Research
http://hpathy.com/scientific-research/an-update-on-research-in-homeopathy/
https://hpathy.com/homeopathy-papers/commentaries-on-some-mistakes-in-the-german-english-translations-of-three-organons/
Vergleich: Siehe: Group Analysis Evaluation + Research Anhang (Bellavite, Salvatore
Chirumbolo and Marta Marzotto) + Scientific study of
homeopatic treatment
[H. Frei (Kinderarzt Laupen Schweiz) and A. Thurneysen] + Microdosing
https://www.researchgate.net/publication/7471540_Research_on_Homeopathy_State_of_the_Art
[Harald Walach, Ph.D. /Wayne B. Jonas, M.D., Ph.D./John Ives, Ph.D./Roel van Wijk, Ph.D./Otto Weingärtner, Dr.Phil.Nat.]
In this paper, we review research on homeopathy from four perspectives,
focusing on reviews and some landmark studies. These perspectives are
laboratory studies, clinical trials, observational studies, and theoretical
work. In laboratory models, numerous effects and anomalies have been reported.
However, no single model has been sufficiently widely replicated. Instead,
researchers have focused on ever-new models and experiments, leaving the
picture of scattered anomalies without coherence. Basic research, trying to
elucidate a purported difference between homeopathic remedies and control
solutions has also produced some encouraging results, but again, series of
independent replications are missing. While there are nearly 200 reports on
clinical trials, few series have been conducted for single conditions. Some of
these series document clinically useful effects and differences against placebo
and some series do not. Observational research into uncontrolled homeopathic
practice documents consistently strong therapeutic effects and sustained
satisfaction in patients. We suggest that this scattered picture has to do with
the fourth line of research: lack of a good theory. Some of the extant
theoretical models are reviewed, including placebo, water structure,
silica contamination, energy models, and entanglement models. It emerges that
local models, suggesting some change in structure in the solvent, are far from
convincing. The nonlocal models proposed would predict that it is impossible to
nail down homeopathic effects with
direct experimental testing and this places homeopathy in a scientific
dilemma. We close with some suggestions for potentially fruitful research.
INTRODUCTION
The Myth of Telephos is the first clear trace of it in the West: Telephos
was the king of the Mysians, who the Greeks attacked accidentally when they
were on their way
to raid Troy. Telephos was wounded by the spear of Achilles. And, when
the wound did not heal and festered, he asked the Pythia, the prophetess of
Delphi, for advice.
She gave him the cryptic answer: “Ho trosas kai iasetai”—“He who has
slain the wound will cure it again.” He then visited Achilles, who brought some
of the spear’s rust
into the wound, which subsequently healed. This first echo of the therapeutic
simile principle in the West shows that it is an ancient therapeutic idea. It
was taken up by Hippocratic medicine, by Galen and Celsus. It can be found in
Paracelsus’ work.
It
University College Northampton, UK.
University Hospital Freiburg, Germany.
Samueli Institute, Alexandria, VA.
International Institute of Biophysics, Neuss, Germany.
Dr. Reckeweg & Co. GmbH, Bensheim, Germany.
seems likely that Hahnemann knew of this tradition.
But it was his idea to test remedies in healthy volunteers and to note
the symptoms as a way to put the simile principle into concrete practice.
These symptoms he then used as indications of remedies in sick people.
While the principle of testing remedies was new in Hahnemann’s time, other
researchers, such as
the Swiss physician and researcher von Haller, had already advocated
this. It was Hahnemann’s insight to combine the simile principle with testing
of medications and to use this information for therapy.
Today, the simile principle is also used in other branches of therapy.
Allergology makes use of it in desensitization. Psychotherapy, in some
forms, uses the activation of similar situations or constellations of symptoms
that produced trouble to cure it.
Hahnemann’s unique insight was what he called dynamization or potentization.
Although a case can be made that this is an idea that, in principle, has been
around at least
since Paracelsus, who also spoke of letting the “spirit of substances”
free, the practical application by Hahnemann was unique. When he adminstered
his remedies to his volunteers, initially his family and students, he soon
discovered that crude substances needed dilution because of toxic sideeffects.
So he started a process of stepwise dilution and succussion. When diluting a
substance, after 24 steps in a dilution ratio of 1:10 or after 12 steps in a
ratio of 1:100, a dilution of one mole of starting substance would,
by calculation, not have any molecules of the initial substance left.
This corresponds to a Hahnemannian dilution of C12 or 24
Beyond this boundary, statistically speaking, none of the starting
material remains in a homeopathic remedy.
Avogadro’s number refers to the number of molecules in one mole (i.e.,
6.023*1023). This fact was not known to Hahnemann. Although Hahnemann did not
know for sure,
he guessed that his dilutions would have very little or none of the
starting substance and, therefore, he called his remedies dynamizations or
potencies, referring to the paradoxical experience that, with his stepwise
process of dilution and succussion, he observed stronger therapeutic effects
than with original substances. It is precisely homeopathy’s emphasis on
so-called high potencies (i.e., remedies succussed and diluted beyond
Avogadro’s number) that creates tension with modern science because no accepted
rational theory exists that could explain increased therapeutic effect with
decreasing amounts of the active agent, even to the point of there being no
molecules of
the initial agent present at all.
In this paper, we wish to point out a few findings from homeopathic
research that appear to be robust, delineate areas of contention, and outline
potentially fruitful avenues
for research. We do not consider the practical or therapeutic
applications and the wide variety thereof. We have organized this brief review
in four sections:
1. Experimental research to study the efficacy of homeopathic remedies
in vitro, in cell systems, or in vivo
2. Basic research that tries to elucidate the nature of homeopathic remedies
3. Clinical research that tries to find proof of clinical efficacy and
experimental research in humans (so called “provings” or pathogenetic trials)
4. Some theoretical models.
Since, in most fields, reviews have been presented and are discussed and
referenced elsewhere, we restrict ourselves to the most outstanding findings
and to areas of hot
debate.
EXPERIMENTAL RESEARCH
Historically, homeopaths were among the first to introduce
double-blinded experiments in human subjects.
Arguably, among the first experimental models in homeopathy was the one
presented by Kolisko who studied the influence of high potencies of silver
nitrate (Argentum
nitricum) on the growth of plant seedlings, mostly wheat, and found
cyclical changes.
Some potencies, even beyond
Avogadro’s number, produced an increase in growth length of seedlings,
while other potencies produced a decrease. This experiment has recently been
reproduced in blinded fashion, with similar results.
Our own joint attempts, however, were equivocal (data not yet
published).
Many plant and animal models have been studied but only few have been
replicated independently, and the quality of the studies is often poor. A
review of detoxification
paradigms brings them into context.
In this type of experiment, a biologic system -plant or animal- is
intoxicated with a substance, and is either pretreated with a homeopathically
succussed and diluted substance, or is treated therapeutically after the fact.
One hundred and five (105) such experiments were reviewed. The vast majority
were of suboptimal quality. Among the high-quality experiments, positive
results were reported twice as frequently as negative ones, with an overall positive
effect in 4 of 5 experiments and a protection index of roughly 20%. The authors
of the review noted that many models exist but only a few replications have
been achieved. A more specialized recent review presented studies on agents
used in warfare and tolerance-induction via diluted substances and concluded that
these models documented some effects of such diluted substances.
A full database of all experiments has been compiled by Albrecht and van
Wijk and will shortly be available as the HomBRex-Data Base (see www.carstens-stiftung.de).
WALACH ET AL. 814
*
“
Hahnemannian” here refers to the method of using a fresh vial for every
step; frequently, the same glass vial is used for Korsakovian potencies, mainly
beyond C200.
