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{{Short description|Pseudoscientific system of alternative medicine}}
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{{for|the journal|Homeopathy (journal){{!}}''Homeopathy'' (journal)}}
{{See also|classical homeopathy|clinical homeopathy|complex homeopathy}}
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'''Homeopathy''' (also spelled '''homœopathy''' or '''homoeopathy''') from the Greek words ''όμοιος, hómoios'' (similar) and ''πάθος, páthos'' (suffering)<ref> at Skylark Books website</ref>, is an ] that attempts to treat "like with like." The term "homeopathy" was coined by the German physician ] (]&ndash;]) and first appeared in print in ],<ref>Hahnemann, S. Fingerzeige auf den homöopathischen Gebrauch der Arzneien in der bisherigen Praxis. N. J. d. pract. Arzkd. (1807) 26:5-43)</ref> although he began outlining his axiom of medical similars in a series of articles and monographs in ].<ref>Hahnemann, S. Versuch über ein neues Prinzip zur Auffindung der Heilkräfte der Arzneisubstanzen, nebst einigen Blicken auf die bisherigen. J. d. pract. Arzkd. (1796) 2(3):391-439) and 2(4):465-561 This article in English translation can be read in the </ref>
{{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 holds the premise of treating the sick with extremely diluted agents that, in undiluted doses, produce similar symptoms in the healthy. Its adherents and practitioners assert that the therapeutic potency of a remedy can be increased by serial dilution of the drug, combined with ], or vigorous shaking. Like conventional medicine, homeopathy regards diseases as <cite>morbid derangements of the organism</cite>.<ref>Organon § 11</ref> However, homeopathy states that instances of disease in different people differ fundamentally.<ref>Morrell, Peter </ref> Homeopathy views a sick person as having a dynamic disturbance in a hypothetical "vital force," and so rejects standard medical diagnoses of named diseases.<ref></ref>
|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
Critics frequently describe it as ]<ref> at UK-Skeptics</ref> and ].<ref> National Council Against Health Fraud</ref> Homeopathy is inconsistent with known laws of chemistry and physics, since its theory states that extreme dilution makes drugs more powerful by enhancing their "spirit-like medicinal powers."<ref></ref> Placebo-controlled clinical trials have given mixed results, but most have methodological problems, with better-quality trials more likely to give negative results.<ref>{{cite journal | author=Shang A, Huwiler-Muntener K, Nartey L, Juni P, Dorig S, Sterne JA, Pewsner D, Egger M | title=Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy | journal=Lancet | year=2005 | pages=726-32 | volume=366 | issue=9487 | id=PMID 16125589}}</ref> Additionally, cases have been reported of life-threatening complications resulting from attempts to treat serious conditions solely with homeopathic remedies.<ref>http://news.bbc.co.uk/2/hi/programmes/newsnight/5178122.stm BBC news, Malaria advice 'risks lives', By Meirion Jones</ref><ref></ref>
|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.
Homeopathy is particularly popular in Europe and India,<ref></ref><ref></ref> although less so in the USA,<ref>Tindle HA, Davis RB, Phillips RS, Eisenberg DM "Trends in use of complementary and alternative medicine by US adults: 1997-2002" ''Altern. Ther. Health Med.'' 2005 Jan-Feb;11(1):42-9.</ref> where such therapies have been subject to tighter regulation. Stricter European regulations have also been implemented recently by the EDQM.<ref> EDQM website</ref>


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>
{{Alternative medical systems}}


==History==
==The principle of medical similars==
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">
Homeopathy is based on the 'Principle of Similars', first expressed by Hahnemann in the exhortation ''similia similibus curentur'' or 'let likes cure likes'. This is the opposite of 'contraries' upon which the ] medicine of his day was based, which Hahnemann initially practised and in which he had been trained.
{{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===
The 'law of similars' is an ancient medical maxim,<ref></ref><ref></ref> but its modern form is based on Hahnemann's conclusion that a constellation of symptoms induced by a given homeopathic remedy in a group of healthy individuals will cure a similar set of symptoms in the sick. Symptom patterns associated with various remedies are determined by 'provings', in which healthy volunteers are given remedies, often in molecular doses, and the resulting physical, mental and spiritual symptoms are compiled by observers into a 'Drug Picture'.
], 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>
Hahnemann says of the attitude his first proving inspired in him: ''"with this first trial broke upon me the dawn that has since brightened into the most brilliant day of the medical art; that it is only in virtue of their power to make the healthy human being ill that medicines can cure morbid states, and indeed, only such morbid states are composed of symptoms which the drug to be selected for them can itself produce in similarity on the healthy."''<ref> at Hpathy.com</ref>


====Provings====
Homeopathic practitioners rely on two types of reference in prescribing. The Homeopathic ]e comprise alphabetical indexes of Drug Pictures organized by remedy and describe the symptom patterns associated with individual remedies. The ] consists of an index of sickness symptoms, listing all remedies associated with specific symptoms. The first such ] was George Jahr's Repertory, published in 1835.<ref></ref>
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}}.
Hahnemann first tested in homeopathic provings substances commonly used as medicines in his time, such as ] and ], and also poisons like ], ] 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====
Hahnemann recorded his first provings of 27 drugs in the '']'' in 1805 and later in his '']'', which contained 65 proven drugs. He was most heavily engaged in proving in the 1790s and early 1800s, but he never abandoned these experiments. Another phase of proving commenced with his Miasm theory and The Chronic Diseases,<ref></ref> published in 1828, and containing 48 freshly 'proven' drugs.
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">
] ''Lectures on Homoeopathic Materia Medica'' (]) lists 217 remedies, and new substances are continually added to contemporary versions. Homeopathy uses many animal, plant, mineral, and synthetic substances. Examples include ''Natrum muriaticum'' (] or table salt), '']'' (the venom of the ] ]), '']'', and ''Thyroidinum'' (]). Other homeopathic remedies, ('isopathic' remedies'), involve dilution of the agent or product of the disease. ] nosode, for example, is made by diluting the saliva of a rabid dog. Some modern homeopaths are exploring the use of more esoteric substances, known as "imponderables" because they do not originate from a material but from ] presumed to have been "captured" by alcohol or lactose ('']'', ''Sol'' (sunlight), , and (electricity) or through the use of a telescope ('']''). Recent ventures by homeopaths into even more esoteric substances include (thunderstorm), and .
{{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}}
Today, about 3000 remedies are used in homeopathy; about 300 are based on comprehensive ] information, about 1500 on relatively fragmentary knowledge and the rest are used experimentally in difficult cases based on the law of similars, either without knowledge of their homeopathic properties or through speculative knowledge independent of the law of similars. This modern approach also harks back to the ancient 'doctrine of signatures,' which Hahnemann definitely rejected as uncertain guesswork: ''"The ancients imagined that the yellow colour of the juice of...(Chelidonium, Yellow Poppy) was an indication (signature) of its utility in bilious diseases. The moderns from this extended its employment to hepatic diseases...the importance of human health does not admit of any such uncertain directions for the employment of medicines. It would be criminal frivolity to rest contented with such guesswork at the bedside of the sick. Only that which the drugs themselves unequivocally reveal of their peculiar powers in their effects on the healthy human body – that is to say, only their pure symptoms – can teach us loudly and clearly when they can be advantageously used with certainty; and this is when they are administered in morbid states very similar to those they are able to produce on the healthy body."''<ref> at Hpathy.com</ref>


