">{{Cite news |url=https://elpais.com/elpais/2018/11/14/inenglish/1542203925_514487.html |title=Spain moves to ban pseudo-therapies from universities and health centers |last=Güell |first=Oriol |date=2018-11-14 |work=El País |access-date=2019-07-30 |language=en |issn=1134-6582}}</ref>
Beginning with his early work, Hahnemann rejected the prevailing ] model, in favour of a view of disease as more dynamic or spirit-like. He came to consider the ] factors as the root cause of all disease, in what he termed the "highest disease." Some later homeopaths, in particular ], have tended to put even more emphasis on spiritual factors.


==History==
] had been a part of mainstream science through the ]. Whereas modern medicine sees ] and ]es as ], some modern homeopaths regard them as effects, not causes, of disease. Others have to some extent adapted to the views of modern medicine by referring to disturbances in, and stimulation of, the immune system, rather than the vital force.
Homeopathy was created in 1796 by ].<ref>{{Cite journal|last=Loudon|first=Irvine|date=December 2006|title=A brief history of homeopathy|journal=Journal of the Royal Society of Medicine|volume=99|issue=12|pages=607–610|doi=10.1177/014107680609901206|issn=0141-0768|pmc=1676328|pmid=17139061}}</ref> Hahnemann rejected the mainstream medicine of the late 18th century as irrational and inadvisable, because it was largely ineffective and often harmful.<ref name="Lasagna">
{{cite book
|author =Lasagna L
|title =The doctors' dilemmas
|location =New York
|publisher =Collier Books
|year =1970
|orig-date =1962
|page =33
|isbn =978-0-8369-1669-0
}}</ref><ref name="isbn0-393-06661-4">{{cite book |author1=Edzard Ernst |author-link1=Edzard Ernst|author2=Singh, Simon |author-link2=Simon Singh|title=Trick or Treatment: The Undeniable Facts about Alternative Medicine |publisher=W. W. Norton |location=New York |year=2008 |isbn=978-0-393-06661-6 |title-link=Trick or Treatment: The Undeniable Facts about Alternative Medicine }}</ref> He advocated the use of single drugs at lower doses and promoted an immaterial, ] view of how living organisms function.<ref name="Pray2003">{{cite book|author=W. Steven Pray|title=a History of Nonprescription Product Regulation|url=https://books.google.com/books?id=uadgq04eLr0C&pg=PA192|access-date=January 21, 2013|date=August 1, 2003|publisher=Psychology Press|isbn=978-0-7890-1538-9|page=192}}</ref> The term ''homeopathy'' was coined by Hahnemann and first appeared in print in 1807.<ref>
{{cite journal|author=Dean ME|year=2001|title=Homeopathy and "the progress of science"|url=http://www.shpltd.co.uk/dean-homeopathy.pdf|journal=Hist Sci|volume=39|issue=125 Pt 3|pages=255–83|bibcode=2001HisSc..39..255E|doi=10.1177/007327530103900301|pmid=11712570|archive-url=https://web.archive.org/web/20060101084902/http://www.shpltd.co.uk/dean-homeopathy.pdf|archive-date=January 1, 2006|access-date=March 31, 2009|s2cid=23943688}}
</ref> He also coined the expression "]", which was used to pejoratively refer to traditional Western medicine.<ref name="Whorton2004">{{cite book|author=Whorton JC|url=https://books.google.com/books?id=RU0DndWVSPoC&pg=PA18|title=Nature Cures: The History of Alternative Medicine in America|publisher=]|year=2004|isbn=978-0-19-517162-4|location=New York|pages=18, 52}}</ref>


===Concept===
Scientific medicine has discarded vitalism and its associated beliefs in favour of the germ theory of disease, as part of a physiological model based on the work of scientists like ], ], and ]. Moreover, following ] discovery it has firmly rejected the possibility of highly diluted homeopathic preparations having any medicinal action.
], Washington, D.C., with the inscription ''Similia Similibus Curentur'' – "Like cures Like"]]
Hahnemann conceived of homeopathy while translating a medical treatise by the Scottish physician and chemist ] into German. Being sceptical of Cullen's theory that ] cured ] because it was bitter, Hahnemann ingested some bark specifically to investigate what would happen. He experienced fever, shivering and ]: symptoms similar to those of malaria itself. From this, Hahnemann came to believe that all effective drugs produce symptoms in healthy individuals similar to those of the diseases that they treat.<ref name="UllmanReichenberg-Ullman1994">{{cite book|author1=Robert W. Ullman|author2=Judyth Reichenberg-Ullman|title=The patient's guide to homeopathic medicine |url=https://archive.org/details/patientsguidetoh00robe |url-access=registration|access-date=January 24, 2013|date=October 1, 1994|publisher=Picnic Point Press|isbn=978-0-9640654-2-0|pages=–2}}</ref> This led to the name ''"homeopathy"'', which comes from the {{langx|grc|ὅμοιος}} ''hómoios'', "-like" and {{lang|el|πάθος}} ''páthos'', "suffering".<ref>{{Cite journal|last1=Merrell|first1=Woodson C.|last2=Shalts|first2=Edward|date=2002|title=Homeopathy|journal=The Medical Clinics of North America|volume=86|issue=1|pages=47–62|doi=10.1016/s0025-7125(03)00071-3|issn=0025-7125|pmid=11795090}}</ref>


The doctrine that those drugs are effective which produce symptoms similar to the symptoms caused by the diseases they treat, called "the law of similars", was expressed by Hahnemann with the Latin phrase '']'', or "like cures like".<ref name="Hahnemann" /> Hahnemann's law of similars is unproven and does not derive from the ].<ref name="Kirk">{{cite journal|date=December 1894|editor2=John Hugh McQuillen|editor3=George Jacob Ziegler|editor4=James William White|editor5=Edward Cameron Kirk|editor6=Lovick Pierce Anthony|title=A wail from the waste-basket|url=http://quod.lib.umich.edu/d/dencos/acf8385.0036.001/1050:349?didno=ACF8385.0036.001;rgn=full+text;view=image|journal=]|type=editorial|volume=36|issue=12|pages=1030–32|editor=J. D. White}}</ref> An account of the effects of eating cinchona bark noted by ], published in 1861, failed to reproduce the symptoms Hahnemann reported.<ref name="Holmes" />{{rp|128}} Subsequent scientific work showed that cinchona cures malaria because it contains ], which kills the '']'' parasite that causes the disease; the mechanism of action is unrelated to Hahnemann's ideas.<ref name="Atwood-BTTF1">{{cite web |url=http://www.sciencebasedmedicine.org/homeopathy-and-evidence-based-medicine-back-to-the-future-part-i/ |title=Homeopathy and evidence-based medicine: back to the future |publisher=] |date=January 4, 2008 |access-date=September 9, 2013 |last=Atwood |first=Kimball}}</ref>
=== The "Law of Similars" ===
Homeopathy rests on a principle known as the "Law of Similars". Hahnemann first expressed it as the exhortation ''similia similibus curentur'' or "let likes cure likes." The idea did not originate with Hahnemann, but he was the first to use it as the basis of a system of medicine. The "Law of Similars" is generally considered by homeopaths as a ]. Following this principle, the appropriate homeopathic substance for treating a disease is one which induces similar symptoms in a healthy person.


====Provings====
The relation of similarity is primarily determined through ''provings'', in which relatively healthy volunteers who are given a substance in homeopathic form record changes in their physical, mental, emotional, and spiritual symptoms. This information is subsequently compiled and presented remedy-by-remedy in a ''Materia Medica''. Subsequent versions of the Materia Medica additionally incorporate symptoms observed to have been cured by the remedy. A ] is an index of the Materia Medica, namely a listing of symptoms, followed by remedies reputed to cure them. With the growth of information on remedies such an index has become an indispensable tool for narrowing down the range of possibilities of appropriate remedy for a given case, although it is still properly treated as an adjunct to the Materia Medica.
Hahnemann began to test what effects various substances may produce in humans, a procedure later called "homeopathic proving". These tests required subjects to test the effects of ingesting substances by recording all their symptoms as well as the ancillary conditions under which they appeared.<ref name="Haehl1922">{{cite book|author=Richard Haehl|title=Samuel Hahnemann: His Life and Work: Based on Recently Discovered State Papers, Documents, Letters, Etc|url=https://books.google.com/books?id=Q80gR6OxDVsC&pg=PA101|access-date=January 24, 2013|year=1922|publisher=B. Jain Publishers|isbn=978-81-7021-693-3|page=101}}</ref> He published a collection of provings in 1805, and a second collection of 65 preparations appeared in his book, ''Materia Medica Pura'' (1810).<ref name="Kirschmann2004">{{cite book|author=Anne Taylor Kirschmann|title=A vital force: women in American homeopathy |url=https://archive.org/details/vitalforcewomeni0000kirs|url-access=registration|access-date=January 28, 2013|year=2004|publisher=Rutgers University Press|isbn=978-0-8135-3320-9|page=}}</ref>


As Hahnemann believed that large doses of drugs that caused similar symptoms would only aggravate illness, he advocated for extreme dilutions. A technique was devised for making dilutions that Hahnemann claimed would preserve the substance's therapeutic properties while removing its harmful effects.<ref name="Dynamization and Dilution">{{cite web |title=Dynamization and dilution |work=Complementary and Alternative Medicine |publisher=] Department of Pharmacology |url=http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm |archive-url=https://web.archive.org/web/20020826082134/http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm |archive-date=August 26, 2002 |access-date=March 24, 2009}}</ref> Hahnemann believed that this process enhanced "the spirit-like medicinal powers of the crude substances".<ref name="Organon_5th_269">{{cite book |author=Hahnemann S |title=The organon of the healing art |year=1833 |publisher=Keats Pub. |edition=5th |at=aphorism 269 |isbn=978-0-87983-228-5}}.
At first, Hahnemann proved substances known to him as poisons or as remedies. Hahnemann's findings from provings were first recorded in his '']''. ] ''Lectures on Homoeopathic Materia Medica'' (]) lists 217 remedies, and modern drugs and chemicals are being added continually to contemporary versions. As a result, homeopathy uses a wide variety of animal, plant, mineral, and chemical substances of natural or synthetic origin. Examples include ''Natrum muriaticum'' (] or table salt),'']'' (the venom of the ] ]), '']'', and ''Thyroidinum'' (]). Other homeopaths during and after Hahnemann's time, notably Hering and Lux, developed remedies called '']s'', which are homeopathic dilutions of the agent or the product of the disease in question. ] nosode, for example, is made by potentizing the saliva of a rabid dog. Some homeopaths also use a number of more esoteric substances, known as ''imponderables'' because the prepartions do not originate from a material substance but from electromagnetic or electrical energy presumed to have been captured by direct exposure ('']'', ''Sol'' (sunlight), , and (electricity)) or through the use of a telescope ('']''). Recent ventures by individual homeopaths into the realm of esoteric substances include (thunderstorm), and .
{{cite book |author=Hahnemann S |title=The organon of the healing art |publication-date=1921 |year=1842 |publisher=Keats Pub. |edition=6th |at=aphorism 270 |isbn=978-0-87983-228-5}}</ref> He gathered and published an overview of his new medical system in his book, '']'' (1810), with a sixth edition published in 1921 that homeopaths still use today.<ref name="homhist1">
{{cite web |title=History of Homeopathy |publisher=Creighton University Department of Pharmacology |url=http://altmed.creighton.edu/Homeopathy/history.htm |access-date=July 23, 2007 |date=July 2007 |archive-url=https://web.archive.org/web/20070705095116/http://altmed.creighton.edu/Homeopathy/history.htm |archive-date=July 5, 2007}}</ref>


====Miasms and disease====
Today, about 3000 remedies are used in homeopathy, of which approximately 300 are used based on comprehensive Materia Medica information, a further 1500-or-so on relatively fragmentary knowledge, and the rest are used experimentally in difficult clinical situations based on the law of similars, either without empirical knowledge of their homeopathic properties or through purely empirical knowledge independent of the law of similars. Examples include: the use of an isopathic (disease causing) agent as a first prescription in a 'stuck' case, when the beginning of disease can be traced to a specific event such as vaccination; the use of a biologically or chemically related substance when a remedy fails to act yet seems well-indicated; and more recently, the use of substances based on their place in the natural classification of their respective kingdoms (the ] or relevant biological ]). This last approach is considered very promising by progressives in the homeopathic community, because it allows for grouping remedies and classifying the ever-burgeoning Materia Medica, but is rejected by many purists because it involves speculation about remedy action in the absence of proper provings.
In the ''Organon'', Hahnemann introduced the concept of "miasms" as the "infectious principles" underlying chronic disease<ref name="ClarkeClarke2001">{{cite book |author=John Henry Clarke |title=Homeopathy explained |url=https://books.google.com/books?id=ZUGIWuo4qc8C&pg=PA22 |access-date=January 12, 2013 |date=January 1, 2001 |publisher=Nanopathy |pages=22–|id=GGKEY:JWCD56EF80T }}</ref> and as "peculiar morbid derangement of vital force".<ref name="Grimes2012">{{cite journal
|author=Grimes, D. R.
|title=Proposed mechanisms for homeopathy are physically impossible
|journal=]
|date=2012
|volume=17
|issue=3
|page=154|doi=10.1111/j.2042-7166.2012.01162.x
}}</ref> Hahnemann associated each miasm with specific diseases, and thought that initial exposure to miasms causes local symptoms, such as skin or venereal diseases. His assertion was that if these symptoms were suppressed by medication, the cause went deeper and began to manifest itself as diseases of the internal organs.<ref name="miasms" /> Homeopathy maintains that treating diseases by directly ], 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".<ref>
{{cite journal
|url =http://homeoint.org/cazalet/ward/historycase.htm
|author =Ward JW
|title=Taking the history of the case
|journal=Pacific Coast Journal of Homeopathy
|date=July 1937
|access-date =October 22, 2007
}}</ref> The underlying imputed miasm still remains, and deep-seated ailments can be corrected only by removing the deeper disturbance of the vital force.<ref name="homphilo">
{{cite web
|title=Cause of disease in homeopathy
|publisher=Creighton University Department of Pharmacology
|url=http://altmed.creighton.edu/Homeopathy/philosophy/cause.htm
|access-date=July 23, 2007
|archive-url=https://web.archive.org/web/20091231160035/http://altmed.creighton.edu/Homeopathy/philosophy/cause.htm
|archive-date=December 31, 2009
}}</ref>


Hahnemann's ] for miasms originally presented only three local symptoms: psora (the itch), ] (venereal disease) or ] (fig-wart disease).<ref>{{cite EB1911 |wstitle=Homoeopathy |volume=13 |page=645 |first=William Tod |last=Helmuth}}</ref> Of these the most important was ''psora'', described as being related to any itching diseases of the skin and was claimed to be the foundation of many further disease conditions. Hahnemann believed it to be the cause of such diseases as ], ], ], ], and ].<ref name="Hahnemann_Chronic">
The "Law of Similars" is the guiding principle in homeopathy, but calling it a "law" is misleading. It is, rather, an axiom or ''postulate'' which forms the foundation of the homeopathic system and through the application of which homeopaths arrive at their diagnosis. As it cannot be disproved scientifically (since a failure to cure homeopathically can always be attributed to incorrect selection of a remedy), the "Law of Similars" derives its justification from its contribution to the clinical results that homeopaths claim. The application of this principle, however, is not straightforward: there exist multiple methodologies for determining the most-similar remedy (the ''simillimum''), and homeopaths will often disagree on the diagnosis. This is due in part to the complexity of the idea of 'totality of symptoms' to which the law refers, as homeopaths will not use ''all'' the symptoms of a patient, but will decide which are the most ''characteristic''; this evaluation of the gathered clinical data is the aspect of diagnosis requiring the most knowledge and experience. Finally, the remedy picture as found in entries of the Materia Medica is always more comprehensive than the symptomatology that a single individual can ever exhibit. These confounding factors mean that a homeopathic diagnosis remains presumptive until it is verified through testing the effect of the remedy on the patient.
{{cite book
|author =Hahnemann S
|title =Die chronischen Krankheiten, ihre eigenthümliche Natur und homöopathische Heilung
|url =https://books.google.com/books?id=Xfk3AAAAMAAJ
|location =] and ]
|publisher =Arnoldische Buchhandlung
|year =1828
}}{{Page needed|date=March 2011}}</ref> Since Hahnemann's time, other miasms have been proposed, some replacing illnesses previously attributed to the psora, including ] and ] miasms.<ref name="miasms">
{{cite web
|work = Classical homeopathy
|title = Miasms in homeopathy
|url = http://homepage.ntlworld.com/homeopathy_advice/Theory/Intermediate/miasm.html
|author = King S
|access-date = March 25, 2009
|archive-url = https://web.archive.org/web/20090307120146/http://homepage.ntlworld.com/homeopathy_advice/Theory/Intermediate/miasm.html
|archive-date = March 7, 2009
}}</ref>


Hahnemann's miasm theory remains disputed and controversial within homeopathy even in modern times. The theory of miasms has been criticized as an explanation developed 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 ], environmental factors, and the unique disease history of each patient.<ref name="Shelton">{{cite book |last=Shelton |first=JW |year=2004 |title=Homeopathy: How it really works |url=https://archive.org/details/homeopathyhowitr0000shel |url-access=registration |location=Amherst, New York |publisher=] |isbn=978-1-59102-109-4}}</ref>{{rp|148–9|date=November 2012}}
''See also'': ]


===19th century: rise to popularity and early criticism===
=== The "Theory of Infinitesimals" ===
]'', an 1857 painting by Alexander Beydeman, showing historical figures and personifications of homeopathy observing the ] of the 19th century]]Homeopathy achieved its greatest popularity in the 19th century. It was introduced to the United States in 1825 by Hans Birch Gram, a student of Hahnemann.<ref name="Miller">{{cite book |last=Miller |first=Timothy |author-link=Timothy Miller |title=America's alternative religions |publisher=State University of New York Press, Albany |date=1995 |pages= |isbn=978-0-7914-2397-4 |url=https://archive.org/details/americasalternat00mill/page/80 }}</ref> The first homeopathic school in the United States opened in 1835 and the ] was established in 1844. Throughout the 19th century, dozens of homeopathic institutions appeared in Europe and the United States,<ref name="Julian">{{cite web
The most characteristic&mdash;and controversial&mdash;principle of homeopathy is that the potency of a remedy can be enhanced (and side effects diminished) by dilution in a particular procedure known as '']'' or ''potentization''. Liquids are successively diluted (with water or, in the case of water-insoluble material, alcohol) and shaken by ten hard strikes against an elastic body, a process called ''']'''. Insoluble solids are diluted by grinding them with ], a process known as ]. Homeopathic practitioners claim to observe that the vigorous agitation following each dilution transfers some of the "essential property" of the substance to the water. The dilution factor at each stage is traditionally 1:10 (D or X potencies) or 1:100 (C potencies). Hahnemann advocated the use of 30C dilutions for most purposes, i.e. dilution by a factor of 100<sup>30</sup> = 10<sup>60</sup>.
|url = http://www.wholehealthnow.com/homeopathy_pro/homeopathy_1825_1849.html
|title = Homeopathy Timeline
|access-date = July 23, 2007
|website= Whole Health Now
|archive-date = December 15, 2018
|archive-url = https://web.archive.org/web/20181215122834/http://www.wholehealthnow.com/homeopathy_pro/homeopathy_1825_1849.html
}}</ref> and by 1900, there were 22 homeopathic colleges and 15,000 practitioners in the United States.<ref name="Time19951125" />


Because medical practice of the time relied on treatments which were often ineffective and harmful, patients of homeopaths often had better outcomes than those being treated by medical practitioners.<ref name="pmid8885813">{{cite journal |last1=Ernst |first1=E. |last2=Kaptchuk |first2=TJ |title=Homeopathy revisited |journal=Archives of Internal Medicine |volume=156 |issue=19 |pages=2162–4 |year=1996 |pmid=8885813 |doi=10.1001/archinte.156.19.2162}}</ref> Though ineffective, homeopathic preparations are rarely detrimental, thus users are less likely to be harmed by the treatment that is supposed to be helping them.<ref name="homhist1" /> The relative success of homeopathy in the 19th century may have led to the abandonment of the ineffective and harmful treatments of ] and purging and begun the move towards more effective, ].<ref name="kaufmanm">
However, since ] is only 6.022 × 10<sup>23</sup> particles/mole the chance that even one molecule of the original would be present in a 15C solution is small and the chance of one molecule of the original being present in a 30C solution is infinitesimal.
{{cite book
|author =Kaufman M
|title =Homeopathy in America: The rise and fall of a medical heresy
|publisher =]
|year =1971
|isbn =978-0-8018-1238-5
}}{{Page needed|date=March 2011}}</ref> One reason for the growing popularity of homeopathy was its apparent success in treating people suffering from infectious disease epidemics.<ref>
{{cite book
|author =Coulter HL
|year =1973
|title =Divided Legacy
|pages =II:544–46; III:267–70, 298–305
|location =Berkeley
|publisher =North Atlantic
|oclc =9538442
}}</ref> During 19th-century epidemics of diseases such as ], 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.<ref>Death rates in conventional hospitals were typically two- to eight-fold higher than in homeopathic hospitals for patients with these infectious diseases; see
{{cite book
|title =The logic of figures or comparative results of homeopathic and other treatments
|author =Bradford TL
|publisher =Kessinger
|year =2007
|orig-date =1900
|isbn =978-1-4304-8892-7
}}{{Page needed|date=March 2011}}</ref>


Even during its rise in popularity, homeopathy was criticized by scientists and physicians. ], physician to ], said in 1843 that the extremely small doses of homeopathy were regularly derided as useless and considered it "an outrage to human reason".<ref name="John_Forbes">
Some later homeopaths, in particular Kent, advocated the use of much higher potencies, whose manufacture could no longer be practically achieved by the traditional methods, but required succussion without dilution (Jenichen), higher dilution factors (LM potencies are diluted by a factor of 50,000), or machines which in some way integrate dilution and succussion into a continuous process (Korsakoff). Higher dilutions are generally considered stronger and 'deep-acting'. This is in contrast to ] and ], which hold that the effects of a substance are always due to its physical or biochemical activity in the patient's body, and therefore that generally the more of an active ingredient is present in a drug, the more effect (whether positive, negative, or both) it will have.
{{cite book
|author =Forbes J
|title =Homeopathy, allopathy and young physic
|location =London
|year =1846
}}</ref> ] 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."<ref>
{{cite book
|author =Simpson JY
|title =Homoeopathy, its tenets and tendencies, theoretical, theological and therapeutical
|location =Edinburgh
|publisher =Sutherland & Knox
|year =1853
|page =11
}}</ref> Nineteenth-century American physician and author ] was also a vocal critic of homeopathy and published an essay entitled '']'' (1842).<ref name="Holmes" /> The members of the French Homeopathic Society observed in 1867 that some leading homeopaths of Europe not only were abandoning the practice of administering infinitesimal doses but were also no longer defending it.<ref>
{{cite journal
|title =Homœopathists vs homœopathy
|editor =Allen JA
|journal =Chic Med J
|pages =268–69
|year =1867
|volume =24
|issue =6
|pmid =37412875
|pmc =9801777
|url =https://books.google.com/books?id=R08VAAAAYAAJ&q=leading+europe+abandoning&pg=PA268
}}</ref> The last school in the United States exclusively teaching homeopathy closed in 1920.<ref name="homhist1" />


=== Revival in the 20th century ===
The choice of potency will depend on a number of subjective factors. These include how deep-seated the disease appears to be; whether the disease is primarily physical or more mental/emotional; the patient's sensitivity based on the practitioner's intuitive assessment or previous reactions to remedies; and the desired dosing regimen based on patient-compliance considerations (e.g., low potency repeated often vs. high potency repeated seldom). There are many theories and traditions of potency use. For example, as a general rule French and German homeopaths use lower potencies than their ] counterparts. What most homeopaths agree on is that the choice of potency is secondary to the choice of remedy: a well chosen remedy will act in a variety of potencies, but an approximately matched remedy might act only in certain potencies.
According to academics {{Interlanguage link|Paul U. Unschuld|lt=|de||WD=}} and ], the ] regime in Germany was fond of homeopathy, and spent large sums of money on researching its mechanisms, but without gaining a positive result.<ref>{{Cite news|last=Ernst|first=Edzard|title=Standing up for the truth about homeopathy and Nazi medicine|url=https://www.irishtimes.com/culture/books/standing-up-for-the-truth-about-homeopathy-and-nazi-medicine-1.2138835|access-date=2020-10-26|newspaper=The Irish Times|language=en}}</ref> Unschuld also states that homeopathy never subsequently took root in the ], but remained more deeply established in European thinking.<ref name="Unschuld2009">{{cite book|author=Paul Ulrich Unschuld|title=What Is Medicine?: Western and Eastern Approaches to Healing|url=https://books.google.com/books?id=bPMTlS1pzEUC&pg=PA171|access-date=September 7, 2013|date=August 9, 2009|publisher=University of California Press|isbn=978-0-520-94470-1|page=171}}</ref> In the United States, the '']'' of 1938 (sponsored by ], a ] from ] and homeopathic physician) recognized homeopathic preparations as drugs. In the 1950s, there were only 75 solely homeopathic practitioners in the U.S.<ref>
{{cite news
|title =Homeopathic Hassle
|url =http://www.time.com/time/magazine/article/0,9171,891760,00.html
|archive-url =https://web.archive.org/web/20081214115339/http://www.time.com/time/magazine/article/0,9171,891760,00.html
|archive-date =December 14, 2008
|magazine =]
|date =August 20, 1956
}}</ref> By the mid to late 1970s, homeopathy made a significant comeback and the sales of some homeopathic companies increased tenfold.<ref name="rader">
{{cite news
|date =March 1, 1985
|publisher =FDA Consumer Magazine
|author =Rader WM
|url =http://www.homeowatch.org/history/fdac1.html
|title =Riding the coattails of homeopathy's revival
}}</ref>


Some homeopaths credit the revival to Greek homeopath ], who conducted a "great deal of research to update the scenarios and refine the theories and practice of homeopathy" in the 1970s,<ref name="pmid12614092">{{Cite journal |volume=138 |issue=5 |pages=393–99 |last=Jonas |first=WB |author2=TJ Kaptchuk |author3=K Linde |title=A critical overview of homeopathy |journal=Annals of Internal Medicine |year=2003 |doi=10.7326/0003-4819-138-5-200303040-00009|pmid=12614092 |s2cid=22787732 }}</ref><ref>{{cite book |first=Andrew |last=Lockie |title=Encyclopedia of Homeopathy |url=https://archive.org/details/encyclopediahome00lock_433 |url-access=limited |publisher=] |year=2000 |location=New York |edition=1st |page= |isbn=978-0-7566-1871-1 }}</ref> but Ernst and ] consider it to be linked to the rise of the ].<ref name="isbn0-393-06661-4" /> ] has argued that the increased popularity of homeopathy in recent times may be due to the comparatively long consultations practitioners are willing to give their patients, and to a ], which people think are the basis of homeopathic preparations.<ref name="Hood2009">{{cite book|author=Bruce M. Hood|title=SuperSense|url=https://archive.org/details/supersensewhyweb00hood|url-access=registration|access-date=September 7, 2013|date=April 7, 2009|publisher=HarperCollins|isbn=978-0-06-186793-4|page=}}</ref>
=== Chronic disease ===
Although homeopathy is often used for the treatment of acute illness, there are several distinctive theoretical principles that apply mainly to the homeopathic treatment of chronic disease:


Towards the end of the century opposition to homeopathy began to increase again; with ], the President of the ], saying that "Homeopathy is a fraud perpetrated on the public with the government's blessing, thanks to the abuse of political power of Sen. Royal S. Copeland."<ref>{{cite web|author=William T. Jarvis|author-link=William T. Jarvis|title=Response to Isadora Stehlin "Homeopathy: real medicine or empty promises?" (originally published in ''FDA Consumer'' April 1997)|date=December 15, 2001|url=http://www.homeowatch.org/articles/fdac2.html}}</ref>
==== Suppression ====
A prominent role in the homeopathic theory of disease belongs to the notion of ''suppression''. Its initial meaning consisted of the belief that there are diseases whose external manifestations prevent development of inner symptoms of the same disease. In his ''Chronic Diseases'' Hahnemann argued that mistreatment of diseases of the skin leads to disease 'deeper' in the organism, listing numerous cases in support. Present-day homeopaths invoke this notion in their claim that symptoms are not in themselves the disease, but rather represent an underlying disturbance of the organism's vitality. As they seek to address this underlying disease, homeopaths do not automatically regard the disappearance of a symptom (whether spontaneous or in response to some treatment) as a favorable event: under some cases this could instead indicate a weakening of the organism's ability to express the symptom, and because the underlying disturbance is still present, sooner or later it is expressed as a symptom elsewhere in the organism. They further claim that the tendency of past skin manifestations to reappear transiently following successful homeopathic prescribing is considered evidence in support of the this notion. It is maintained that although suppression is sometimes necessary for the patient's welfare or may even be life saving, it is regarded unfavorably in the context of long-term prognosis. In the modern context the issue arises mainly with respect to the use of corticosteroid treatment for skin disease, allergies, and asthma, and the use of chemotherapy, as homeopathic treatment is claimed to be significantly less effective under immune-system suppression.