When using that method, molecules remain longer, through adhesive forces.
One seemingly promising model was developed by french homeopaths.
The basic idea is the following: Basophil cells are extracted from the
blood of donors. These cells are then stimulated by an antigen, causing them to
degranulate. The antigen
is diluted and then presented, testing whether the diluted antigen is
also active. As a variant model, one can try to prevent degranulation by using
another potentized substance (such as potentized histamine) that may inhibit
degranulation. In the most recent set of experiments, potentized histamine has
been used. A series of experiments was conducted by Benveniste and his laboratory
groups, culminating in a final publication postulating the replicability of the
effect across laboratories.
This publication was heavily criticized, resulting in independent investigations
of the paradigm with no clear-cut reproducible effect, although other experiments,
again, yielded positive results.
Apparently, even before that, some of the participating laboratories had
withdrawn because the effect was not consistent across laboratories. This and
similar models were continued by Benveniste later as so-called “digital biology”
because he believed that a kind of electromagnetic information was responsible
for the effect. He claimed that
one could save this information in digital media and play it to a
biologic system, with the same effect.
Rigorous recent independent replications of this effect with the cooperation
of Benveniste’s team revealed that the effect is not reproducible but is likely
to be the result of
a very subtle experimenter effect.
A similar model was presented recently by a multinational group, using
roughly the same procedure and reporting an overall significant summary
statistic, claiming a reduction of basophil degranulation caused by the
application of histamine potentized up to 30, which is beyond Avogadro’s number.
An independent group, using the same model but even better methods of
identifying the cells, replicated the result.
A careful analysis of the studies, however, shows a common pattern in
this research.
One laboratory found a reduction of degranulation, while another laboratory
saw an increase, and still another laboratory noted no effect. It remains to be
seen whether the model will be reproducible and stable in the hands of
independent researchers. What we see in these studies has been a recurrent pattern
in homeopathy research, with equally intensive attempts at finding stable in
vitro models.
This pattern is that there are dramatic results, often in the first
experimental tests, which are not compatible with random fluctuations only. These
results are often also replicable to a certain degree. But rarely are they
stable to the degree demanded by mainstream research to accept such phenomena
beyond doubt and without a comprehensive theoretical framework.
Another experimental model that has achieved some reputation for
replicability is the thyroxin-dependent stimulation of metamorphosis in
tadpoles.
In that model, tadpole metamorphosis is accelerated by adding thyroxin
in a high potency (usually 30). Thyroxin stimulates growth and quickens the metamorphosis from the
two-legged stage into the four-legged stage. Potentized thyroxin can produce
this effect also and, if potentized thyroxin is administered before a
stimulating dose, it can also reverse the effect. This model has been mainly
used by one group of researchers but has been partially replicated in several
laboratories. However, one completely independent replication failed and one
was positive.
In addition, in one large study, the effect was significant mainly
because, in one laboratory, there were very strong effects.
A number of groups, mainly in France, have studied the effects of
potentized dilutions beyond Avogadro’s number.
While a number of interesting single results have been reported, which
have been reviewed in a report soon to be presented to the World Health
Organization, there has
been no consistent attempt at isolating one replicable model. Thus,
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.
One noticeable advancement has been made: van Wijk and colleagues
demonstrated in a series of studies how the similia principle can be captured
biologically.
Although these studies were mainly carried out with low doses of substances
with some potential molecular action, these investigations are interesting
nevertheless because they elucidate what potential avenues the effect can take.
Cell cultures were treated with low levels of toxic substances. The cell
cultures then expressed different patterns of heat shock or stress pro teins,
dependent on the substance used, as a sign of the stress the cells suffered.
Patterns can be considered as remedy pictures, and chemical compounds can be
defined by their degree of similarity regarding these patterns. The following question
can then be addressed: Is stimulation of vitality of diseased cells related to
the degree of similarity between the symptom pattern of diseased cells and the
remedy picture?
Cells’ survival was recorded for their vitality. Experiments were
carried out with a disease induced by physical means:
heat shock. These cells were then treated with chemical compounds that
were applied in low doses. The chemical compounds were defined by their degree
of similarity regarding the heat-shock symptom pattern. Experimental data
showed that stimulation of survival capacity was positively correlated with the
degree of similarity; the correlation was highly significant. For instance,
when heat-shocked cells were treated with low doses of arsenite this resulted
in less cell
HOMEOPATHY RESEARCH
815
†
van Wijk R, Wiegant FAC. Cultured Mammalian Cells in Ho-
moeopathy Research: The Similia Principle in Self-Recovery.
Utrecht, Germany: Faculteit Biologie, Universiteit Utrecht, 1994.
‡
van Wijk R, Wiegant FAC. The Similia Principle in Surviving
Stress: Mammalian Cells in Homoeopathy Research. Utrecht, Ger-
many: Department of Molecular Cell Biology, Utrecht University,
1997.
death than without treatment. The patterns of arsenite and
heat shock show a high degree of similarity. In contrast, a
treatment with copper does not decrease cell death; the pat-
terns of heat shock and copper show a low degree of simi-
larity. These data suggest that we can, quite exclusively, rely
upon symptomatic (molecular) expression for indicating a
treatment. It means that stimulation of the (disease) pattern
by another irritation that has a similar pattern is able to ex-
tinguish the diseased state in cells and increases the number
of surviving cells.
54,55
Subsequently, research by Jonas and colleagues demon-
strated that specific protective proteins and their mRNA pre-
cursors are stimulated by specific dilutions of toxins.
56
This
finding bridges the gap somewhat between the simile prin-
ciple and potential biologic mechanisms but does not ad-
dress the question of ultra-high dilutions.
Using an in vitro model, Schmidt, Süß, and Nieber eval-
uated the inhibitory effects of liquid belladonna in high po-
tencies on the acetylcholine-induced contraction of the rat
ileum.
57
This result, of course, also waits for replication.
BASIC RESEARCH
In order to truly understand the mechanism, one would
have to find a plausible theory and experimental backing
to clarify how a highly diluted substance can affect a bio-
logic system. Since it is unlikely that a sufficient number
of molecules of the initial active agent are present in high
dilutions of homeopathic remedies, a researcher would have
to explain how a biologic effect can be brought about in
the first place. One of the earliest attempts at theoretically
explaining potential effects hypothesized that an “imprint”
of homeopathic “information” from the molecules dis-
solved in the remedy is produced by the potentization
process, conserved, multiplied by further potentization, and
then communicated to the body and taken up as a biologic
signal.
58–60
Different attempts have been made to substantiate the
claim that homeopathic dilutions are different from control
solutions. A thorough review of existing studies showed that
the studies presented so far were methodologically deficient
in several respects.
61
Modern attempts at measuring differ-
ences were either negative or produced small effects. How-
ever, during the potentization process, ions are dissolved out
of the glass vials. Thus, homeopathic potencies always con-
tain many different substances apart from the purported re-
medial one
62,63
and, therefore, only studies conducted with
succussed controls and in blinded measurements can be in-
formative. Only a few such studies have been performed. A
series of studies using nuclear magnetic resonance imaging
were able to document differences.
64,65
However, very thor-
ough predecessor studies, conducted in a triple-blinded
setup, were unable to confirm clear-cut and replicable dif-
ferences,
66
and other independent studies yielded sometimes
positive,
67
sometimes negative results.
68
A recent study us-
ing thermoluminescence found significant differences be-
tween a homeopathic test substance and succussed con-
trols,
69
a result that awaits replication. Another recent study
using a high-frequency electromagnetic probing device
demonstrated some differences,
61
while another purported
black-box measurement device did not produce replicable
results.