===19th century: rise to popularity and early criticism===
Examples of this impulse to expand the materia medica include: the use of an isopathic (disease associated) agent as a first prescription in a 'stuck' case,<ref>Manish Bhatia </ref> when the beginning of disease coincides with a specific event such as ]; the use of a chemically-related substance when a remedy that was well-indicated fails. A good example of this is found in the Bowel Nosodes<ref></ref> which were introduced by the British homeopaths, ] (1886-1936), John Paterson (1890-1954) and Charles Edwin Wheeler (1868-1946) in the 1920s. Their use is based on the variable bowel ] flora thought to be associated with persons of different homeopathic constitutional types. Though receiving more attention today, the Bowel Nosodes are rarely used outside British homeopathy.
]'', 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
|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">
More recently, homeopathy has embraced substances based on their elemental classification (the ] or biological ]).<ref></ref><ref></ref> This approach may create neat systems for grouping remedies and classifying the ever-burgeoning ], but its usefulness is questioned by some purists on the basis that it involves speculation about remedy action without provings.<ref></ref>
{{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">
There are many methods for determining the most-similar remedy (the ''simillimum''), and homeopaths sometimes disagree. This is partly due to the complexity of the 'totality of symptoms' concept; homeopaths do not use all symptoms, but decide which are the most characteristic; this subjective evaluation of case analysis rests crucially on knowledge and experience. Finally, the Drug Picture in the ] is always more comprehensive than the symptoms exhibited by any individual. These factors mean that a homeopathic prescription can remain presumptive until it is verified by testing the effect of the remedy on the patient.
{{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 ===
Alternative modes of selecting remedies include ]<ref></ref> or the use of other ].<ref></ref><ref></ref> However, these methods are controversial and not accepted by most homeopathic practitioners.
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>
The law of similars is more of a guiding principle than a scientific law. It is not built on a hypothesis that can be ]; a failure to cure homeopathically can always be attributed to incorrect selection of a remedy: ''I have often heard physicians tell me that it was due to suggestion that my medicines acted so well; but my answer to this is, that I suggest just as strongly with my wrong remedy as with the right one, and my patients improve only when they have received the similar or correct remedy''.<ref>James Tyler Kent, ''New Remedies, Lesser Writings and Aphorisms & Precepts'', Chicago: Ehrhart & Karl, 1926, quoted in Francis Treuherz, ''Origins of Kent's Homeopathy'', Jnl Amer Inst Homeo, 77.4, 1984, 130-49; 140-1</ref>


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>
''See also'': ]


===21st century: renewed criticism===
==Preparation of similars ==
===Succussion and dilution===
]
The most characteristic and controversial principle of homeopathy is that the potency of a remedy can be enhanced (and the side-effects diminished) by dilution, in a procedure known as ''dynamization'' or ''potentization''. Liquids are progressively diluted (with water, or alcohol) and shaken by ten hard strikes against an elastic body (''succussion''). For this purpose, Hahnemann had a saddlemaker construct a special wooden striking board covered in leather on one side and stuffed with horsehair. This can be viewed at the Hahnemann Museum in Stuttgart.<ref></ref> Insoluble solids, such as Quartz and Oyster shell, are diluted by grinding with ] ('']''). The original serial dilutions by Hahnemann were performed using a 1 part in 100 or centesimal scale, or 1 part in 50,000 or Quintamillesimal (LM or Q potencies). Higher 'potencies' are considered to be stronger 'deep-acting' remedies.


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" />
The dilution factor at each stage is traditionally 1:10 ('D' or 'X' potencies) or 1:100 ('C' potencies). Hahnemann advocated 30C dilutions for most purposes, i.e. dilution by a factor of 100<sup>30</sup> = 10<sup>60</sup>. As ] is only 6.02 × 10<sup>23</sup> particles/mole, the chance of any molecule of the original substance being present in a 15C solution is small, and it is extremely unlikely that one molecule of the original solution would be present in a 30C dilution. For a perspective on these numbers, there are in the order of 10<sup>32</sup> molecules of water in an ]; to expect to get one molecule of a 15C solution, one would need to take 1% of the volume of such a pool, or roughly 25 metric tons of water. <!-- As per orders of magnitude (volume) article, there's over 2.5 Gg of water in a pool, or about 1.4E8 moles at 18 to the gram, or somewhat over 1E32 molecules -- Pakaran --> Thus, even homeopathic remedies of a high "potency" contain, with overwhelming probability, only water. Practitioners of homeopathy believe that this water retains some 'essential property' of one of the substances that it has contacted in the past.


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>
Water will have been in contact with millions of different substances in its history. According to this molecular paradigm, any glass of water must be regarded as an extreme dilution of almost any agent you care to mention. Thus, critics argue that by drinking water one receives homeopathic treatment for every imaginable condition.<ref>{{cite web | title=Horizon's Homeopathic Coup, Cuzco's Altitude, More Funny Sites, The Clangers, Overdue, Orbito Nabbed in Padua, Randi A Zombie?, Stellar Guests at Amazing Meeting, and Great New Shermer Books! | work=James Randi Educational Foundation | url=http://www.randi.org/jr/112902.html | accessdate=2006-09-20}}</ref><ref>{{cite web | title=HOMEOPATHY AND SCIENCE: A CLOSER LOOK | work=The Technology Journal of the Franklin Institute | url=http://www.colorado.edu/philosophy/vstenger/Medicine/Homeop.html | accessdate=2006-09-20}}</ref> Proponents of homeopathy are unable to accept the molecular paradigm as a complete account of life phenomena and therapeutics. They believe that the methodical dilution of a particular substance, beginning with a 10% solution and working downwards, produces a therapeutically active 'remedy', in contrast to regular water which is therapeutically inert. However, in terms of chemistry, a dilution of anything at 30C is identical to water.


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>
===Alternative methods of preparation===


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>
High potency remedies were first produced in the 1830s. Though Hahnemann wished to see 30c as standard potency in homeopathy, the majority of his contemporaries preferred tinctures and 3x, while others, like the powerfully-built horse-trainer, Caspar Julius Jenichen (1787-1849),<ref></ref> General Korsakoff (1788-1853) and Dr N Schreter (1803-1864), were busy raising potency to heights beyond his wildest dreams.


==Preparations and treatment==
''Jenichen sat or stood stripped naked to the waist, holding the bottle in his fist in an oblique direction from left to right, and shook it in a vertical direction. The fluid, at every stroke, emitted a sound like the ringing of silver coins. He paused after every 25th potency, and the muscles of his naked arm vibrated...he was latterly able to give 8400 strokes in an hour.''<ref></ref>
{{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>
Such high potencies could not be made by traditional methods, but required succussion without dilution (Jenichen), higher dilution factors (LM potencies are diluted by a factor of 50,000), or machines which integrate dilution and succussion into a continuous process (Korsakoff). Such a Korsakoff potentising machine can be seen and . Some old potentising devices can be seen . Such machines are still on sale today and some manufacturers claim it is undefined "vibrations" that produce the healing effect and, when the correct vibration is selected, only water need be added to produce a remedy.<ref></ref> Today, '']'' potentising devices are used by many homeopaths to prepare remedies.<ref></ref> These are based on the work of the British engineer, Malcom Rae (1913-1979)<ref></ref> and the potentising devices he developed in the 1960s.<ref></ref>
{{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>


=== Consultation ===
Yet another technique used by few homeopaths involves using ''"a paper remedy. Write the remedy and potency on a piece of paper and place the paper on the left hand side of the body with the writing towards the body."''<ref></ref> One homeopath, ''"finds out what they need, writes the remedy down on a piece of paper, they put it in their pocket and it works."''<ref></ref> In essence, this comprises an emerging alternative homeopathic tradition, ''"`paper remedies' i.e., a name of a remedy just written on a piece of paper."''<ref></ref>
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 ===
The practitioner's choice of what potency is appropriate derives in part from a judgement as to whether the disease is acute and superficial or 'deeper' and more chronic in nature; whether it is primarily physical or more mental/emotional; the patient's sensitivity and previous reactions to remedies; and the practitioner's preferred posology (dosing regimen), e.g. low potency repeated often, vs. high potency repeated seldom. For example, French and German homeopaths generally prefer to use lower potencies than their American and British counterparts. Most homeopaths assert that the choice of potency is secondary to the choice of remedy: i.e. that a well-chosen remedy will act in a variety of potencies, but an approximately matched remedy might act only in certain potencies, or not at all.
]'', 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>
==Miasms as a cause of disease==


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>
By 1816, Hahnemann was concerned at the failure of his homeopathic remedies to produce lasting cures for chronic diseases. He found that ''"...the non-venereal chronic diseases, after being time and again removed homoeopathically … always returned in a more or less varied form and with new symptoms."'' To explain this, Hahnemann introduced the miasmatic theory, that three fundamental "miasms" are the underlying root causes of all the chronic diseases of mankind: ], Sycosis (suppressed ]), and Psora.
{{cite journal
|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>
This miasm theory was first published in 1828.<ref>The Chronic Diseases, their Nature and Homoeopathic Treatment, ] and ], Arnold. Vols. 1, 2, 3, 1828; vol. 4, 1830</ref> Though Hahnemann first suspected miasms in 1816, he took 12 years before he published his views. It is possible that the study of ] under the guidance of his Patron, the Grand Duke Ferdinand of Anhalt-Coethen influenced his thinking.<ref></ref> He adopted a reclusive lifestyle while residing in ] and his new inclination towards metaphysical pursuits may explain his sudden adoption of Olfaction (inhaling the remedy), which he continued to use until his death in ] in 1843.<ref></ref> Olfaction might derive from ] medicine and the art of ].<ref></ref>
{{cite web
|url =http://www.askdrshah.com/images/lancet.pdf
|title=Call for introspection and awakening
|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 ===
The miasm of Psora, he concluded, underpinned most of the chronic diseases known to medicine. Miasma, from the Greek for 'stain', was an old medical concept, used for "pestiferous exhalations". The sense of this is indicated by Hahnemann's Note 2 to §11 of the Organon:
{{Main|Homeopathic dilutions}}
''"...a child with small-pox or measles communicates to a near, untouched healthy child in an invisible manner (dynamically) the ] or ], … in the same way as the magnet communicated to the near needle the magnetic property..."''