===21st century: renewed criticism===
Critics assert that the notion of suppression is deeply flawed, being based on erroneous intepretation of some clinical facts Hahnemann adduced in support of the theory. This is illustrated by Hahnemann's reasoning about the development of symptoms of syphilis{{fn|21}}: Physicians of his time regularly tried but failed to stop the progression of the disease by destroying the chancre that manifests early on. Hahnemann saw a non-existent causal relation between these events, arguing that the removal of the chancre was the cause of the disease's progression, writing that syphilis


Since the beginning of the 21st century, a series of ] have further shown that the therapeutic claims of homeopathy lack scientific justification.<ref name="champe">{{cite journal |last1=Crockett |first1=Chambers |title=Death by homeopathy: issues for civil, criminal and coronial law and for health service policy |pmid=22558899 |journal=Journal of Law, Medicine & Ethics |volume=19 |issue=3 |pages=454–78 |year=2012 }}</ref> This had led to a decrease or suspension of funding by many governments. In a 2010 report, the ] recommended that homeopathy should no longer receive ] (NHS) funding due its lack of scientific credibility;<ref name="champe" /> NHS funding for homeopathy ceased in 2017.<ref name="TNHS" /> They also asked the ] in the UK to add homeopathic remedies to the list of forbidden prescription items.<ref name="bbc-blacklist" />
:''"...can only proceed from the uncured indwelling veneral disease, whose external substitute and suppresser (the chancre, which, as long as it exists undisturbed, prevents the outbreak of the syphilis) has been destroyed locally by the physician, and can consequently no longer hinder its outbreak."''


In 2015, the ] of Australia found that "there are no health conditions for which there is reliable evidence that homeopathy is effective".<ref>{{cite web |title=The Australian report |url=https://www.hri-research.org/resources/homeopathy-the-debate/the-australian-report-on-homeopathy/ |website=HRI Research |access-date=13 August 2018|date=April 6, 2017 }}</ref> The federal government only ended up accepting three of the 45 recommendations made by the 2018 review of Pharmacy Remuneration and Regulation.<ref>{{cite news|last1=Abusson|first1=Kate|date=3 May 2018|title=Pharmacies avoid homeopathy ban as government parks recommendations|work=Sydney Morning Herald|url=https://www.smh.com.au/national/pharmacies-avoid-homeopathy-ban-as-government-parks-recommendations-20180503-p4zd94.html|access-date=13 August 2018}}</ref> The same year the US ] (FDA) held a hearing requesting public comment on the regulation of homeopathic drugs.<ref name="Science42115">{{cite news|author1=Kelly Servick|date=April 21, 2015|title=FDA takes new look at homeopathy|work=Science|url=https://www.science.org/content/article/fda-takes-new-look-homeopathy|access-date=April 23, 2015|quote=Under FDA guidelines issued in 1988, a company can sell homeopathic products over the counter without demonstrating their safety or efficacy, and―unlike dietary supplements―their packaging can include claims about treating specific conditions, as long as they are "self-limiting" and not chronic. Such conditions include sprains, colds, or allergies.}}</ref> In 2017 the FDA announced it would strengthen regulation of homeopathic products.<ref name="Frazier FDA to Reg">{{cite journal|last1=Frazier|first1=Kendrick|author-link=Kendrick Frazier|date=2018|title=FDA to Regulate Some Homeopathic Products; CFI Hails Move|journal=]|volume=42|issue=2|page=12}}</ref>
But since the clinical course of untreated syphilis involves the ''spontaneous'' disappearance of the primary chancre only to be followed by more extensive skin and systemic manifestations some time later, Hahnemann was wrong both in his observations (that the chancre remained indefinitely when untreated) and theory (that localized treatment of the chancre was the cause of later symptoms).


The American non-profit ] (CFI) filed a lawsuit in 2018 against the ] pharmacy for consumer fraud over its sale of homeopathic medicines.<ref name="CVS">{{cite press release|author=<!--Staff writer(s); no by-line.-->|title=CENTER FOR INQUIRY SUES CVS FOR FRAUD OVER SALE OF HOMEOPATHIC FAKE MEDICINE|url=https://centerforinquiry.org/press_releases/cfi-sues-cvs/|publisher=Center for Inquiry|date=9 July 2018|access-date=9 July 2018}}</ref> It claimed that CVS was selling homeopathic products on an easier-to-obtain basis than standard medication.<ref>{{cite web|last1=Bellamy|first1=Jann|title=CVS sued for deceiving consumers in sale of homeopathic remedies|url=https://sciencebasedmedicine.org/cvs-sued-for-deceiving-consumers-in-sale-of-homeopathic-remedies/|access-date=22 January 2019|website=Science Based Medicine|date=July 19, 2018}}</ref> In 2019, CFI brought a similar lawsuit against ] for "committing wide-scale consumer fraud and endangering the health of its customers through its sale and marketing of homeopathic medicines".<ref>{{cite magazine|last=Fidalgo|first=Paul|date=September 2019|title=CFI sues Walmart for fraud for selling homeopathic fake medicine|magazine=]|location=Amherst, NY|publisher=Center for Inquiry}}</ref><ref>{{cite web|last1=Vyse|first1=Stuart|author-link=Stuart Vyse|title=What Should Become of a Monument to Pseudoscience?|url=https://skepticalinquirer.org/exclusive/what-should-become-of-a-monument-to-pseudoscience/|access-date=2 December 2019|website=Skeptical Inquirer|date=July 10, 2019|publisher=Center for Inquiry}}</ref> They also conducted a survey in which they found consumers felt ripped off when informed of the lack of evidence for the efficacy of homeopathic remedies, such as those sold by Walmart and CVS.<ref name="CFISurvey SI 2019">{{cite journal|last1=Frazier|first1=Kendrick|authorlink= Kendrick Frazier|date=2019|title=CFI survey on Homeopathy: Consumers feel scammed by Walmart and CVS|journal=Skeptical Inquirer|volume=43|issue=6|page=7}}</ref><ref name="CFI 2019 Survey">{{cite web|last1=Fidalgo|first1=Paul|title=CONSUMERS FEEL "SCAMMED" BY WALMART AND CVS OVER HOMEOPATHIC FAKE MEDICINE, SURVEY SHOWS|url=https://centerforinquiry.org/press_releases/consumers-feel-scammed-by-walmart-and-cvs-over-homeopathic-fake-medicine/|access-date=9 November 2019|website=Center for Inquiry|date=September 17, 2019}}</ref>
==== Direction of cure ====
Hahnemann's protégé Constantine Hering systematized Hahnemann's observations concerning the relation between symptoms by noting that homeopathic treatment often brought back previously suppressed symptoms of the patient (known as "return of old symptoms"), with cure tending to proceed:


In 2021, the French healthcare minister phased out social security reimbursements for homeopathic drugs.<ref name="GuardianFrance" /><ref name="FranceEndFunding2021" /> France has long had a stronger belief in the virtues of homeopathic drugs than many other countries and the world's biggest manufacturer of alternative medicine drugs, ], is located in that country.<ref>{{cite news |url=https://www.reuters.com/article/us-france-health-homeopathy/france-will-end-healthcare-refunds-for-homeopathic-drugs-idUSKCN1U42B6 |title=France will end healthcare refunds for homeopathic drugs |website=] |date=July 9, 2019}}</ref> Spain has also announced moves to ban homeopathy and other pseudotherapies.<ref name="El Pais 2019-07-30" /> In 2016, the ] cancelled its master's degree in Homeopathy citing "lack of scientific basis", after advice from the Spanish Ministry of Health.<ref>{{cite news|last1=Ansede|first1=Manuel|date=March 4, 2016|title=La Universidad de Barcelona fulmina su máster de homeopatía|newspaper=El País|url=http://elpais.com/elpais/2016/03/01/ciencia/1456856774_534268.html}}</ref> Shortly afterwards the ] announced the elimination of its Masters in Homeopathy.<ref>{{cite web|date=April 7, 2016|title=El Máster de Homeopatía de la Universidad de Valencia cancela su edición para el próximo curso.|url=http://www.abc.es/sociedad/abci-master-homeopatia-universidad-valencia-cancela-edicion-para-proximo-curso-201604072200_noticia.html|publisher=Diario ABC}}</ref>
* from more vital to less vital organs;
* from the interior to the surface; and (when applicable)
* from the head and torso to the extremities.


==Preparations and treatment==
Thus, as an example, a patient originally treated with medicinal ointments for a body-wide rash, later became asthmatic, and was now being treated homeopathically for suicidal depression, would tend first to recover emotionally while experiencing transient asthma symptoms and the reappearance of his skin rash, which would leave the core of his body first and his extremities last. Although this set of observations later became known as "Hering's Law of Direction of Cure", it is not a strict law but a clinical pattern whose presence indicates a high likelihood that deep cure has taken place and that recurrence is unlikely.
{{see also|List of homeopathic preparations}}]]]


Homeopathic preparations are referred to as "homeopathic remedies".<ref name="Consumer Reports">{{cite news |date=December 21, 2015 |title=Homeopathic drugs: No better than placebos? |newspaper=] |url=https://www.washingtonpost.com/national/health-science/homeopathic-drugs-no-better-than-placebos/2015/12/18/037b3976-7750-11e5-a958-d889faf561dc_story.html |access-date=December 22, 2015 }}</ref> Practitioners rely on two types of reference when prescribing: '']'' and repertories. A homeopathic ''materia medica'' is a collection of "drug pictures", organized alphabetically. A homeopathic repertory is a quick reference version of the ''materia medica'' that indexes the symptoms and then the associated remedies for each. In both cases different compilers may dispute particular inclusions in the references.<ref>Jonas: Mosby's Dictionary of Complementary and Alternative Medicine. (c) 2005, Elsevier</ref> The first symptomatic homeopathic ''materia medica'' was arranged by Hahnemann. The first homeopathic repertory was Georg Jahr's ''Symptomenkodex'', published in German in 1835, and translated into English as the ''Repertory to the more Characteristic Symptoms of Materia Medica'' in 1838. This version was less focused on disease categories and was the forerunner to later works by ].<ref name="pmid16322800">{{cite journal|last1=Bellavite|first1=Paolo|last2=Conforti|first2=Anita|last3=Piasere|first3=Valeria|last4=Ortolani|first4=Riccardo|year=2005|title=Immunology and Homeopathy. 1. Historical Background|journal=Evidence-Based Complementary and Alternative Medicine|volume=2|issue=4|pages=441–52|doi=10.1093/ecam/neh141|pmc=1297514|pmid=16322800}}</ref><ref>
==== Homeopathic aggravation ====
{{cite book|author=Mathur KN|title=Prinzipien der homöopathischen Verschreibung: Synopsis weltweiter klinischer Erfahrungen|publisher=Georg Thieme Verlag|year=2003|isbn=978-3-8304-9021-0|pages=122–23|language=de|oclc=76518035}}</ref> There are over 118 repertories published in English, with Kent's being one of the most used.<ref>{{Cite web|title=Repertories today and yesterday|url=http://www.homeopathycenter.org/homeopathy-today/repertories-today-and-yesterday|archive-url=https://web.archive.org/web/20170414063600/http://www.homeopathycenter.org/homeopathy-today/repertories-today-and-yesterday|archive-date=April 14, 2017|access-date=2020-08-31|website=National Center for Homeopathy}}</ref>
The phenomenon of existing symptoms worsening in response to homeopathic treatment is termed ''homeopathic aggravation''. The idea of aggravation can be considered a consequence of the law of similars, whereby a remedy acts by accentuating the disease symptoms, thus prompting the organism's healing response. Some homeopaths regard a quick aggravation as an indication of strong vitality and tend to be encouraged by its presence, while others strive to avoid aggravations in favor of the patient's comfort throughout treatment.


==== Constitutional treatment ==== === Consultation ===
Homeopaths generally begin with a consultation, which can be a 10–15 minute appointment or last for over an hour, where the patient describes their ]. The patient describes the "modalities", or if their symptoms change depending on the weather and other external factors.<ref name="Vickers 1115–11182">{{Cite journal|last1=Vickers|first1=Andrew|last2=Zollman|first2=Catherine|date=1999-10-23|title=Homoeopathy|journal=BMJ: British Medical Journal|volume=319|issue=7217|pages=1115–1118|doi=10.1136/bmj.319.7217.1115|issn=0959-8138|pmc=1116906|pmid=10531108}}</ref> The practitioner also solicits information on mood, likes and dislikes, physical, mental and emotional states, life circumstances, and any physical or emotional illnesses.<ref name="Stehlin">
{{cite web|author=Stehlin I|year=1996|title=Homeopathy: Real medicine or empty promises?|url=http://findarticles.com/p/articles/mi_m1370/is_n10_v30/ai_18979004/|archive-url=https://web.archive.org/web/20090924121418/http://findarticles.com/p/articles/mi_m1370/is_n10_v30/ai_18979004/|archive-date=September 24, 2009|access-date=October 1, 2007|publisher=U.S. ]}}</ref> This information (also called the "symptom picture") is matched to the "drug picture" in the ''materia medica'' or repertory and used to determine the appropriate homeopathic remedies. In classical homeopathy, the practitioner attempts to match a single preparation to the totality of symptoms (the ''simlilum''), while "clinical homeopathy" involves combinations of preparations based on the illness's symptoms.<ref name="pmid12614092" />


=== Preparation ===
Although Hahnemann himself did not have an explicit theory of physical constitution or psychological disposition, he did observe that general symptoms pertaining to the whole organism (e.g., reactions to weather, perspiration and sleep patterns) plus the patient's disposition were of special importance both diagnostically and for case management. Later homeopaths, notably James Tyler Kent, increasingly used overall disposition as a basis for determining the remedy and assessing the patient's vitality in response to treatment. Such treatment, which was applied in cases of chronic illness, became known as ''constitutional prescribing''. Recent developments in the understanding of remedies and the homeopathic process, such as George Vithoulkas' ''essence prescribing'' and ]'s concept of ''central delusion'', are continuations of this trend.
]'', a homeopathic remedy in pill form]]Homeopathy uses animal, plant, mineral, and synthetic substances in its preparations, generally referring to them using ] names.<ref name="WHO Safety">{{Cite web|title=Safety issues in the preparation of homeopathic medicines|url=https://www.who.int/medicines/areas/traditional/Homeopathy.pdf|website=World Health Organization}}</ref> Examples include '']'' (arsenic oxide), ''natrum muriaticum'' (] or table salt), '']'' (the venom of the ]), '']'', and ''thyroidinum'' (]). Homeopaths say this is to ensure accuracy.<ref>{{Cite web|title=FAQs|url=https://www.theaahp.org/consumer-information/faqs/|access-date=2020-08-31|website=The American Association of Homeopathic Pharmacists|language=en}}</ref> In the USA the common name must be displayed, although the Latin one can also be present.<ref name="WHO Safety" /> Homeopathic pills are made from an inert substance (often sugars, typically lactose), upon which a drop of liquid homeopathic preparation is placed and allowed to evaporate.<ref name="Ernst2005">{{cite journal|last1=Ernst|first1=E|year=2005|title=Is homeopathy a clinically valuable approach?|url=http://www.dcscience.net/ernst-tips-sept-2005.pdf|journal=Trends in Pharmacological Sciences|volume=26|issue=11|pages=547–48|citeseerx=10.1.1.385.5505|doi=10.1016/j.tips.2005.09.003|pmid=16165225}}</ref><ref>{{cite journal|last1=Sagar|first1=SM|year=2007|title=Homeopathy: Does a teaspoon of honey help the medicine go down?|journal=Current Oncology|volume=14|issue=4|pages=126–27|doi=10.3747/co.2007.150|pmc=1948865|pmid=17710203}}</ref>


Isopathy is a therapy derived from homeopathy in which the preparations come from diseased or pathological products such as fecal, urinary and respiratory discharges, blood, and tissue.<ref name="pmid16322800" /> They are called nosodes (from the Greek ''nosos'', disease) with preparations made from "healthy" specimens being termed "sarcodes". Many so-called "homeopathic vaccines" are a form of isopathy.<ref>{{cite book|author=Kayne SB|url=https://books.google.com/books?id=w2IFcHJYTSYC|title=Homeopathic pharmacy: theory and practice|publisher=Elsevier Health Sciences|year=2006|isbn=978-0-443-10160-1|edition=2|page=171}}</ref> Tautopathy is a form of isopathy where the preparations are composed of drugs or ]s that a person has consumed in the past, in the belief that this can reverse the supposed lingering damage caused by the initial use.<ref>{{Cite book|last=Owen|first=David|url=https://books.google.com/books?id=UZ72uQy385wC&q=Tautopathy&pg=PA56|title=Principles and Practice of Homeopathy: The Therapeutic and Healing Process|date=2007-01-01|publisher=Elsevier Health Sciences|isbn=978-0-443-10089-5|page=56|language=en}}</ref> There is no convincing scientific evidence for isopathy as an effective method of treatment.<ref>{{Cite book|last1=Lack|first1=Caleb W.|url=https://books.google.com/books?id=Miy2CwAAQBAJ&q=isopathy+pseudoscience&pg=PA206|title=Critical Thinking, Science, and Pseudoscience: Why We Can't Trust Our Brains|last2=Rousseau|first2=Jacques|date=2016-03-08|publisher=Springer Publishing Company|isbn=978-0-8261-9426-8|page=206|language=en}}</ref>
Because in the present social context classical homeopaths are usually seen for chronic complaints, these principles feature prominently in current homeopathic education and practice. In accordance with this view of disease, classical homeopathic treatment of chronic disease requires a long interview, often longer than an hour, to determine the totality of the patient's symptoms: a thorough history is taken, including childhood and physically or psychologically traumatic or memorable events; important or recurrent dreams are elicited; and a unified understanding of the person's unique perception of the world is sought.


Some modern homeopaths use preparations they call "imponderables" because they do not originate from a substance but some other phenomenon presumed to have been "captured" by alcohol or ].<!--See next two sources, and the rest of the journal issue they came from for more information--> Examples include ]s<ref>
==== Miasms ====
{{cite journal
Although nowadays homeopathy is especially known for its treatment of chronic diseases, Hahnemann recognized already early on that homeopathy, like conventional medicine, had more difficulty with these than with acute illness. In response, in his later years he developed the concept of ''miasms'', an idea that is still as complex as it ever was, and which remains contentious. After some years of homeopathic experience Hahnemann began noticing that many of his chronic patients tended to relapse even after prolonged homeopathic treatment: though they responded to remedies, over time their symptoms would tend to shift around without a fundamental improvement in their state. This led to his hypothesizing that health was not only determined by the person's present vitality, but also related to historical factors in the person's own life, as well as that of immediate ancestors; what he called ''miasm'' (from the Greek for ''taint''). These factors had to be addressed before the patient could experience satisfactory improvement of the symptoms, while in cases where the miasmatic load was heavy only partial improvement was to be expected.
|vauthors=Lee J, Thompson E |title =X-ray drug picture
|journal =The Homeopath
|volume =26
|issue =2
|pages =43–48
|year =2007
|issn =0263-3256
}}</ref> and ].<ref>
{{cite journal
|vauthors=Lee J, Thompson E |title =Postironium – the vastness of the universe knocks me off my feet
|journal =The Homeopath
|volume =26
|issue =2
|pages =49–54
|year =2007
|issn =0263-3256
}}</ref> Another derivative is ], where an electric bio-energy of therapeutic value is supposedly extracted from plants. Popular in the late nineteenth century, electrohomeopathy is extremely pseudo-scientific.<ref>{{cite journal|last1=Kempf|first1=EJ|year=1906|title=European Medicine: A Résumé of Medical Progress During the Eighteenth and Nineteenth Centuries|journal=Medical Library and Historical Journal|volume=4|issue=1|pages=86–100|pmc=1692573|pmid=18340908}}</ref> In 2012, the Allahabad High Court in Uttar Pradesh, India, handed down a decree stating that electrohomeopathy was quackery and no longer recognized it as a system of medicine.<ref name="toie">{{cite news|date=5 March 2012|title=Electro-homeopathy clinics to be sealed after Holi|work=]|url=https://timesofindia.indiatimes.com/city/kanpur/Holi-Electro-homeopathy-clinics-to-be-sealed-after-the-festival/articleshow/12140070.cms|access-date=13 August 2018}}</ref>


Other minority practices include paper preparations, in which the terms for substances and dilutions are written on pieces of paper and either pinned to the patients' clothing, put in their pockets, or placed under glasses of water that are then given to the patients. ], the use of ] such as ]s, can also be used to manufacture preparations. Such practices have been strongly criticized by classical homeopaths as unfounded, speculative, and verging upon magic and superstition.<ref>
Hahnemann described three types of miasm in his ''Chronic Diseases'' (vol. 1):
{{cite web
* Psora (possibly from Greek for ''itch''): This was associated with cutaneous manifestations such as ], as well as diseases that tended to present as ''constantly irritating or distracting yet completely reversible'' (e.g. eczema, mild asthma, recurring infections). Hahnemann considered this the primordial miasm, arguing that improper treatment of such manifestations throughout history was what led to chronic disease and the other miasms.
|url =http://www.askdrshah.com/images/lancet.pdf
* Sycosis (from the Greek for fig-wart): This was associated with genital infections such as fig-wart (today recognized as HPV) and gonorrhea. These infections and diseases such as cutaneous warts, benign tumors, and psychological neuroses had the shared quality of being ''relatively fixed yet non life-threatening''. Psychologically such states were associated with the need to accept the problem as an irremediable defect.
|title=Call for introspection and awakening
* Syphilis (from the disease name) was associated with syphilis and other manifestations such as bone ulcers, organic heart disease, and dementia that had the shared tendency of producing ''irreversible tissue destruction''.
|publisher =Life Force Center
|access-date =July 24, 2007
|author =Shah R
|archive-url =https://web.archive.org/web/20070202082349/http://www.askdrshah.com/images/lancet.pdf |archive-date=February 2, 2007}}</ref><ref name="Barwell">
{{cite journal
|url = http://www.homeopathy.ac.nz/editorials/2000/vol-20-no-3-june-2000-the-wo-wo-effect/
|title = The wo-wo effect
|access-date = April 2, 2009
|author = Barwell B
|journal = Homoeopathica
|volume = 20
|issue = 3
|year = 2000
|archive-url = https://web.archive.org/web/20090726180731/http://www.homeopathy.ac.nz/editorials/2000/vol-20-no-3-june-2000-the-wo-wo-effect/
|archive-date = July 26, 2009
|df = mdy-all
}}</ref> Flower preparations are produced by placing flowers in water and exposing them to sunlight. The most famous of these are the ], which were developed by ].<ref>{{cite journal|last1=Vanhaselen|first1=R|year=1999|title=The relationship between homeopathy and the Dr Bach system of flower remedies: A critical appraisal|journal=British Homoeopathic Journal|volume=88|issue=3|pages=121–27|doi=10.1054/homp.1999.0308|pmid=10449052}}</ref>


=== Dilutions ===
Later in the nineteenth century the following miasms, which are considered intermediate in severity between sycosis and syphilis, were further delineated:
{{Main|Homeopathic dilutions}}
* Tuberculosis: Associated with the infection as well as with life-threatening yet reversible asthma or pneumonia and (psychologically) with constant dissatisfaction and desire for change;
* Cancer: Associated with malignant states as well as Obsessive-Compulsive Disorder and psychological traits of perfectionism, and excessive responsibility or ambition.


]'' (wolf's bane) D6, i.e. the nominal dilution is one ] (10<sup>'''-6'''</sup>).]]Hahnemann claimed that undiluted doses caused reactions, sometimes dangerous ones, and thus that preparations be given at the lowest possible dose.<ref name="Kayne 53">
More recently, the highly influential ] has further developed the understanding of the psychological qualities of miasms, and has made miasms an integral aspect of his diagnostic approach. He further expanded the list of miasms by largely supplanting Psora in favor of several, more specific miasms previously subsumed under it:
{{cite book|author=Kayne SB|url=https://books.google.com/books?id=w2IFcHJYTSYC&q=homeopathic%20proving%20method&pg=PA53|title=Homeopathic pharmacy: theory and practice|publisher=Elsevier Health Sciences|year=2006|isbn=978-0-443-10160-1|edition=2|page=53}}</ref> A solution that is more dilute is described as having a higher "potency", and thus are claimed to be stronger and deeper-acting.<ref>
* Acute: Diseases (whether acute of chronic) that present with a pattern of ''recover (with no ill effects) or succumb'';
{{cite web|title=Glossary of Homeopathic Terms|url=http://altmed.creighton.edu/Homeopathy/Glossary.htm|archive-url=https://web.archive.org/web/20121016234338/http://altmed.creighton.edu/Homeopathy/glossary.htm|archive-date=October 16, 2012|access-date=February 15, 2009|publisher=Creighton University Department of Pharmacology|df=mdy-all}}</ref> The general method of dilution is ], where solvent is added to part of the previous mixture, but the "Korsakovian" method may also be used. In the Korsakovian method, the vessel in which the preparations are manufactured is emptied, refilled with solvent, with the volume of fluid adhering to the walls of the vessel deemed sufficient for the new batch.<ref name="Shelton" />{{rp|270|date=January 2015}} The Korsakovian method is sometimes referred to as K on the label of a homeopathic preparation.<ref>{{cite web|date=January 22, 2011|title=Homeopathy: Diluted out of existence?|url=http://www.scilogs.com/in_scientio_veritas/homeopathy-diluted-out-of-existence/|access-date=June 15, 2015|publisher=scilogs.com/in_scientio_veritas}}</ref><ref>{{cite web|title=Homeopathic Medicine Potency or Dilution|url=http://www.ritecare.com/homeopathic/guide_potency.asp|archive-url=https://web.archive.org/web/20150821064849/http://www.ritecare.com/homeopathic/guide_potency.asp|archive-date=August 21, 2015|access-date=June 15, 2015|publisher=ritecare.com}}</ref> Another method is Fluxion, which dilutes the substance by continuously passing water through the vial.<ref>{{Cite journal|last=Winston|first=Julian|date=1989-04-01|title=A brief history of potentizing machines|url=http://www.sciencedirect.com/science/article/pii/S000707858980050X|journal=British Homoeopathic Journal|language=en|volume=78|issue=2|pages=59–68|doi=10.1016/S0007-0785(89)80050-X|s2cid=71942187 |issn=0007-0785}}</ref> Insoluble solids, such as ], ], and ], are diluted by grinding them with lactose ("]").<ref name="Shelton" />{{rp|23}}
* Typhus (after the clinical pattern of the infection): Enormous, short-term struggle followed by recovery;
* Ringworm (after the clinical pattern of the infection): Cyclical recovery followed by likely recurrence;
* Malaria (after the clinical pattern of the infection): Low-grade, fixed illness (similar to a sycotic manifestation) punctuated by acute exacerbations.
He further added a miasm between cancer and syphilis:
* Leprosy (after the clinical pattern of the infection): Destructive, irreversible, yet not necessarily life-threatening manifestations such as leprosy and other disfigurements and AIDS that lead to both physical and social disability.