70
A recent thorough attempt to identify a specific set
of water clusters in homeopathic preparations that looked
promising was subsequently found to be unworkable be-
cause the preparations had subtle contaminants. This study
clearly showed the complex interdisciplinary expertise re-
quired to conduct high-quality research in homeopathy.
71
A
review of all extant literature on physical studies trying to
identify a materially active component and methodologi-
cally rating the studies concluded that most studies were
rather weak from a methodological point of view
72
(see
Table 1 for an overview). Together, this very weak litera-
ture shows that no viable evidence for stable water clusters
(required for so called “water memory”) currently exists.
We have developed a model system for testing homoeo-
pathically prepared solutions using the reaction between en-
zymes and their substrates as the test bed. With this system,
we measure the amount of product produced in an enzyme-
substrate reaction per unit time in a water environment. We
have observed that homeopathically prepared solutions sta-
bilize these reactions in water (manuscript in preparation).
Under normal circumstances, enzymes denature in water.
However, when in the presence of C30 potencies of a vari-
ety of compounds, this denaturation does not occur. Water
diluted and succussed to C30 does not provide a significant
level of stabilization. Furthermore, the starting compound
influences the degree of enzyme stabilization observed. We
have done a careful chemical analysis of the various prepa-
rations and have discovered that silica is the principal con-
stituent that varies among the solutions (4–40 micromolar
amounts). Succussed water also has dissolved silica in it but
at lower concentrations and perhaps in different forms and
molecular structures. As silica may occur in a variety of con-
figurations and in various molecular forms with other ele-
ments from the glass vials, this could explain the differences
among the various solutions. It is reasonable to assume that
the nature of the starting material affects the amount and na-
ture of the silica dissolved from the glass. In addition, var-
ious forms of silica are known to interact with proteins and
have been shown to interact with cells of the immune sys-
tem.
73
It is, therefore, possible that this contamination from
the walls of the glass in which homeopathic remedies are
made is an underlying explanation for some of the effects
reported with homeopathic remedies. According to this hy-
pothesis, the mechanism of action is fairly nonspecific and
most of the specificity is imparted from the patient’s im-
mune system. This could explain the variability observed in
a number of published trials and experiments.
WALACH ET AL.
816
CLINICAL RESEARCH
Pathogenetic trials
Hahnemann’s observation that substances ingested by
volunteers, even when diluted, produce symptoms was the
background for the first blinded experimental study in home-
opathy, probably even in the history of pharmacology. It was
a trial conducted by homeopaths in Nuremberg in 1835.
74
Volunteers were to take either Natrum muriaticum C30 or
a control substance from coded bottles and report back af-
ter some days. Of the 55 volunteers, 50 produced reports.
Eight (8) volunteers had symptoms, 5 with Nat. mur, 3 with
water. Thus, this first test ended inconclusively. Homeopaths
have conducted many so-called “proving” trials, an inade-
quate translation of the original German word Prüfung,
which means “testing.” More recently, these tests have been
called pathogenetic trials (PTs).
75
Normally, provings have
not been conducted blindly or in double-blinded fashion and
have not been usually evaluated with qualitative methods.
The homeopathic epistemology here is circular: Symptoms
observed in PTs are being used for treatment. If patients are
cured by the remedies prescribed, based on these symptoms,
the symptoms are verified, and the remedy picture is sup-
ported. If not, the symptom is discarded. Only rarely, and
very recently, has this methodology been brought under crit-
ical scrutiny and used as an experimental model. Reviews
indicate that the vast majority of PTs are largely inadequate
from a methodological point of view.
76,
§
However, it should
be noted that, for homeopathy to work as a therapeutic sys-
tem, usual methodological principles, such as blinding or
quantitative analysis, are considered to be less relevant be-
cause the circular epistemology is said to correct for bias.
Modern PTs that serve more of an apologetic and scruti-
nizing purpose are only partially useful from a homeopathic
clinical point of view. They have been conducted with blind-
ing of participants, and differential symptom pictures have
been obtained that seem to be useful in therapy.
77
When sub-
jected to scrutiny in placebo-controlled trials, however, it is
difficult to separate symptoms experienced with placebo and
symptoms experienced with homeopathic substances.
77–80
Researchers using more recent study designs have reported
that symptoms observed overall are specific and not just
“background noise.”
81–83
Very few studies have been done
with these recent study designs and much remains to be clar-
ified in this field.
Therapeutic trials
Naturally, randomized clinical trials have attracted most
research interest among researchers and are more well-
known. Several high-quality reviews of all published or a
selection of published studies exist (Table 2).
84–89
There is
even a comprehensive review of all clinical studies ever con-
ducted, including early studies published in German. This
review concluded that homeopathy is clinically effective.
,90
In addition, meta-analyses and reviews of several speci-
fic diagnoses have been carried out.
86,91–98
Most of these
reviews and meta-analyses, with some exceptions,
99–101
reached the conclusion that the effects observed in all trials
are not compatible with the hypothesis that homeopathy is
identical with placebo but that too few trials exist in any sin-
gle clinical areas to recommend homeopathy clinically.
Whether homeopathy is a placebo or not is also dependent
on the inclusion and analysis criteria used by a meta-analy-
sis or a review.
102–104
If the analysis is based on studies re-
HOMEOPATHY RESEARCH
817
T
ABLE
1. R
EVIEW OF
P
HYSICOCHEMICAL
E
XPERIMENTS
T
HAT
a
H
AVE
B
EEN
D
ONE TO
I
DENTIFY A
T
HERAPEUTICALLY
A
CTIVE
I
NGREDIENT IN
H
OMEOPATHIC
P
OTENCIES
Method # of publications Years SAPEH
b
score
Dielectric strength 6 1951–1983 1–50
Galvanic effects 5 1971–1992 1–50
Absorption 4 1941–1995 3–50
NMR-spectra shape 8 1966–1992 3–60
NMR-spectra T
1
T
2
10 1985–2001 2–80
Raman-Spectra 7 1975–1992 2–40
Black-box devices 4 1993–2000 1–10
a
According to ref. 72.
b
SAPEH-Score: a quality score that is comprised of Objectives, Controls,
Bindings, Randomiza-
tion, Consistency, Standardization, Statistics, and Presentation of the
Results. Maximal SAPEH-
Score is 10, SAPEH 6 low
quality, SAPEH
7 high quality.
NMR, nuclear magnetic resonance.
§
Dantas F, Fisher P, Walach H, et al. Homoeopathic remedy
provings: An international review. 2003; in preparation.
Dean ME. The Trials of Homeopathy: A Critical-Historical Ac-
count of the Origins, Structure and Development of Hahnemann’s
Scientific Therapeutics, and Two Systematic Reviews of Homeo-
pathic Clinical Trials. York, UK: Department of Health Sciences
and Clinical Evaluation, University of York, 2001.
trievable only through MEDLINE
®
and published in the
peer-reviewed literature, the outcome is normally not dif-
ferent from placebo. If all evidence is included, there is a
difference from placebo. Hence, the conclusion varies with
the decision as to what one is willing to accept as scientific
information.
105
As a result of the bias in the scientific com-
munity against homeopathy, it is easier to publish negative
results in the peer-reviewed literature than positive ones. The
latter are scrutinized more closely for methodological short-
comings than studies with the expected negative outcome,
a prominent example being the recently published meta-
analysis by Shang and colleagues the reporting of which is
unacceptably bad and yet it passed peer-review.