]'' (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">
According to Hahnemann, miasmatic infection causes local symptoms, usually in the skin. If these are suppressed by external medication, the hidden cause goes deeper, and manifests itself later as organ pathologies. In §80 of the ''Organon'' he asserted Psora to be the cause of such diseases as ], cyphosis, ], ], ], and ].
{{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>
{{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}}


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">
Even in his own time, many followers of Hahnemann, including Hering, made almost no reference to Hahnemann’s concept of chronic diseases. Today, some homeopathic practitioners<ref></ref> find Hahnemann’s theory difficult to reconcile with current knowledge of ], ], ] and ], as it seems to ignore the importance of ], ], ], ], and ] factors in ]; the theory also fails to differentiate between the multitude of ]. However, most insist that the key elements of his theory are valid. For instance, most of them believe that the fundamental cause of disease is internal and constitutional (i.e. the susceptibility to becoming ill), and that it is contrary to good health to suppress symptoms, especially skin eruptions and discharges. They also accept Hahnemann's concept of latent Psora, the early signs of an organism’s imbalance, which indicate that treatment is needed to prevent the development of more advanced disease.
{{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 miasm theory is not the only meaningful aspect of homeopathy. For example, Hahnemann strongly advocated good ], fresh air, regular ], and good ] as precursors of good health (see his 1792 essay: ''The Friend of Health''); he was also a pioneer in 1792-3 of humane treatment of the ] (1796, ''Description of Klockenbring During his Insanity'') a year before ] and ], and he published tracts in which he described the cause of ] as ''"excessively minute, invisible, living creatures"'' . Hahnemann's acceptance of the emerging idea of infectious disease before its final proof by ] and ] indicates some of his medical views incorporated ideas that were at the cutting-edge of contemporary science. These 17th-century epidemiological theories built on the ideas of ] in the 16th century and the discovery of microbes by ] one hundred years previously.
{{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">
=== Theory of disease ===
{{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>
In Hahnemann's day, the conventional theory of disease was based on the ]. Mainstream medicine focused on restoring the balance in the humours, either by attempting to remove an excess (by such methods as ] and purging, ]s, ]s and nauseous substances that made patients ]) or by suppressing symptoms, such as by lowering the body temperature of patients who were feverish. By contrast, Hahnemann promoted an immaterial, ] view of disease: ''"...homeopathy...can easily convince...that the diseases of man are not caused by any substance, any acridity...any disease matter, but that they are solely spirit-like (dynamic) derangements of the spirit-like power (the vital principle) that animates the human body."''<ref>http://homeoint.org/books/hahorgan/orgapref.htm Organon, Preface, xxix</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===
] was a part of mainstream science in the ]. In the twentieth century, medicine discarded vitalism in favour of the ] of disease, following the work of ], ], ] and many others. Modern medicine sees ] and ]es as ], but Kent and some modern homeopaths regard them as effects, not causes, of disease. Others have adapted to the views of modern medicine by referring to disturbances in, and stimulation of, the immune system, rather than the vital force.
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>
As previously stated, homeopathy stemmed in part from the idea of medical similars, the idea that 'like cures like' while Hahnemann was translating into German the Materia Medica (1789) of ], the so-called Scottish Hippocrates. On reading that Cinchona bark (which contains ]) was effective because it was bitter, Hahnemann felt this implausible because other substances were as bitter but had no therapeutic value. To understand the effects of Cinchona bark, he decided to take it himself, and saw that his reactions were similar to the symptoms of the disease it was used to treat. At least one writer has suggested that Hahnemann was hypersensitive to quinine, and that he may have had an allergic reaction.<ref>. </ref>
{{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" />
Yet, this proving experiment by Hahnemann was by no means unique, as others before him had tried the same approach, such as, for example, Anton von Störck (1731-1803), "in the 1760’s, who advocated treatment by cautious use of poisons."<ref></ref> Indeed, Hahnemann had studied briefly in Vienna (1777) where Störck eventually became head of the University. The proving idea had also been recommended by the great Swiss medical botanist, Albrecht von Haller, (1708-77), who Hahnemann admired, and whose Materia Medica he translated in 1806. It might be said the proving experiment came to Hahnemann from several previous sources.


== Evidence and efficacy ==
For Hahnemann, the whole body and spirit was the focus of therapy, not just localised disease. Hahnemann spent a lot of time with his patients, asking them not only about their symptoms or illness, but also about their daily lives. This gentle approach contrasted with the violent forms of ] common at the time, which included techniques such as bleeding as a matter of course.
{{main|Evidence and efficacy of homeopathy}}
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" />


=== Lack of scientific evidence ===
Nearly as important as Hahnemann to the development of homeopathy was ] (] &ndash; ]). Kent's influence in the USA was limited, but in the UK, his ideas became the homeopathic orthodoxy by the end of the ].<ref>A. Campbell, , Chapter 8 of ''Homeopathy in Perspective''</ref> His most important contribution may be his repertory, which is still used today. Kent's attempt to rescue an idealized pure homeopathy from what he saw as its degenerate mongrel forms was authoritarian, as he sought to re-emphasize the metaphysical and clinical aspects of Hahnemann's teachings, in particular:
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" />
* insistence on the core doctrines of miasm and vital force;
* emphasis on case totality rather than rote prescribing for 'named diseases'
* emphasis on psychological symptoms (to supplement physical pathology) in prescribing; and
* regular use of very high potencies.


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...".
Influenced by ], Kent reputedly emphasized '] factors' as the root cause of disease.<ref></ref>
''<blockquote>"...for it goes to the very primitive wrong of the human race, the very first sickness of the human race that is the spiritual sickness... which in turn laid the foundation for other diseases." </blockquote>''


=== 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 ===
There are estimated<ref> from Deutsche Welle</ref> to be more than 100,000 physicians practising homeopathy worldwide, with an estimated 500 million people receiving treatment. More than 12,000 medical doctors and licensed health care practitioners administer homeopathic treatment in the UK, ], and ]. Homeopathy was regulated by the ] in 2001, by Directive 2001/83/EC.


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" />
<!--English speaking countries-->
'''Britain''' Homeopathy was first established in ] by Dr Frederick Quin (1799-1878) around 1827, though two Italian homeopathic doctors (Drs Romani and Roberta) had been employed two years previously by the Earl of Shrewsbury based at ] in ]; however, they soon returned to ] as they could not tolerate the cool damp ] climate. Homeopathy in the UK quickly became the preferred medical treatment of the upper classes: Regarding Dr Quin, ''"...with his connections, he was quickly established among the well-known and wealthy. Quin counted the Dukes of Edinburgh and Beaufort among his patients, and became physician to the household of the Duchess of Cambridge."''<ref>Leary, B, Lorentzon M & Bosanquet, A, 1998, It Wont Do Any Harm: Practice & People At The London Homeopathic Hospital, 1889-1923, in Juette, Risse & Woodward, 1998 Juette, R, G Risse & J Woodward , 1998, Culture, Knowledge And Healing: Historical Perspectives On Homeopathy In Europe And North America, Sheffield Univ. Press, UK, p.253</ref> Furthermore, ''"the principal supporters of the (homeopathic) hospital, until Quin's death in 1878, were members of the aristocracy."''<ref>Leary, et al, 1998, 254</ref>
Homeopathy in Britain ''"...retained an elite clientele, including members of the royal family."''<ref>Sharma, Ursula, 1992, Complementary Medicine Today, Practitioners And Patients, Routledge, UK, p.185</ref> and ''"...homeopathy still had much support from people in high places in the mid-nineteenth century..."''<ref>Sharma, 1992, p.183</ref> At its peak in the 1870s ] had numerous homeopathic dispensaries and small hospitals as well as large busy hospitals in ], ],<ref></ref> ], ] and ], almost exclusively funded and run by members of the local gentry.<ref></ref> For example, the ] hospital was funded and run by several generations of the ] tobacco family, while the Hahnemann Hospital ] was built by members of the Tate family of sugar importers, who also funded the ] in ].<ref></ref>