Three main ] dilution 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. There is also a decimal dilution scale (notated as "X" or "D") in which the preparation is diluted by a factor of 10 at each stage.<ref>{{cite web|url=http://www.ritecare.com/homeopathic/guide_potency.asp|title=Homeopathic Medicine Potency or Dilution|archive-url=https://web.archive.org/web/20150821064849/http://www.ritecare.com/homeopathic/guide_potency.asp|archive-date=August 21, 2015|access-date=June 15, 2015}}</ref> The centesimal scale was favoured by Hahnemann for most of his life, although in his last ten years Hahnemann developed a quintamillesimal (Q) scale which diluted the drug 1 part in 50,000.<ref>{{Cite journal|last1=Adler|first1=U. C.|last2=Adler|first2=M. S.|date=2006|title=Hahnemann's experiments with 50 millesimal potencies: a further review of his casebooks|journal=Homeopathy|volume=95|issue=3|pages=171–181|doi=10.1016/j.homp.2006.03.003|issn=1475-4916|pmid=16815521|s2cid=3760829 }}</ref> A 2C dilution works out to one part of the original substance in 10,000 parts of the solution. In standard chemistry, this produces a substance with a concentration of 0.01% (]). A 6C dilution ends up with the original substance diluted by a factor of 100<sup>−6</sup> (one part in one trillion). The end product is usually so diluted as to be indistinguishable from the diluent (pure water, sugar or alcohol).<ref name="Dynamization and Dilution" /><ref name="homsim">
Miasms are determined through careful inquiry into the patient's personal and family medical history in search for previous infections (especially ones that from which recovery was incomplete) such as tuberculosis or diseases such as cancer. The presence of such manifestations can influence the choice of remedy beyond the presenting symptoms, and also provides a prognostic measure in a similar way as familial inheritance influences prognosis in conventional medicine.
{{cite web
|title = Similia similibus curentur (Like cures like)
|publisher = Creighton University Department of Pharmacology
|url = http://altmed.creighton.edu/Homeopathy/philosophy/similia.htm
|access-date = August 20, 2007
|archive-url = https://web.archive.org/web/20070808051756/http://altmed.creighton.edu/Homeopathy/philosophy/similia.htm
|archive-date = August 8, 2007
|df = mdy-all
}}</ref> The greatest dilution reasonably likely to contain at least one molecule of the original substance is approximately 12C.<ref>{{cite web|last1=Page 3|title=Alternative Medicine: Homeopathy-A Review|url=http://www.ijopjournal.com/File_Folder/57-69.pdf|archive-url=https://web.archive.org/web/20150903231608/http://www.ijopjournal.com/File_Folder/57-69.pdf|archive-date=September 3, 2015|access-date=August 10, 2015|publisher=International Journal of Pharmacotherapy|df=mdy-all}}</ref>


Hahnemann advocated dilutions of 1 part to 10<sup>60</sup> or 30C.<ref name="Organon_6th_128">
The acceptance of miasms varies within the homeopathic community. Some homeopaths find the concept unhelpful or otherwise unacceptable; others will make occasional use of it; while other yet strive in every case to determine the miasmatic nature of the illness in order to facilitate prescribing (since remedy selection can be assisted by knowledge of the miasm). Of the latter two groups some regard miasms as objective features of the disease, while others view them merely as clinically useful categorizations.
{{cite book
|author =Hahnemann S
|title =The Organon of the Healing Art
|year =1921
|publisher =Keats Pub.
|edition =6th
|at =aphorism 128
|isbn =978-0-87983-228-5
}}</ref> Hahnemann regularly used dilutions of up to 30C but opined that "there must be a limit to the matter".<ref name="Haehl1922" />{{rp|322|date=January 2015}} To counter the reduced potency at high dilutions he formed the view that vigorous shaking by striking on an elastic surface – a process termed ''succussion'' – was necessary.<ref name="Kayne 53" /> Homeopaths are unable to agree on the number and force of strikes needed, and there is no way that the claimed results of succussion can be tested.<ref name="Shelton" />{{rp|67–69|date=January 2015}}


Critics of homeopathy commonly emphasize the dilutions involved in homeopathy, using analogies.<ref name="Appendix2">For further discussion of homeopathic dilutions and the mathematics involved, see ].</ref> One mathematically correct example is that a 12C solution is equivalent to "a pinch of salt in both the North and South Atlantic Oceans".<ref name="Bambridge">
== History ==
{{cite book|author=Bambridge AD|title=Homeopathy investigated|publisher=Diasozo Trust|year=1989|isbn=978-0-948171-20-8|location=], England}}</ref><ref name="Andrews">
According to homeopathic lore, Hahnemann began developing the homeopathic method after coming upon the idea that "like cures like" while translating a work on malaria. Upon reaching a passage stating that ] was an effective treatment because it was bitter and astringent, Hahnemann felt this implausible because there were many other substances that were equally bitter yet lacked any therapeutic value. To better understand the effects of quinine, he decided to take it himself and observed that his reactions were similar to the symptoms of the disease it was used to treat.
{{cite web|author=Andrews P|year=1990|title=Homeopathy and Hinduism|url=http://www.watchman.org/na/homeopth.htm|publisher=]|periodical=The Watchman Expositor|volume=7|issue=3}}</ref><ref>
A 12C solution produced using ] (also called ''natrum muriaticum'' in homeopathy) is the equivalent of dissolving 0.36&nbsp;mL of table salt, weighing about 0.77&nbsp;g, into a volume of water the size of the Atlantic Ocean, since the volume of the Atlantic Ocean and its adjacent seas is 3.55×10<sup>8</sup>&nbsp;km<sup>3</sup> or 3.55×10<sup>20</sup>&nbsp;L :
{{cite book|url=https://books.google.com/books?id=6J0TAAAAYAAJ&q=355+x+106+km3+in+the+whole|title=The geology of the Atlantic Ocean|vauthors=Emery KO, Uchupi E|publisher=Springer|year=1984|isbn=978-0-387-96032-6}}</ref> One-third of a ] of some original substance diluted into all the water on Earth would produce a preparation with a concentration of about 13C.<ref name="Appendix2" /><ref>The volume of all water on earth is about 1.36×10<sup>9</sup>&nbsp;km<sup>3</sup>:
{{cite web
|url = http://ga.water.usgs.gov/edu/waterdistribution.html
|title = Earth's water distribution
|website= ]
|date = August 28, 2006
|access-date = March 14, 2008
|archive-date = June 29, 2012
|archive-url = https://web.archive.org/web/20120629055146/http://ga.water.usgs.gov/edu/waterdistribution.html
}}</ref><ref>Gleick PH, ''Water resources'', In
{{cite book
|title =Encyclopedia of climate and weather
|editor1 =Schneider SH
|publisher =]
|location =New York
|volume =2
|year =1996
|pages =817–823
}}</ref> ] points out that a 200C dilution of duck liver, marketed under the name ], would require 10<sup>320</sup> universes worth of molecules to contain just one original molecule in the final substance.<ref>{{cite book
|title =Superstition: Belief in the Age of Science
|url =https://archive.org/details/superstitionbeli00park
|url-access =limited
|author =Robert L. Park
|author-link =Robert L. Park
|publisher =Princeton University Press
|year =2008
|pages =–46
|isbn=978-0-691-13355-3}}</ref> The high dilutions characteristically used are often considered to be the most controversial and implausible aspect of homeopathy.<ref>{{cite journal |last1=Fisher |first1=P |title=The Memory of Water: a scientific heresy? |journal=Homeopathy |volume=96 |issue=3 |pages=141–2 |year=2007 |pmid=17678808 |doi=10.1016/j.homp.2007.05.008|s2cid=3737723 }}</ref>


===Provings===
For Hahnemann and his students the whole of the body and spirit was the focus of therapy, not just the localised disease. Hahnemann himself spent extended periods of time with his patients, asking them questions that dealt not only with their particular symptoms or illness, but also with the details of their daily lives. It is also suggested that the gentle approach of homeopathy was a reaction to the violent forms of ] common at the time, which included techniques such as bleeding as a matter of course.
Homeopaths claim that they can determine the properties of their preparations by following a method which they call "proving".<ref>{{cite journal |last1=Dantas |first1=F |last2=Fisher |first2=P |last3=Walach |first3=H |last4=Wieland |first4=F |last5=Rastogi |first5=D |last6=Teixeira |first6=H |last7=Koster |first7=D |last8=Jansen |first8=J |last9=Eizayaga |first9=J |title=A systematic review of the quality of homeopathic pathogenetic trials published from 1945 to 1995 |journal=Homeopathy |volume=96 |issue=1 |pages=4–16 |year=2007 |pmid=17227742 |doi=10.1016/j.homp.2006.11.005|s2cid=3689226 }}</ref> As performed by Hahnemann, provings involved administering various preparations to healthy volunteers. The volunteers were then observed, often for months at a time. They were 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.<ref>{{cite book|last1=Bradford|first1=Thomas Lindsley|title=The Life and Letters of Dr. Samuel Hahnemann|date=1895|publisher=Boericke & Tafel|location=Philadelphia|isbn=978-1-330-00150-9|pages=–04|url=https://archive.org/details/lifelettersofdrs00brad|access-date=August 27, 2015}}</ref> At first Hahnemann used undiluted doses for provings, but he later advocated provings with preparations at a 30C dilution,<ref name="Organon_6th_128" /> and most modern provings are carried out using ultra-dilute preparations.<ref>
{{cite book|url=https://books.google.com/books?id=w2IFcHJYTSYC&q=homeopathic+proving+method&pg=PA52|title=Homeopathic pharmacy: theory and practice|author=Kayne SB|publisher=Elsevier Health Sciences|year=2006|isbn=978-0-443-10160-1|edition=2|page=52}}</ref>


Provings are claimed to have been important in the development of the ], due to their early use of simple control groups, systematic and quantitative procedures, and some of the first application of ] in medicine.<ref>
Homeopathy was brought to America in 1825 and rapidly gained in popularity, partly due to the fact that the excesses of conventional medicine were especially extreme there, and partly due to the efforts of Constantine Hering. Homeopathy reached its peak of popularity in America in the decades 1865&ndash;1885 and thereafter declined due to a combination of the recognition by the establishment of the dangers of large doses of drugs and bleeding and dissent between different schools of homeopathy.
{{cite book
|author=Cassedy JH
|title=American Medicine and Statistical Thinking, 1800–1860
|publisher=iUniverse
|year=1999
|isbn=978-1-58348-428-9
}}{{Page needed|date=March 2011}}</ref> The lengthy records of ] by homeopaths have occasionally proven useful in the development of modern drugs: For example, evidence that ] might be useful as a treatment for ] was discovered by looking through homeopathic provings, though homeopaths themselves never used it for that purpose at that time.<ref name="pmid2866851">
{{cite journal
|author=Fye WB
|title=Nitroglycerin: a homeopathic remedy
|journal=Circulation
|volume=73
|issue=1
|pages=21–29
|year=1986
|pmid=2866851
|doi=10.1161/01.CIR.73.1.21
|doi-access=free
}}</ref> The first recorded provings were published by Hahnemann in his 1796 ''Essay on a New Principle''.<ref>
{{cite journal
|author=Hahnemann S
|title=Versuch über ein neues Prinzip zur Auffindung der Heilkräfte der Arzneisubstanzen, nebst einigen Blicken auf die bisherigen
|journal=]
|editor=C. W. Hufelands
|language=de
|volume=II
|issue=3
|year=1796
}}</ref> His ''Fragmenta de Viribus'' (1805)<ref>
{{cite book
|title=Fragmenta de Viribus medicamentorum Positivis
|author=Hahnemann S
|language=la
|location=Leipzig
|year=1805
}}</ref> contained the results of 27 provings, and his 1810 ''Materia Medica Pura'' contained 65.<ref>
{{cite book
|title=Materia medica pura; sive, Doctrina de medicamentorum viribus in corpore humano sano observatis; e Germanico sermone in Latinum conversa
|vauthors=Hahnemann S, Stapf E, Gross G, de Brunnow EG |language=la
|location=Dresden
|publisher=Arnold
|year=1826–1828
|oclc=14840659
}}</ref> For James Tyler Kent's 1905 ''Lectures on Homoeopathic Materia Medica'', 217 preparations underwent provings and newer substances are continually added to contemporary versions.<ref>{{Cite book|last=Kent|first=James Tyler|url=https://books.google.com/books?id=c-ArAQAAMAAJ|title=Lectures on Homoeopathic Materia Medica|date=1905|publisher=Boericke & Tafel|isbn=978-0-7222-9856-5|language=en}}</ref><ref>{{Cite book|last=Kent|first=James Tyler|url=https://books.google.com/books?id=RZtEPAAACAAJ|title=Lectures on Homoeopathic Materia Medica: Together With Kent's "New Remedies" Incorporated and Arranged in One Alphabetical Order|date=2020-03-31|publisher=B. Jain Publishers (P) Limited|isbn=978-81-319-0259-2|language=en}}</ref>


Though the proving process has superficial similarities with clinical trials, it is fundamentally different in that the process is subjective, not ], and modern provings are unlikely to use pharmacologically active levels of the substance under proving.<ref name="Creighton">{{cite web |url=http://altmed.creighton.edu/Homeopathy/science/validity.htm |title=Are the principles of Homeopathy scientifically valid? |publisher=Creighton University School of Medicine |archive-url=https://web.archive.org/web/20120816233729/http://altmed.creighton.edu/Homeopathy/science/validity.htm |archive-date=August 16, 2012 |df=mdy-all }}</ref> As early as 1842, Oliver Holmes had noted that provings were impossibly vague, and the purported effect was not repeatable among different subjects.<ref name="Holmes" />
Nearly as important as Hahnemann himself to the development and popularization of homeopathy was the American physician ] (] &ndash; ]). His most important contribution may be his repertory, which is still widely used today. Kent's approach to homeopathy was decidedly authoritarian, emphasizing the metaphysical and clinical aspects of Hahnemann's teachings, in particular


== Evidence and efficacy ==
* insistence on the doctrines of miasm and vitalism;
{{main|Evidence and efficacy of homeopathy}}
* more emphasis on psychological symptoms (as opposed to physical pathology) in prescribing; and
Outside of the ] community, scientists have long considered homeopathy a sham<ref name="aaci2">{{cite journal|last1=Caulfield|first1=Timothy|last2=Rachul|first2=Christen|year=2011|title=Supported by science?: What Canadian naturopaths advertise to the public|journal=Allergy, Asthma & Clinical Immunology|volume=7|issue=1 |page=14|doi=10.1186/1710-1492-7-14|pmc=3182944|pmid=21920039|quote=Within the non-CAM scientific community, homeopathy has long been viewed as a sham|author-link1=Timothy Caulfield |doi-access=free }}</ref> or a ],<ref name="Tuomela p83-101">{{cite book |author=Tuomela, R |title=Rational Changes in Science |chapter=Science, Protoscience, and Pseudoscience |publisher=Springer |year=1987 |isbn=978-94-010-8181-8 |veditors=Pitt JC, Marcello P |series=Boston Studies in the Philosophy of Science |volume=98 |pages=83–101 |doi=10.1007/978-94-009-3779-6_4 |author-link=Raimo Tuomela|issn = 0068-0346}}</ref><ref name="Why">{{cite journal |vauthors=Mukerji N, Ernst E |title=Why homoeopathy is pseudoscience |journal=Synthese |date=14 September 2022 |volume=200 |issue=5 |eissn=1573-0964 |doi=10.1007/s11229-022-03882-w |pmid=|s2cid=252297716 |url= |doi-access=free }}</ref><ref name="Baran20142">{{cite book|vauthors=Baran GR, Kiana MF, Samuel SP|title=Healthcare and Biomedical Technology in the 21st Century |chapter=Science, Pseudoscience, and Not Science: How do They Differ? |publisher=Springer|year=2014|isbn=978-1-4614-8540-7|pages=19–57|doi=10.1007/978-1-4614-8541-4_2|quote=within the traditional medical community it is considered to be quackery}}</ref><ref name="Ladyman2">{{cite book|author=Ladyman J|title=Philosophy of Pseudoscience: Reconsidering the Demarcation Problem|publisher=University of Chicago Press|year=2013|isbn=978-0-226-05196-3|veditors=Pigliucci M, Boudry M|pages=48–49|chapter=Chapter 3: Towards a Demarcation of Science from Pseudoscience|quote=Yet homeopathy is a paradigmatic example of pseudoscience. It is neither simply bad science nor science fraud, but rather profoundly departs from scientific method and theories while being described as scientific by some of its adherents (often sincerely).}}</ref> and the medical community regards it as ].<ref name="Baran20142" /> There is an overall absence of sound ] of therapeutic efficacy, which is consistent with the lack of any ] pharmacological ] or mechanism.<ref name="pmid124926032" /> Proponents argue that homeopathic medicines must work by some, as yet undefined, biophysical mechanism.<ref name="Vickers 1115–11182" /> No homeopathic preparation has been shown to be different from ].<ref name="pmid124926032" />
* regular use of very high potencies.


=== Lack of scientific evidence ===
Kent's influence in America was somewhat limited, but his ideas were re-imported into the ], where they became the homeopathic orthodoxy by the end of the ].{{fn|1}}
The lack of convincing scientific evidence supporting its efficacy<ref name="Adler2">{{Cite news|author=Adler J|date=February 4, 2004|title=No way to treat the dying|magazine=]|url=http://www.newsweek.com/id/105581}}</ref> and its use of preparations without active ingredients have led to characterizations of homeopathy as pseudoscience and quackery,<ref name="Dearden2">{{cite news|last=Dearden|first=Lizzie|date=February 7, 2017|title=Russian Academy of Sciences says homeopathy is dangerous 'pseudoscience' that does not work|newspaper=]|url=https://www.independent.co.uk/news/world/europe/russia-academy-of-sciences-homeopathy-treaments-pseudoscience-does-not-work-par-magic-a7566406.html|access-date=February 7, 2017}}</ref><ref name="pmid146761792">{{cite journal|last1=Atwood|first1=KC|year=2003|title="Neurocranial restructuring" and homeopathy, neither complementary nor alternative|journal=Archives of Otolaryngology–Head & Neck Surgery|volume=129|issue=12|pages=1356–57|doi=10.1001/archotol.129.12.1356|pmid=14676179}}</ref><ref name="NdububaQuack2">{{cite journal|last1=Ndububa|first1=VI|year=2007|title=Medical quackery in Nigeria; why the silence?|journal=Nigerian Journal of Medicine|volume=16|issue=4|pages=312–17|doi=10.4314/njm.v16i4.37328|pmid=18080586|doi-access=free}}</ref> or, in the words of a 1998 medical review, "placebo therapy at best and quackery at worst".<ref name="Ernst2">{{cite journal|last1=Ernst|first1=E|last2=Pittler|first2=MH|year=1998|title=Efficacy of homeopathic arnica: a systematic review of placebo-controlled clinical trials|journal=Archives of Surgery|volume=133|issue=11|pages=1187–90|doi=10.1001/archsurg.133.11.1187|pmid=9820349|doi-access=free}}</ref> The ] considers homeopathy a "dangerous 'pseudoscience' that does not work", and "urges people to treat homeopathy 'on a par with magic{{'"}}.<ref name="Dearden2" /> The Chief Medical Officer for England, ], has stated that homeopathic preparations are "rubbish" and do not serve as anything more than placebos.<ref>{{cite news|last=Silverman|first=Rosa|title=Homeopathy is 'rubbish', says chief medical officer|work=]|location=London|url=https://www.telegraph.co.uk/health/healthnews/9822744/Homeopathy-is-rubbish-says-chief-medical-officer.html|archive-url=https://web.archive.org/web/20130126102237/http://www.telegraph.co.uk/health/healthnews/9822744/Homeopathy-is-rubbish-says-chief-medical-officer.html|archive-date=January 26, 2013|access-date=January 24, 2013|issn=0307-1235|oclc=49632006}}</ref> In 2013, ], the UK ] and head of the ] said "homeopathy is nonsense, it is non-science."<ref name="Collins2">{{cite news|author=Nick Collins|date=April 18, 2013|title=Homeopathy is nonsense, says new chief scientist|work=]|url=https://www.telegraph.co.uk/health/healthnews/10003680/Homeopathy-is-nonsense-says-new-chief-scientist.html|archive-url=https://web.archive.org/web/20130420234704/http://www.telegraph.co.uk/health/healthnews/10003680/Homeopathy-is-nonsense-says-new-chief-scientist.html|archive-date=April 20, 2013}}</ref> His predecessor, ], also said that homeopathy "has no underpinning of scientific basis" and is being "fundamentally ignored" by the Government.<ref>{{Cite web|last=Gray|first=Richard|date=April 9, 2013|title=Homeopathy on the NHS is 'mad' says outgoing scientific adviser|url=https://www.telegraph.co.uk/news/health/news/9982234/Homeopathy-on-the-NHS-is-mad-says-outgoing-scientific-adviser.html |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/news/health/news/9982234/Homeopathy-on-the-NHS-is-mad-says-outgoing-scientific-adviser.html |archive-date=January 11, 2022 |url-access=subscription |url-status=live|access-date=2020-10-28|website=The Telegraph|language=en-GB}}{{cbignore}}</ref>


Jack Killen, acting deputy director of the ], says homeopathy "goes beyond current understanding of chemistry and physics". He adds: "There is, to my knowledge, no condition for which homeopathy has been proven to be an effective treatment."<ref name="Adler2" /> ] says that homeopaths who misrepresent scientific evidence to a ] public, have "... walled themselves off from academic medicine, and critique has been all too often met with avoidance rather than argument".<ref name="Goldacre20072">{{cite journal|last1=Goldacre|first1=Ben|year=2007|title=Benefits and risks of homoeopathy|journal=The Lancet|volume=370|issue=9600|pages=1672–73|doi=10.1016/S0140-6736(07)61706-1|pmid=18022024|s2cid=43588927}}</ref> Homeopaths often prefer to ignore ] in favour of ] positive results, such as by promoting a particular ] (one which Goldacre describes as "little more than a customer-satisfaction survey") as if it were more informative than a series of randomized controlled trials.<ref name="Goldacre20072" />
In the ] the popularity of homeopathy began to wane, especially in ] and the ], partly due to advances in biology and conventional medicine, to the ] (1910) which led (in North America) to the closure of virtually all medical schools teaching alternative medicine, and due to a decline in coherence in the homeopathic community. Homeopathy experienced a renaissance in the ], largely thanks to the efforts of ] in Europe and North America, that continues to this day. In India homeopathy had remained relatively strong throughout the 20th century due to its isolation from the above factors, and at present Indian homeopaths are among the most influential world-wide. Finally, the rise in popularity of homeopathy must also be seen as part of the general rise in interest in ] over the past few decades.{{fn|2}}


In an article entitled "Should We Maintain an Open Mind about Homeopathy?"<ref name="Baum_&_Ernst2">{{cite journal|last1=Baum|first1=Michael|last2=Ernst|first2=Edzard|year=2009|title=Should We Maintain an Open Mind about Homeopathy?|journal=The American Journal of Medicine|volume=122|issue=11|pages=973–74|doi=10.1016/j.amjmed.2009.03.038|pmid=19854319|quote=Homeopathy is among the worst examples of faith-based medicine... These axioms 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... To have an open mind about homeopathy or similarly implausible forms of alternative medicine (e.g., Bach Flower remedies, spiritual healing, crystal therapy) is, therefore, not an option}}</ref> published in the '']'', ] and ]{{spaced ndash}}writing to other physicians{{spaced ndash}}wrote that "Homeopathy is among the worst examples of faith-based medicine... These axioms 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...".
The ease with which large ]s can be manipulated has brought about profound changes in the way homeopathy is practised. Today many homeopaths use personal computers to sift through hundreds of thousands of pages of provings and case studies. Because the information about lesser-known remedies is more accessible, it is now more common for homeopaths to prescribe them, which in turn has lead to an increase in the number of new provings. Database technology has also encouraged researchers to reorganize and restructure existing information.


=== Plausibility of dilutions ===
''See also:'' ]
]: the "15C" dilution shown here means the original solution was diluted to 1/10<sup>30</sup> of its original strength.]]
The exceedingly low concentration of homeopathic preparations, which often lack even a single ] of the diluted substance,<ref name="Ernst2005" /> has been the basis of questions about the effects of the preparations since the 19th century.<ref name="GrimesFACT">{{cite journal|last1=Grimes|first1=D.R.|year=2012|title=Proposed mechanisms for homeopathy are physically impossible|journal=Focus on Alternative and Complementary Therapies|volume=17|issue=3|pages=149–55|doi=10.1111/j.2042-7166.2012.01162.x}}</ref> The laws of chemistry give this dilution limit, which is related to the ], as being roughly equal to 12C homeopathic dilutions (1 part in 10<sup>24</sup>).<ref name="Appendix2" /><ref name="Sbarrett2">{{cite web|author=Barrett S|date=December 28, 2004|title=Homeopathy: the ultimate fake|url=http://www.quackwatch.org/01QuackeryRelatedTopics/homeo.html|access-date=July 25, 2007|publisher=]}}</ref><ref name="dynam2">{{cite web|author=Faziola L|title=Dynamization and dilution|url=http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm|access-date=July 24, 2007|work=Homeopathy Tutorial|publisher=Creighton University School of Medicine|archive-date=August 26, 2002|archive-url=https://web.archive.org/web/20020826082134/http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm}}</ref> ] and the ] groups have highlighted the lack of ]s by taking large 'overdoses'.<ref name="Jones2">Sam Jones, , '']'', January 29, 2010</ref> 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".<ref name="Jones2" />


Modern advocates of homeopathy have proposed a concept of "]", according to which water "remembers" the substances mixed in it, and transmits the effect of those substances when consumed. This concept is inconsistent with the current understanding of matter, and water memory has never been demonstrated to have any detectable effect, biological or otherwise.<ref name="NatureWhenToBelieve2">{{cite journal|author=Maddox J|year=1988|title=When to believe the unbelievable|journal=Nature|type=editorial|volume=333|issue=6176|pages=1349–56|bibcode=1988Natur.333Q.787.|doi=10.1038/333787a0|pmid=<!--none-->|s2cid=4369459|doi-access=free}}</ref><ref name="delusion2">{{cite journal|last1=Maddox|first1=J|last2=Randi|first2=J|last3=Stewart|first3=W|year=1988|title="High-dilution" experiments a delusion|journal=Nature|volume=334|issue=6180|pages=287–91|bibcode=1988Natur.334..287M|doi=10.1038/334287a0|pmid=2455869|s2cid=9579433}}</ref> Existence of a ] in the absence of any true active ingredient is inconsistent with the ] and the observed ]s characteristic of therapeutic drugs.<ref name="Levy2">{{cite journal|last1=Levy|first1=G|year=1986|title=Kinetics of drug action: An overview|journal=Journal of Allergy and Clinical Immunology|volume=78|issue=4 Pt 2|pages=754–61|doi=10.1016/0091-6749(86)90057-6|pmid=3534056}}</ref> Homeopaths contend that their methods produce a therapeutically active preparation, selectively including only the intended substance, though in reality any water will have been in contact with millions of different substances throughout its history, and homeopaths cannot account for the selected homeopathic substance being isolated as a special case in their process.<ref name="Smith20122">{{cite journal|author=Smith K|year=2012|title=Homeopathy is Unscientific and Unethical|journal=Bioethics|volume=26|issue=9|pages=508–12|doi=10.1111/j.1467-8519.2011.01956.x|s2cid=143067523|url=https://zenodo.org/record/1035885 }}</ref>
=== Homeopathy around the world ===


Practitioners also hold that higher dilutions produce stronger medicinal effects. This idea is also inconsistent with observed dose-response relationships, where effects are dependent on the concentration of the active ingredient in the body.<ref name="Levy2" /> Some contend that the phenomenon of ] may support the idea of dilution increasing potency,<ref>{{cite journal|author1=Oberbaum, M|author2=Singer, SR|author3=Samuels, N.|date=Jul 2010|title=Hormesis and homeopathy: bridge over troubled waters|journal=Hum Exp Toxicol|volume=29|issue=7|pages=567–71|doi=10.1177/0960327110369777|pmid=20558608|s2cid=8107797|doi-access=free|bibcode=2010HETox..29..567O }}</ref><ref>{{cite journal|last1=Khuda-Bukhsh|first1=Anisur Rahman|date=2003|title=Towards understanding molecular mechanisms of action of homeopathic drugs: an overview|journal=Molecular and Cellular Biochemistry|volume=253|issue=1/2|pages=339–45|doi=10.1023/A:1026048907739|pmid=14619985|s2cid=10971539}}</ref> but the dose-response relationship outside the zone of hormesis declines with dilution as normal, and nonlinear pharmacological effects do not provide any credible support for homeopathy.<ref name="Smith20122" />
There are estimated{{fn|3}} to be over 100,000 physicians practising homeopathy world wide, with an estimated 500 million people receiving treatment. Over twelve thousand medical doctors and licensed health care practitioners administer homeopathic treatment in the United Kingdom, ], and ]. Since 2001 homeopathy is regulated in the ] by Directive 2001/83/EC. The latest amendments to this directive make it compulsory for all member states to implement a special registration procedure for homeopathic remedies.