104,¶
Thus,
reviews based on the peer-reviewed literature are likely to
underestimate the effect and those outside of this literature
are likely to overestimate the effect. Moreover, some evi-
dence has been produced that effect-size between placebo
and homeopathy groups decreases, as methodological rigor
increases across studies,
102,106,107
a finding reported in con-
ventional clinical research also.
A summary of studies and conclusions is presented in Ta-
bles 2 and 3.
When reviewing the clinical evidence, one should bear in
mind that the material is quite heterogeneous. One would,
for instance, not ask the question “is conventional medicine
a placebo effect?” subjecting all available trials to a meta-
analysis. Rather, one would want independent evidence for
certain interventions, say statins, to produce a definite out-
come, say a decrease in heart-disease–related mortality. In
the same vein, one would want a series of relatively simi-
lar trials in homeopathy to test for the applicability of home-
opathy in certain clinical areas. Only in a few areas has a
series of studies been carried out and some of those have
been subjected to a meta-analysis (see Table 3). While the
meta-analyses are frequently positive overall, these results
should be approached with caution. The use of a homeo-
pathic preparation to treat postoperative ileus, for instance,
has been shown to be superior to placebo.
91
However, the
largest and most definitive trial in the series yielded nega-
tive results.
108,109
Isopathic preparations for the treatment of
atopic conditions with an allergic basis have been shown to
be more effective than placebo
110–112
and a meta-analysis
was positive also.
98
However, a large trial intended to be a
replication and a definite study was negative, showing only
significant interactions, but no therapeutically beneficial ef-
fect,
113
and other studies in the same area were also incon-
clusive.
114–116
Homeopathic therapy has been shown to be
useful in childhood diarrhea. A definite study building on a
pilot showed clear effects,
117,118
However, a follow-up study
showed effects only for an outcome different from the pre-
defined primary outcome,
119
and only the meta-analysis
found the effect significant.
97
A series of studies on homeopathy for chronic headaches/
migraines were built on an initially promising model
120,121
but were unable to reproduce the effect.
122–124
The same is
true with a seemingly simple and uncontested area: Arnica
for muscle soreness after exertion.
94,100
Only when all Ar-
nica studies are put together, independent of the model, can
effects be seen.
92
Our review shows a prominent feature of clinical home-
opathy research: The problem is not finding a stunning ini-
tial result, as in early studies such as those done with fi-
bromyalgia,
125–127
or with premenstrual syndrome,
128
or
combination homeopathy in ulcers in children with can-
cer,
129
although some recent results from initial studies have
produced negative results.
131–133
The real problem is repli-
cating the effect once it has been seen in a model, poten-
tially in different independent studies. There is, to our
knowledge, no single clinical area where reported effects
have been demonstrated unequivocally. Thus, the overall
picture of clinical evidence that is emerging is quite disap-
pointing for the homeopathic community. Still, the number
of studies is quite few compared to research in conventional
medicine.
Viewed together, the clinical research on homeopathy
compared to placebo is not much different from conven-
tional medicine research where approximately the same pro-
portion of studies are positive and negative.
134
Once un-
published studies are retrieved from drug-licensing agencies,
well-supported substances, such as selective serotonin re-
uptake inhibitors for depression, show diminishing ef-
fects.
135,136
But overall, effect sizes are still statistically ro-
bust, even if diminished. This same result cannot be claimed
for homeopathy, except in a few clearly delineated areas (see
Table 3).
The situation is different for studies on homeopathic sub-
stances compared to active controls or standard treatment.
There are considerably fewer studies in this field.
137–149
But,
when taken together, it seems to be much easier to prove
equivalence to standard treatments than superiority over
placebo. This is certainly a paradox, for standard treatments
are supposed to be superior to placebo, and this is the rea-
son they are standard in the first place. Jonas and colleagues
did a systematic review (SR) of the homeopathic literature
using an established process taken from the behavioral med-
icine literature that avoided the bias toward drug studies pro-
duced by most medical SR approaches. This review allowed
for calculation of a “valence effect” (a measure of confi-
dence in reported effects) of homeopathic compared to con-
ventional treatment or placebo comparison groups. The re-
searchers found that homeopathy produced more favorable
effects when compared to conventional treatments than
compared to placebo studies. Thus, the system of home-
opathy may be more beneficial in actual practice than when
studying the isolated remedies themselves.
150
This situation has led to a new movement: the documen-
tation of homeopathic care and its effects in primary or sec-
WALACH ET AL.
818
¶
See special section at the beginning of this issue regarding the
Shang et al. study and the accompanying editorial in The Lancet.
ondary care. Most randomized controlled studies start from
a rather vague notion of normal practice. Since homeopathy
has been used for centuries, it has a special status in some
European countries. The remedies are registered, but not
tested for efficacy in certain diagnoses. The logic and epis-
temology of testing is often reversed in traditional healing
practices such as homeopathy.
151
In pharmacology, after a
broad basic research and screening process, only few sub-
stances make their way to final phase 3 and phase 4 testing
for efficacy and, only later, is their broad applicability tested
in postmarketing surveillance studies. In homeopathy, there
is a well-known and broad spectrum of potential single
remedies we know little about in terms of classical efficacy.
Thus, testing should start from a broad documentation of
safety, satisfaction, and effects, comparable to postmarket-
ing surveillance studies in modern pharmacology. Compar-
HOMEOPATHY RESEARCH
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LACEBO OR
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OT
a
Homeopathy N and type
Author (ref.) type/control of studies Results Conclusions
Kleijnen et al. (
a
) All/placebo, 107 CCTs 81 trials reported Available evidence positive
conventional positive results; but not sufficient to draw
most trials low- definitive conclusions
quality, but many
exceptions
Linde et al. (87) All/placebo 89 RCTs OR of all trials over Results not
compatible with
placebo, 2.45 (95% the hypothesis that all
CI, 2.05–2.93); in homeopathy is placebo;
better trials, 1.66 no firm evidence for any
(CI, 1.33–2.08) single condition
Linde and Melchart (88) Classical/placebo, 32 RCTs Responder RR vs.
Available evidence suggests
conventional placebo, 1.62 (CI, effects over placebo;
1.17–2.23); in evidence not convincing
better-quality trials, because of shortcomings
1.12 (CI, 0.87–1.44) and inconsistencies
Ernst (
b
) Classical/ 3 RCTs, 3 All trials burdened Relative efficacy of
classical
conventional CCTs with serious homeopathy compared to
methodological conventional treatments
flaws; results unknown; no evidence of
nonuniform effects greater than placebo
Cucherat et al. (84) All/placebo 17 RCTs Combined p-value Some evidence
suggests
for an effect over homeopathy more than
placebo
0.001; effective placebo; studies
for best trials only, of high quality more
p 0.08
likely to be negative
Walach
c
All/placebo 41 RCTs Random-effect size, Effects of homeopathy not
conventional 0.259 (CI, 0.319– significantly different
0.837); fixed-effects, from those of placebo
0.295 (CI, 0.223 to
0.366)
Shang et al. (104) All (unknown)/ 8 RCTs of OR 0.88 (CI 0.65– Effects of
homeopathy
placebo, 110 1.19) for
indistinguishable from
conventional homeopathic homeopathy vs. placebo, while effects
vs. 6 RCTs placebo (i.e. no of conventional trials
conventional difference); OR remain different from
0.58 (CI 0.39–0.85) placebo
for conventional
trials (i.e. significant
difference)
CCT, nonrandomized controlled trial; OR, odds ratio; CI, confidence interval;
RCT, randomized controlled trial; RR, rate ratio.