===Efficacy===
In ], homeopathic remedies are sold over the counter. Today Britain has five homeopathic hospitals, funded by the ], and many regional clinics. Homeopathy is not practised by most of the medical profession, but there is public support for it, including from the ] and many other members of the royal family.
{| class="wikitable floatright" style="width:40%;"
|+ 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>
Rumour has it that it was after homeopathy was used in treating ] for seasickness in the ] or ] that the British royal family became firm devotees of this medical system.<ref name="royals"> Recent email Correspondence touching on royal use of homeopathy </ref>
|-

| The ]
The largest organisation of homeopaths in ], the Society of Homeopaths, was founded in ] and has been growing steadily since then; it now has 1300 members, an increasing proportion of whom are women.<ref></ref> The medically qualified homeopaths in ] are represented by the Faculty of Homeopathy based in ]: ''"The Faculty, which was incorporated by an ] in ], has over 1,400 members throughout the world and is poised for growth as interest in homeopathy increases both among the public and within the health care sector."''<ref></ref>
| The intensive consultation process and expectations for the homeopathic preparations may cause the effect

|-
'''India''' Homeopathy arrived in ] with Dr John Martin Honigberger (1795-1869) in ], in 1829-30,<ref></ref> and is officially recognized. ''"The first doctor who brought homeopathy to India was Dr. Martin Honigburger, who first came to the Punjab...in 1829."''<ref>Jugal Kishore, About Entry of Homeopathy Into India, Bull. Ind. Hist. Med., vol. 3 (2), April 1973, pp.76-78; p.76</ref> ] has the largest homeopathic infrastructure in the world, with 300,000 qualified homeopaths, 180 colleges, 7500 government clinics, and 307 hospitals.<ref>Dr. Raj Kumar Manchanda & Dr. Mukul Kulashreshtha, ''''</ref> The Association of Qualified Homoeopaths in India (IHMA) is the largest of its kind.<ref></ref>
| 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.
'''USA''' Homeopathy was first established in the ] by Dr Hans Burch Gram (1787-1840)<ref></ref> in 1825 and rapidly gained popularity, partly because the excesses of conventional medicine were extreme there, and partly due to the efforts of Dr Constantine Hering (1800-1880):
|-
''"Dr. Hering immigrated to America in 1833 and later became known as the father of American homeopathy."''<ref>Frederick Karst, Homeopathy In Illinois, Caduceus, 4:2, 1988, pp.1-33; p.5</ref> Homeopathy in the US rose to great prominence. ''"By 1826 homeopathy had taken root in France, Italy, England and the Scandinavian countries....the doctrine arrived in New York in 1825."''<ref>Charles S Cameron, Homeopathy in Retrospect, Trans. Stud. Coll. Phys. Philadelp., 27, 1959, 28-33; p.30</ref> ''"Homeopathy spread first in Germany, then France, and England. Its greatest popularity, however, was in America."''<ref>Lewis B Flinn, Homeopathic Influences in the Delaware Community A Retrospective Reassessment, Del. Med. Jnl., 48:7, July 1976, pp.418-428; p.427</ref> ''"Nowhere did (homeopathy) flourish as luxuriantly as in the United States."''<ref>Cameron, op cit, 30</ref> ''"...by the early 1840s American homeopathic practitioners were gaining considerable influence and prestige."''<ref>John Harley Warner, The Nature-Trusting Heresy, Perspectives on American History, 11, 1977, 291-324; p.299</ref> The use of homeopathy in America increased still further in the next decade, ''In the period 1880-1900 they were at the height of their influence. Hardly any city numbering over 50,000 souls was without a homeopathic hospital and many smaller communities could claim them. In 1890 there were 93 regular schools, 14 homeopathic and 8 eclectic. In 1900, there were 121 regular schools, 22 homeopathic and 10 eclectic."''<ref>Cameron, op cit, 31</ref> ''"Homeopathy enjoyed wide popularity after 1841...many orthodox physicians gradually embraced homeopathy."''<ref>A. Clair Siddall, History of Homeopathic Medicine at Oberlin, Ohio, 1833-1933, Ohio State Med. Jnl, 74, pt. 2, 1978, pp.121-124; p.121</ref>
| Unassisted ]

| Time and the body's ability to heal without assistance can eliminate many diseases of their own accord.
===Historical note===
|-
In the ] homeopathy's popularity waned, especially in the USA and ], partly due to advances in conventional medicine and to skepticism. This led to the closure of virtually all medical schools teaching alternative medicine in the USA. Homeopathy in the West had a renaissance in the ], largely because of ], that continues to this day.
| Unrecognized treatments

| An unrelated food, exercise, environmental agent, or treatment for a different ailment, may have occurred.
Homeopathy reached a peak of popularity in 1865&ndash;1885 and thereafter declined due partly to recognition by the establishment of the dangers of large doses of drugs and bleeding, and via dissent between different schools of homeopathy. However, The ] issued the ] in 1910 that supported allopathic (conventional) medical schools while condemning homeopathic schools. ''This was based on the premise that homeopathic teachers were also practitioners and that courses in pharmacology were taught. With newer medicines and $350 million being poured into ] medicine and hospitals by ], homeopathic schools began to close due to lack of support and money,"''<ref></ref> such that by the 1950s, homeopathy had been virtually extinguished in the US.
|-

| ]
In the USA, homeopathic remedies are, like all health-care products, regulated by the ]. However, the FDA treats homeopathic remedies very differently than conventional medicines. Homeopathic products do not need FDA approval before sale, they do not have to be proven either safe or effective, they do not have to be labeled with an expiration date, and they do not have to undergo finished product testing to verify contents and strength. Unlike conventional drugs, homeopathic remedies do not have to identify their active ingredients on the grounds that they have few or no active ingredients. In the USA, only homeopathic medicines that claim to treat self-limiting conditions may be sold over the counter; homeopathic medicines that claim to treat a serious disease can be sold only by prescription.
| 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.

|-
<!--deutschsprachiger Raum-->
| Non-homeopathic treatment
In '''Germany''', about 6,000 physicians specialize in homeopathy. In ] homeopathy, ] and ], were recognized as "special forms of therapy", meaning that their medications are freed from the usual requirement of proving efficacy. Since January 1, 2004 homeopathic medications, with some exceptions, are no longer covered by the country's public health insurance.<ref> (in German)</ref> Most private health insurers continue to cover homeopathy.
| Patients may also receive standard medical care at the same time as homeopathic treatment, and the former is responsible for improvement.

|-
'''Switzerland''' In ], homeopathic medications were formerly covered by the basic health insurance system, if prescribed by a physician. This ended in June 2005.<ref>] by Vera Kaufmann, BHSc.Hom.] (in German)</ref> The ] Government, after a 5-year trial, withdrew insurance coverage for homoeopathy and four other complementary treatments, claiming that they did not meet efficacy and cost-effectiveness criteria. This change applied only to compulsory insurance; homeopathy and other complementary medicine is covered by additional insurance, if the treatment is provided by a medical doctor.
| 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.
The histories of homeopathy in many different countries, written in their own languages, are available at the

=== Classical versus non-classical homeopathy ===
Hahnemann's formulation of homeopathy is often referred to as '']''. Classical homeopaths use one remedy at a time, and base their prescription also on incidental or constitutional symptoms. However, homeopathic remedies are often used both by practitioners and by the public based on formulations marketed for specific medical conditions. Some formulations use a 'shotgun' approach of the most commonly indicated single remedies in mixture form, while others, such as those by ''Heel'' and ''Reckeweg'', are proprietary mixtures marketed for specific diagnostic criteria based on various systems. Many members of the public are unfamiliar with classical homeopathy, and equate these practices with homeopathy; others are familiar with the classical approach but regard these as legitimate variants; while others consider it a misuse of the term. Use of non-classical approaches is confined mainly to places where over-the-counter preparations are popular and where many doctors use natural medicines in a conventional clinical setting.