===Efficacy===
<!--English speaking countries-->
{| class="wikitable floatright" style="width:40%;"
In the United Kingdom, as in most countries, homeopathic remedies may be sold over the counter. The UK has five homeopathic hospitals where treatment, funded by the ], is available and there are numerous regional clinics. Homeopathy is not practised by the majority of the medical profession but there is a core of public support, especially in ] and also from the English royal family.
|+ Explanations for efficacy of homeopathic preparations:<ref name="Shelton" />{{rp|155–167|date=November 2012}}<ref name="BrienRheumatology">{{cite journal |url= |title=Homeopathy has clinical benefits in rheumatoid arthritis patients that are attributable to the consultation process but not the homeopathic remedy: a randomized controlled clinical trial |author1=Brien S |author2=Lachance S |author3=Prescott P |author4=McDermott C |author5=Lewith G |journal=Rheumatology |date=June 2011 |volume=50 |issue=6 |pages=1070–82 |doi=10.1093/rheumatology/keq234 |pmid=21076131 |pmc=3093927}}</ref>
|-
| The ]
| The intensive consultation process and expectations for the homeopathic preparations may cause the effect
|-
| Therapeutic effect of the consultation
| The care, concern, and reassurance a patient experiences when opening up to a compassionate caregiver can have a positive effect on the patient's well-being.
|-
| Unassisted ]
| 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.
|-
| ]
| 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 of the timing of the visit to the homeopath they attribute improvement to the preparation taken.
|-
| Non-homeopathic treatment
| Patients may also receive standard medical care at the same time as homeopathic treatment, and the former is responsible for improvement.
|-
| Cessation of unpleasant treatment
| Often homeopaths recommend patients stop getting medical 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, but the underlying disease remains untreated and still dangerous to the patient.
|}


No individual homeopathic preparation has been unambiguously shown by research to be different from placebo.<ref name="pmid124926032" /> The ] quality of the early primary research was low, with problems such as weaknesses in ] and reporting, small ], and ]. Since better quality trials have become available, the evidence for efficacy of homeopathy preparations has diminished; the highest-quality trials indicate that the preparations themselves exert no intrinsic effect.<ref name="Caulfield20053" /><ref name="Shelton2">{{cite book|last=Shelton|first=JW|url=https://archive.org/details/homeopathyhowitr0000shel|title=Homeopathy: How it really works|publisher=]|year=2004|isbn=978-1-59102-109-4|location=Amherst, New York|url-access=registration}}</ref>{{rp|206|date=November 2012}}<ref name="Linde19992">{{cite journal|last1=Linde|first1=K|last2=Scholz|first2=M|last3=Ramirez|first3=G|last4=Clausius|first4=N|last5=Melchart|first5=D|last6=Jonas|first6=WB|year=1999|title=Impact of study quality on outcome in placebo-controlled trials of homeopathy|journal=Journal of Clinical Epidemiology|volume=52|issue=7|pages=631–36|doi=10.1016/S0895-4356(99)00048-7|pmid=10391656}}</ref> A review conducted in 2010 of all the pertinent studies of "best evidence" produced by the ] concluded that this evidence "fails to demonstrate that homeopathic medicines have effects beyond placebo."<ref name="Ernst20102" />
Homeopathy has been used in India since the middle of the ] and is today a widely practised and officially recognized system of medicine there. India has the largest homeopathic infrastructure in the world in terms of manpower, institutions and drug manufacturing industry. There are 300,000 qualified homeopaths, 180 colleges, 7500 government clinics, and 307 hospitals{{fn|4}}


In 2009, the United Kingdom's ] Science and Technology Committee concluded that there was no compelling evidence of effect other than placebo.<ref name="inquiry_cfm">UK Parliamentary Committee Science and Technology Committee. </ref> The Australian ] completed a comprehensive review of the effectiveness of homeopathic preparations in 2015, in which it concluded that "there were no health conditions for which there was reliable evidence that homeopathy was effective."<ref name="NHMRC2">{{cite book|author1=National Health and Medical Research Council|url=https://www.nhmrc.gov.au/guidelines-publications/cam02|title=NHMRC statement on homeopathy and NHMRC information paper – Evidence on the effectiveness of homeopathy for treating health conditions|date=2015|publisher=National Health and Medical Research Council|isbn=978-1-925129-29-8|location=Canberra|page=16|quote=There is no reliable evidence that homoeopathy is effective for treating health conditions.|author1-link=National Health and Medical Research Council|access-date=August 18, 2016|archive-url=https://web.archive.org/web/20170419065845/https://www.nhmrc.gov.au/guidelines-publications/cam02|archive-date=April 19, 2017|df=mdy-all}}</ref> The European Academies' Science Advisory Council (EASAC) published its official analysis in 2017 finding a lack of evidence that homeopathic products are effective, and raising concerns about quality control.<ref name="EASAC2017">{{cite web|date=September 2017|title=Homeopathic products and practices: assessing the evidence and ensuring consistency in regulating medical claims in the EU|url=http://www.easac.eu/fileadmin/PDF_s/reports_statements/EASAC_Homepathy_statement_web_final.pdf|access-date=1 October 2017|work=European Academies' Science Advisory Council|page=1|quote=... we agree with previous extensive evaluations concluding that there are no known diseases for which there is robust, reproducible evidence that homeopathy is effective beyond the placebo effect.}}</ref> In contrast a 2011 book was published, purportedly financed by the Swiss government, that concluded that homeopathy was effective and cost efficient.<ref>{{Cite book|last1=Bonhöft|first1=Gudrun|title=Homeopathy in healthcare: effectiveness, appropriateness, safety, costs.|last2=Matthiessen|first2=Peter|publisher=Springer|year=2012}}</ref> Although hailed by proponents as proof that homeopathy works,<ref name="ShawMisconduct2">{{cite journal|author=Shaw, David|date=May 2012|title=The Swiss report on homeopathy: a case study of research misconduct|journal=]|volume=142|pages=w13594|doi=10.4414/smw.2012.13594|pmid=22653406|doi-access=free}}</ref> it was found to be scientifically, logically and ethically flawed, with most authors having a ].<ref name="ShawMisconduct2" /> The ] later released a statement saying the book was published without the consent of the Swiss government.<ref>{{cite journal|author=Gurtner, Felix|date=December 2012|title=The report "Homeopathy in healthcare: effectiveness, appropriateness, safety, costs" is not a "Swiss report"|journal=]|volume=142|pages=w13723|doi=10.4414/smw.2012.13723|pmid=23255156|doi-access=free}}</ref>
In the United States, homeopathic remedies are, like all healthcare products, subject to regulation by the ]. However, the FDA accords homeopathic remedies a treatment significantly different from that accorded to other drugs. Homeopathic products are not required to be approved by the FDA prior to sale, not required to be proven either safe or effective prior to being sold, not required to be labeled with an expiration date, and not required to undergo finished product testing to verify contents and strength. Homeopathic remedies have their own imprints that, unlike conventional drugs, do not have to identify their active ingredients on the grounds that they have few or no active ingredients. In the United States only homeopathic medicines that claim to treat self-limiting conditions may be sold over the counter, while homeopathic medicines that claim to treat a serious disease can be sold only by prescription. Neither the ] nor the ] has an official policy for or against homeopathy, but unofficially, the AMA has denounced homeopathy as unscientific quackery, and will censure any physician who advocates homeopathy as a viable alternative to drug treatment or sugery. As an historical note, the AMA was originally founded in response to the American Foundation for Homeopathy, although it was not considered an official policy, nor stated anywhere in their charter. Reading the homeopathic journals of the time, however will highlight the intense political debate going on which prompted the formation of the AMA.


], essential tools to summarize evidence of therapeutic efficacy,<ref name="PRISMA2">{{cite journal|last1=Liberati|first1=A|last2=Altman|first2=DG|last3=Tetzlaff|first3=J|last4=Mulrow|first4=C|last5=Gøtzsche|first5=PC|last6=Ioannidis|first6=J PA|last7=Clarke|first7=M|last8=Devereaux|first8=PJ|last9=Kleijnen|first9=J|last10=Moher|first10=D|year=2009|title=The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration|journal=PLOS Medicine|volume=6|issue=7|pages=e1000100|doi=10.1371/journal.pmed.1000100|pmc=2707010|pmid=19621070|doi-access=free}}</ref> and ]s have found that the methodological quality in the majority of randomized trials in homeopathy have shortcomings and that such trials were generally of lower quality than trials of conventional medicine.<ref>{{cite journal|last1=Jonas|first1=WB|last2=Anderson|first2=RL|last3=Crawford|first3=CC|last4=Lyons|first4=JS|date=2001|title=A systematic review of the quality of homeopathic clinical trials|journal=BMC Complementary and Alternative Medicine|volume=1|page=12|doi=10.1186/1472-6882-1-12|pmc=64638|pmid=11801202 |doi-access=free }}</ref><ref name="pmid114160762">{{cite journal|last1=Linde|first1=K|last2=Jonas|first2=WB|last3=Melchart|first3=D|last4=Willich|first4=S|year=2001|title=The methodological quality of randomized controlled trials of homeopathy, herbal medicines and acupuncture|journal=International Journal of Epidemiology|volume=30|issue=3|pages=526–31|doi=10.1093/ije/30.3.526|pmid=11416076|author-link1=Klaus Linde|doi-access=free}}</ref> A major issue has been ], where positive results are more likely to be published in journals.<ref>{{cite journal|author=Jeffrey D. Scargle|year=2000|title=Publication Bias: The "file-drawer problem" in scientific inference|url=http://www.scientificexploration.org/journal/jse_14_1_scargle.pdf|journal=]|volume=14|issue=2|pages=94–106|arxiv=physics/9909033|bibcode=1999physics...9033S|access-date=January 19, 2011|archive-date=January 22, 2015|archive-url=https://web.archive.org/web/20150122021757/http://scientificexploration.org/journal/jse_14_1_scargle.pdf}}</ref>{{unreliable source?|date=February 2020}}<ref name="pmid160607222">{{cite journal|last1=Ioannidis|first1=John P. A.|year=2005|title=Why most published research findings are false|journal=PLOS Medicine|volume=2|issue=8|pages=e124|doi=10.1371/journal.pmed.0020124|pmc=1182327|pmid=16060722 |doi-access=free }}</ref><ref name="pmid18258002">{{cite journal|last1=Kleijnen|first1=J|last2=Knipschild|first2=P|last3=Ter Riet|first3=G|year=1991|title=Clinical trials of homoeopathy|journal=BMJ|volume=302|issue=6772|pages=316–23|doi=10.1136/bmj.302.6772.316|pmc=1668980|pmid=1825800}}</ref> This has been particularly marked in alternative medicine journals, where few of the published articles (just 5% during the year 2000) tend to report ]s.<ref name="Goldacre20072" /> A systematic review of the available systematic reviews confirmed in 2002 that higher-quality trials tended to have less positive results, and found no convincing evidence that any homeopathic preparation exerts clinical effects different from placebo.<ref name="pmid124926032" /> The same conclusion was also reached in 2005 in a meta-analysis published in ''The Lancet''. A 2017 systematic review and meta-analysis found that the most reliable evidence did not support the effectiveness of non-individualized homeopathy.<ref>{{Cite journal|last1=Mathie|first1=Robert T.|last2=Ramparsad|first2=Nitish|last3=Legg|first3=Lynn A.|last4=Clausen|first4=Jürgen|last5=Moss|first5=Sian|last6=Davidson|first6=Jonathan R. T.|last7=Messow|first7=Claudia-Martina|last8=McConnachie|first8=Alex|date=March 24, 2017|title=Randomised, double-blind, placebo-controlled trials of non-individualised homeopathic treatment: systematic review and meta-analysis|journal=Systematic Reviews|volume=6|issue=1|page=63|doi=10.1186/s13643-017-0445-3|issn=2046-4053|pmc=5366148|pmid=28340607 |doi-access=free }}</ref>
Homeopathy's popularity in the United States is growing. The 1995 retail sales of homeopathic medicines in the United States were estimated at US$201 million and growing at a rate of 20 percent a year, according to the American Homeopathic Pharmaceutical Association. The number of homeopathic practitioners in the United States has increased from fewer than 200 in the 1970s to approximately 3,000 in 1996.


Health organizations, including the UK's ],<ref name="nhs_choices2">{{cite web|title=Health A-Z -- Homeopathy|url=http://www.nhs.uk/conditions/Homeopathy/Pages/Introduction.aspx|access-date=April 22, 2013|publisher=National Health Service}}</ref> the ],<ref name="amapseudo2">{{cite web|author=AMA Council on Scientific Affairs|year=1997|title=Alternative medicine: Report 12 of the Council on Scientific Affairs (A–97)|url=http://www.ama-assn.org/ama/no-index/about-ama/13638.shtml|archive-url=https://web.archive.org/web/20090614085504/http://www.ama-assn.org/ama/no-index/about-ama/13638.shtml|archive-date=June 14, 2009|access-date=March 25, 2009|publisher=]}}</ref> the ],<ref name="Weissmann2">{{cite journal|last1=Weissmann|first1=G|year=2006|title=Homeopathy: Holmes, Hogwarts, and the Prince of Wales|journal=The FASEB Journal|volume=20|issue=11|pages=1755–58|doi=10.1096/fj.06-0901ufm|pmid=16940145|s2cid=9305843|doi-access=free}}</ref> and the ] of Australia,<ref name="NHMRC2" /> have issued statements saying that there is no good-quality evidence that homeopathy is effective as a treatment for any health condition.<ref name="nhs_choices2" /> In 2009, ] official ] criticized the use of homeopathy to treat ]; similarly, another WHO spokesperson argued there was no evidence homeopathy would be an effective treatment for ].<ref>{{cite news|date=August 20, 2009|title=Homeopathy not a cure, says WHO|work=BBC News|url=http://news.bbc.co.uk/2/hi/8211925.stm|access-date=October 20, 2014}}</ref> They warned against the use of homeopathy for serious conditions such as ], ] and ].<ref>{{cite journal|last=Mashta|first=O|date=August 24, 2009|title=WHO warns against using homoeopathy to treat serious diseases|journal=BMJ|volume=339|issue=aug24 2|pages=b3447|doi=10.1136/bmj.b3447|pmid=19703929|s2cid=9303173}}</ref> The ] and the ] recommend that no one use homeopathic treatment for disease or as a preventive health measure.<ref name="toxicfive2">{{cite web|author1=American College of Medical Toxicology|author1-link=American College of Medical Toxicology|author2=American Academy of Clinical Toxicology|author2-link=American Academy of Clinical Toxicology|date=February 2013|title=Five things physicians and patients should question|url=http://www.choosingwisely.org/doctor-patient-lists/american-college-of-medical-toxicology-and-the-american-academy-of-clinical-toxicology/|access-date=December 5, 2013|work=]: an initiative of the ]|publisher=American College of Medical Toxicology and American Academy of Clinical Toxicology}}, which cites {{cite journal|last1=Woodward|first1=KN|date=May 2005|title=The potential impact of the use of homeopathic and herbal remedies on monitoring the safety of prescription products|journal=Human & Experimental Toxicology|volume=24|issue=5|pages=219–33|doi=10.1191/0960327105ht529oa|pmid=16004184|bibcode=2005HETox..24..219W |s2cid=34767417}}</ref> These organizations report that no evidence exists that homeopathic treatment is effective, but that there is evidence that using these treatments produces harm and can bring indirect health risks by delaying conventional treatment.<ref name="toxicfive2" />
<!--deutschsprachiger Raum-->
In Germany, about 6,000 physicians specialize in homeopathy. In ] homeopathy, along with ] and ], were recognized as "special forms of therapy", meaning that their medications are freed from the usual requirement of proving efficacy. Since ], ] homeopathic medications, albeit with some exceptions, are no longer covered by the country's public health insurance{{fn|5}}. Most private health insurers continue to cover homeopathy.


===Purported effects in other biological systems===
In ] homeopathy has been a recognized part of the medical system since ].
While some articles have suggested that homeopathic solutions of high dilution can have statistically significant effects on organic processes including the growth of ]<ref>{{cite book
|author =Kolisko L
|trans-title =Physiological and physical evidence of the effectiveness of the smallest entities |title=Physiologischer und physikalischer Nachweis der Wirksamkeit kleinster Entitäten
|language =de
|location =Stuttgart
|year =1959
}}</ref> and ], such evidence is disputed since attempts to replicate them have failed.<ref name="pmid11316508">{{cite journal |last1=Walach |first1=H |last2=Köster |first2=H |last3=Hennig |first3=T |last4=Haag |first4=G |title=The effects of homeopathic belladonna 30CH in healthy volunteers – a randomized, double-blind experiment |journal=Journal of Psychosomatic Research |volume=50 |issue=3 |pages=155–60 |year=2001 |pmid=11316508 |doi=10.1016/S0022-3999(00)00224-5}}</ref><ref name="pmid8255290">{{cite journal |last1=Hirst |first1=SJ |last2=Hayes |first2=NA |last3=Burridge |first3=J |last4=Pearce |first4=FL |last5=Foreman |first5=JC |title=Human basophil degranulation is not triggered by very dilute antiserum against human IgE |journal=Nature |volume=366 |issue=6455 |pages=525–27 |year=1993 |pmid=8255290 |doi=10.1038/366525a0|bibcode=1993Natur.366..525H |s2cid=4314547 }}</ref><ref name="pmid1376282">{{cite journal |last1=Ovelgönne |first1=J. H. |last2=Bol |first2=AWJM |last3=Hop |first3=WCJ |last4=Wijk |first4=R |title=Mechanical agitation of very dilute antiserum against IgE has no effect on basophil staining properties |journal=Experientia |volume=48 |issue=5 |pages=504–08 |year=1992 |pmid=1376282 |doi=10.1007/BF01928175|s2cid=32110713 }}</ref><ref name="pmid16722785">{{cite journal |last1=Witt |first1=Claudia M |last2=Bluth |first2=M |last3=Hinderlich |first3=S |last4=Albrecht |first4=H |last5=Ludtke |first5=R |last6=Weisshuhn |first6=Thorolf ER |last7=Willich |first7=Stefan N |title=Does potentized HgCl<sub>2</sub> (mercurius corrosivus) affect the activity of diastase and amylase? |journal=Journal of Alternative and Complementary Medicine |volume=12 |pages=359–65 |year=2006 |doi=10.1089/acm.2006.12.359 |pmid=16722785 |issue=4}}</ref><ref name="pmid16036166">{{cite journal |last1=Guggisberg |first1=A |last2=Baumgartner |first2=S |last3=Tschopp |first3=C |last4=Heusser |first4=P |title=Replication study concerning the effects of homeopathic dilutions of histamine on human basophil degranulation in vitro |journal=Complementary Therapies in Medicine |volume=13 |issue=2 |pages=91–100 |year=2005 |pmid=16036166 |doi=10.1016/j.ctim.2005.04.003}}</ref><ref>{{cite journal|last1=Vickers|first1=AJ|title=Independent replication of pre-clinical research in homeopathy: a systematic review.|journal=Forschende Komplementärmedizin|date=December 1999|volume=6|issue=6|pages=311–20|doi=10.1159/000021286|pmid=10649002|s2cid=22051466}}</ref> In 2001 and 2004, ] published a number of studies that reported that homeopathic dilutions of ] exerted an effect on the activity of ]s.<ref>{{cite journal|last1=Brown|first1=V|last2=Ennis|first2=M|date=April 2001|title=Flow-cytometric analysis of basophil activation: inhibition by histamine at conventional and homeopathic concentrations|journal=Inflammation Research|volume=50|issue=Suppl 2|pages=S47–48|doi=10.1007/PL00022402|pmid=11411598|s2cid=10880180}}</ref><ref>{{cite journal|last1=Cumps|first1=J.|last2=Ennis|first2=M.|last3=Mannaioni|first3=P. F.|last4=Roberfroid|first4=M.|last5=Sainte-Laudy|first5=J.|last6=Wiegant|first6=F.A.C.|last7=Belon|first7=P.|date=April 1, 2004|title=Histamine dilutions modulate basophil activation|journal=Inflammation Research|volume=53|issue=5|pages=181–88|doi=10.1007/s00011-003-1242-0|pmid=15105967|s2cid=8682416}}</ref> In response to the first of these studies, '']'' aired a programme in which British scientists attempted to replicate Ennis' results; they were unable to do so.<ref>{{cite web|title=Homeopathy: The Test|url=http://www.bbc.co.uk/science/horizon/2002/homeopathytrans.shtml|access-date=April 29, 2015|publisher=BBC}}</ref> A 2007 systematic review of high-dilution experiments found that none of the experiments with positive results could be reproduced by all investigators.<ref>{{cite journal|last1=Witt|first1=CM|last2=Bluth|first2=M|last3=Albrecht|first3=H|last4=Weisshuhn|first4=TE|last5=Baumgartner|first5=S|last6=Willich|first6=SN|title=The in vitro evidence for an effect of high homeopathic potencies--a systematic review of the literature|journal=Complementary Therapies in Medicine|date=June 2007|volume=15|issue=2|pages=128–38|pmid=17544864|doi=10.1016/j.ctim.2007.01.011}}</ref>


In 1988, French immunologist ] published a paper in the journal '']'' while working at ].<ref>{{Cite journal|last1=Davenas|first1=E.|last2=Beauvais|first2=F.|last3=Amara|first3=J.|last4=Oberbaum|first4=M.|last5=Robinzon|first5=B.|last6=Miadonnai|first6=A.|last7=Tedeschi|first7=A.|last8=Pomeranz|first8=B.|last9=Fortner|first9=P.|last10=Belon|first10=P.|last11=Sainte-Laudy|first11=J.|date=1988|title=Human basophil degranulation triggered by very dilute antiserum against IgE|url=http://www.nature.com/articles/333816a0|journal=Nature|language=en|volume=333|issue=6176|pages=816–818|doi=10.1038/333816a0|pmid=2455231|bibcode=1988Natur.333..816D|s2cid=12992106|issn=0028-0836}}</ref> The paper purported to have discovered that basophils released histamine when exposed to a homeopathic dilution of anti-immunoglobulin E antibody. Skeptical of the findings, ''Nature'' assembled an independent investigative team to determine the accuracy of the research. After investigation the team found that the experiments were "statistically ill-controlled", "interpretation has been clouded by the exclusion of measurements in conflict with the claim", and concluded, "We believe that experimental data have been uncritically assessed and their imperfections inadequately reported."<ref name="delusion">
In ] homeopathy is one of the five classes of complementary medicine. At one time, homeopathic medications were covered by the basic health insurance system, as long as they were prescribed by a physician. This practice ended in June 2005. The Swiss Government, after a 5-year trial, has withdrawn insurance coverage for homoeopathy and four other complementary treatments because they did not meet efficacy and cost-effectiveness criteria.
{{cite journal |last1=Maddox |first1=J |last2=Randi |first2=J |last3=Stewart |first3=W |title="High-dilution" experiments a delusion |journal=Nature |volume=334 |issue=6180 |pages=287–91 |year=1988 |pmid=2455869 |doi=10.1038/334287a0 |bibcode=1988Natur.334..287M |s2cid=9579433 }}</ref><ref name="Sullivan 1988-07-27">
{{cite news
|author =Sullivan W
|title =Water that has a memory? Skeptics win second round
|date =July 27, 1988
|work =]
|url =https://www.nytimes.com/1988/07/27/us/water-that-has-a-memory-skeptics-win-second-round.html
|access-date =October 3, 2007
|author-link =Walter S. Sullivan
}}</ref><ref>Benveniste defended his results by comparing the inquiry to the Salem witch hunts and asserting that "It may be that all of us are wrong in good faith. This is no crime but science as usual and only the future knows."</ref>