Adapted from ref. 86: Jonas WB, Kaptchuk TJ, Linde K. A critical
overview of homeopathy. Ann Intern Med 2003;138:393–399, with
permission.
a
Kleijnen J, Knipschild P, ter Riet G. Clinical trials of homeopathy. Br
Med J 1991;302:316–323.
b
Ernst E. Classical homeopathy versus conventional treatments: A
systematic review. Perfusion 1999;12:13–15.
c
Walach H. The importance of non-specific effects of therapy: The example of homeopathy [in German]. Freiburg, Germany:
Philosophische Fakultät, Freiburg, 1997.
WALACH ET AL.
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ONDITIONS
Homeopathy type/ N and
Author (ref.) Indication control studies trial types Results Conclusions
Linde & Asthma
Various/placebo 3 RCTs Trials highly
Currently available
Melchart heterogeneous; 2
evidence insufficient
(88) reported statistically to assess possible
significant effects role of homeopathy
for treating asthma
Ernst (
a
) Headache Individualized/ 4 RCTs 1 trial positive; Trial data do not
prophylaxis placebo 1 partially positive; suggest effect
2 negative over placebo
for prophylaxis
migraine or
headache
Ernst (
b
) Delayed-onset Various/placebo 8 double- Most trials had Published evidence
muscle blinded severe flaws; does not support
soreness trials the 3 RCTs hypothesis that
(3 explicitly showed no homeopathic
RCTs) statistically remedies are
significant effective for
effects muscle soreness
over placebo
Ernst & Pittler All (mainly
Arnica/placebo, 4 RCTs; 2
positive trials; Claims that
(100) trauma conventional 4 CCTs 2 trials with homeopathic Arnica
positive trend; efficacious not
most studies supported by
had severe rigorous trials
flaws
Lüdtke & All trauma and Arnica/placebo, 23 RCTs; Quality often low; Available evidence
Wilkens postoperatively no
treatment 14 CCTs 13 of 35 studies suggests that
(92) vs. placebo with Arnica can be
statistically efficacious;
significant further rigorous
results, 10 with trials needed
trend toward
significance
Vickers & Influenza-like
Oscillococcinum/ 7 RCTs No evidence for
Oscillococcinum
Smith (
c
) syndrome placebo preventive effect probably reduces
(3 trials) duration of influenza-
but reduction of like syndromes;
length of illness further trials
in treatment needed
trials
Wiesenauer Pollinosis Galphimia/ 8 RCTs;
Responder RR Galphima
statistically
and placebo 1 CS; for Galphimia significantly more
Lüdtke (93) 2 UCTs vs. placebo
effective than
from 7 trials, placebo
1.25 (95%
CI, 1.09–1.43)
Barnes et al. Postoperative
Various/placebo 4 RCTs; Time to first
flatus Available evidence
(91) ileus 2 CCTs in homeopathy positive but several
statistically caveats preclude
significantly definitive conclusions
shorter; best
trial negative
Jonas et al. Rheumatic
Various/placebo 6 RCTs 4 studies achieved Few high-quality placebo-
(86) conditions good-quality controlled clinical
scores; combined trials on treatment
OR of these four of rheumatic syndromes
studies, 2.11 (CI, with homeopathy and
1.32–3.35) results are mixed
ative effectiveness between two treatments can be tested to
find out about pragmatic usefulness compared to standard
applications. It is at the end of the epistemological chain that
research on mechanisms of action is done.
152
Thus, the or-
der of testing is reversed. The goal is to document effects
in clinical practice broadly. Where such studies are being
done, sizeable and stable clinical effects on homeopathy are
reported.
#,153–155
Roughly 70% of all patients using home-
opathy report they are considerably improved after treat-
ment, and these effects remain stable during follow-up pe-
riods of 2–5 years.
In summary, there is an efficacy/effectiveness paradox
(similar to that found in several other areas of complemen-
tary medicine research) with very weak evidence that home-
opathy is different from placebo but yet there is documented
usefulness in general practice
156
: We have a therapy that is
useful when applied in open practice and produces substan-
tial effects, even in patients with chronic diseases. But, ac-
cording to controlled studies, it is difficult to show that
homeopathy is different from placebo.
This leads to the conclusion that, before clinical home-
opathy research can proceed with success, it needs a viable
theory.
THEORETICAL MODELS
Hahnemann himself hated speculation. His approach was
purely empirical, and he was not given to theorize about the
nature of homeopathic effects. We do not have a proper the-
ory of homeopathy from him. He satisfied himself by call-
ing the effect of his remedies “spirit-like,” brought about by
a “vital force” or a “dynamis” (the Greek term for “power”).
This will not do for a modern understanding, since sci-
ence is built on an intricate interplay between theory and
data. Data only make sense in the light of a theory, and the-
ories can only be supported or refuted by data.
HOMEOPATHY RESEARCH
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ONTINUED
)
Homeopathy type/ N and
Author (ref.) Indication control studies trial types Results Conclusions
Taylor et al. Allergic Isopathic
4 RCTs Pooled analysis of Isopathic
nosodes
(98)* conditions nosodes/ 100-mm visual
different from
placebo analogue scores; placebo
on both
scores were subjective and
9.8 mm (CI, objective measures
4.2–15.4) better
with isopathy
Jacobs et al. Childhood Classical/
3 RCTs Combined mean Individualized
homeopathic
(95)* diarrhea placebo effect size
treatment decreases the
differences in duration and number of
duration of stools in children with
diarrhea between acute diarrhea, but
groups 0.66 days sample sizes small
(CI, 0.16–1.15;
p
0.008)
Jacobs Rheumatic Various/ 4 CCTs
Three of four No specific
et al. (
d
) diseases placebo trials positive; conclusion on
quality poor homeopathy (no
convincing evidence
for alternative
therapies for
rheumatism)
RCT, nonrandomized, controlled trial; CCT, nonrandomized, controlled
trial; CS, cohort study; UCS, uncontrolled study; RR, rate
ratio; CI, confidence interval; OR, odds ratio.
*Meta-analytic overviews of researchers of their own trials on the
topic.
Adapted from ref. 86: Jonas WB, Kaptchuk TJ, Linde K. A critical
overview of homeopathy. Ann Intern Med 2003;138:393–399,
with permission.
a
Ernst E. Homeopathic prophylaxis of headaches and migraine? A systematic
review. J Pain Symptom Manage 1999;18:353–357.
b
Ernst E. Does homeopathic Arnica montana reduce delayed onset muscle
soreness? A meta-analysis. Perfusion 1997;11:29–35.
c
Vickers AJ, Smith C. Homeopathic Oscillococcinum for preventing and
treating influenza and influenza-like syndromes. Cochrane
Database Syst 2000; rev. vol.: CD001957.
d
Jacobs JW, Rasker JJ, Van Rie
[Elzbieta Malarczyk]
Dr. Elzbieta Malarczyk, PhD, Professor emeritus at the Maria
Curie-Sklodowska University in Lublin, Poland. Since 2000, she has been
studying the effects of homeopathic dilutions of phenol on the enzyme processes
of fungi and bacteria. She has also undertaken studies of classical homeopathy
in cooperation with medical doctors; this cooperation yielding many popular
articles. Her research confirms what homeopaths have known for over 200 years:
increasing potentisation according to the homeopathic principles of dilution
and succusion has an obvious and predictable effect on living material even at
sub-Avogadro dilutions (those where no molecules of the initial substance
remain). The paper has been presented in short at a recent congress on
complementary medicine in Florence, Italy, but given the abundance of
information available at the congress, its importance seems to have been
overlooked. Yet, this research could be rated as having the same importance as
the works of Montagnier, no less.