== The popularity of homeopathy ==
===Numbers of people receiving homeopathic treatment===
Homeopathy is much more popular in Europe and India than in the USA. A study exploring the use of complementary medicine found the following percentages of various countries' population to be using homeopathy for some of their health needs (data from 1985-92):<ref></ref>
{|"style=width:50%" cellpadding="2" align="center"
!width="150"|Country
!width="200"|Percentage of population using homeopathy
|-align="center"
|Belgium||56%
|-align="center"
|Denmark||28%
|-align="center"
|France||32%
|-align="center"
|Netherlands||31%
|-align="center"
|Sweden||15%
|-align="center"
|UK||16%
|-align="center"
|USA||3%
|} |}
The number of people using homeopathy is also increasing in Europe, with the British market increasing by about 20% per year, with even higher rates of growth in Germany and Portugal.<ref></ref> Interestingly, while in Europe alternative medicine is usually regarded as complementary to conventional medical treatment, in India, 10% of the population are estimated to use homeopathy ''exclusively'' for their medical needs.<ref></ref>


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" />
A more recent study indicates that the percentage of people seeking homeopathic treatment in the United States significantly declined from 3.4% in 1997 to 1.7% in 2002.<ref>Tindle HA, Davis RB, Phillips RS, Eisenberg DM. ''Trends in use of complementary and alternative medicine by US adults: 1997-2002.'' Altern Ther Health Med. 2005 Jan-Feb;11(1):42-9.</ref>


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>
Online homeopathy advocate, Dana Ullman estimates that ''"over 30% of French physicians and 20% of German physicians prescribe homeopathic medicines, that over 40% of British physicians refer patients to homeopathic doctors, and that 45% of Dutch physicians consider homeopathic medicines to be effective."''<ref>http://www.homeopathic.com/articles/intro/education_of_h.php The Education of Homeopaths by Dana Ullman</ref>


], 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>
===Number of homeopaths===
In Britain, the number of homeopaths registered with the Society of Homeopaths increased from 15 to 708 between 1979 and 1999.<ref>Registers of Society of Hom.; Society of homeopaths Annual Report 1989-93; Society of Homeopaths Newsletter 25 p.5; Society of Homeopaths Newsletter 24 p.5; Society of Homeopaths Newsletter 21 p.5</ref> More recent data from the same source shows currently 1300 homeopaths, over 75% of whom are women.


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" />
Similarly, the number of homeopathic doctors in the UK was for most of the 20th century static at about 100-150. For example, it gradually rose from 185 in 1932 to 244 in 1972,<ref></ref> an increase of 3.3% per annum, but in the 1980s it began to grow faster: for example, from 1972 to 1988 it grew from 244 to 586, a real increase of 15% per annum. This increase may reflect the number of British people using homeopathic treatment, as discussed above. Today, "the Faculty, which was incorporated by an Act of Parliament in 1950, has over 1,400 members throughout the world and is poised for growth as interest in homeopathy increases both among the public and within the health care sector."<ref></ref>


===Purported effects in other biological systems===
===Sales of homeopathic medicine===
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
In the USA, in 1995, retail sales of homeopathic medicines were estimated at US$201 million, and growing at 20% per year, according to the American Homeopathic Pharmaceutical Association, and the number of homeopathic practitioners increased from fewer than 200 in the 1970s to approximately 3,000 in 1996. The increased popularity of homeopathy since the 1970s was accompanied by a rise in interest in other ]s.<ref></ref>
|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">
==Scientific testing of homeopathic treatment==
{{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">
===Early critiques of high dilutions===
{{cite news
] (1787-1861), physician to ] (1841-61) said the extremely small doses were regularly derided as useless, laughably ridiculous and "an outrage to human reason."<ref>Sir John Forbes, ''Homeopathy, Allopathy and Young Physic'', London, 1846</ref> Although such homeopathic cures were accepted as valid by regular physicians at the time, they were ascribed entirely to the body's innate healing powers. And Professor Sir ] said of the highly diluted drugs: "no poison, however strong or powerful, the billionth or decillionth of which would in the least degree affect a man or harm a fly."<ref>James Y Simpson, ''Homoeopathy, Its Tenets and Tendencies, Theoretical, Theological and Therapeutical'', Edinburgh: Sutherland & Knox, 1853, 11</ref>.
|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 ==
===Mechanism of action of homeopathic preparations===
]]]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>
{{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:
Since homeopathic remedies at potencies higher than about D23 (10<sup>-23</sup>) contain no detectable ingredients apart from the diluent (water, alcohol or sugar), there is no known basis for them to have medicinal action. Some tests suggest that potentized solutions up to D120 can have statistically significant effects on organic processes, including the growth of grain,<ref>Kolisko, Lily, ''Physiologisher und physikalischer Nachweis der Wirksamkeit kleinster Entitäten'', Stuttgart (1959), Junker, H. ''Biologisches Zentralblatt'', 45. Nr. 1 (1925), p. 26 and ''Plügers Arhiv f. ges. Phys. 219B Nr. 5/6 (1928)</ref> histamine release by leukocytes,<ref>Davenas, E., et al., "Human basophil degranulation trigtgered by very dilute antiserum against IgE", ''Nature", V. 333, pp. 816-8</ref><ref>Wälchli, Baumgartner and Bastide, "Effect of Low Doses and High Homeopathic Potencies in Normal and Cancerous Human Lymphocytes: An In Vitro Isopathic Study", ''Journal of Alternative and Complementary Medicine'', Jun 2006, Vol. 12, No. 5: 421-427</ref> and enzyme reactions.<ref>*Husemann, Friedwart, "The Activity of Very Small Entities: Its Verification from Kolisko (1923) to Benveniste (1988), ''The Anthroposophical Conceptual Basis of Potentization'', v. IV.
*Pelikan, W. and Unger, G. ''Die Wirkung potenzierter Substanzen Dornach (1965)
*Schwenk, Theodor, ''Grundlagen der Potenzforschung'', Stuttgart (1974)</ref> These publications are controversial since attempts to replicate some of these studies on leukocytes and enzymes have failed, even when using the potentization method.<ref># Hirst SJ, Hayes NA, Burridge J, Pearce FL, ''Human basophil degranulation is not triggered by very dilute antiserum against human IgE.'' Nature. 1993 Dec 9;366(6455):525-7.</ref><ref>Ovelgonne JH, Bol AW, Hop WC, van Wijk R. ''Mechanical agitation of very dilute antiserum against IgE has no effect on basophil staining properties.'' Experientia. 1992 May 15;48(5):504-8.</ref><ref> Claudia M Witt, Michael Bluth, Stephan Hinderlich, Henning Albrecht, Rainer Lüdtke, Thorolf E R Weisshuhn, Stefan N Willich ''Does Potentized HgCl(2) (Mercurius corrosivus) Affect the Activity of Diastase and alpha-Amylase?''J Altern Complement Med. 2006 May ;12:359-65</ref><ref>Guggisberg AG, Baumgartner SM, Tschopp CM, Heusser P. ''Replication study concerning the effects of homeopathic dilutions of histamine on human basophil degranulation in vitro.'' Complement Ther Med. 2005 Jun;13(2):91-100.</ref> A recent review of tests of high potencies summarized the situation as follows: "...there are some hints from experimental research that homeopathic substances diluted and succussed beyond Avogadro’s number are biologically active but there are no consistent effects from independently reproducible models."<ref>Walach et al., "Research on Homeopathy: State of the Art", ''Journal of Alternative and Complementary Medicine'', Volume 11, Number 5, 2005, pp. 813–829</ref>


* {{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}}
These positive studies are unusual since no effects of high dilutions are seen in the huge number of similar studies on other biological systems. Here, low doses of chemicals give small effects and high doses large effects. This simple ] has been confirmed in many hundreds of thousands of experiments on organisms as diverse as nematodes,<ref>Boyd WA, Williams PL. "Comparison of the sensitivity of three nematode species to copper and their utility in aquatic and soil toxicity tests." ''Environ Toxicol Chem.'' 2003 Nov;22(11):2768-74</ref> rats<ref>Goldoni M, Vettori MV, Alinovi R, Caglieri A, Ceccatelli S, Mutti A. "Models of neurotoxicity: extrapolation of benchmark doses in vitro." ''Risk Anal.'' 2003 Jun;23(3):505-14.</ref> and humans.<ref>Yu HS, Liao WT, Chai CY. "Arsenic Carcinogenesis in the Skin." ''J Biomed Sci.'' 2006 Jun 29;</ref>
* {{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>