== Ethics and safety ==
<!--The rest-->
]]]The provision of homeopathic preparations has been described as unethical.<ref name="unethical">{{cite journal |last1=Shaw |first1=DM |title=Homeopathy is where the harm is: Five unethical effects of funding unscientific 'remedies' |journal=Journal of Medical Ethics |volume=36 |issue=3 |pages=130–31 |year=2010 |pmid=20211989 |doi=10.1136/jme.2009.034959 |s2cid=206996446 |doi-access=free }}</ref><ref name="Shaw2010">{{cite journal |last=Shaw |first=David |title=Homeopathy and medical ethics |journal=Focus on Alternative and Complementary Therapies |publisher=Wiley |volume=16 |issue=1 |date=4 November 2010 |issn=1465-3753 |doi=10.1111/j.2042-7166.2010.01051.x |pages=17–21}}</ref> ], professor emeritus of surgery and visiting professor of medical humanities at ] (UCL), has described homeopathy as a "cruel deception".<ref name="Janes">{{cite news |author=Hilly Janes |url=http://www.timesonline.co.uk/tol/life_and_style/article4682309.ece |title=The Lifestyle 50: The top fifty people who influence the way we eat, exercise and think about ourselves |work=] |date=September 6, 2008 |archive-url=https://web.archive.org/web/20110727183929/http://www.timesonline.co.uk/tol/life_and_style/article4682309.ece |archive-date=July 27, 2011}}</ref> ], the first professor of ] in the United Kingdom and a former homeopathic practitioner,<ref name="Ernst_memo"> to the ]</ref><ref>
In ] the Instituto Politécnico Nacional (IPN) has had a school of Homeopathy since 1936. This school has both bachelor and master degrees.
{{cite news
|title=The alternative professor
|url=https://www.theguardian.com/science/2003/sep/25/scienceinterviews.health
|author=Boseley S
|newspaper=]
|date=July 21, 2008
|location=London
}}</ref><ref name="Con?">{{cite news
|url=https://www.independent.co.uk/life-style/health-and-wellbeing/features/complementary-therapies-the-big-con-813248.html
|title=Complementary therapies: The big con?
|work=The Independent
|access-date=May 4, 2010
|location=London
|date=April 22, 2008
|archive-url=https://web.archive.org/web/20090427070400/http://www.independent.co.uk/life-style/health-and-wellbeing/features/complementary-therapies-the-big-con-813248.html
|archive-date=April 27, 2009
}}</ref> has expressed his concerns about ]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.<ref>
{{cite news
|title=Pharmacists urged to 'tell the truth' about homeopathic remedies
|url=https://www.theguardian.com/science/2008/jul/21/pharmacists.homeophathy
|author=Sample I
|newspaper=]
|date=July 21, 2008
|location=London
}}</ref> In 2013 the ] concluded that the ] were targeting vulnerable ill people and discouraging the use of essential medical treatment while making misleading claims of efficacy for homeopathic products.<ref name="ASA">{{cite web|date=July 3, 2013|title=ASA adjudication on Society of Homeopaths|url=http://www.asa.org.uk/Rulings/Adjudications/2013/7/Society-of-Homeopaths/SHP_ADJ_157043.aspx|archive-url=https://web.archive.org/web/20130706020223/http://asa.org.uk/Rulings/Adjudications/2013/7/Society-of-Homeopaths/SHP_ADJ_157043.aspx|archive-date=July 6, 2013|access-date=July 4, 2013|publisher=ASA|df=mdy-all}}</ref> In 2015 the ] imposed penalties on a homeopathic company for making false or misleading statements about the efficacy of the whooping cough vaccine and recommending homeopathic remedies as an alternative.<ref name="ACCC">{{cite web|title=Court imposes penalty for false or misleading claims by Homeopathy Plus and Ms Frances Sheffield |url=https://www.accc.gov.au/media-release/court-imposes-penalty-for-false-or-misleading-claims-by-homeopathy-plus-and-ms-frances-sheffield|publisher=ACCC|access-date=March 31, 2016|date=October 14, 2015}}</ref>] preparation|alt=|left]]A 2000 review by homeopaths reported that homeopathic preparations are "unlikely to provoke severe adverse reactions".<ref>{{cite journal|last1=Dantas|first1=F|last2=Rampes|first2=H|year=2000|title=Do homeopathic medicines provoke adverse effects? A systematic review|journal=British Homoeopathic Journal|volume=89|pages=S35–S38|doi=10.1054/homp.1999.0378|pmid=10939781|s2cid=24738819}}</ref> In 2012, a systematic review evaluating evidence of homeopathy's possible ]s concluded that "homeopathy has the potential to harm patients and consumers in both direct and indirect ways".<ref name="sr2012">{{cite journal|last1=Posadzki|first1=P|last2=Alotaibi|first2=A|last3=Ernst|first3=E|year=2012|title=Adverse effects of homeopathy: A systematic review of published case reports and case series|journal=International Journal of Clinical Practice|volume=66|issue=12|pages=1178–88|doi=10.1111/ijcp.12026|pmid=23163497|s2cid=2930768|doi-access=free}}</ref> A 2016 systematic review and meta-analysis found that, in homeopathic clinical trials, adverse effects were reported among the patients who received homeopathy about as often as they were reported among patients who received placebo or conventional medicine.<ref>{{cite journal|last1=Stub|first1=T|last2=Musial|first2=F|last3=Kristoffersen|first3=AA|last4=Alræk|first4=T|last5=Liu|first5=J|date=June 2016|title=Adverse effects of homeopathy, what do we know? A systematic review and meta-analysis of randomized controlled trials|url=https://munin.uit.no/bitstream/10037/10908/4/article.pdf|journal=Complementary Therapies in Medicine|volume=26|pages=146–63|doi=10.1016/j.ctim.2016.03.013|pmid=27261996|hdl=10037/10908}}</ref>


Some homeopathic preparations involve poisons such as ], ], and ]. In rare cases, the original ingredients are present at detectable levels. This may be due to improper preparation or intentional low dilution. Serious adverse effects such as seizures and death have been reported or associated with some homeopathic preparations.<ref name="sr2012" /> Instances of ] have occurred.<ref name="J Toxicology: Arsenic toxicity" /> In 2009, the FDA advised consumers to stop using three discontinued cold remedy ] products because it could cause permanent damage to users' sense of smell.<ref>Sources:
== Diversity ==
There is, and always has been, considerable diversity in the theory and practice of homeopathy, some of which are mentioned below:


* {{cite news|author=Julianne Pepitone|date=June 16, 2009|title=Zicam may damage sense of smell – FDA|publisher=]|url=https://money.cnn.com/2009/06/16/news/companies/zicam_sense_of_smell/index.htm?section=money_latest}}
=== Pragmatism versus mysticism ===
* {{cite web|date=June 16, 2009|title=Information on Zicam Cold Remedy nasal gel, Zicam Cold Remedy nasal swabs, and Zicam Cold Remedy swabs, kids size|url=https://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm166834.htm|publisher=]}}</ref> In 2016 the FDA issued a safety alert to consumers<ref name="FDAconsumers">{{cite web |url=https://www.fda.gov/safety/medwatch/safetyinformation/safetyalertsforhumanmedicalproducts/ucm523435.htm |title=Homeopathic Teething Tablets and Gels: FDA Warning – Risk to Infants and Children |publisher=FDA |date=September 30, 2016 |access-date=October 17, 2016}}</ref> warning against the use of homeopathic teething gels and tablets following reports of adverse events after their use.<ref name="FDANewsRelease">{{cite web |url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm523468.htm |title=FDA warns against the use of homeopathic teething tablets and gels |publisher=FDA |date=September 30, 2016 |access-date=October 17, 2016}}</ref> A previous FDA investigation had found that these products were improperly diluted and contained "unsafe levels of belladonna" and that the reports of serious adverse events in children using this product were "consistent with belladonna toxicity".<ref name="arstechnicaFDA">{{cite web |url=http://arstechnica.co.uk/science/2016/10/fda-homeopathic-teething-gels-may-have-killed-10-babies-sickened-400/ |title=FDA: Homeopathic teething gels may have killed 10 babies, sickened 400 |publisher=Ars Technica UK |date=October 13, 2016 |access-date=October 17, 2016 |author=Mole, Beth}}</ref>
One notable distinction is between what can be called the 'pragmatic' and the 'mystical' approach - but it should be remembered that there are not two distinct groups, but a spectrum of attitudes and practices. An early advocate of pragmatism was Richard Hughes, while the most influential mystic was James Tyler Kent. The pragmatists tend to be open to "whatever works," whereas the mystics tend to rely on authority and tradition. There is still considerable diversity in both camps because the pragmatists usually define "working" based on personal experience and the mystics use various sources as authorities. The pragmatists tend to see homeopathy as ''complementary'' medicine and are more willing to co-exist with conventional doctors. The mystics, some of whom are also conventional doctors, see homeopathy as ''alternative'' medicine and have more confidence that homeopathy can be used effectively against all diseases. Pragmatists are more likely to be interested in proving homeopathy within the framework of mainstream science, and will talk about such concepts as the "memory of water" and stimulation of the immune system. The mystics see less need to justify their methods with conventional criteria; for them homeopathy acts on a vital force that is, so far, not accessible to science. The pragmatists are more likely to prescribe relatively low dilutions because the action of those seems more plausible, whereas mystics will often use high dilutions in single dose. Finally, pragmatists are more likely to use homeopathy in non-classical ways (see below).


Patients who choose to use homeopathy rather than ] risk missing timely diagnosis and effective treatment, thereby worsening the outcomes of serious conditions such as cancer.<ref name="Mayo Clinic Proceedings: trials" /><ref name="pmid12974558">{{cite journal |last1=Malik |first1=IA |last2=Gopalan |first2=S |title=Use of CAM results in delay in seeking medical advice for breast cancer |journal=European Journal of Epidemiology |volume=18 |issue=8 |pages=817–22 |year=2002 |pmid=12974558 |doi=10.1023/A:1025343720564 |s2cid=19059757 |quote=CAM use was associated with delay in seeking medical advice (OR: 5.6; 95% CI: 2.3, 13.3) and presentation at an advanced stage of disease}}</ref><ref name="pmid8554846" /><ref name="BBC malaria" /> The Russian ] has said homeopathy is not safe because "patients spend significant amounts of money, buying medicines that do not work and disregard already known effective treatment."<ref>{{Cite web|date=2017-02-07|title=Memorandum #2. Homeopathy as pseudoscience|url=http://klnran.ru/en/2017/02/memorandum02-homeopathy/|access-date=March 19, 2021|website=]}}</ref> Critics have cited cases of patients failing to receive proper treatment for diseases that could have been easily managed with conventional medicine and who have died as a result.<ref name="Baby_Gloria">Case of Baby Gloria, who died in 2002:
=== Classical versus non-classical homeopathy ===
*{{cite news
{{mainarticle|Classical homeopathy}}
|title = Homeopath Thomas Sam guilty of daughter Gloria's death
Hahnemann's formulation of homeopathy and subsequent advances are often referred to as ''classical homeopathy'' in contrast with variants of homeopathy that do not observe all of its original tenets: in particular, classical homeopaths use one remedy at a time and base their prescription also on incidental or constitutional symptoms. But in reality homeopathic remedies are frequently used both by professionals and by the lay public based on formulations marketed for specific medical conditions. Occasionally single remedies are so used, but more typically mixtures of several remedies known to be useful for certain conditions are used in a practice collectively known as ''complex homeopathy''. Some formulations are simply based on a 'shot-gun' approach of prescribing the most commonly indicated single remedies in mixture form, while other formulations, such as those by ''Heel'' and ''Reckeweg'', are proprietary mixtures marketed for specific diagnostic critera based on various diagostic systems described in accompanying manuals. Much of the public and some practitioners are not familiar with classical homeopathy and equate these practices with homeopathy; others are familiar with the classical approach but regard these as legitimate variants; while others yet consider it a misuse of the term as such practice merely represents the use of homeopathic preparations without regard to (classical) homeopathic principles. Numerically the use of non-classical approaches probably exceeds that of classical homeopathy, at least in places like France and Germany where over-the-counter preparations are popular and where many doctors use natural medicines in a conventional clinical setting.
|newspaper = ]
|location = Sydney
|date = June 5, 2009
|url = http://www.dailytelegraph.com.au/news/homeopath-thomas-sam-guilty-of-daughter-glorias-death/story-e6freuy9-1225723018271
|access-date = March 17, 2010
|archive-date = November 18, 2012
|archive-url = https://web.archive.org/web/20121118064506/http://www.dailytelegraph.com.au/news/homeopath-thomas-sam-guilty-of-daughter-glorias-death/story-e6freuy9-1225723018271
}}
*{{cite news
|title = Parents guilty of manslaughter over daughter's eczema death
|newspaper = ]
|date = June 5, 2009
|url = http://www.canberratimes.com.au/news/national/national/general/parents-guilty-of-manslaughter-over-daughters-eczema-death/1533293.aspx
|archive-url = https://web.archive.org/web/20100625160931/http://www.canberratimes.com.au/news/national/national/general/parents-guilty-of-manslaughter-over-daughters-eczema-death/1533293.aspx
|archive-date = June 25, 2010
|df = mdy-all
}}</ref><ref name="Dingle">{{cite web |author1=Alastair Neil Hope |author2=State Coroner |url=https://www.scribd.com/doc/68731728/Coroner-Dingle-Finding |title=Coroner's inquest into the death of Penelope Dingle. Ref No: 17/10 }}</ref> They have also condemned the "marketing practice" of criticizing and downplaying the effectiveness of medicine.<ref name="Goldacre20072" /><ref name="Dingle" /> Homeopaths claim that use of conventional medicines will "push the disease deeper" and cause more serious conditions, a process referred to as "suppression".<ref>
{{cite book
|author=Schmukler AV
|year=2006
|url=https://books.google.com/books?id=E1fVzLCmk5gC&q=suppression+homeopathy&pg=PA16
|title=Homeopathy: An A to Z Home Handbook
|publisher=Llewellyn Worldwide
|page=16
|isbn=978-0-7387-0873-7
}}</ref> In 1978, ], a consultant physician at the Royal London Homeopathic Hospital, criticized statements by ] claiming that ], when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the ].<ref>{{cite journal|author=Campbell A|date=October 1978|title=The science of homoeopathy, by G. Vithoulkas|journal=British Homoeopathic Journal|type=book review|volume=67|issue=4|pages=299–301|doi=10.1016/S0007-0785(78)80061-1|s2cid=69144584 }}</ref> Vithoulkas' claims echo the idea that treating a disease with external medication used to treat the symptoms would only drive it deeper into the body and conflict with scientific studies, which indicate that ] treatment produces a complete cure of syphilis in more than 90% of cases.<ref name="Birnbaum">{{cite journal|vauthors=Birnbaum NR, Goldschmidt RH, Buffett WO|year=1999|title=Resolving the common clinical dilemmas of syphilis|url=http://www.aafp.org/afp/990415ap/2233.html|journal=American Family Physician|volume=59|issue=8|pages=2233–40, 2245–46|pmid=10221308|access-date=September 3, 2007|archive-date=June 6, 2011|archive-url=https://web.archive.org/web/20110606033808/http://www.aafp.org/afp/990415ap/2233.html}}</ref>


The use of homeopathy as a preventive for serious infectious diseases, called ], is especially controversial.<ref name="BBC-malaria">{{cite news|date=January 5, 2011|title=Is bad homeopathic advice putting travellers at risk?|work=Newsnight|agency=BBC|url=http://news.bbc.co.uk/1/hi/programmes/newsnight/9341713.stm|access-date=January 10, 2015}}</ref> Some homeopaths (particularly those who are non-physicians) advise their patients against ].<ref name="pmid8554846" /><ref name="pmid9243229">{{cite journal |last1=Ernst |first1=E. |title=The attitude against immunisation within some branches of complementary medicine |journal=European Journal of Pediatrics |volume=156 |issue=7 |pages=513–15 |year=1997 |pmid=9243229 |doi=10.1007/s004310050650|s2cid=25420567 |doi-access=free }}</ref><ref>{{cite journal |last1=Ernst |first1=E |title=Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination |journal=Vaccine |volume=20 |pages=S90–93; discussion S89 |year=2001 |doi=10.1016/S0264-410X(01)00290-0 |pmid=11587822}}</ref> Others have suggested that vaccines be replaced with homeopathic "nosodes".<ref>
== The popularity of homeopathy ==
{{cite journal
Over the past two decades the use of homeopathic remedies and visits to homeopathic practitioners have increased. Possible reasons for this trend are:
|author =Pray WS
* ''Reported clinical efficacy:'' Some homeopathic patients may have personally found previous treatment to be effective, or heard from friends, colleagues, and the press of many cases in which a sickness was healed after homeopathic treatment. Some reinforce their favorable judgement with selective reference to positive scientific reports. Though they are aware that science has found no adequate explanation for the mechanism of homeopathy, they may subscribe to an empirical view of the matter: whatever works in their experience is good enough for them. This attitude arguably characterizes most health consumers nowadays, whose main concern is for perceived efficacy rather than scientific sanction of their treatment choice. This attraction is possibly further amplified from the inability by conventional healthcare to treat long term diseases.
|title =The challenge to professionalism presented by homeopathy
|journal =American Journal of Pharmaceutical Education
|volume =60
|pages =198–204
|year =1996
|issue =2
|doi =10.1016/S0002-9459(24)04582-0
}}</ref> While Hahnemann was opposed to such preparations, modern homeopaths often use them although there is no evidence to indicate they have any beneficial effects.<ref>
{{cite journal
|title =A challenge to the credibility of homeopathy
|journal =American Journal of Pain Management
|year =1992
|author =Pray WS
|issue =2
|pages =63–71
}}</ref><ref>{{cite journal |last1=English |first1=J |title=The issue of immunization |journal=British Homoeopathic Journal |volume=81 |pages=161–63 |year=1992 |doi=10.1016/S0007-0785(05)80171-1 |issue=4|s2cid=71502677 }}</ref> Promotion of homeopathic alternatives to vaccines has been characterized as dangerous, inappropriate and irresponsible.<ref name="CBC-Irresponsible">{{cite web|date=November 28, 2014|title=Vaccine alternatives offered by homeopaths 'irresponsible'|url=http://www.cbc.ca/news/health/vaccine-alternatives-offered-by-homeopaths-irresponsible-1.2852408|access-date=January 10, 2015|work=Marketplace|publisher=CBC}}</ref><ref name="BBC-Poling">{{cite news|author=Poling, Samantha|date=September 13, 2010|title=Doctors warn over homeopathic 'vaccines'|agency=BBC|url=https://www.bbc.co.uk/news/uk-scotland-11277990|access-date=January 10, 2015}}</ref> In December 2014, the Australian homeopathy supplier ] was found to have acted deceptively in promoting homeopathic alternatives to vaccines.<ref name="ACCC-HPlus">{{cite web|date=December 23, 2014|title=Court finds Homeopathy Plus! vaccine claims misleading|url=https://www.accc.gov.au/media-release/court-finds-homeopathy-plus-vaccine-claims-misleading|access-date=January 10, 2015|publisher=Australian Competition and Consumer Commission}}</ref> In 2019, an investigative journalism piece by the ] revealed that homeopathy practitioners were actively discouraging patients from vaccinating their children.<ref>{{Cite news|last1=Rushton|first1=Katherine|last2=Foggo|first2=Daniel|last3=Barnes|first3=Sophie|date=2019-11-01|title=Homeopaths warning mothers not to have children vaccinated, investigation reveals|language=en-GB|work=]|url=https://www.telegraph.co.uk/news/2019/11/01/homeopaths-warning-mothers-not-have-children-vaccinated-investigation/ |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/news/2019/11/01/homeopaths-warning-mothers-not-have-children-vaccinated-investigation/ |archive-date=January 11, 2022 |url-access=subscription |url-status=live|access-date=2019-11-03|issn=0307-1235}}{{cbignore}}</ref> Cases of homeopaths advising against the use of anti-malarial drugs have also been identified,<ref name="BBC malaria" /><ref name="Guardian malaria" /><ref name="pmid11082104" /> putting visitors to the tropics in severe danger.<ref name="BBC malaria">
{{cite news
|author =Jones M
|title =Malaria advice 'risks lives'
|date =July 14, 2006
|periodical =]
|publisher =]
|url =http://news.bbc.co.uk/2/hi/programmes/newsnight/5178122.stm
|access-date =March 24, 2009
}}</ref><ref name="Guardian malaria">
{{cite news
|author =Jha A
|title =Homeopaths 'endangering lives' by offering malaria remedies
|date =July 14, 2006
|url =https://www.theguardian.com/science/story/0,,1820103,00.html
|newspaper =]
|location =London
}}</ref><ref name="pmid11082104">{{cite journal |last1=Starr |first1=M. |title=Malaria affects children and pregnant women most |journal=BMJ |volume=321 |page=1288 |year=2000 |doi=10.1136/bmj.321.7271.1288 |issue=7271|pmc=1119021 |pmid=11082103}}</ref><ref name="Coffman">{{cite web|author=Coffman, Becky |url=https://www.cdc.gov/malaria/stories/homeopathic_drugs.html |url-status=dead |archive-url=https://web.archive.org/web/20140324180407/https://www.cdc.gov/malaria/stories/homeopathic_drugs.html |archive-date=March 24, 2014 |title=A cautionary tale: the risks of unproven antimalarials |publisher=] |date=January 28, 2019 }}{{cbignore}}</ref>


A 2006 review recommends that pharmacy colleges include a required course where ethical dilemmas inherent in recommending products lacking proven safety and efficacy data be discussed and that students should be taught where unproven systems such as homeopathy depart from evidence-based medicine.<ref>
* ''Disaffection with the establishment:'' Some reject the medical establishment, which is perceived to place too much emphasis on machines and chemicals and to treat the disease, not the person. Homeopathic practitioners often spend more time dealing with their patients than do conventional practitioners. Furthermore, homeopathic preparations have few if any side effects and are generally much cheaper than conventional medications.
{{cite journal
|author=Pray WS
|title=Ethical, scientific, and educational concerns with unproven medications
|journal=American Journal of Pharmaceutical Education
|volume=70
|issue=6
|page=141
|year=2006
|pmid=17332867
|pmc=1803699
|doi=10.5688/aj7006141
}}</ref>


==Regulation and prevalence==
* ''Attraction to the homeopathic world-view:'' Some are attracted to homeopathy through its holistic world-view, their desire for their story to be heard out in detail, their belief that their individually diagnosed complaints belong together in one pattern (classical homeopaths will usually prescribe one remedy to cover assorted ailments), and so on.
{{Main|Regulation and prevalence of homeopathy}}
]]]


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 practiced worldwide and professional qualifications and licences are needed in most countries.<ref name="Who Legal">{{Cite web|date=2001|title=Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review|url=http://apps.who.int/medicinedocs/pdf/h2943e/h2943e.pdf|archive-url=https://web.archive.org/web/20090927001352/http://apps.who.int/medicinedocs/pdf/h2943e/h2943e.pdf|archive-date=September 27, 2009|access-date=2020-09-01|website=World Health Organization}}</ref> A 2019 WHO report found that 100 out of 133 Member States surveyed in 2012 acknowledged that their population used homeopathy, with 22 saying the practice was regulated and 13 providing health insurance coverage.<ref name="WHO traditional">{{Cite web|date=4 June 2019|title=WHO global report on traditional and complementary medicine 2019|url=https://www.who.int/traditional-complementary-integrative-medicine/WhoGlobalReportOnTraditionalAndComplementaryMedicine2019.pdf?ua=1|access-date=2020-09-04|website=WHO|language=en}}</ref> 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 2001 homeopathy had been integrated into the national health care systems of many countries, including India, Mexico, Pakistan, Sri Lanka, and the United Kingdom.<ref name="Who Legal" />
* ''Exhaustion of other options:'' Some come to homeopathic treatment following years of other conventional or alternative treatment. They therefore try homeopathy, figuring that they have nothing to lose, even though in some cases they actively disbelieve it.


=== Regulation ===
==The scientific validity of homeopathy==
Some homeopathic treatment is covered by the public health service of several European countries, including Scotland,<ref>{{cite news |last1=Green |first1=Chris |title=Scotland urged to stop funding homeopathy on NHS |url=https://inews.co.uk/news/health/scotland-urged-stop-funding-homeopathy-nhs-522057 |access-date=18 January 2020 |publisher=iNews |date=2 August 2017}}</ref> and ].<ref>{{cite web |last1=Clarinval |first1=France |title=Homeopathy to remain reimbursable in Luxembourg |url=https://today.rtl.lu/news/luxembourg/a/1393668.html |website=today.rt.lu |publisher=RTL Today |access-date=4 May 2020}}</ref> It used to be covered in France until 2021.<ref name="FranceEndFunding2021" /> 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,<ref>
The following are the main scientific issues that arise in the ongoing debate between skeptics and proponents of homeopathy:
{{cite web|author=]|date=March 31, 2004|title=Liste nicht erstattungsfähiger Arzneimittelkategorien gemäß § 351c Abs. 2 ASVG (List of treatments not reimbursable by social service providers in Austria)|url=https://www.avsv.at/avi/dokument/dokumentanzeige.xhtml?dokid=2004%3D34&dokStat=0&csrId=1736&tlId=1231413537940|archive-url=https://web.archive.org/web/20110706091417/https://www.avsv.at/avi/dokument/dokumentanzeige.xhtml?dokid=2004%3D34&dokStat=0&csrId=1736&tlId=1231413537940|archive-date=July 6, 2011|language=de|df=mdy-all}}</ref> but exceptions can be made;<ref>
{{cite court|litigants=Rechtssatz (legal rule)|court=Oberster Gerichtshof (Austrian supreme court)|opinion=RS0083796 {{in lang|de}}|date=February 28, 1994|url=http://www.ris.bka.gv.at/Dokumente/Justiz/JJR_19940228_OGH0002_010OBS00103_9300000_001/JJR_19940228_OGH0002_010OBS00103_9300000_001.pdf|format=PDF}}</ref> private health insurance policies sometimes include homeopathic treatments.<ref name="Who Legal" /> In 2018, Austria's ] stopped teaching homeopathy.<ref name="Undark 2020-09-02">{{Cite web|date=2020-03-16|title=In Germany, a Heated Debate Over Homeopathy|url=https://undark.org/2020/03/16/homeopathy-globuli-germany/|access-date=2020-09-02|website=Undark Magazine|language=en-US}}</ref> The Swiss government withdrew coverage of homeopathy and four other complementary treatments in 2005, stating that they did not meet efficacy and cost-effectiveness criteria,<ref name="EndofHomeopathy">{{cite journal|author=<!-- No author listed -->|year=2005|title=The end of homoeopathy|journal=The Lancet|volume=366|issue=9487|page=690|doi=10.1016/S0140-6736(05)67149-8|pmid=16125567|s2cid=6115077|doi-access=free}}</ref> but following a referendum in 2009 the five therapies were reinstated for a further 6-year trial period.<ref>{{cite web|author=Dacey J|date=January 14, 2011|title=Alternative therapies are put to the test|url=http://www.swissinfo.ch/eng/swiss_news/Alternative_therapies_are_put_to_the_test.html?cid=29242484|access-date=January 17, 2011|publisher=swissinfo.ch|archive-date=April 22, 2014|archive-url=https://web.archive.org/web/20140422184705/http://www.swissinfo.ch/eng/swiss_news/Alternative_therapies_are_put_to_the_test.html?cid=29242484|url-status=dead}}</ref> In Germany, homeopathic treatments are covered by 70 percent of government medical plans, and available in almost every pharmacy.<ref name="Undark 2020-09-02" /> In January 2024, ] ] announced plans to withdraw all statutory health insurance coverage for homeopathic and anthroposophic treatments, citing a lack of scientific evidence for their efficacy.<ref>{{cite web|author=Tagesschau|date=January 11, 2024|title="Homöopathie macht als Kassenleistung keinen Sinn"|url=https://www.tagesschau.de/inland/innenpolitik/lauterbach-homoeopathie-kassenleistung-100.html|access-date=January 18, 2024|publisher=tagesschau.de}}</ref>


The English NHS recommended against prescribing homeopathic preparations in 2017.<ref name="NHS Homeo" /> In 2018, prescriptions worth £55,000 were written in defiance of the guidelines, representing less than 0.001% of the total NHS prescribing budget.<ref>{{Cite web|date=2017-10-18|title=Homeopathy|url=https://www.nhs.uk/conditions/homeopathy/|access-date=2020-01-18|website=nhs.uk|language=en}}</ref><ref>{{Cite news|last1=Donnelly|first1=Laura|last2=Taylor|first2=Rosie|date=2019-04-05|title=NHS still spending £55,000 a year on homeopathy, despite ban|language=en-GB|work=The Telegraph|url=https://www.telegraph.co.uk/news/2019/04/05/nhs-still-spending-55000-year-homeopathy-despite-ban/ |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/news/2019/04/05/nhs-still-spending-55000-year-homeopathy-despite-ban/ |archive-date=January 11, 2022 |url-access=subscription |url-status=live|access-date=2020-01-18|issn=0307-1235}}{{cbignore}}</ref> In 2016 the UK's ] compliance team wrote to homeopaths<ref name="NightingaleASA_CAP">{{cite web|date=September 29, 2016|title=Diluting misleading claims – ASA update|url=http://www.nightingale-collaboration.org/news/185-diluting-misleading-claims-asa-update.html|access-date=September 30, 2016|publisher=Nightingale Collaboration}}</ref> in the UK to "remind them of the rules that govern what they can and can't say in their marketing materials".<ref name="ASA_CAP">{{cite web|date=September 29, 2016|title=Advertising standards for homeopathy|url=https://www.asa.org.uk/News-resources/Media-Centre/2016/Advertising-standards-for-homeopathy.aspx|access-date=September 30, 2016|publisher=Advertising Standards Authority}}</ref> The letter told homeopaths to "ensure that they do not make any direct or implied claims that homeopathy can treat medical conditions" and asks them to review their marketing communications "including websites and social media pages" to ensure compliance.<ref name="LetterToHomeopaths">{{cite web|author=CAP Compliance Team|date=September 28, 2016|title=Advertising standsards for homeopaths|url=https://www.asa.org.uk/News-resources/Media-Centre/2016/~/media/Files/CAP/News/Letter%20to%20Homeopaths.pdf|archive-url=https://web.archive.org/web/20161003143347/https://www.asa.org.uk/News-resources/Media-Centre/2016/~/media/Files/CAP/News/Letter%20to%20Homeopaths.pdf|archive-date=October 3, 2016|access-date=September 30, 2016|publisher=Committee of Advertising Practice|df=mdy-all}}</ref> Homeopathic services offered at ] in the UK ceased in October 2015.<ref name="GoodThinking">{{cite web|date=June 5, 2015|title=Bristol Homeopathic Hospital To Cease Offering Homeopathic Treatments|url=http://goodthinkingsociety.org/bristol-homeopathic-hospital-cease-offering-homeopathic-treatments/|access-date=April 29, 2016|publisher=Good Thinking}}</ref><ref name="BristolPost-10-06-2015">{{cite news|last1=Cardwell|first1=Mark|date=June 10, 2015|title=Homeopathy services will no longer be available at Bristol NHS Trust hospitals|work=Bristol Post|url=http://www.bristolpost.co.uk/Homeopathy-services-longer-available-NHS-Bristol/story-26666377-detail/story.html|access-date=April 29, 2016|archive-url=https://web.archive.org/web/20150928025310/http://www.bristolpost.co.uk/Homeopathy-services-longer-available-NHS-Bristol/story-26666377-detail/story.html|archive-date=September 28, 2015|df=mdy-all}}</ref>
====Homeopathic claims contradict established scientific theories====
] consider homeopathy to be lacking any plausible mechanism. They often view homeopathy as a ] remnant from the age of ], when important concepts such as molecules and germs were understood poorly or not at all. In the view of modern scientists, the basic interactions of molecules are sufficient to explain all known chemical and biological phenomena, even if many processes are too complex to be understood at this time. This consensus developed during and after the formulation of homeopathy, as a result of discoveries like the size of atoms by ] in ], the synthesis of ] by ] in ], and advances in understanding many more diseases.