For those of us who see the effects of accurate homeopathic
prescriptions every day, no one would be surprised at the outcome. Some might
not even consider that it is necessary to try to convince disbelievers that
“homeopathy works” and yet, it is heartening to see that such research is being
carried out. One would hope that it attracts the attention it deserves, adding
yet another piece of evidence in support of the veracity of homeopathic
dilutions. Through such research, it is becoming increasingly difficult
to sweep aside homeopathy as “nonsense” or “against the laws of nature”.
“The activity of enzymes can be modified by homeopathic dilutions of
their effectors”
Introduction: The fungal and bacterial materials are very useful for
testing the influence of low and very low doses of molecular phenolic effectors
on the enzymatic system
of phenoloxidases when they are incubated together in the reaction
space.
Aim: To search for a useful model of biological systems in order to
study the action of diluted low molecular substances on living organisms, which
is based on common physical and biochemical analytical procedures.
Method: The fungal and actinomyecetal bacterial materials from
laboratory cultures, as a source of common phenoloxidases, laccase, perioxidase
and O-demethylase, as well as the pure plant peroxidise, were used in
experiments described earlier (1-5). Subsequent dilutions of low molecular
phenolic metabolites, appropriate for the study of enzymatic systems, prepared
in 75% ethanol in the proportion of 1:100 (centesimal) and dynamized by
shaking, in accordance with homeopathic procedures, were prepared in our
laboratory. During experiments with bacterial and fungal materials and a pure
plant peroxidise, which were incubated together with subsequent dilutions of
proper phenolic effector, different analytic methods were used, including a gel
(PAGE) (4) and capillary (MEKCE) electrophoresis (5), spectral and
coloricmetric methods as well as electron microscopy.
Results: According to the presented data, the incubation of biological
material with diluted phenolic effectors induces various effects on tested
enzyme activity.
The activity changed in a sinusoidal manner with a gradual growth of
dilution rate of tested effectors, which was distinctly visible on the diagram
when the number of dilutions was localised on abacissa and biological activity
on the ordinate.
Exemplary results of the chosen experiments will be presented. For
tested enzymes: laccase, peroxidise and O-demethylase, the distance between
maximal points of enzymatic activity, shown on a sine curve, repeats more often
every 10 subsequent centesimal dilutions. Along with the extension of the
incubation period, the displacement of maximal and minimal points on the curve
were noticed, which revealed a dynamic aspect of the studied phenomenon.
Conclusions: Fungal and bacterial cells seem to be a very convenient
material for studying the action of diluted metabolites on enzymatic systems
due to their popular presence in the environment. Results of all the
experiments confirmed the same nature of aforementioned observations. Since
other authors had similar conclusions concerning human (6,7) and plant
materials (8,9), the described relations seem to be common in the natural world. It could also be stressed that
the therapeutic effect of homeopathic remedies could be based on the mechanism
described above, and it is highly probably that it leads to a normalisation of
disturbed enzyme systems in living organisms.
For the full articles, click on the
following links: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2655704/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2651610/
[Dr. Farokh Master]
Research Methodology In Homoeopathy
Research is to discover answers through scientific application of
procedures e.g. collecting, analysing and interpreting the data.
The research can be of following types: Dr. Archana Narang and Dr.
Aurora has very beautifully classified the methods into following titles.
Applied Research
- This is carried out to find solution or remedies to a particular
disease.
Fundamental Research
- It is as the name implies a very basic research, it’s usually undertaken
for curiosity rather than to find solutions that we face in our homoeopathic
clinical practice.
Exploratory Research
- It is the research we undertake to gain knowledge about the disease or
the drug we don’t know at all, here the intension is to bring in new suggestion
and idea.
This kind of research is key point to our trials regarding the action of
remedies onto various systems in our body and diseases.
Historical Research
- It is the study of past case history and other information sources,
with an intension to find the origin and development of a
phenomenon/disease/remedy and to discover the
trends in the past, in order to understand the present and to anticipate
the future.
Descriptive Research
- It is done to portray accurately the characteristics of a particular
individual, situation or a group - i.e., drug pictures, disease pictures,
individualized case studies, and research
regarding group studies.
Diagnostic Research
- It is also called clinical research which aims at identifying the
solutions e.g. role of glonine in benign hypertension or role of Pulsatilla on
ovulation.
Experimental Research
– It is designed to assess the effect of one particular variable on a
phenomenon by keeping the other variables constant or controlled. It is done to
test a hypothesis of a causal
relationship between variables
– Hypothesis
- Testing Research, i.e., clinical trials of (new or old) drugs on
conditions which not appeared during drug proving but were benefitted in
therapeutics (action of certain remedies on cancers).
• One-time Research- Research confined to a single time period.
• Longitudinal Research
– Research carried on over several time periods. The need of the hour
according to me is clinical research: or "Evidence based medicine" is
propagated through clinical research everywhere in the world, what is important
is to select a best protocol, in my clinic at Bombay I use Karnofsky
performance status scale definitions rating criteria along with European
Organization for research and treatment of cancer QLQ-C 30,
The protocols used by international agencies like OR, ICMR should always
be tried first.
Also one should include lots of experts from other system to evaluate
our results and methods. The role of bio statistician can never be ignored in a
best clinical trial.
The aim of the clinical research process is to gather scientific data at
one place and to support & propagate Homoeopathy as evidence based science.
Clinical verification:
- Here one must do clinical drug proving from different age group,
different sex, different occupation, different culture and compare the symptoms
and signs that come out, I have been now engaged in this field for more than
two decades proving snake remedies with the same idea.
Drug standardization: The drug standardization is conducted to ensure
quality, genuiness, and authenticity of raw drugs and to evaluate the safety
and efficacy of drugs as favourable results cannot be expected from the
remedies until they are of good quality.
Refer aphorism 122 it tells everything in this matter.
Here like allopathic drug companies we as a homoeopath should study the
physiology, the metabolic pathways, the neuroendocrine mechanisms, the effects
on neuromuscular system and all other Systems including immunological system.
Homoeopathic pathogenetic trials (HPTs): commonly known as Drug Proving
is the need of the hour.
Even though the method has not changed much after Hahnemann yet Dr.
Jeremy Sherr’s book on drug proving methodologies is very useful. All
practicing Homoeopaths can contribute to the research in homoeopathy by
contributing cases from their consulting rooms, this will help us to write down
most reliable indications of our remedies, next area is repertory verification,
if we can do this much I think it’s enough for the present. Let’s see two
examples which I love to share with you, the following experiments shows that
how beautifully homoeopathy works.
Paulo Bellavite, MD, and a group at the University of Verona (Italy)
wrote an excellent review of clinical research in homeopathy in which they
concluded:
“Overall, the literature concerning a total of 83 original studies
suggests that homeopathy may have significant effects in some conditions, e.g.
Galphimia glauca (low homeopathic dilutions/ dynamizations) in allergic
oculorhinitis, Anas barbariae (high homeopathic dilution/dynamization) in
influenza-like syndromes, classical individualised homeopathy in otitis, in
allergic complaints and in fibromyalgia, and a few low-potency homeopathic
complexes in sinusitis, rhinoconjunctivitis, arthritis. The evidence for
individualised homeopathic therapy in the field of upper respiratory tract
infections and for homeopathic immunotherapy in respiratory allergies is more
conflicting. Pragmatic equivalence trials suggest that, in primary care,
homeopathic treatment is not inferior to conventional treatment. A larger
number of observational studies and of clinical trials -conducted in a
methodologically correct manner without altering the treatment setting- are
needed before sure conclusions concerning the application of homeopathy for
specific diseases can be drawn.” (Bellavite, Marzotto, Chirumbolo, 2011)
Autism and the Autism Spectrum
In 2011 an outcomes based study reported the results of treating 123
children with autism who underwent homeopathic treatment between from 1998 to
2009 (Bravalia, 2011).