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:
Although some patients report benefits from homeopathic preparations,<ref></ref> the large majority of scientists attribute this to the ], the ] and/or the ]. Ideally, drugs are tested in large, multi-centre, randomised, placebo-controlled ] ], to test whether the drug has an effect that is significantly better than a placebo or an alternative treatment. Many clinical trials that partially meet these criteria have investigated homeopathy, and some have indicated efficacy above placebo.<ref></ref> However, many of the trials are open to technical criticism or involve samples that are too small to allow firm conclusions to be drawn.<ref>{{cite journal | author=Jonas WB, Anderson RL, Crawford CC, Lyons JS | title=A systematic review of the quality of homeopathic clinical trials | journal=BMC Complement Altern Med | year=2001 | pages=12 | volume=1 | id=PMID 11801202}}</ref>
*{{cite news
|title = Homeopath Thomas Sam guilty of daughter Gloria's death
|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>
Some homeopathic apologists claim that orthodox double-blind trials are inherently insufficient for deriving evidence for the technique. For example, a spokeswoman from the UK has said: "''It has been established beyond doubt and accepted by many researchers, that the placebo-controlled randomised controlled trial is not a fitting research tool with which to test homeopathy''"<ref>{{cite web|url=http://news.bbc.co.uk/1/hi/health/4183916.stm|title=Homoeopathy's benefit questioned|publisher=BBC News}}</ref> since homeopathy is positioned as a ] treatment, incorporating psychological/spiritual concerns as well as an active ingredient. Some critics<ref></ref> have noted that homeopathy ''includes'' falsifiable claims, even if that is only part of the homeopathic process, or simply that such claimed immunity from orthodox scientific scrutiny is reminiscent of ].
{{cite journal
|author =Pray WS
|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>
===European Journal of Cancer 2006 study===
{{cite journal
In January 2006 the European Journal of Cancer published a ] of six trials of homeopathic treatments for recovery from cancer therapy, including radio- and chemo-therapy.<ref>Milazzo S, Russell N, Ernst E Efficacy of homeopathic therapy in cancer treatment. ''Eur J Cancer.'' 2006 Feb;42(3):282-9.</ref> Three of the trials included were randomised double-blind placebo-controlled clinical trials. The authors were from the Department of Complementary Medicine at the Universities of Exeter and Plymouth. Their analysis found insufficient evidence to support the use of homeopathic remedies in cancer treatment recovery. They wrote that "In conclusion, the evidence emerging from this systematic review is encouraging but not convincing. Further research should attempt to answer the many open questions related to homeopathy."
|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==
===Lancet 2005 study===
{{Main|Regulation and prevalence of homeopathy}}
In August 2005, The ] published a ] of 110 placebo-controlled homoeopathy trials and 110 matched conventional-medicine trials<ref>{{cite journal | author=Shang A, Huwiler-Muntener K, Nartey L, Juni P, Dorig S, Sterne JA, Pewsner D, Egger M | title=Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy | journal=Lancet | year=2005 | pages=726-32 | volume=366 | issue=9487|id=PMID 16125589}}</ref> based upon the Swiss government's ], or PEK. The outcome of this meta-analysis suggested that the clinical effects of homeopathy are likely to be placebo effects.
]]]
The Lancet paper is notable not least for its design, as another "global" meta analysis of homeopathy, not an analysis of particular effects, i.e. it tested the global hypothesis that the reported effects of homeopathy are placebo effects. If this is accurate, then the reported positive effects are due to placebo effects, publication bias, observer effects etc., and if so, then the magnitude of reported effects should diminish with sample size and study quality, and with the best studies there should be consistently no effect, and this is the prediction that the study sought to test. For comparison, they subjected an equal set of conventional medicine trials for identical analysis. These were matched for study disease and sample size, but not for trial quality which was significantly better in the homeopathic trials than the randomly chosen biomedical trials. The prediction was supported by the study - whereas the conventional tests showed a real effect independent of sample size, the homeopathy studies did not. The study does not prove that homeopathy is never effective or that all its findings are placebo effects, but does show that the totality of tests analysed show outcomes consistent with the interpretation that all of the reported effects are placebo effects. The Lancet accompanied the meta-analysis with invited editorials. The Lancet study was criticized by a number of homeopathic researchers and statisticians on methodological grounds, including lack of transparency concerning the review protocol and reporting, leading to the allegation of ].<ref>Peter Fisher. Homeopathy and The Lancet. eCAM 2006 3(1):145-147; doi:10.1093/ecam/nek007 </ref> The Lancet rejected the majority of criticisms submitted for publication. Some of the correspondence rejected by the Lancet was subsequently published in the Journal of Alternative and Complementary Medicine.<ref>Kim A. Jobst. Homeopathy, Hahnemann, and The Lancet 250 Years On: A Case of the Emperor's New Clothes?
] Oct 2005, Vol. 11, No. 5: 751-754.
</ref>


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" />
===British Medical Journal 1991 study===
In 1991, three professors of medicine from the Netherlands, performed a meta-analysis of 25 years of clinical studies using homeopathic medicines and published their results in the British Medical Journal. This meta-analysis covered 107 controlled trials, of which 81 showed that homeopathic medicines were effective, 24 showed they were ineffective, and 2 were inconclusive.


=== Regulation ===
The professors concluded, "The amount of positive results came as a surprise to us." The proportion of positive results may be biased by the so-called 'drawer effect,' where studies with positive results are more easily and more readily published than studies with negative results (which tend to end up in the desk drawer). They found evidence for successful treatment of respiratory and other infections, diseases of the digestive system, hay fever, rheumatological disease, mental or psychological
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>
problems and other ailments. In addition, they found evidence that homeopathic treatment helped patients recover after abdominal surgery and to address pain or trauma.
{{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>
Despite the high percentage of studies that provided evidence of success with homeopathic medicine, most of these studies were flawed. Still, researchers found 22 high-caliber studies, 15 of which showed that homeopathic medicines were effective. Of further interest, they found that 11 of the best 15 studies showed efficacy.


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 meta-analysis on homeopathy concluded, "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. This indicates that there is a legitimate case for further evaluation of homoeopathy, but only by means of well performed trials."<ref>J. Kleijnen, P. Knipschild, G. ter Riet, "Clinical Trials of Homoeopathy," British Medical Journal, February 9, 1991, 302:316-323.</ref>
], India]]
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.'').
===Basophil stimulation===


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>
Madeleine Ennis, a pharmacologist at Queen's University, Belfast, and her team looked at the effects of ultra-dilute solutions of ] on human white blood cells involved in inflammation. These cells, called ], release histamine when they are stimulated. However, exposure to histamine stops these cells releasing any more, an example of ] regulation. Three of the four participating groups observed this inhibitory effect with homeopathic solutions of histamine, solutions so dilute that they probably didn't contain a single histamine molecule. These low-dilution effects were seen in six of the 24 independent sets of experiments (Table 1 of paper).<ref></ref> However, other investigators failed to find any effect from these ultra-dilute solutions and suggested that methodological problems accounted for the positive results.<ref>Guggisberg AG, Baumgartner SM, Tschopp CM, Heusser P. ''Replication study concerning the effects of homeopathic dilutions of histamine on human basophil degranulation in vitro.'' Complement Ther Med. 2005 Jun;13(2):91-100.</ref>


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>
===Evidence-based medicine===
There is widespread consensus in the medical community that ] is the best standard for assessing efficacy and safety of health-care practices, for it is "the expression of the scientific method in clinical medicine."<ref></ref> Therefore, systematic reviews with strict protocols are essential to establish proof for various therapies. While committed to this principle, much of modern medicine is subject to ongoing efforts to comply with evidence-based standards.