Member states of the ] are required to ensure that homeopathic products are registered, although this process does not require any proof of efficacy.<ref name="Commander Snake">{{Cite web|last=Commander|first=Emily|date=2018-10-01|title=Snake oil or science? Homeopathy in Europe|url=https://www.euronews.com/2018/10/01/snake-oil-or-science-homeopathy-in-europe|access-date=2020-09-04|website=euronews|language=en}}</ref> In Spain, the ] is lobbying to get rid of the easy registration procedure for homeopathic remedies.<ref name="Commander Snake" /> In Bulgaria, Hungary, Latvia, Romania and Slovenia homeopathy, by law, can only be practiced by medical practitioners. However, in Slovenia if doctors practice homeopathy their medical license will be revoked.<ref name="Commander Snake" /> In Germany, to become a homeopathic physician, one must attend a three-year training program, while France, Austria and Denmark mandate licences to diagnose any illness or dispense of any product whose purpose is to treat any illness.<ref name="Who Legal" /> Homeopaths in the UK are under no legal regulations, meaning anyone can call themselves homeopaths and administer homeopathic remedies.<ref name="NHS Homeo">{{Cite web|date=2017-10-18|title=Homeopathy|url=https://www.nhs.uk/conditions/homeopathy/|access-date=2020-09-02|website=nhs.uk|language=en}}</ref>], India]]
The primary criticism of homeopathy by established science are the lack of evidence in form of patient studies conforming to a high scientific standard and
], India]]
the lack of a chemical mechanism to explain how ultra-dilute solutions can retain an imprint of a molecule that no longer exists in solution. Regardless of whether the dilution medium is water or alcohol, ] does not allow for imprinting of anything in a liquid medium once those molecules have been diluted to near nonexistence and experiments trying to measure this effect have mostly failed.
The ] recognizes homeopathy as one of its national systems of medicine and they are sold with medical claims.<ref>{{cite web
|url = http://india.gov.in/citizen/health/healthcare_system.php
|title = Alternative System of Health Care
|publisher = Government of India
|access-date = January 15, 2010
|archive-url = https://web.archive.org/web/20100102154756/http://india.gov.in/citizen/health/healthcare_system.php
|archive-date = January 2, 2010
}}</ref><ref name="WHO traditional" /> It has established the ] (AYUSH) under the ].<ref>{{cite news|url=http://indianmedicine.nic.in/index.asp?lang=1|title=AYUSH|publisher=]. website|archive-url=https://archive.today/20130822171213/http://indianmedicine.nic.in/index.asp?lang=1|archive-date=August 22, 2013|df=mdy-all}}</ref> The south Indian state of ] also has a cabinet-level AYUSH department.<ref>{{cite web|url=http://www.homoeoscan.com/2015/06/Kerala-AYUSH-department-Final-nod.html|title=Kerala AYUSH department- Final nod|date=June 4, 2015|website=Homoeoscan|access-date=October 1, 2017}}</ref> The ] was established in 1973 to monitor higher education in homeopathy, and the ] in 1975.<ref>{{cite web|title=Professional Councils |url=http://www.ugc.ac.in/inside/pcouncil.html#CCH |publisher=] (UGC) website |archive-url=https://web.archive.org/web/20100106075646/http://www.ugc.ac.in/inside/pcouncil.html |archive-date=January 6, 2010 }}</ref> Principals and standards for homeopathic products are covered by the '']''.<ref name="WHO Safety" /> A minimum of a recognized diploma in homeopathy and registration on a state register or the Central Register of Homoeopathy is required to practice homeopathy in India.<ref>{{cite web
|url = http://www.cchindia.com/central_act3.htm
|title = The Homoeopathy Central Council Act, 1973, s. 15 and Sch. II
|publisher = Central Council of Homeopathy, India
|access-date = January 18, 2010
|archive-url = https://web.archive.org/web/20091123105853/http://www.cchindia.com/central_act3.htm
|archive-date = November 23, 2009
|df = mdy-all
}}</ref>


Some ]s in Pakistan,<ref>{{Cite web |url=https://www.thenews.com.pk/print/436504-govt-asked-to-set-up-university-to-promote-homoeopathy |title=Govt asked to set up university to promote homoeopathy}}</ref> India,<ref>{{cite news|last1=MANDHANI|first1=APOORVA|title=Gujarat HC Quashes Rules Permitting Common Counselling By State For Management Quota Seats in Ayurveda Colleges |url=http://www.livelaw.in/gujarat-hc-quashes-rules-permitting-common-counselling-state-management-quota-seats-ayurveda-colleges-read-judgment/|publisher=Live Law|date=August 8, 2017}}</ref><ref>{{cite news|title=Alternative Medicine: Emerging Careers|url=https://www.northeasttoday.in/alternative-medicine-emerging-careers/|publisher=northeasttoday.in|date=March 23, 2017|access-date=March 4, 2021|archive-date=January 8, 2018|archive-url=https://web.archive.org/web/20180108062819/https://www.northeasttoday.in/alternative-medicine-emerging-careers/}}</ref> and Bangladesh,<ref>{{Cite web |url=https://books.google.com/books?id=7u8QjjEwif4C&q=bachelor+of+homoeopathy+medicine+and+surgery+in+bangladesh |title=Statistical Yearbook of Bangladesh|year=2012}}</ref><ref>{{Cite web |url=https://www.homoeopathicboardbd.org/ |title=Bangladesh Homoeopathy Board – Bangladesh Homoeopathy Board}}</ref> offer an undergraduate degree programme in homeopathy.<ref>{{Cite book |url=https://books.google.com/books?id=3RYrDwAAQBAJ&q=Bachelor+of+Homoeopathy+Medicine+and+Surgery&pg=PT77 |title=Educational Equivalency Analysis: India & USA Degrees: 108 India Degrees and Equivalency to USA degrees |isbn=978-93-5278-117-1 |last1=Raghu Korrapati |first1=Dr |date=2017-07-06|publisher=Diamond Pocket Books Pvt }}</ref> Upon completion the college may award a ''{{visible anchor|Bachelor of Homoeopathy Medicine and Surgery}}'' (''B.H.M.S.'').
Critics also reject homeopathic theory as being logically inconsistent. Why should only the properties of the one intended remedy be imprinted during dynamization, and not the properties of all of the impurities in the water, particularly since all of the substances in complex mother tinctures are presumably imprinted? Why should artificial shaking and swirling imprint the water, but not similar processes in nature? Why should the same information be imprinted by dynamization with alcohol or by trituration with sugar, although the properties of these substances are very different from those of water?


In the United States each state is responsible for the laws and licensing requirements for homeopathy.<ref>{{Cite web|title=Practicing & Studying Homeopathy|url=https://www.homeopathycenter.org/practicing-studying-homeopathy/|access-date=2020-09-02|website=The National Center for Homeopathy|language=en|archive-date=April 14, 2021|archive-url=https://web.archive.org/web/20210414135845/https://www.homeopathycenter.org/practicing-studying-homeopathy/}}</ref> In 2015, the FDA held a hearing on homeopathic product regulation.<ref>{{cite journal|last1=Frazier|first1=Kendrick|authorlink= Kendrick Frazier|year=2015|title=CFI testimony urges FDA to regulate homeopathic products|journal=Skeptical Inquirer|volume=39|issue=4|pages=6–7}}</ref> At the hearing, representatives from the ] and the ] summarized the harm that is done to the general public from homeopathics and proposed regulatory actions:<ref name="fdahearing">{{cite web|author=De Dora, Michael|date=April 20, 2015|title=Homeopathic product regulation: evaluating the Food and Drug Administration's regulatory framework after a quarter-century. Testimony of the Center for Inquiry to the Food and Drug Administration|url=https://www.fda.gov/downloads/Drugs/NewsEvents/UCM443495.pdf|publisher=FDA}}</ref> In 2016 the United States ] (FTC) issued an "Enforcement Policy Statement Regarding Marketing Claims for Over-the-Counter Homeopathic Drugs" which specified that the FTC will apply the same standard to homeopathic drugs that it applies to other products claiming similar benefits.<ref name="FTC2016">{{cite web|title=FTC: Enforcement Policy Statement on Marketing Claims for OTC Homeopathic Drugs|url=https://www.ftc.gov/system/files/documents/public_statements/996984/p114505_otc_homeopathic_drug_enforcement_policy_statement.pdf|access-date=November 18, 2016|publisher=Federal Trade Commission}}</ref> A related report concluded that claims of homeopathy effectiveness "are not accepted by most modern medical experts and do not constitute competent and reliable scientific evidence that these products have the claimed treatment effects."<ref name="WSReport">{{cite web|title=Homeopathic Medicine & Advertising Workshop Report|url=https://www.ftc.gov/system/files/documents/reports/federal-trade-commission-staff-report-homeopathic-medicine-advertising-workshop/p114505_otc_homeopathic_medicine_and_advertising_workshop_report.pdf|access-date=November 18, 2016|publisher=Federal Trade Commission}}</ref> In 2019, the FDA removed an enforcement policy that permitted unapproved homeopathics to be sold.<ref>{{Cite web|title=FDA Toughens Enforcement of Homeopathic Products|url=https://www.natlawreview.com/article/fda-toughens-enforcement-homeopathic-products|access-date=2020-09-02|website=The National Law Review|language=en}}</ref> Currently no homeopathic products are approved by the FDA.<ref>{{Cite journal|last=Research|first=Center for Drug Evaluation and|date=2020-07-22|title=Homeopathic Products|url=https://www.fda.gov/drugs/information-drug-class/homeopathic-products|journal=FDA|language=en}}</ref>
====Theoretical and laboratory investigation of homeopathic preparations====
The main difficulty in providing scientific support for the effect of homeopathic remedies lies in the lack of explanation for the purported effects of remedies. This is both a problem in itself and a hindrance to the acceptance of favourable clinical evidence (see below).


Homeopathic remedies are regulated as natural health products in Canada.<ref name="WHO Safety" /> ] became the first province in the country to regulate the practice of homeopathy, a move that was widely criticized by scientists and doctors.<ref>{{Cite news|title='A pseudo-science': Outrage after Ontario government funds college program in homeopathy|url=https://nationalpost.com/news/canada/a-diploma-in-magical-thinking-critics-want-funding-pulled-for-ontario-colleges-homeopathy-course|access-date=2020-09-02|website=National Post|date=February 8, 2018|language=en-CA|last1=Kirkey|first1=Sharon}}</ref> ] requires all products to have a licence before being sold and applicants have to submit evidence on "the safety, efficacy and quality of a homeopathic medicine".<ref>{{Cite web|last=Canada|first=Health|date=2006-10-26|title=Evidence for Homeopathic Medicines|url=https://www.canada.ca/en/health-canada/services/drugs-health-products/natural-non-prescription/legislation-guidelines/guidance-documents/evidence-homeopathic-medicines.html|access-date=2020-09-04|website=aem}}</ref> In 2015 the ] tested the system by applying for and then receiving a government approved licence for a made-up drug aimed at kids.<ref>{{Cite web|date=Mar 13, 2015|title=Drugstore remedies: Licence to Deceive|url=https://www.cbc.ca/marketplace/episodes/2014-2015/drugstore-remedies-licence-to-deceive|website=CBC}}</ref>
Nevertheless there is a small-scale research effort, primarily by physicists and chemists, to try to detect phenomena relating to, and provide potential mechanisms for, the purported effects of submolecular or "ultra-dilute" solutions. In addition there are occasional results that become identified by the homeopathic community or researchers as relevant to homeopathy. Though, there is some question as to whether these results are relevant to homeopathy.


In Australia, the sale of homeopathic products is regulated by the ].<ref>{{Cite web|date=2008-09-01|title=Regulation of homoeopathic and anthroposophic medicines in Australia|url=https://www.tga.gov.au/consultation/regulation-homoeopathic-and-anthroposophic-medicines-australia|access-date=2020-09-01|website=Therapeutic Goods Administration (TGA)|language=en}}</ref> In 2015, the ] of Australia concluded that there is "no reliable evidence that homeopathy is effective and should not be used to treat health conditions that are chronic, serious, or could become serious". They recommended anyone considering using homeopathy should first get advice from a registered health practitioner.<ref name="NHMRC2" /> A 2017 review into Pharmacy Remuneration and Regulation recommended that products be banned from pharmacies;<ref>{{Cite web|date=2017|title=Review of Pharmacy Remuneration and Regulation Final Report|url=https://www1.health.gov.au/internet/main/publishing.nsf/content/7E5846EB2D7BA299CA257F5C007C0E21/$File/review-of-pharmacy-remuneration-and-regulation-final-report.pdf|access-date=September 1, 2020|archive-date=March 4, 2021|archive-url=https://web.archive.org/web/20210304103416/https://www1.health.gov.au/internet/main/publishing.nsf/content/7E5846EB2D7BA299CA257F5C007C0E21/$File/review-of-pharmacy-remuneration-and-regulation-final-report.pdf}}</ref> while noting the concerns the government did not adopt the recommendation.<ref>{{Cite web|date=2018|title=AUSTRALIAN GOVERNMENT RESPONSE TO THE REVIEW OF PHARMACY REMUNERATION AND REGULATION|url=https://www1.health.gov.au/internet/main/publishing.nsf/content/7E5846EB2D7BA299CA257F5C007C0E21/%24File/Pharmacy-Review-Aus-Gov-Response-3-May-2018.pdf|access-date=September 1, 2020|archive-date=March 3, 2021|archive-url=https://web.archive.org/web/20210303041051/https://www1.health.gov.au/internet/main/publishing.nsf/content/7E5846EB2D7BA299CA257F5C007C0E21/$File/Pharmacy-Review-Aus-Gov-Response-3-May-2018.pdf}}</ref> In New Zealand there are no regulations specific to homeopathy<ref>{{Cite web|title=Natural health products|url=https://www.health.govt.nz/our-work/regulation-health-and-disability-system/natural-health-products|access-date=2020-09-01|website=Ministry of Health NZ|language=en}}</ref> and the ] does not oppose the use of homeopathy,<ref>{{Cite web|date=2017|title=Doctors and CAM (complementary and alternative medicine)|url=https://www.mcnz.org.nz/assets/standards/7eb60db2d2/Doctors-and-CAM-Complementary-and-alternative-medicine.pdf|website=MEDICAL COUNCIL OF NEW ZEALAND|access-date=September 1, 2020|archive-date=January 29, 2021|archive-url=https://web.archive.org/web/20210129025723/https://www.mcnz.org.nz/assets/standards/7eb60db2d2/Doctors-and-CAM-Complementary-and-alternative-medicine.pdf}}</ref> a stance that has been called unethical by some doctors.<ref>{{cite journal|last=Holt|first=Shaun|author2=Gilbey, Andrew|author3=Colquhoun|author4=David|author5=Baum, Michael|author6=Ernst, Edzard|date=15 April 2011|title=Call for doctors not to practice homeopathy or refer to homeopaths|journal=New Zealand Medical Journal|volume=124|issue=1332|pages=87–88|pmid=21747430|issn=1175-8716}}</ref>
The following are examples of observations of anomalous properties of diluted materials reported in peer-reviewed publications:


=== Prevalence ===
Anomalous physical properties of homeopathic water have been observed:
* L. Rey "" (''Physica A'', 2003; 323:67-74) observed physical properties that related to the original composition of the solution prior to dilution.
* Vittorio Elia and Marcella Niccoli in "," (''Annals NY Acad Sci'', 1999; 827:241-248) observed differences in thermal properties between double-distilled water undergoing homeopathic serial dilution-and-succussion with no starting solvent and ones with solvent initially present;
* See also their "New Physico-Chemical Properties of Extremely Diluted Aqueous Solutions" ''J Thermal Analysis and Calorimetry'', 2004; 75:815-836.


Homeopathy is one of the most commonly used forms of alternative medicines and it has a large worldwide market.<ref name="WHO Safety" /> The exact size is uncertain, but information available on homeopathic sales suggests it forms a large share of the medical market.<ref name="WHO Safety" />
Immunological effects of ultradilute preparations on living cells have been observed:
* Davenas et al. "" ''Nature'' 1998; 333(6176):816-818 (a notorious paper made famous by ''Nature'''s retraction of it soon after publication - what became know as the ].
* P. Belon, J. Cumps, M. Ennis, et al., "," ''Inflam Res'' 48 Suppl. 1, 1999:17-18.


In 1999, about 1000 UK doctors practiced homeopathy, most being general practitioners who prescribe a limited number of remedies. A further 1500 homeopaths with no medical training are also thought to practice. Over ten thousand German and French doctors use homeopathy.<ref name="Vickers 1115–11182" /> In the United States a National Health Interview Survey estimated 5 million adults and 1 million children used homeopathy in 2011. An analysis of this survey concluded that most cases were self-prescribed for colds and musculoskeletal pain.<ref>{{Cite web|title=Homeopathy|url=https://www.nccih.nih.gov/health/homeopathy|access-date=2020-09-02|website=NCCIH|language=en}}</ref> Major retailers like ], ], and ] sell homeopathic products that are packaged to resemble conventional medicines.<ref name="Undark 2020-09-02" />
The phenomenon of ] has been suggested to be a plausible mechanism for how low potency homeopathic preparations still containing molecules of the solute can work. It does not, however, address the question of the efficacy of the submolecular preparations.


The homeopathic drug market in Germany is worth about 650 million euro with a 2014 survey finding that 60 percent of Germans reported trying homeopathy.<ref name="Undark 2020-09-02" /> A 2009 survey found that only 17 percent of respondents knew how homeopathic medicine was made.<ref name="Undark 2020-09-02" /> France spent more than US$408 million on homeopathic products in 2008.<ref name="WHO Safety" /> In the United States the homeopathic market is worth about $3 billion-a-year;<ref>{{Cite web|last=Fox|first=Maggie|date=2017|title=Homeopathic products useless and often even harmful, FDA says|url=https://www.nbcnews.com/health/health-news/fda-crack-down-snake-oil-homeopathy-n830756|access-date=2020-09-04|website=NBC News|language=en}}</ref> with 2.9 billion spent in 2007.<ref name="WHO Safety" /> Australia spent US$7.3 million on homeopathic medicines in 2008.<ref name="WHO Safety" />
Recent theoretical hypotheses concerning mechanism of action invoke ], which are non-random aggregations of solutes in solution that seem to occur also in water-alcohol mixtures such as are frequently used in homeopathy:
* S. Dixit et al. ''Nature'' 416: 829-832 (Apr 2002).
* T. Yokono et al. "," ''Jap J Appl Phys'' 43 (2004), L1436-38.


In India, a 2014 national health survey found that homeopathy was used by about 3% of the population.<ref>{{cite journal |last1=Rudra |first1=Shalini |last2=Kalra |first2=Aakshi |last3=Kumar |first3=Abhishek |last4=Joe |first4=William |date=2017 |title=Utilization of alternative systems of medicine as health care services in India: Evidence on AYUSH care from NSS 2014 |journal=PLOS ONE |volume=12|issue=5 |pages=e0176916 |doi=10.1371/journal.pone.0176916 |pmid=28472197 |pmc=5417584 |bibcode=2017PLoSO..1276916R |doi-access=free }}</ref> Homeopathy is used in China, although it arrived a lot later than in many other countries, partly due to the restriction on foreigners that persisted until late in the nineteenth century.<ref>{{Cite journal|last=Lu|first=Di|date=2019-09-20|title='Homoeopathy flourishes in the far East': A forgotten history of homeopathy in late nineteenth-century China|url=https://royalsocietypublishing.org/doi/10.1098/rsnr.2018.0041|journal=Notes and Records: The Royal Society Journal of the History of Science|volume=73|issue=3|pages=329–351|doi=10.1098/rsnr.2018.0041|s2cid=80714173}}</ref> Throughout Africa there is a high reliance on traditional medicines, which can be attributed to the cost of modern medicines and the relative prevalence of practitioners. Many African countries do not have any official training facilities.<ref name="Who Legal" />
This theory suggests physical and not chemical differences between pure water and homeopathic preparations. One predicted physical test which would tell difference is NMR. A recent study using NMR failed to distinguish between homeopathic solutions:
* J. Anick " ''BMC Complement Alt Med'' 4:15 (2004).


==Veterinary use==
It is important to note that there is still ''no proposed mechanism'' for how such ''clathrates'' can invoke healing once inside the body.
]]]
Using homeopathy as a treatment for animals is termed "veterinary homeopathy" and dates back to the inception of homeopathy; Hahnemann himself wrote and spoke of the use of homeopathy in animals other than humans.<ref name="Saxton2007">{{cite journal|last1=Saxton|first1=J|year=2007|title=The diversity of veterinary homeopathy|journal=Homeopathy|volume=96|issue=1|page=3|doi=10.1016/j.homp.2006.11.010|pmid=17227741|s2cid=3715861}}</ref> The use of homeopathy in the ] industry is heavily promoted.<ref>{{Cite journal|last1=Doehring|first1=C.|last2=Sundrum|first2=A.|date=2016-12-17|title=Efficacy of homeopathy in livestock according to peer-reviewed publications from 1981 to 2014|journal=The Veterinary Record|volume=179|issue=24|page=628|doi=10.1136/vr.103779|issn=0042-4900|pmc=5256414|pmid=27956476}}</ref> Given that homeopathy's effects in humans are due to the placebo effect and the counseling aspects of the consultation, such treatments are even less effective in animals.<ref>{{Cite journal|last1=Lees|first1=P.|last2=Pelligand|first2=L.|last3=Whiting|first3=M.|last4=Chambers|first4=D.|last5=Toutain|first5=P-L.|last6=Whitehead|first6=M.L.|date=2017-08-19|title=Comparison of veterinary drugs and veterinary homeopathy: part 2|journal=]|volume=181|issue=8|pages=198–207|doi=10.1136/vr.104279|issn=0042-4900|pmc=5738588|pmid=28821700|quote=In human medicine, there may be a place for the counselling/psychotherapeutic aspects of homeopathic consults and the placebo effects generated by homeopathic products in patients who believe in such treatments, but in veterinary medicine these factors are unlikely to benefit patients, and the use of homeopathic products in veterinary medicine is contrary to best evidence, irrational, and inconsistent with current scientific and medical knowledge}}</ref> Studies have also found that giving animals placebos can play active roles in influencing pet owners to believe in the effectiveness of the treatment when none exists.<ref name="Hektoen" /> This means that animals given homeopathic remedies will continue to suffer, resulting in ] concerns.<ref>{{Cite journal|last1=Lees|first1=P.|last2=Pelligand|first2=L.|last3=Whiting|first3=M.|last4=Chambers|first4=D.|last5=Toutain|first5=P-L.|last6=Whitehead|first6=M. L.|date=2017-08-12|title=Comparison of veterinary drugs and veterinary homeopathy: part 1|journal=The Veterinary Record|volume=181|issue=7|pages=170–176|doi=10.1136/vr.104278|issn=0042-4900|pmc=5738587|pmid=28801498}}</ref><ref>{{Cite journal|last1=Whitehead|first1=M L|last2=Lees|first2=P|last3=Toutain|first3=P L|date=2018|title=Veterinary homeopathy regulation in the UK – a cause for concern.|url=https://www.researchgate.net/publication/329152074|journal=Regulatory Rapporteur|volume=15|pages=21–25}}</ref>


Little existing research on the subject is of a high enough scientific standard to provide reliable data on efficacy.<ref name="Hektoen">{{cite journal|last1=Hektoen|first1=L|year=2005|title=Review of the current involvement of homeopathy in veterinary practice and research|journal=]|volume=157|issue=8|pages=224–29|doi=10.1136/vr.157.8.224|pmid=16113167|s2cid=12525634}}</ref><ref>{{cite journal|last1=Mathie|first1=RT|last2=Clausen|first2=J|date=October 18, 2014|title=Veterinary homeopathy: systematic review of medical conditions studied by randomised placebo-controlled trials|journal=The Veterinary Record|volume=175|issue=15|pages=373–81|doi=10.1136/vr.101767|pmid=25324413|s2cid=22894207}}</ref><ref>{{cite journal|last1=Mathie|first1=RT|last2=Clausen|first2=J|date=September 15, 2015|title=Veterinary homeopathy: systematic review of medical conditions studied by randomised trials controlled by other than placebo.|journal=]|volume=11|page=236|doi=10.1186/s12917-015-0542-2|pmc=4570221|pmid=26371366 |doi-access=free }}</ref> A 2016 review of peer-reviewed articles from 1981 to 2014 by scientists from the ], Germany, concluded that there is not enough evidence to support homeopathy as an effective treatment of infectious diseases in livestock.<ref>{{Cite journal|last1=Doehring|first1=C.|last2=Sundrum|first2=A.|date=December 12, 2016|title=Efficacy of homeopathy in livestock according to peer-reviewed publications from 1981 to 2014|journal=Veterinary Record|language=en|volume=179|issue=24|pages=vetrec–2016–103779|doi=10.1136/vr.103779|issn=2042-7670|pmc=5256414|pmid=27956476}}</ref> The UK's ] (Defra) has adopted a robust position against use of "alternative" pet preparations including homeopathy.<ref>{{cite web |url=https://www.gov.uk/government/news/alternative-pet-remedies-government-clampdown |title=Alternative pet remedies: Government clampdown}}</ref> The British Veterinary Association's position statement on alternative medicines says that it "cannot endorse" homeopathy,<ref name="BVA">{{cite web|title=Veterinary medicines|url=http://www.bva.co.uk/News-campaigns-and-policy/Policy/Medicines/Veterinary-medicines/|access-date=January 5, 2015|publisher=British Veterinary Association}}</ref> and the Australian Veterinary Association includes it on its list of "ineffective therapies".<ref name="AVA">{{cite web|title=Ineffective therapies|url=http://www.ava.com.au/12057|archive-url=https://web.archive.org/web/20150207080041/http://www.ava.com.au/12057|archive-date=February 7, 2015|access-date=January 5, 2015|publisher=Australian veterinary association}}</ref>
====Clinical trials====
A ] is a tool for aggregating and evaluating research data from a series of individual ]s that address a single topic, within which can be found references to individual trials. To date, specific meta-analyses of peer-reviewed publications which suggest ''no significant difference'' between placebo and homeopathy include:


==See also==
* Walach (1997) {{fn|12}} found that the effects of homeopathy were not significantly different from those of a placebo.
* ]
* Ernst (1999) {{fn|13}} was more ambiguous and did not find evidence of effects greater than placebo. However, he suggests that studies were not of good enough quality to point in either direction.
* ]
* Rodrigues & Moritz (2003) {{fn|14}} concluded that "ample evidence exists to show that the homeopathic therapy is not scientifically justifiable", because of serious shortcomings in terms of ] and lack of methodologically sound trials validating homeopathy.
* ]
* White et al. (2003) {{Ref|White2003}} found that there was no evidence that adjunctive homeopathic remedies, as prescribed by experienced homeopathic practitioners, are superior to placebo in improving the quality of life of children with mild to moderate asthma in addition to conventional treatment in primary care.
* Shang et al. (2005) {{fn|15}} state in ''The Lancet'', a leading medical journal, that no convincing evidence has been found that homeopathy performs any better than placebo, whereas under the same evaluative criteria conventional medicine performs better than placebo, and concluded that doctors should be able to inform patients of the "lack of benefit." The trial results were derived from a comparative review of 8 trials of homeopathy verus 6 of trials of conventional medicine selected from two groups of 110 matching trials, based on predetermined criteria of internal validity that sought to extract the best-quality trials in both groups.