Treatment effectiveness was determined by the ATEC (Autism Treatment
Evaluation Check-list) scoring system, an internationally recognized scoring system
to measure changes in autistic symptoms after any treatment. The ATEC has four
subsets that measure a range of symptom scores for the following categories:
communication, sociability, sensory problems, and health and behavior.
Because ATEC is a system of evaluating the progress of different subsets
of autistic children, they found groups of remedies that were valuable for
autistic children with sensory problems (touch, sound, smell, vision); kinetic
problems (hyperactive, aggressive, destructive, self-injurious, and violent
behaviors); regressive problems (involuntary stool or urination and
inappropriate sexual symptoms); problematic affects or moods; intense fears
(dark, thunderstorms, ghosts, downward motion, being alone, crowds, heights,
etc.); those with autistic savant abilities; and strong causation in the
child’s history for the onset of autism (for example: the autistic symptoms
began after an acute illness, vaccination, use of suppressive medications, or
after an acute emotional trauma).
The results of the study were promising. ATEC scores were assessed six
months prior to treatment, at baseline when beginning treatment, and were then
repeated every three months up to one year after onset of homeopathic
treatment. The study had a good cross section of children of various age
groups, both genders, and a cross section of children suffering from mild,
moderate, and severe autism.
Changes in the ATEC scores were statistically significant with an
average ATEC score improvement of 19.72 points (p value < 0.05). The ATEC
scores improved almost 34% in the first three months and by 60% by six months
into treatment. The quick change in symptoms within the first three months of
treatment suggests a strong positive effect of the homeopathic treatment.
Autistic Hyperactivity Scores (AHS), which measures autistic
hyperactivity symptoms such as restlessness, spinning, object fixation,
fidgety, etc. in a range from 0 to 59, improved significantly after homeopathic
treatment from a score of 36 to 14.3 (p value < 0.05).
Most impressive was the observation nine children had complete reversal
of their Childhood Autism Rating Scale (CARS) score below the 30 level, which
is in the neurotypical, non-autistic range after only one year of homeopathic
treatment.
32 of the children in the study were in a subgroup that was analyzed
because they had very pronounced sensory problems at onset of the study. Their
ATEC scores began
at 73.68 at the time of starting homeopathic treatment and were reduced
to 55.74 after 12 months of treatment, and continued to reduce further to 46.41
after 18 months
of treatment. This significant 43% reduction in symptoms shows that
homeopathy can be very effective for treating sensory integration problems in
children with autism.
Of interest to practicing homeopaths, the study showed that 1/3 of the
children needed sequentially different changes in homeopathic remedies over
time as their pattern
of symptoms changed.
This observation is commonly seen in homeopathic clinical practice with
patient experiencing long-standing chronic illness like autism where several
different homeopathic prescriptions over time are needed as the main problems
change.
Bravalia, P. Autism Spectrum Disorder: Holistic Homeopathy.
Homeopathic Links Spring 2011, Vol. 24: pp. 31
Hormesis (griech.: „Anregung, Anstoß“, engl.: adaptive response) ist die schon von Paracelsus formulierte Hypothese, dass geringe Dosen schädlicher oder giftiger Substanzen eine positive Wirkung auf den Organismus haben können. Sie wird heute in der Definition weiter gefasst. Bei medizinisch wirksamen Substanzen ist ein solcher dosisabhängiger Umkehreffekt gut nachweisbar (z.B. Digitalis, Colchicin oder Opium). Bei einer Reihe anderer Verbindungen und der Wirkung von radioaktiver Strahlung wird die Hypothese in Fachkreisen sehr kontrovers diskutiert.
Hormetische Effekte zeichnen sich durch eine nach oben oder unten geöffnete J- oder U-förmige Dosis-Wirkungs-Kurve aus (z.B. rote Kurve im Bild rechts). Hormetische Effekte kommen in unterschiedlichen Kontexten vor und haben unterschiedliche ihnen zugrundeliegende Mechanismen.
Verwandte Konzepte
Immunstimulantien (z.B. Echinacea-Produkte) sollen -ohne im Sinn einer Impfung zu wirken- das Immunsystem des Körpers unspezifisch aktivieren, um so Infektionen abzuwehren. Dies ist eine hormetische Wirkung im engeren Sinn, die Effekte sind jedoch meist nicht wissenschaftlich sicher belegt.
Die Homöopathie verwendet Giftstoffe in extrem verdünnter Form als Heilmittel gegen Krankheiten, die vermeintlich dieselben Symptome aufweisen, wie durch die unverdünnten Giftstoffe beim Gesunden verursacht werden. Die Heilwirkung hatte jedoch der Begründer der Homöopathie, Samuel Hahnemann, einer „im innern Wesen der Arzneien verborgene[n], geistartige[n] Kraft“ zugeschrieben. Nach den Vorstellungen der meisten Homöopathen werden durch das Potenzieren ausschließlich die unerwünschten Wirkungen der Substanz reduziert, die erwünschten Wirkungen jedoch nicht. Viele Homöopathen glauben außerdem, dass durch das Zubereitungsverfahren die erwünschte Wirkung verstärkt wird. In der Praxis werden oft so hohe Verdünnungen („Hochpotenzen“) verwendet, dass kaum noch ein Molekül des ursprünglichen Stoffes in einer Medikamentendosis enthalten ist. Zur Begründung der Hochpotenzen ging Hahnemann davon aus, dass sich hier „die Materie […] roher Arznei-Substanzen […] zuletzt gänzlich in ihr individuelles geistartiges Wesen auflöse“. Heute behaupten Protagonisten der Homöopathie einen „Gedächtniseffekt“ des als Verdünnungsmittel benutzten Wassers. Kritiker schreiben etwaige Therapieerfolge dem Placeboeffekt zu. [Aus: Wikipedia]
[Farokh Master]
Modus Operandi of Homoeopathy
There surrounds ample debate over whether Homoeopathy works or not. One
way to deal with the scepticism is to make people familiar with the extensive
scientific research and lab investigations being carried out in this field. It
should be clear that this research is not carried out as a necessity to
conclude upon a working principle of homoeopathic medicines or how miniscule
doses of medicine are used in practice.
Research is carried out to augment and enhance the use of homoeopathic
medicines. Some of these researches with explicit results have been published
and made available to the public in order to generate an interest in
homeopathic healing principles and also to enlighten readers on how to evaluate
homeopathic research.
However, it can be rather confusing for readers to refer to research
analysis as some studies show that homeopathy works and some say that it
doesn’t. To rid readers of this confusion, a very recent development in
research is used, called a "meta-analysis," which is a systematic
review of a research that evaluates the overall results of experiments instead
of single studies.
The following literature has been referred from Consumer's Guide to
Homeopathy, Tarcher/Putnam.
In 1991, three professors of medicine from the Netherlands, none of them
homoeopaths, 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.
The professors concluded, "The amount of positive results came as a
surprise to us." With this knowledge, the researchers of the meta-analysis
on homeopathy concluded, "The evidence presented in this review would
probably be sufficient for establishing homeopathy as a regular treatment for
certain indications."
There are different types of homeopathic clinical research, some of
which provide research on individualization of remedies; some of which give a
commonly prescribed remedy to all patients with similar ailment, and some of
which give a combination of homeopathic remedies to people with a similar
condition. These form good research material; however there are certain issues
that researchers have to be aware of in order to obtain the best objective
results.