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>
Systematic reviews conducted by the ] found insufficient evidence that homeopathy is beneficial for asthma,<ref>{{cite web|url=http://www.cochrane.org/reviews/en/ab000353.html|title=''Cochrane Collaboration-asthma''}}</ref> dementia,<ref>{{cite web|url=http://www.cochrane.org/reviews/en/ab003803.html|title=''Cochrane Collaboration-dementia''}}</ref> and induction of labor.<ref>{{cite web|url=http://www.cochrane.org/reviews/en/ab003399.html|title=''Cochrane Collaboration-induction of labor''}}</ref> They also found no evidence that homeopathic treatment can prevent influenza,<ref>{{cite web|url=http://www.cochrane.org/reviews/en/ab001957.html|title=''Cochrane Collaboration-influenza''}}</ref> but reported that it appears to shorten the duration of the disease. Systematic reviews conducted by other researchers found insufficient evidence that homeopathy is beneficial for osteoarthritis,<ref>{{cite web|url=http://www.jr2.ox.ac.uk/bandolier/booth/alternat/homearth.html|title=osteoarthritis article|publisher=Bandolier Journal}}</ref> migraine prophylaxis,<ref>{{cite web|url=http://www.jr2.ox.ac.uk/bandolier/booth/alternat/AT015.html|title=migraine prophylaxis article|publisher=Bandolier Journal}}</ref> delayed-onset muscle soreness,<ref>{{cite web|url=http://www.jr2.ox.ac.uk/bandolier/booth/alternat/AT011|title=delayed-onset muscle soreness article|publisher=Bandolier Journal}}</ref> or symptoms of menopause.<ref>{{cite web|url=http://www.jr2.ox.ac.uk/bandolier/band56/b56-3.html|title=symptoms of menopause article|publisher=Bandolier Journal}}</ref>


=== Prevalence ===
====Medical organizations' attitudes towards homeopathy====
*The ], part of the U.S. ], states that:<ref></ref>
**The results of individual, controlled clinical trials of homeopathy have been contradictory. In some trials, homeopathy appeared to be no more helpful than a placebo; in other studies, some benefits were seen that the researchers believed were greater than one would expect from a placebo.
**A common theme in the reviews of homeopathy trials is that because of these problems and others, it is difficult or impossible to draw firm conclusions about whether homeopathy is effective for any single clinical condition.
**There is a point of view that homeopathy does work, but that modern scientific methods have not yet explained why. The failure of science to provide full explanations for all treatments is not unique to homeopathy.
**Some people feel that if homeopathy appears to be helpful and safe, then scientifically valid explanations or proofs of this alternative system of medicine are not necessary.
**The National Center for Complementary and Alternative Medicine continues to fund research into homeopathy.


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" />
*The UK ] statement on homeopathy includes the following:
**Around 200 randomised controlled trials evaluating homeopathy have been conducted, and there are also several reviews of these trials. Despite the available research, it has proven difficult to produce clear clinical evidence that homeopathy works. Many studies suggest that any effectiveness that homeopathy may have is due to the placebo effect, where the act of receiving treatment is more effective than the treatment itself.
**Medical doctors and scientists do not generally accept homeopathy because its claims have not been verified to the standards of modern medicine and scientific method. Scientists argue that homeopathy cannot work because the remedies used are so highly diluted that in many there can be none of the active substance remaining.
**Supporters of homeopathy counter the scientific arguments with claims for a high success rates in babies, infants, and animals. Others argue that much of the research conducted into the effectiveness of homeopathy is not representative of routine homeopathic practice and that homeopathic treatment cannot be properly tested through standard clinical means.


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" />
*In 1997, the following statement was adopted as policy of the ] (AMA) after a report on a number of alternative therapies including homeopathy:<ref>{{cite web|url=http://www.ama-assn.org/ama/pub/category/13638.html|title=alternative theories including homeopathy|publisher=American Medical Association}}</ref>
**There is little evidence to confirm the safety or efficacy of most alternative therapies. Much of the information currently known about these therapies makes it clear that many have not been shown to be efficacious. Well-designed, stringently controlled research should be done to evaluate the efficacy of alternative therapies.</blockquote>''


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" />
*The Indian Ministry of Health and Family Welfare states that:<ref></ref>
**Homoeopathy today is a rapidly growing system and is being practiced almost all over the world. In India it has become a household name due the safety of its pills and gentleness of its cure.
**Homeopathy has been recognised as one of the National Systems of Medicine and plays an important role in providing health care to a large number of people. Its strength lies in its evident effectiveness as it takes a holistic approach towards the sick individual through promotion of inner balance at mental, emotional, spiritual and physical levels.


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" />
===Regulatory decisions===
In 2006 Australia's Therapeutic Goods Advertising Code Council (TGACC) found that a homeopathic Hangover Relief Oral Spray marketed by Brauer Natural Medicine P/L was "in breach of section 4(1)(b) of the Therapeutic Goods Advertising Code 2005 (the Code), which states that an advertisement must contain correct and balanced statements only and claims which the sponsor has already verified, and section 4(2)(c) which prohibits misleading advertisements."<ref></ref> The TGACC is established under Australian law and the Therapeutic Goods Advertising Code is generally consistent with the ]'s "Ethical Criteria For Medicinal Drug Promotion 1988"


==Veterinary use==
== Misconceptions about homeopathy ==
]]]
=== Composition of homeopathic remedies ===
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>
It is a common misconception that homeopathic remedies use only natural herbal components (akin to ]). Herbs are used, but homeopathy also uses non-biological substances (such as ]s) and components of animal origin, such as ] ] in the remedy ].


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>
In herbology, measurable amounts are used, while in homeopathy the active ingredient is diluted until it is no longer detectable, or do not contain any of the original active ingredient at all (when the dilution exceeds the ]). Homeopathy also uses substances of human origin, called '']s''. Some people have the opposite misconception, that homeopathic remedies are based only on ] substances like ] or ].


==See also==
As the term homeopathy is well known and has good marketing value, the public can be confused by people who have adopted the term for other therapies. For example, some companies combine homeopathic with non-homeopathic substances such as herbs or vitamins, and some preparations marketed as such contain no homeopathic preparations at all. Classical homeopaths argue that only remedies prepared and prescribed in accordance with the principles of 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 confusion for the public.
* ]
* ]
* ]


==References==
===Homeopathy and vaccination===
{{Reflist| refs=
{{See also|Isopathy}}
<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>
To some, homeopathy, particularly the use of nosodes, resembles ], in that ]s contain a small dose of the "disease" against which they protect. Hahnemann interpreted the introduction of vaccination applied nowadays as such: <cite>But to use a human morbific matter (a Psorin taken from the itch in man) as a remedy for the same itch or for evils arisen therefrom, stay away from it! Nothing can result from this but trouble and aggravation of the disease.</cite><ref>Organon § 56 6th. edition</ref> Roberts: <cite>giving the identical instead of the similar means the difference between isopathy and homoeopathy.</cite><ref>H.A. Roberts: The Principles and Art of Cure by Homoeopathy, chapter 1</ref>
<ref name="Holmes">
{{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>
<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>
According to homeopathy, the body could become susceptible to "morbific noxious agents". The challenge of the homeopath is to prevent disease in the first place with the first sign of symptoms. This could be imminent long before an acute disease appears.<ref>Organon § 31 </ref> Hahnemann classified succeeded vaccination of smallpox due to the interaction of two similar diseases (the law of similars).<ref>Organon § 56</ref> When an epidemic is near, one or a few remedies could be chosen to treat a population in order to prevent the epidemic.<ref>Organon § 33</ref> Hahnemann gave this the description of acute collective diseases.<ref>Organon § 73</ref> When the epidemic is there, according to Hahnemann, the homeopath observes a complete picture of the epidemic and can constitute from a small box of remedies the fitting remedy to each individual patient.<ref>Organon § 100-104</ref><ref>http://www.homeopathy.healthspace.eu/regular/homeopathy.php#Homeopathy-vaccination</ref>
<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>
}}
In contrast, modern scientists and doctors see the two practices as fundamentally different. A ] is usually a preparation made from a ] or ] that cannot cause disease, while still providing enough information to the ] to afford protection.<ref>''Understanding Vaccines: what they are and how they work.'' National Institute of Allergy and Infectious Diseases NIH Publication No. 03-4219 July 2003 </ref> 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 prevent or cure it with dilutions. Another important difference is that vaccine contains measurable amounts of ], usually ] or ]<ref>Vliegenthart JF. ''Carbohydrate based vaccines.'' FEBS Lett. 2006 May 22;580(12):2945-50. PMID 16630616</ref> from the disease-causing organism, whereas homeopathic remedies have been diluted to such an extent they are unlikely to contain any detectable active ingredients.
The predominant view of homeopaths is that <cite>vaccination is not consistent with the principles of homeopathy, even if it is an application of the law of similars,</cite><ref>Rudi Verspoor Homeopathy Online</ref> they also believe that <cite>vaccination holds serious short and long-term (health) consequences</cite><ref>ibid</ref> and that
<cite>vaccination may potentially arouse latent inherited and constitutional
weaknesses.</cite><ref>ibid</ref>
However, their main objection is that vaccination is a mass-applied technique based on the ] of disease, a view homeopaths reject, instead preferring to individualize each case of sickness.