==References==
Reviews ''suggesting'' an effect above placebo include:
{{Reflist| refs=
* Kleijnen et al (1991) {{Ref|Kleijnenan}} concluded that "At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias."
<ref name="Hahnemann">{{cite book |title=The homœopathic medical doctrine, or "Organon of the healing art" |publisher=W. F. Wakeman |author=Hahnemann, Samuel |author-link=Samuel Hahnemann |year=1833 |location=Dublin |pages=, |quote=Observation, reflection, and experience have unfolded to me that the best and true method of cure is founded on the principle, '']''. To cure in a mild, prompt, safe, and durable manner, it is necessary to choose in each case a medicine that will excite an affection similar (''{{lang|el|ὅμοιος πάθος}}'') to that against which it is employed.}} Translator: Charles H. Devrient, Esq.</ref>
* Linde et al (1997),{{Ref|Linde1997}} who concluded "the results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo". However in his latter 1999 study this conclusion was largely withdrawn {{fn|18}} and questions have been raised about the original study{{fn|17}}.
<ref name="Holmes">
* Linde & Melchart (1998) {{fn|10}} found that there was evidence to support homeopathy but this evidence was not very strong.
{{cite book
* Cucherat et al (2000) {{fn|11}} found some evidence in support of homeopathy, but (like Linde & Melchart) found that higher quality studies were more likely to disprove homeopathy.
|author=Oliver Wendell Holmes Sr.
|title=Homoeopathy and its kindred delusions: Two lectures delivered before the Boston Society for the Diffusion of Useful Knowledge
|url=https://archive.org/details/64340260R.nlm.nih.gov
|location=Boston
|year=1842
|author-link=Oliver Wendell Holmes Sr
}} as reprinted in
{{cite book
|author=Oliver Wendell Holmes Sr.
|title=Currents and counter-currents in medical science
|year=1861
|publisher=Ticknor and Fields
|pages=72–188
|url=https://catalog.hathitrust.org/Record/011611362
|oclc=1544161
|ol=14731800M
|author-link=Oliver Wendell Holmes Sr
}}</ref>
<ref name="Time19951125">{{cite news |vauthors=Toufexis A, Cole W, Hallanan DB |url=http://www.time.com/time/magazine/article/0,9171,983466,00.html |archive-url=https://web.archive.org/web/20090614091356/http://www.time.com/time/magazine/article/0,9171,983466,00.html |archive-date=June 14, 2009 |title=Is homeopathy good medicine? |magazine=] |date=September 25, 1995}}</ref>
<ref name="shang">{{cite journal |last1=Shang |first1=Aijing |last2=Huwiler-Müntener |first2=Karin |last3=Nartey |first3=Linda |last4=Jüni |first4=Peter |last5=Dörig |first5=Stephan |last6=Sterne |first6=Jonathan AC |last7=Pewsner |first7=Daniel |last8=Egger |first8=Matthias |title=Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy |journal=The Lancet |volume=366 |pages=726–32 |year=2005 |doi=10.1016/S0140-6736(05)67177-2 |pmid=16125589 |issue=9487|s2cid=17939264 }}</ref>
<ref name="J Toxicology: Arsenic toxicity">{{cite journal |last1=Chakraborti |first1=D |last2=Mukherjee |first2=SC |last3=Saha |first3=KC |last4=Chowdhury |first4=UK |last5=Rahman |first5=MM |last6=Sengupta |first6=MK |title=Arsenic toxicity from homeopathic treatment |journal=Journal of Toxicology. Clinical Toxicology |volume=41 |issue=7 |pages=963–67 |year=2003 |pmid=14705842 |doi=10.1081/CLT-120026518|s2cid=25453468 }}</ref>


<ref name="Mayo Clinic Proceedings: trials">{{cite journal |last1=Altunc |first1=U. |last2=Pittler |first2=M. H. |last3=Ernst |first3=E |title=Homeopathy for childhood and adolescence ailments: systematic review of randomized clinical trials |journal=Mayo Clinic Proceedings |volume=82 |issue=1 |pages=69–75 |year=2007 |pmid=17285788 |doi=10.4065/82.1.69 |quote=However, homeopathy is not totally devoid of risks... it may delay effective treatment or diagnosis|citeseerx=10.1.1.456.5352 }}</ref>
====Persistent lack of concrete evidence of efficacy====
<ref name="pmid8554846">{{cite journal |last1=Ernst |first1=E |author-link=Edzard Ernst |last2=White |first2=AR |title=Homoeopathy and immunization |journal=The British Journal of General Practice |volume=45 |issue=400 |pages=629–30 |year=1995 |pmid=8554846 |pmc=1239445}}</ref>
Despite the available research, homeopathy has not been proven conclusively to work either in the clinic or in the lab, and the available research remains inconsistent and of variable quality. Another complicating factor is the claim by both sides of the debate for the existence of a ]: critics of homeopathy propose the likely existence of many negative trials of homeopathy that are not submitted for publication, whereas homeopaths claim that it is difficult to publish in the maintream scientific press because they present scientifically implausible conclusions.
}}


==External links==
Skeptic ] has offered an award of one million ]s to anyone who can prove the existence of anything supernatural or paranormal; Randi stipulates that homeopathy qualifies as such. The million dollars are also available to anyone who can, by any means of their choosing, tell the difference between plain water and any homeopathic remedy of their choosing. A recent attempt to win the prize was aired on the ] science program '']''.{{fn|7}} The Randi challenge is not specific to homeopathy, and is not a specific scientific research protocol. {{fn|20}}
{{commons category}}
{{EB1911 poster|Homoeopathy}}
* (], UK)


{{Homoeopathy}}
Having concluded that the controlled studies of homeopathy are too weak to be convincing, homeopathists say the skeptics must still address the widespread claims of successful treatments. Scientist would argue that if such cases were connected to the use of homeopathy and not caused by chance, placebo effect or other (simulatenously used) treatments, the effects should also be visible in controlled experiments. In particular, they argue that without control cases, it is impossible to distinguish between efficacy of a treatment and spontaneous remission. Without double blinding it is impossible to rule out observer bias and the placebo effect. Without reproduction in a separate study, it is difficult to rule out chance, fraud, or poorly understood systematic effects.
{{pseudoscience}}


{{Authority control}}
====The possibility of testing homeopathy scientifically====
It is often said that homeopathy does not lend itself to being tested through statistical means because of the individualized nature of homeopathic treatment and the role of the doctor-patient relationship. But while it may be difficult to objectively study some aspects of homeopathic treatment, the efficacy of homeopathic preparations in high dilution is easily studied using standard methods of ] control: if the placebo and treatment groups cannot be distinguished at a statistically significant level on the basis of the clinical evaluation, patient report, or objective measures, then the hypothesis of efficacy can be rejected. Indeed, homeopathic remedies are popularly used over-the-counter in an analogous manner to conventional medicines (rather than following classical-homeopathic principles), so likewise should be amenable to testing.


]
Because homeopathy lacks the research infrastructure of modern medicine, but is largely clinically based, few homeopaths are properly trained in the methods of scientific research. Following a recent period of much interest in clinical support for homeopathy (possibly due to the rise of the evidence-based medicine movement, beginning in the early 1990s), many in the homeopathic community have concluded that, until a plausible mechanism-of-action is found, further clinical evidence will carry little weight, and the limited resources of the community should therefore be invested elsewhere, such as in improving educational standards. Moreover, proponents of alternative medicine often criticize the medical establishment and government agencies for failing to invest the necessary resources for testing their hypotheses thoroughly&mdash;demanding robust proof of efficacy according to the latest standards, while devoting only scant resources to the enterprise&mdash;although those that see little promise in alternative approaches often argue that such expenditure is unwarranted. Ultimately the issue becomes political, because health-care systems are subject to public scrutiny and preference. This concerns many in the scientific establishment, who regard this as a threat to the autonomy of science from political forces.

Some researchers of homeopathy downplay the importance of the placebo effect by pointing to reports of successful treatment of infants and animals. Even in such cases, in the absence of double-blinding, practitioner bias or patient expectation may still continue to play a role.

Yet another perspective favors the use of observational studies in place of placebo-controlled studies to compare the clinical efficacy of homeopathy to that of other methods of known efficacy. Although observational studies do not use placebo control, they have advantages such as lower cost and better modelling of clinical practice, which makes them an often-used alternative to controlled studies.

Finally, scientific studies do not in themselves represent objective data, but have to be scrutinized and interpreted by competent scientists. While skeptics tend to reject borderline results from scientific studies, because they have a prior belief that there can be no effect (due to the lack of a plausible mechanism), proponents of homeopathy tend to accept these results due to their predisposition toward homeopathy.

===The status quo===
Upwards of 130 clinical trials have been carried out investigating homeopathy or related uses of ultradilutions, mainly ], and approximately 70% of these trials are in favour of some kind of efficacy above placebo{{fn|8}}. However, several ] have yielded inconclusive or unfavourable results, with two in particular observing that the higher quality trials were more likely to reject claims of efficacy over the placebo effect.

Linde et al (2001) {{fn|9}} summarize as such:

''<blockquote> In conclusion, the available ]s on homeopathy provide little guidance for patients and doctors. They rather reflect the ongoing fundamental controversy on this therapy and strengthen the perception that, on one side, positive evidence from clinical trials will not convince skeptics, and that on the other side negative results from trials not representing actual practice will not have any impact on homeopaths. </blockquote>''

== Misconceptions about homeopathy ==
=== Composition of homeopathic remedies ===
A common misconception is that homeopathic remedies use only natural, and thus presumed by some to be safe, herbal components (akin to ]). While herbs are used in homeopathy, there is also use of non-biological substances (such as ]s) and components of animal origin, such as ] ] in the popular remedy ]. Homeopathy also uses substances of human origin, called '']s''. Some people have the opposite misconception, that homeopathic remedies are only based on ] substances like ] or ].

Another difference is that although both use herbs, in herbology measurable amounts of the herbs are in the remedy, while in homeopathy the active ingredient is diluted to the point where it is no longer measurable.

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

===Homeopathy and vaccination===
To some, homeopathy, particularly the use of nosodes, resembles the mainstream practice of ], in that vaccines contain a small, closely-related dose of the disease against which they are to protect. Hahnemann himself interpreted the introduction of vaccination by ] in ] as a confirmation of the law of similars. To those familiar with the modern practices of homeopathy and ], the two practices are fundamentally different. A vaccine is usually a ] or ] whose capability to produce symptoms has deliberately been weakened, while still providing enough information to the immune system to afford protection. By preparing the immune system of a healthy organism to meet a future attack by the pathogen, vaccination hopes to prevent disease, in contrast to homeopathy's hope, which is to cure it.

== Safety of homeopathic treatment ==
As homeopathic dilutions are usually considered by skeptics not to have any direct effect at all (since they should contain only water), it is usually assumed that the remedies themselves do not have any harmful effects. Since some homeopathic remedies are prepared by serial dilution of ] substances, there is a risk that they may contain undiluted toxic substances. The medical literature contains several case reports of poisoning by heavy metals such as ]{{fn|23}} and ]{{fn|24}}{{fn|25}}{{fn|26}} found in homeopathic remedies. However, the main potential harm from homeopathic treatment arises not from the remedies themselves, but from the withholding of arguably more efficacious treatment, or from misdiagnosis of dangerous conditions by the non-medically qualified homeopathist.

== References ==
*{{fnb|1}} , Chapter 8 of ''Homeopathy in Perspective'' by A. Campbell

*{{fnb|2}}

*{{fnb|3}} from Deutsche Welle

*{{fnb|4}} by Dr. Raj Kumar Manchanda and Dr. Mukul Kulashreshtha

*{{fnb|5}} (in German)

*6 {{Note|magicalthinking}} from the Skeptical Enquirer

*{{fnb|7}} from BBC

*{{fnb|8}} Jonas WB, Kaptchuk TJ, Linde K. "A critical overview of homeopathy" ''Annals of Internal Medicine'', (2003); '''138''': 393-399

*{{fnb|9}} Linde K, Hondras M, et al. "", ''BMC Complementary and Alternative Medicine'' 2001; '''1''', 4.

*{{fnb|10}} Klaus Linde and Dieter Melchart "Randomized Controlled Trials of Individualized Homeopathy: A State-of-the-Art Review", ''Journal of Alternative and Complementary Medicine'' '''4''' (1998): 371-88 ()

*{{fnb|11}} M. Cucherat ''et al''. "Evidence of Clinical Efficacy of Homeopathy: A Meta-Analysis of Clinical Trials", ''European Journal of Clinical Pharmacology'' '''56''' (2000): 27-33 ()

*{{fnb|12}} Walach H "Unspezifische Therapie-Effekte. Das Beispiel Homöopathie" . Freiburg, Germany: Psychologische Institut, Albert-Ludwigs-Universität Freiburg, (1997)

*{{fnb|13}} Ernst E. "Classical homeopathy versus conventional treaments: a ]" ''Perfusion'', (1999); '''12''': 13-15

*{{fnb|14}} Moritz RV, Rodrigues A. , ''Rev. Hosp. Clin.'' '''58'''(6)

*{{fnb|15}} Linde K, Clausius N, Ramirez G, Melchart D, Eitel F, Hedges LV, Jonas WB. "Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials" ''Lancet'' (1997); '''350''': 834-943

*16 {{Note|Kleijnen}} Kleijenen J, Knipschild P, ter Riet G. "Clincal trials of homeopathy." ''BMJ'' (1991); '''302''': 316-323

*{{fnb|17}} Bandolier Homeopathy - dilute information and little knowledge

*{{fnb|18}} Linde K, Scholz M, Ramirez G, Clausius N, Melchart D, Jonas WB. "Impact of study quality on outcome in placebo-controlled trials of homeopathy" J Clin Epidemiol. 1999 Jul;52(7):631-6.

*19 {{Note|Shang2005}} Shang et al. . ''Lancet'' 2005, '''366''': 726-732 () (both require registration, but abstract is free).

*{{fnb|20}} James Randi Educational Foundation. "The JREF Million Dollar Paranormal Challenge 'FAQ'". Retrieved 13 September, 2005.

*{{fnb|21}} footnote to pp.12-13, ''Hahnemann's Chronic Diseases'', ed. P. Dudley, ''B. Jain Publishers'', 1998 reprint

*{{fnb|22}} answer to article of lancet (note 19)

*{{Ref|White2003}}

== External links ==
=== References ===
* Online etext of Hahnemann's ''Organon der Heilkunst'': and

=== Neutral ===
*A recent article on homeopathy testing from the
* (transcripts, discussion, etc.)
* &mdash; critical online book, covering the history and present state of homeopathy
*
*

=== Supportive ===
*
*
*
*
* - Forum discussing health issues, homeopathic remedies, and veterinary homeopathy.
* BBC's "Complementary Medicine" article on Homeopathy
*
*
* &mdash; The English language version of ''Homéopathe International''
* with a wealth of historical and biographical information
* Adjuvant homeopathic treatment in Breastcancer, a pilot study (in German)

Books on scientific research on homeopathy:

* Paolo Bellavite & Andrea Signorini (2002). ''The Emerging Science of Homeopathy: Complexity, Biodynamics and Nanopharmacology''.
* Rolland R. Conte, Henri Berliocchi, Yves Lasne, Gabriel Vernot (1996). ''Theory of High Dilutions and Experimental Aspects''.

=== Critical ===
*
*
*
* &mdash; A Skeptical Guide to Homeopathic History, Theories, and Current Practices, operated by ], M.D. (founder of ])
* .
*
* - American Council on Science and Health
*
*
*


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Latest revision as of 15:58, 28 November 2024

Pseudoscientific system of alternative medicine For the journal, see Homeopathy (journal).

Homeopathy
Alternative medicine
Homoeopathy
Samuel HahnemannSamuel Hahnemann, originator of homeopathy
Pronunciation
Claims"Like cures like", dilution increases potency, disease caused by miasms
Related fieldsAlternative medicine
Original proponentsSamuel Hahnemann
Subsequent proponents
MeSHD006705
See alsoHumorism, heroic medicine
Part of a series on
Alternative medicine
General information
Fringe medicine and science
Controversies
Classifications
Traditional medicine
Alternative diagnoses

Homeopathy or homoeopathy is a pseudoscientific system of alternative medicine. It was conceived in 1796 by the German physician Samuel Hahnemann. Its practitioners, called homeopaths or homeopathic physicians, believe that a substance that causes symptoms of a disease in healthy people can cure similar symptoms in sick people; this doctrine is called similia similibus curentur, or "like cures like". Homeopathic preparations are termed remedies and are made using homeopathic dilution. In this process, the selected substance is repeatedly diluted until the final product is chemically indistinguishable from the diluent. Often not even a single molecule of the original substance can be expected to remain in the product. Between each dilution homeopaths may hit and/or shake the product, claiming this makes the diluent "remember" the original substance after its removal. Practitioners claim that such preparations, upon oral intake, can treat or cure disease.

All relevant scientific knowledge about physics, chemistry, biochemistry and biology contradicts homeopathy. Homeopathic remedies are typically biochemically inert, and have no effect on any known disease. Its theory of disease, centered around principles Hahnemann termed miasms, is inconsistent with subsequent identification of viruses and bacteria as causes of disease. Clinical trials have been conducted and generally demonstrated no objective effect from homeopathic preparations. The fundamental implausibility of homeopathy as well as a lack of demonstrable effectiveness has led to it being characterized within the scientific and medical communities as quackery and fraud.

Homeopathy achieved its greatest popularity in the 19th century. It was introduced to the United States in 1825, and the first American homeopathic school opened in 1835. Throughout the 19th century, dozens of homeopathic institutions appeared in Europe and the United States. During this period, homeopathy was able to appear relatively successful, as other forms of treatment could be harmful and ineffective. By the end of the century the practice began to wane, with the last exclusively homeopathic medical school in the United States closing in 1920. During the 1970s, homeopathy made a significant comeback, with sales of some homeopathic products increasing tenfold. The trend corresponded with the rise of the New Age movement, and may be in part due to chemophobia, an irrational aversion to synthetic chemicals, and the longer consultation times homeopathic practitioners provided.

In the 21st century, a series of meta-analyses have shown that the therapeutic claims of homeopathy lack scientific justification. As a result, national and international bodies have recommended the withdrawal of government funding for homeopathy in healthcare. National bodies from Australia, the United Kingdom, Switzerland and France, as well as the European Academies' Science Advisory Council and the Russian Academy of Sciences have all concluded that homeopathy is ineffective, and recommended against the practice receiving any further funding. The National Health Service in England no longer provides funding for homeopathic remedies and asked the Department of Health to add homeopathic remedies to the list of forbidden prescription items. France removed funding in 2021, while Spain has also announced moves to ban homeopathy and other pseudotherapies from health centers.

History

Homeopathy was created in 1796 by Samuel Hahnemann. Hahnemann rejected the mainstream medicine of the late 18th century as irrational and inadvisable, because it was largely ineffective and often harmful. He advocated the use of single drugs at lower doses and promoted an immaterial, vitalistic view of how living organisms function. The term homeopathy was coined by Hahnemann and first appeared in print in 1807. He also coined the expression "allopathic medicine", which was used to pejoratively refer to traditional Western medicine.

Concept

Samuel Hahnemann Monument, Washington, D.C., with the inscription Similia Similibus Curentur – "Like cures Like"

Hahnemann conceived of homeopathy while translating a medical treatise by the Scottish physician and chemist William Cullen into German. Being sceptical of Cullen's theory that cinchona cured malaria because it was bitter, Hahnemann ingested some bark specifically to investigate what would happen. He experienced fever, shivering and joint pain: symptoms similar to those of malaria itself. 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 led to the name "homeopathy", which comes from the Ancient Greek: ὅμοιος hómoios, "-like" and πάθος páthos, "suffering".

The doctrine that those drugs are effective which produce symptoms similar to the symptoms caused by the diseases they treat, called "the law of similars", was expressed by Hahnemann with the Latin phrase similia similibus curentur, or "like cures like". Hahnemann's law of similars is unproven and does not derive from the scientific method. An account of the effects of eating cinchona bark noted by Oliver Wendell Holmes, published in 1861, failed to reproduce the symptoms Hahnemann reported. Subsequent scientific work showed that cinchona cures malaria because it contains quinine, which kills the Plasmodium falciparum parasite that causes the disease; the mechanism of action is unrelated to Hahnemann's ideas.

Provings

Hahnemann began to test what effects various substances may produce in humans, a procedure later called "homeopathic proving". These tests required subjects to test the effects of ingesting substances by recording all their symptoms as well as the ancillary conditions under which they appeared. He published a collection of provings in 1805, and a second collection of 65 preparations appeared in his book, Materia Medica Pura (1810).

As Hahnemann believed that large doses of drugs that caused similar symptoms would only aggravate illness, he advocated for extreme dilutions. A technique was devised for making dilutions that Hahnemann claimed would preserve the substance's therapeutic properties while removing its harmful effects. Hahnemann believed that this process enhanced "the spirit-like medicinal powers of the crude substances". He gathered and published an overview of his new medical system in his book, The Organon of the Healing Art (1810), with a sixth edition published in 1921 that homeopaths still use today.

Miasms and disease

In the Organon, Hahnemann introduced the concept of "miasms" as the "infectious principles" underlying chronic disease and as "peculiar morbid derangement of vital force". Hahnemann associated each miasm with specific diseases, and thought that initial exposure to miasms causes local symptoms, such as skin or venereal diseases. His assertion was that if these symptoms were suppressed by medication, the cause went deeper and began to manifest itself as diseases of the internal organs. Homeopathy maintains that treating diseases by directly alleviating 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's hypotheses for miasms originally presented only three local symptoms: psora (the itch), syphilis (venereal disease) or sycosis (fig-wart disease). Of these the most important was psora, described as being related to any itching diseases of the skin and was claimed to be the foundation of many further disease conditions. Hahnemann believed it to be the cause of such diseases as epilepsy, cancer, jaundice, deafness, and cataracts. Since Hahnemann's time, other miasms have been proposed, some replacing illnesses previously attributed to the psora, including tuberculosis and cancer miasms.

Hahnemann's miasm theory remains disputed and controversial within homeopathy even in modern times. The theory of miasms has been criticized as an explanation developed 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, environmental factors, and the unique disease history of each patient.

19th century: rise to popularity and early criticism

Homeopathy Looks at the Horrors of Allopathy, an 1857 painting by Alexander Beydeman, showing historical figures and personifications of homeopathy observing the brutality of medicine of the 19th century

Homeopathy achieved its greatest popularity in the 19th century. It was introduced to the United States in 1825 by Hans Birch Gram, a student of Hahnemann. The first homeopathic school in the United States opened in 1835 and the American Institute of Homeopathy was established in 1844. Throughout the 19th century, dozens of homeopathic institutions appeared in Europe and the United States, and by 1900, there were 22 homeopathic colleges and 15,000 practitioners in the United States.

Because medical practice of the time relied on treatments which were often ineffective and harmful, patients of homeopaths often had better outcomes than those being treated by medical practitioners. Though ineffective, homeopathic preparations are rarely detrimental, thus users are less likely to be harmed by the treatment that is 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 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, 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.

Even during its rise in popularity, homeopathy was criticized by scientists and physicians. Sir John Forbes, physician to Queen Victoria, said in 1843 that the extremely small doses of homeopathy were regularly derided as useless and considered it "an outrage to human reason". James Young Simpson 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." Nineteenth-century American physician and author Oliver Wendell Holmes was also a vocal critic of homeopathy and published an essay entitled Homœopathy and Its Kindred Delusions (1842). The members of the French Homeopathic Society observed in 1867 that some leading homeopaths of Europe not only were abandoning the practice of administering infinitesimal doses but were also no longer defending it. The last school in the United States exclusively teaching homeopathy closed in 1920.

Revival in the 20th century

According to academics Paul U. Unschuld [de] and Edzard Ernst, the Nazi regime in Germany was fond of homeopathy, and spent large sums of money on researching its mechanisms, but without gaining a positive result. Unschuld also states that homeopathy never subsequently took root in the United States, but remained more deeply established in European thinking. In the United States, the Food, Drug, and Cosmetic Act of 1938 (sponsored by Royal Copeland, a Senator from New York and homeopathic physician) recognized homeopathic preparations as drugs. In the 1950s, there were only 75 solely homeopathic practitioners in the U.S. By the mid to late 1970s, homeopathy made a significant comeback and the sales of some homeopathic companies increased tenfold.

Some homeopaths credit the revival to Greek homeopath George Vithoulkas, who conducted a "great deal of research to update the scenarios and refine the theories and practice of homeopathy" in the 1970s, but Ernst and Simon Singh consider it to be linked to the rise of the New Age movement. Bruce Hood has argued that the increased popularity of homeopathy in recent times may be due to the comparatively long consultations practitioners are willing to give their patients, and to a preference for "natural" products, which people think are the basis of homeopathic preparations.

Towards the end of the century opposition to homeopathy began to increase again; with William T. Jarvis, the President of the National Council Against Health Fraud, saying that "Homeopathy is a fraud perpetrated on the public with the government's blessing, thanks to the abuse of political power of Sen. Royal S. Copeland."

21st century: renewed criticism

Since the beginning of the 21st century, a series of meta-analyses have further shown that the therapeutic claims of homeopathy lack scientific justification. This had led to a decrease or suspension of funding by many governments. In a 2010 report, the Science and Technology Committee of the United Kingdom House of Commons recommended that homeopathy should no longer receive National Health Service (NHS) funding due its lack of scientific credibility; NHS funding for homeopathy ceased in 2017. They also asked the Department of Health in the UK to add homeopathic remedies to the list of forbidden prescription items.

In 2015, the National Health and Medical Research Council of Australia found that "there are no health conditions for which there is reliable evidence that homeopathy is effective". The federal government only ended up accepting three of the 45 recommendations made by the 2018 review of Pharmacy Remuneration and Regulation. The same year the US Food and Drug Administration (FDA) held a hearing requesting public comment on the regulation of homeopathic drugs. In 2017 the FDA announced it would strengthen regulation of homeopathic products.