==External links==
== Safety of homeopathic treatment ==
{{commons category}}
The United States Food & Drug Administration considers that there is no real concern over the safety of most homeopathic products "because they have little or no pharmacologically active ingredients". There have been few reports of illness associated with the use of homeopathic products, but the medical literature contains a few case reports of poisoning by heavy metals such as ]<ref>{{cite journal | author=Chakraborti D, Mukherjee SC, Saha KC, Chowdhury UK, Rahman MM, Sengupta MK | title=Arsenic toxicity from homeopathic treatment | journal=J Toxicol Clin Toxicol | year=2003 | pages=963-7 | volume=41 | issue=7 | id=PMID 14705842}}</ref> and ]<ref>{{cite journal | author=Montoya-Cabrera MA, Rubio-Rodriguez S, Velazquez-Gonzalez E, Avila Montoya S | title=Mercury poisoning caused by a homeopathic drug | journal=Gac Med Mex | year=1991 | pages=267-70 | volume=127 | issue=3 | id=PMID 1839288}} Article in Spanish.</ref><ref>{{cite journal | author=Audicana M, Bernedo N, Gonzalez I, Munoz D, Fernandez E, Gastaminza G | title=An unusual case of baboon syndrome due to mercury present in a homeopathic medicine | journal=Contact Dermatitis | year=2001 | pages=185 | volume=45 | issue=3 | id=PMID 11553159}}</ref><ref>{{cite journal | author=Wiesmuller GA, Weishoff-Houben M, Brolsch O, Dott W, Schulze-Robbecke R | title=Environmental agents as cause of health disorders in children presented at an outpatient unit of environmental medicine | journal=Int J Hyg Environ Health | year=2002 | pages=329-35 | volume=205 | issue=5 | id=PMID 12173530}}</ref> found in homeopathic remedies. However, in cases that they reviewed, the FDA concluded the homeopathic product was not the cause of the adverse reactions. In one case, arsenic was implicated, although FDA analysis revealed that the concentration of arsenic was too low to cause concern. Perhaps the main concern about the safety of homeopathy arises not from the products themselves, but from the possible withholding of more efficacious treatment, or from misdiagnosis of dangerous conditions by a non-medically qualified homeopath.<ref></ref>
{{EB1911 poster|Homoeopathy}}
* (], UK)


{{Homoeopathy}}
==Dangers in misguided advice==
{{pseudoscience}}


{{Authority control}}
Opponents of homeopathy argue that since homeopathy is ineffective, it could indirectly result in harm to patients who refuse medical care (see ]). For example, a 2006 survey by the UK charitable trust "Sense About Science," revealed homeopathic practices which were advising travelers against taking conventional anti-malarial drugs, instead providing them with a homeopathic dilution of quinine. Even the director of the The Royal London Homeopathic Hospital condemned this practice:


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

Several scientists said the homeopaths' advice was reprehensible and likely to endanger lives. Professor Geoffrey Pasvol, a tropical medicine expert at Imperial College in London, was reported as saying "''Medical practitioners would be sued, taken to court and found guilty for far less. What this investigation has unearthed is appalling.''".<ref></ref>
{{Wikiquote}}

== Notes==
* Online etext of Hahnemann's ''Organon der Heilkunst'': () and

<div class="references-small" style="-moz-column-count:2; column-count:2;">
<references/>
</div>

== Sources ==
<!-- :''Please use the APA Style "Reference Examples for Electronic Source Materials" way of resourcing internet text; for unification or use wiki patterns and sort alphabetically'' -->

*About Bandolier and us (Bandolier Homeopathy - dilute information and little knowledge). Boundolier Journal,
*{{cite journal | author=Almeida RM | title=A critical review of the possible benefits associated with homeopathic medicine | journal=Rev Hosp Clin Fac Med Sao Paulo | year=2003 | pages=324-31 | volume=58 | issue=6 | id=PMID 14762492}}
*{{cite journal | author=Cucherat M, Haugh MC, Gooch M, Boissel JP | title=Evidence of clinical efficacy of homeopathy. A meta-analysis of clinical trials. HMRAG. Homeopathic Medicines Research Advisory Group | journal=Eur J Clin Pharmacol | year=2000 | pages=27-33 | volume=56 | issue=1 | id=PMID 10853874 | url=http://nhscrd.york.ac.uk/online/dare/20001151.htm}}
*Dudley, P, ed., ''Hahnemann's Chronic Diseases'', footnote to pp.12-13, ''B. Jain Publishers'', 1998 reprint <!-- Comment: what does this relate to? /read the book and you will probably find? ;PP :}-->
*Ernst, E, ''Classical homeopathy versus conventional treatments: a ]'', ''Perfusion'', (1999); '''12''': 13-15
*{{cite journal | author=Kleijnen J, Knipschild P, ter Riet G | title=Trials of homeopathy | journal=BMJ | year=1991 | pages=960 | volume=302 | issue=6782 | id=PMID 1827743}}
*{{cite journal | author=Linde K, Clausius N, Ramirez G, Melchart D, Eitel F, Hedges LV, Jonas WB | title=Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials | journal=Lancet | year=1997 | pages=834-43 | volume=350 | issue=9081 | id=PMID 9310601}}
*{{cite journal | author=Linde K, Scholz M, Ramirez G, Clausius N, Melchart D, Jonas WB | title=Impact of study quality on outcome in placebo-controlled trials of homeopathy | journal=J Clin Epidemiol | year=1999 | pages=631-6 | volume=52 | issue=7 | id=PMID 10391656}}
*{{cite journal | author=Linde K, Melchart D | title=Randomized controlled trials of individualized homeopathy: a state-of-the-art review | journal=J Altern Complement Med | year=1998 | pages=371-88 | volume=4 | issue=4 | id=PMID 9884175 | url=http://nhscrd.york.ac.uk/online/dare/990167.htm}}
* Phillips Stevens Jr., (Nov-Dec, 2001), ''Magical Thinking in Complementary and Alternative Medicine'' . Skeptical Inquirer.
*Randi, J, An interview with James Randi: ''Homeopathy: The Test - programme summary'' . BBC.
*Randi, J, Educational Foundation. "The JREF Million Dollar Paranormal Challenge 'FAQ'". Retrieved 13 September, 2005.
*Yutar, G, Dr, (April 16, 2006), ''Homeopathy - Why and when?'' Yatar's bolg on blogspot.com .
*Walach, H, ''Unspezifische Therapie-Effekte. Das Beispiel Homöopathie'' . Freiburg, Germany: Psychologische Institut, Albert-Ludwigs-Universität Freiburg, (1997)


<!-- :''Please use the APA Style "Reference Examples for Electronic Source Materials" way of resourcing internet text; for unification or use wiki patterns and sort alphabetically'' -->

== External links ==
=== Neutral ===
*A recent article on homeopathy testing from the
* (transcripts, discussion, etc.)
* A recent Dutch overview.
*
* BBC's "Complementary Medicine" article on Homeopathy
* Copeland's Cure: Homeopathy and the War between Conventional and Alternative medicine/ by Natalie Robins/ Alfred A. Knopf, publishers, 2005
*
* Fact Sheet
* &mdash; critical online book, covering the history and present state of homeopathy
* &mdash; balanced and up-to-date references to current scientific understanding of water, with specific entries on "memory effects" and homeopathy

=== Advocacy ===
*
*
* Adjuvant homeopathic treatment in breast cancer, a pilot study (in German)
*
*
*
* A historical overview
* to get answers on the role of homeopathy for various diseases.
*
* &mdash; The English language version of ''Homéopathe International''
*
*
* Products and Directory with extensive user forums on homeopathic remedies and debates.
* with historical and biographical information
*
*
* - Research articles by Oxford Homeopath, Steven Cartwright
* Home of one of the leading Homeopaths.
*
*
*

=== Critical ===
*
*
* By ]
*.pdf. A 2005 study published in ].
*
* - ], M.D.
* &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

References

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    • Mukerji N, Ernst E (September 14, 2022). "Why homoeopathy is pseudoscience". Synthese. 200 (5). doi:10.1007/s11229-022-03882-w. eISSN 1573-0964. S2CID 252297716.

    • Baran GR, Kiana MF, Samuel SP (2014). "Science, Pseudoscience, and Not Science: How do They Differ?". Healthcare and Biomedical Technology in the 21st Century. Springer. pp. 19–57. doi:10.1007/978-1-4614-8541-4_2. ISBN 978-1-4614-8540-7. within the traditional medical community it is considered to be quackery

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