The American non-profit Center for Inquiry (CFI) filed a lawsuit in 2018 against the CVS pharmacy for consumer fraud over its sale of homeopathic medicines. It claimed that CVS was selling homeopathic products on an easier-to-obtain basis than standard medication. In 2019, CFI brought a similar lawsuit against Walmart for "committing wide-scale consumer fraud and endangering the health of its customers through its sale and marketing of homeopathic medicines". They also conducted a survey in which they found consumers felt ripped off when informed of the lack of evidence for the efficacy of homeopathic remedies, such as those sold by Walmart and CVS.

In 2021, the French healthcare minister phased out social security reimbursements for homeopathic drugs. France has long had a stronger belief in the virtues of homeopathic drugs than many other countries and the world's biggest manufacturer of alternative medicine drugs, Boiron, is located in that country. Spain has also announced moves to ban homeopathy and other pseudotherapies. In 2016, the University of Barcelona cancelled its master's degree in Homeopathy citing "lack of scientific basis", after advice from the Spanish Ministry of Health. Shortly afterwards the University of Valencia announced the elimination of its Masters in Homeopathy.

Preparations and treatment

See also: List of homeopathic preparations
Homeopathic repertory by James Tyler Kent

Homeopathic preparations are referred to as "homeopathic remedies". Practitioners rely on two types of reference when prescribing: Materia medica and repertories. A homeopathic materia medica is a collection of "drug pictures", organized alphabetically. A homeopathic repertory is a quick reference version of the materia medica that indexes the symptoms and then the associated remedies for each. In both cases different compilers may dispute particular inclusions in the references. The first symptomatic homeopathic materia medica was arranged by Hahnemann. The first homeopathic repertory was Georg Jahr's Symptomenkodex, published in German in 1835, and translated into English as the Repertory to the more Characteristic Symptoms of Materia Medica in 1838. This version was less focused on disease categories and was the forerunner to later works by James Tyler Kent. There are over 118 repertories published in English, with Kent's being one of the most used.

Consultation

Homeopaths generally begin with a consultation, which can be a 10–15 minute appointment or last for over an hour, where the patient describes their medical history. The patient describes the "modalities", or if their symptoms change depending on the weather and other external factors. The practitioner also solicits information on mood, likes and dislikes, physical, mental and emotional states, life circumstances, and any physical or emotional illnesses. This information (also called the "symptom picture") is matched to the "drug picture" in the materia medica or repertory and used to determine the appropriate homeopathic remedies. In classical homeopathy, the practitioner attempts to match a single preparation to the totality of symptoms (the simlilum), while "clinical homeopathy" involves combinations of preparations based on the illness's symptoms.

Preparation

Oscillococcinum, a homeopathic remedy in pill form

Homeopathy uses animal, plant, mineral, and synthetic substances in its preparations, generally referring to them using Latin names. Examples include arsenicum album (arsenic oxide), natrum muriaticum (sodium chloride or table salt), Lachesis muta (the venom of the bushmaster snake), opium, and thyroidinum (thyroid hormone). Homeopaths say this is to ensure accuracy. In the USA the common name must be displayed, although the Latin one can also be present. Homeopathic pills are made from an inert substance (often sugars, typically lactose), upon which a drop of liquid homeopathic preparation is placed and allowed to evaporate.

Isopathy is a therapy derived from homeopathy in which the preparations come from diseased or pathological products such as fecal, urinary and respiratory discharges, blood, and tissue. They are called nosodes (from the Greek nosos, disease) with preparations made from "healthy" specimens being termed "sarcodes". Many so-called "homeopathic vaccines" are a form of isopathy. Tautopathy is a form of isopathy where the preparations are composed of drugs or vaccines that a person has consumed in the past, in the belief that this can reverse the supposed lingering damage caused by the initial use. There is no convincing scientific evidence for isopathy as an effective method of treatment.

Some modern homeopaths use preparations they call "imponderables" because they do not originate from a substance but some other phenomenon presumed to have been "captured" by alcohol or lactose. Examples include X-rays and sunlight. Another derivative is electrohomeopathy, where an electric bio-energy of therapeutic value is supposedly extracted from plants. Popular in the late nineteenth century, electrohomeopathy is extremely pseudo-scientific. In 2012, the Allahabad High Court in Uttar Pradesh, India, handed down a decree stating that electrohomeopathy was quackery and no longer recognized it as a system of medicine.

Other minority practices include paper preparations, in which the terms for substances and dilutions are written on pieces of paper and either pinned to the patients' clothing, put in their pockets, or placed under glasses of water that are then given to the patients. Radionics, the use of electromagnetic radiation such as radio waves, can also be used to manufacture preparations. Such practices have been strongly criticized by classical homeopaths as unfounded, speculative, and verging upon magic and superstition. Flower preparations are produced by placing flowers in water and exposing them to sunlight. The most famous of these are the Bach flower remedies, which were developed by Edward Bach.

Dilutions

Main article: Homeopathic dilutions
This bottle is labelled Arnica montana (wolf's bane) D6, i.e. the nominal dilution is one part in a million (10).

Hahnemann claimed that undiluted doses caused reactions, sometimes dangerous ones, and thus that preparations be given at the lowest possible dose. A solution that is more dilute is described as having a higher "potency", and thus are claimed to be stronger and deeper-acting. The general method of dilution is serial dilution, where solvent is added to part of the previous mixture, but the "Korsakovian" method may also be used. In the Korsakovian method, the vessel in which the preparations are manufactured is emptied, refilled with solvent, with the volume of fluid adhering to the walls of the vessel deemed sufficient for the new batch. The Korsakovian method is sometimes referred to as K on the label of a homeopathic preparation. Another method is Fluxion, which dilutes the substance by continuously passing water through the vial. Insoluble solids, such as granite, diamond, and platinum, are diluted by grinding them with lactose ("trituration").

Three main logarithmic dilution 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. There is also a decimal dilution scale (notated as "X" or "D") in which the preparation is diluted by a factor of 10 at each stage. The centesimal scale was favoured by Hahnemann for most of his life, although in his last ten years Hahnemann developed a quintamillesimal (Q) scale which diluted the drug 1 part in 50,000. A 2C dilution works out to one part of the original substance in 10,000 parts of the solution. In standard chemistry, this produces a substance with a concentration of 0.01% (volume-volume percentage). A 6C dilution ends up with the original substance diluted by a factor of 100 (one part in one trillion). The end product is usually so diluted as to be indistinguishable from the diluent (pure water, sugar or alcohol). The greatest dilution reasonably likely to contain at least one molecule of the original substance is approximately 12C.

Hahnemann advocated dilutions of 1 part to 10 or 30C. Hahnemann regularly used dilutions of up to 30C but opined that "there must be a limit to the matter". To counter the reduced potency at high dilutions he formed the view that vigorous shaking by striking on an elastic surface – a process termed succussion – was necessary. Homeopaths are unable to agree on the number and force of strikes needed, and there is no way that the claimed results of succussion can be tested.

Critics of homeopathy commonly emphasize the dilutions involved in homeopathy, using analogies. One mathematically correct example is that a 12C solution is equivalent to "a pinch of salt in both the North and South Atlantic Oceans". One-third of a drop of some original substance diluted into all the water on Earth would produce a preparation with a concentration of about 13C. Robert L. Park points out that a 200C dilution of duck liver, marketed under the name Oscillococcinum, would require 10 universes worth of molecules to contain just one original molecule in the final substance. The high dilutions characteristically used are often considered to be the most controversial and implausible aspect of homeopathy.

Provings

Homeopaths claim that they can determine the properties of their preparations by following a method which they call "proving". As performed by Hahnemann, provings involved administering various preparations to healthy volunteers. The volunteers were then observed, often for months at a time. They were 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. At first Hahnemann used undiluted doses for provings, but he later advocated provings with preparations at a 30C dilution, and most modern provings are carried out using ultra-dilute preparations.

Provings are claimed to have been important in the development of the clinical trial, due to their early use of simple control groups, systematic and quantitative procedures, and some of the first application of statistics in medicine. 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's 1905 Lectures on Homoeopathic Materia Medica, 217 preparations underwent provings and newer substances are continually added to contemporary versions.

Though the proving process has superficial similarities with clinical trials, it is fundamentally different in that the process is subjective, not blinded, and modern provings are unlikely to use pharmacologically active levels of the substance under proving. As early as 1842, Oliver Holmes had noted that provings were impossibly vague, and the purported effect was not repeatable among different subjects.

Evidence and efficacy

Main article: Evidence and efficacy of homeopathy

Outside of the alternative medicine community, scientists have long considered homeopathy a sham or a pseudoscience, and the medical community regards it as quackery. There is an overall absence of sound statistical evidence of therapeutic efficacy, which is consistent with the lack of any biologically plausible pharmacological agent or mechanism. Proponents argue that homeopathic medicines must work by some, as yet undefined, biophysical mechanism. No homeopathic preparation has been shown to be different from placebo.

Lack of scientific evidence

The lack of convincing scientific evidence supporting its efficacy and its use of preparations without active ingredients have led to characterizations of homeopathy as pseudoscience and quackery, or, in the words of a 1998 medical review, "placebo therapy at best and quackery at worst". The Russian Academy of Sciences considers homeopathy a "dangerous 'pseudoscience' that does not work", and "urges people to treat homeopathy 'on a par with magic'". The Chief Medical Officer for England, Dame Sally Davies, has stated that homeopathic preparations are "rubbish" and do not serve as anything more than placebos. In 2013, Mark Walport, the UK Government Chief Scientific Adviser and head of the Government Office for Science said "homeopathy is nonsense, it is non-science." His predecessor, John Beddington, also said that homeopathy "has no underpinning of scientific basis" and is being "fundamentally ignored" by the Government.

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." Ben Goldacre says that homeopaths who misrepresent scientific evidence to a scientifically illiterate public, have "... walled themselves off from academic medicine, and critique has been all too often met with avoidance rather than argument". Homeopaths often prefer to ignore meta-analyses in favour of cherry picked positive results, such as by promoting a particular observational study (one which Goldacre describes as "little more than a customer-satisfaction survey") as if it were more informative than a series of randomized controlled trials.

In an article entitled "Should We Maintain an Open Mind about Homeopathy?" published in the American Journal of Medicine, Michael Baum and Edzard Ernst – writing to other physicians – wrote that "Homeopathy is among the worst examples of faith-based medicine... These axioms 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...".

Plausibility of dilutions

A homeopathic preparation made from marsh tea: the "15C" dilution shown here means the original solution was diluted to 1/10 of its original strength.

The exceedingly low concentration of homeopathic preparations, which often lack even a single molecule of the diluted substance, has been the basis of questions about the effects of the preparations since the 19th century. The laws of chemistry give this dilution limit, which is related to the Avogadro number, as being roughly equal to 12C homeopathic dilutions (1 part in 10). James Randi and the 10:23 campaign groups have highlighted the lack of active ingredients by taking large 'overdoses'. 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".

Modern advocates of homeopathy have proposed a concept of "water memory", according to which water "remembers" the substances mixed in it, and transmits the effect of those substances when consumed. This concept is inconsistent with the current understanding of matter, and water memory has never been demonstrated to have any detectable effect, biological or otherwise. Existence of a pharmacological effect in the absence of any true active ingredient is inconsistent with the law of mass action and the observed dose-response relationships characteristic of therapeutic drugs. Homeopaths contend that their methods produce a therapeutically active preparation, selectively including only the intended substance, though in reality any water will have been in contact with millions of different substances throughout its history, and homeopaths cannot account for the selected homeopathic substance being isolated as a special case in their process.

Practitioners also hold that higher dilutions produce stronger medicinal effects. This idea is also inconsistent with observed dose-response relationships, where effects are dependent on the concentration of the active ingredient in the body. Some contend that the phenomenon of hormesis may support the idea of dilution increasing potency, but the dose-response relationship outside the zone of hormesis declines with dilution as normal, and nonlinear pharmacological effects do not provide any credible support for homeopathy.

Efficacy

Explanations for efficacy of homeopathic preparations:
The placebo effect The intensive consultation process and expectations for the homeopathic preparations may cause the effect
Therapeutic effect of the consultation The care, concern, and reassurance a patient experiences when opening up to a compassionate caregiver can have a positive effect on the patient's well-being.
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 towards the mean 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 of the timing of the visit to the homeopath they attribute improvement to the preparation taken.
Non-homeopathic treatment Patients may also receive standard medical care at the same time as homeopathic treatment, and the former is responsible for improvement.
Cessation of unpleasant treatment Often homeopaths recommend patients stop getting medical 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, but the underlying disease remains untreated and still dangerous to the patient.

No individual homeopathic preparation has been unambiguously shown by research to be different from placebo. The methodological quality of the early primary research was low, with problems such as weaknesses in study design and reporting, small sample size, and selection bias. Since better quality trials have become available, the evidence for efficacy of homeopathy preparations has diminished; the highest-quality trials indicate that the preparations themselves exert no intrinsic effect. A review conducted in 2010 of all the pertinent studies of "best evidence" produced by the Cochrane Collaboration concluded that this evidence "fails to demonstrate that homeopathic medicines have effects beyond placebo."

In 2009, the United Kingdom's House of Commons Science and Technology Committee concluded that there was no compelling evidence of effect other than placebo. The Australian National Health and Medical Research Council completed a comprehensive review of the effectiveness of homeopathic preparations in 2015, in which it concluded that "there were no health conditions for which there was reliable evidence that homeopathy was effective." The European Academies' Science Advisory Council (EASAC) published its official analysis in 2017 finding a lack of evidence that homeopathic products are effective, and raising concerns about quality control. In contrast a 2011 book was published, purportedly financed by the Swiss government, that concluded that homeopathy was effective and cost efficient. Although hailed by proponents as proof that homeopathy works, it was found to be scientifically, logically and ethically flawed, with most authors having a conflict of interest. The Swiss Federal Office of Public Health later released a statement saying the book was published without the consent of the Swiss government.

Meta-analyses, essential tools to summarize evidence of therapeutic efficacy, and systematic reviews have found that the methodological quality in the majority of randomized trials in homeopathy have shortcomings and that such trials were generally of lower quality than trials of conventional medicine. A major issue has been publication bias, where positive results are more likely to be published in journals. This has been particularly marked in alternative medicine journals, where few of the published articles (just 5% during the year 2000) tend to report null results. A systematic review of the available systematic reviews confirmed in 2002 that higher-quality trials tended to have less positive results, and found no convincing evidence that any homeopathic preparation exerts clinical effects different from placebo. The same conclusion was also reached in 2005 in a meta-analysis published in The Lancet. A 2017 systematic review and meta-analysis found that the most reliable evidence did not support the effectiveness of non-individualized homeopathy.

Health organizations, including the UK's National Health Service, the American Medical Association, the FASEB, and the National Health and Medical Research Council of Australia, have issued statements saying that there is no good-quality evidence that homeopathy is effective as a treatment for any health condition. In 2009, World Health Organization official Mario Raviglione criticized the use of homeopathy to treat tuberculosis; similarly, another WHO spokesperson argued there was no evidence homeopathy would be an effective treatment for diarrhoea. They warned against the use of homeopathy for serious conditions such as depression, HIV and malaria. The American College of Medical Toxicology and the American Academy of Clinical Toxicology recommend that no one use homeopathic treatment for disease or as a preventive health measure. These organizations report that no evidence exists that homeopathic treatment is effective, but that there is evidence that using these treatments produces harm and can bring indirect health risks by delaying conventional treatment.

Purported 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 and enzyme reactions, such evidence is disputed since attempts to replicate them have failed. In 2001 and 2004, Madeleine Ennis published a number of studies that reported that homeopathic dilutions of histamine exerted an effect on the activity of basophils. In response to the first of these studies, Horizon aired a programme in which British scientists attempted to replicate Ennis' results; they were unable to do so. A 2007 systematic review of high-dilution experiments found that none of the experiments with positive results could be reproduced by all investigators.

In 1988, French immunologist Jacques Benveniste published a paper in the journal Nature while working at INSERM. The paper purported to have discovered that basophils released histamine when exposed to a homeopathic dilution of anti-immunoglobulin E antibody. Skeptical of the findings, Nature assembled an independent investigative team to determine the accuracy of the research. After investigation 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."

Ethics and safety

Homeopathic preparation Rhus toxicodendron, derived from poison ivy

The provision of homeopathic preparations has been described as unethical. Michael Baum, professor emeritus of surgery and visiting professor of medical humanities at University College London (UCL), has described homeopathy as a "cruel deception". Edzard Ernst, the first professor of complementary medicine in the United Kingdom and a former homeopathic practitioner, has expressed his concerns about pharmacists 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. In 2013 the UK Advertising Standards Authority concluded that the Society of Homeopaths were targeting vulnerable ill people and discouraging the use of essential medical treatment while making misleading claims of efficacy for homeopathic products. In 2015 the Federal Court of Australia imposed penalties on a homeopathic company for making false or misleading statements about the efficacy of the whooping cough vaccine and recommending homeopathic remedies as an alternative.

Old homeopathic belladonna preparation

A 2000 review by homeopaths reported that homeopathic preparations are "unlikely to provoke severe adverse reactions". In 2012, a systematic review evaluating evidence of homeopathy's possible adverse effects concluded that "homeopathy has the potential to harm patients and consumers in both direct and indirect ways". A 2016 systematic review and meta-analysis found that, in homeopathic clinical trials, adverse effects were reported among the patients who received homeopathy about as often as they were reported among patients who received placebo or conventional medicine.

Some homeopathic preparations involve poisons such as Belladonna, arsenic, and poison ivy. In rare cases, the original ingredients are present at detectable levels. This may be due to improper preparation or intentional low dilution. Serious adverse effects such as seizures and death have been reported or associated with some homeopathic preparations. Instances of arsenic poisoning have occurred. In 2009, the FDA advised consumers to stop using three discontinued cold remedy Zicam products because it could cause permanent damage to users' sense of smell. In 2016 the FDA issued a safety alert to consumers warning against the use of homeopathic teething gels and tablets following reports of adverse events after their use. A previous FDA investigation had found that these products were improperly diluted and contained "unsafe levels of belladonna" and that the reports of serious adverse events in children using this product were "consistent with belladonna toxicity".

Patients who choose to use homeopathy rather than evidence-based medicine risk missing timely diagnosis and effective treatment, thereby worsening the outcomes of serious conditions such as cancer. The Russian Commission on Pseudoscience has said homeopathy is not safe because "patients spend significant amounts of money, buying medicines that do not work and disregard already known effective treatment." Critics have cited cases of patients failing to receive proper treatment for diseases that could have been easily managed with conventional medicine and who have died as a result. They have also condemned the "marketing practice" of criticizing and downplaying the effectiveness of medicine. Homeopaths claim that use of conventional medicines will "push the disease deeper" and cause more serious conditions, a process referred to as "suppression". In 1978, Anthony Campbell, a consultant physician at the Royal London Homeopathic Hospital, criticized statements by George Vithoulkas claiming that syphilis, when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the central nervous system. Vithoulkas' claims echo the idea that treating a disease with external medication used to treat the symptoms would only drive it deeper into the body and conflict with scientific studies, which indicate that penicillin treatment produces a complete cure of syphilis in more than 90% of cases.

The use of homeopathy as a preventive for serious infectious diseases, called homeoprophylaxis, is especially controversial. Some homeopaths (particularly those who are non-physicians) advise their patients against immunization. Others have suggested that vaccines be replaced with homeopathic "nosodes". While Hahnemann was opposed to such preparations, modern homeopaths often use them although there is no evidence to indicate they have any beneficial effects. Promotion of homeopathic alternatives to vaccines has been characterized as dangerous, inappropriate and irresponsible. In December 2014, the Australian homeopathy supplier Homeopathy Plus! was found to have acted deceptively in promoting homeopathic alternatives to vaccines. In 2019, an investigative journalism piece by the Telegraph revealed that homeopathy practitioners were actively discouraging patients from vaccinating their children. Cases of homeopaths advising against the use of anti-malarial drugs have also been identified, putting visitors to the tropics in severe danger.

A 2006 review recommends that pharmacy colleges include a required course where 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.

Regulation and prevalence

Main article: Regulation and prevalence of homeopathy
Hampton House, the former site of Bristol Homeopathic Hospital

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 practiced worldwide and professional qualifications and licences are needed in most countries. A 2019 WHO report found that 100 out of 133 Member States surveyed in 2012 acknowledged that their population used homeopathy, with 22 saying the practice was regulated and 13 providing health insurance coverage. 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 2001 homeopathy had been integrated into the national health care systems of many countries, including India, Mexico, Pakistan, Sri Lanka, and the United Kingdom.

Regulation

Some homeopathic treatment is covered by the public health service of several European countries, including Scotland, and Luxembourg. It used to be covered in France until 2021. 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 treatments. In 2018, Austria's Medical University of Vienna stopped teaching homeopathy. The Swiss government withdrew coverage of 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 were reinstated for a further 6-year trial period. In Germany, homeopathic treatments are covered by 70 percent of government medical plans, and available in almost every pharmacy. In January 2024, German health minister Karl Lauterbach announced plans to withdraw all statutory health insurance coverage for homeopathic and anthroposophic treatments, citing a lack of scientific evidence for their efficacy.

The English NHS recommended against prescribing homeopathic preparations in 2017. In 2018, prescriptions worth £55,000 were written in defiance of the guidelines, representing less than 0.001% of the total NHS prescribing budget. In 2016 the UK's Committee of Advertising Practice compliance team wrote to homeopaths in the UK to "remind them of the rules that govern what they can and can't say in their marketing materials". The letter told homeopaths to "ensure that they do not make any direct or implied claims that homeopathy can treat medical conditions" and asks them to review their marketing communications "including websites and social media pages" to ensure compliance. Homeopathic services offered at Bristol Homeopathic Hospital in the UK ceased in October 2015.

Member states of the European Union are required to ensure that homeopathic products are registered, although this process does not require any proof of efficacy. In Spain, the Association for the protection of patients from pseudo-scientific therapies is lobbying to get rid of the easy registration procedure for homeopathic remedies. In Bulgaria, Hungary, Latvia, Romania and Slovenia homeopathy, by law, can only be practiced by medical practitioners. However, in Slovenia if doctors practice homeopathy their medical license will be revoked. In Germany, to become a homeopathic physician, one must attend a three-year training program, while France, Austria and Denmark mandate licences to diagnose any illness or dispense of any product whose purpose is to treat any illness. Homeopaths in the UK are under no legal regulations, meaning anyone can call themselves homeopaths and administer homeopathic remedies.

Homeopathics at a homeopathic pharmacy in Varanasi, India
Homeopathic medicines at a store in West Bengal, India

The Indian government recognizes homeopathy as one of its national systems of medicine and they are sold with medical claims. It has established the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) under the Ministry of Health & Family Welfare. The south Indian state of Kerala also has a cabinet-level AYUSH department. The Central Council of Homoeopathy was established in 1973 to monitor higher education in homeopathy, and the National Institute of Homoeopathy in 1975. Principals and standards for homeopathic products are covered by the Homoeopathic pharmacopoeia of India. A minimum of a recognized diploma in homeopathy and registration on a state register or the Central Register of Homoeopathy is required to practice homeopathy in India.

Some medical schools in Pakistan, India, and Bangladesh, offer an undergraduate degree programme in homeopathy. Upon completion the college may award a Bachelor of Homoeopathy Medicine and Surgery (B.H.M.S.).

In the United States each state is responsible for the laws and licensing requirements for homeopathy. In 2015, the FDA held a hearing on homeopathic product regulation. At the hearing, representatives from the Center for Inquiry and the Committee for Skeptical Inquiry summarized the harm that is done to the general public from homeopathics and proposed regulatory actions: In 2016 the United States Federal Trade Commission (FTC) issued an "Enforcement Policy Statement Regarding Marketing Claims for Over-the-Counter Homeopathic Drugs" which specified that the FTC will apply the same standard to homeopathic drugs that it applies to other products claiming similar benefits. A related report concluded that claims of homeopathy effectiveness "are not accepted by most modern medical experts and do not constitute competent and reliable scientific evidence that these products have the claimed treatment effects." In 2019, the FDA removed an enforcement policy that permitted unapproved homeopathics to be sold. Currently no homeopathic products are approved by the FDA.

Homeopathic remedies are regulated as natural health products in Canada. Ontario became the first province in the country to regulate the practice of homeopathy, a move that was widely criticized by scientists and doctors. Health Canada requires all products to have a licence before being sold and applicants have to submit evidence on "the safety, efficacy and quality of a homeopathic medicine". In 2015 the Canadian Broadcasting Corporation tested the system by applying for and then receiving a government approved licence for a made-up drug aimed at kids.

In Australia, the sale of homeopathic products is regulated by the Therapeutic Goods Administration. In 2015, the National Health and Medical Research Council of Australia concluded that there is "no reliable evidence that homeopathy is effective and should not be used to treat health conditions that are chronic, serious, or could become serious". They recommended anyone considering using homeopathy should first get advice from a registered health practitioner. A 2017 review into Pharmacy Remuneration and Regulation recommended that products be banned from pharmacies; while noting the concerns the government did not adopt the recommendation. In New Zealand there are no regulations specific to homeopathy and the New Zealand Medical Association does not oppose the use of homeopathy, a stance that has been called unethical by some doctors.

Prevalence

Homeopathy is one of the most commonly used forms of alternative medicines and it has a large worldwide market. The exact size is uncertain, but information available on homeopathic sales suggests it forms a large share of the medical market.

In 1999, about 1000 UK doctors practiced homeopathy, most being general practitioners who prescribe a limited number of remedies. A further 1500 homeopaths with no medical training are also thought to practice. Over ten thousand German and French doctors use homeopathy. In the United States a National Health Interview Survey estimated 5 million adults and 1 million children used homeopathy in 2011. An analysis of this survey concluded that most cases were self-prescribed for colds and musculoskeletal pain. Major retailers like Walmart, CVS, and Walgreens sell homeopathic products that are packaged to resemble conventional medicines.

The homeopathic drug market in Germany is worth about 650 million euro with a 2014 survey finding that 60 percent of Germans reported trying homeopathy. A 2009 survey found that only 17 percent of respondents knew how homeopathic medicine was made. France spent more than US$408 million on homeopathic products in 2008. In the United States the homeopathic market is worth about $3 billion-a-year; with 2.9 billion spent in 2007. Australia spent US$7.3 million on homeopathic medicines in 2008.

In India, a 2014 national health survey found that homeopathy was used by about 3% of the population. Homeopathy is used in China, although it arrived a lot later than in many other countries, partly due to the restriction on foreigners that persisted until late in the nineteenth century. Throughout Africa there is a high reliance on traditional medicines, which can be attributed to the cost of modern medicines and the relative prevalence of practitioners. Many African countries do not have any official training facilities.

Veterinary use

Homeopathic cures for small animals on the Isle of Man

Using homeopathy as a treatment for animals is termed "veterinary homeopathy" and dates back to the inception of homeopathy; Hahnemann himself wrote and spoke of the use of homeopathy in animals other than humans. The use of homeopathy in the organic farming industry is heavily promoted. Given that homeopathy's effects in humans are due to the placebo effect and the counseling aspects of the consultation, such treatments are even less effective in animals. 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. This means that animals given homeopathic remedies will continue to suffer, resulting in animal welfare concerns.

Little existing research on the subject is of a high enough scientific standard to provide reliable data on efficacy. A 2016 review of peer-reviewed articles from 1981 to 2014 by scientists from the University of Kassel, Germany, concluded that there is not enough evidence to support homeopathy as an effective treatment of infectious diseases in livestock. The UK's Department for Environment, Food and Rural Affairs (Defra) has adopted a robust position against use of "alternative" pet preparations including homeopathy. The British Veterinary Association's position statement on alternative medicines says that it "cannot endorse" homeopathy, and the Australian Veterinary Association includes it on its list of "ineffective therapies".

See also

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