For instance, if a study shows that there was no difference between
those patients given a remedy and those given a placebo, the study does not
disprove homeopathy; it simply proves that this one remedy is not effective in
treating every person suffering from that ailment and he might most probably
need a remedy based on his individualised study.
Some people are under the mistaken impression that homeopathic studies
are impossibly complicated due to the need to individualize each remedy for the
subjects. This is however not true as evidenced by a clinical trial done on
subjects with asthma. Researchers at the University of Glasgow used
conventional allergy testing to discover which substances these asthma patients
were most allergic to which once was determined, the subjects were randomized
into treatment and placebo groups. Those patients chosen for treatment were
given the 30c potency of the substance to which they were most allergic (the
most common substance was house dust mite). The researchers called this unique
method of individualizing remedies "homeopathic immunotherapy"
(homeopathic m
edicines are usually prescribed based on the patient's idiosyncratic
symptoms, not on laboratory analysis or diagnostic categories). Subjects in
this experiment were evaluated by both homeopathic and conventional physicians.
This study showed that 82% of the patients given a homeopathic medicine
improved, while only 38% of patients given a placebo experienced a similar
degree of relief. Along with this recent asthma study, the authors performed a
meta-analysis, reviewing all the data from three studies they performed on
allergic conditions, which totalled 202 subjects. The researchers found a
similar pattern in the three studies. Improvement began within the first week
and continued through to the end of the trial four weeks later. The results of
this meta-analysis were so substantial (P=0.0004) that the authors concluded
that either homeopathic medicines work or controlled clinical trials do not.
Because modern science is based on controlled clinical trials, it is a more
likely conclusion that homeopathic medicines are effective.
As valuable as clinical studies are, laboratory researches too are
equally important to conclude responses from homoeopathic treatment. Lab
researches show biological activity of homeopathic medicines that cannot be
explained as a placebo response, a common accusation of sceptics. Laboratory
researches also shed some light on the mechanism of action of homeopathic
medicines.
Where clinical research determines improvement in the health of a
person, laboratory research measures changes in biological systems like cells,
tissues and organs.
It is true that homeopaths are not entirely certain of the working
principle of homeopathic medicines, but there are present numerous persuasive
and convincing theories about their mechanism of action. Besides, to be
entirely honest, there are contemporary modern medicines, including aspirin and
certain antibiotics, whose mode of action is not completely known. Yet,
practitioners of modern medicine do not hesitate to prescribe these medicines
that they have incomplete knowledge of. For centuries now, the most common
subject of scepticism towards homoepathy has been the exceedingly small doses
of medicines being used in the treatment and cure of patients. Sceptics of
homeopathy have asserted that there is "nothing" in the medicines
because there are no molecules left in the highly diluted solutions.
However, new research published in the prestigious Annals of the New
York Academy of Sciences (1999) suggests that there may be something active in
homeopathic medicines after all. In the article ‘The Thermodynamics of
Extremely Diluted Solutions” - New Scientific Evidence for Homeopathic Micro
doses by Dana Ullman, he mentions an experiment by Two Italian professors of
chemistry, Vittorio Elia and Marcella Niccoli. They measured the amount of heat
emanating from plain double-distilled water and compared that with
double-distilled water in which a substance was placed. Both the control water
and the treated water underwent consecutive dilution between one to thirty
times, with vigorous shaking in-between each dilution, which represents the
common pharmacological method in which homeopathic medicines are made. The
researchers conducted over 500 experiments, approximately half of which were
made with double-distilled water that was mixed with a specific acid and base
substance and half were in the control group of only double-distilled water.
The researchers found that 92% of the test solutions with the added acid or
base
substance had higher than expected heat emanating from them (sodium
chloride was one of the salt substances and a type of vinegar was one of the
acid substances tested).
Dr. Vittorio Elia, the lead researcher, asserted, "We are setting
the basis for a new science: the physics-chemistry of homeopathic water. These
results make for a strong support to the hypothesis of the existence of a
memory of water." "This study confirms that there is something there
in homeopathic water," affirmed Dana Ullman. "It should now be known
that physicians and scientists who assume that there is nothing in homeopathic
medicines are showing their own ignorance of the scientific literature."
It is common perception that, in treating a disease, the higher or more
potent the dose, the quicker, or better the cure. This common misconception has
not only been proved incorrect but the opposite of this has been proved right.
It was seen in a series of experiments and research that rather than a drug simply
having increased effects as its dose becomes larger, exceedingly small doses of
a drug will have the opposite effects of large doses. For instance, it is known
that normal medical doses of atropine acts on the parasympathetic nerves,
blocking it and causing mucous membranes to dry up, while exceedingly small
doses of atropine cause increased secretions to mucous membranes. This
pharmacological principle was concurrently discovered in the 1870s by two
separate researchers, Hugo Schulz, a conventional scientist, and Rudolf Arndt,
a psychiatrist and homeopath. Initially, this principle was called the
Arndt-Schulz ‘law’, law being defined as a sequence of events that has
been observed to occur with unvarying uniformity under the same
conditions. More specifically, these reseachers discovered that weak stimuli
accelerate physiological activity, medium stimuli inhibit physiological
activity, and strong stimuli halt physiological activity. For example, very
weak concentrations of iodine, bromine, mercuric chloride, and arsenious acid
will stimulate yeast growth, medium doses of these substances will inhibit
yeast growth and large doses will kill the yeast. In the recent past there has
been a surge of experiments confirming and reconfirming this general principle.
Unfortunately though, these experiments have been carried out by
non-homoeopaths or those with little knowledge of homoeopathy, hence there
isn’t any indisputable evidence to prove this principle with respect to
homeopathic principles.
Despite the now strong evidence that homeopathic medicines promote
biological activity and clinical efficacy, there is still great resistance to
them. Recently, the Lancet published the research on the homeopathic treatment
of asthma. In a press release announcing this research, they emphasized that
although homeopathic medicines may provide some benefit to people with asthma,
conventional medicines offer greater benefit.
This statement is bizarre firstly because the study didn't compare
homeopathic and conventional medicine; it only compared homeopathic medicine
with a placebo and secondly, the Lancet refused to openly acknowledge that
homeopathic medicines may work after all.
It is given in the ‘Journal of the French Academy of Sciences‘ evidence
of the bias that "defenders of science" have against homeopathy is
their refusal to publish or even comment on the increasing body of research
accruing to homeopathic medicine.
Science is supposed to be objective, though both physicists and
psychologists teach us that objectivity is impossible. Science's long-term
antagonism to homeopathy is slowly breaking down but not without significant
reaction, fear, anxiety, and sometimes downright attack against homeopaths.
Change is the basis of science. We seek to explore new territories to build
mankind a better present and future. However, change is difficult, and
significant change is even more difficult. Even though science advances from
new knowledge, it tends to be unwilling to accept perspectives and knowledge
that do not fit contemporary concepts and scientific theories.
[Farokh Master/Fernandes]
The Most Useful Method of Learning Materia Medica
The essence of homoeopathy is individualization, with each drug having its
own distinct personality. We have to get acquainted with different remedies in
the Materia Medica and understand them as if they were our friends.
1st step in learning Materia Medica is feeling the remedies.
2nd step is to learn the mental symptoms of a drug, before
the physical symptoms of the drug, as the mind is the most distinct and
innermost part of a person. Unfortunately, our Materia Medica does not have
fully developed mental aspects of drugs of most remedies.
3rd step is to study the aggravations and ameliorations by
meteorological conditions, motion, heat, jar, position, touch etc. The
characteristic desires and aversions of a remedy are
of great importance. Sometimes, in a drug, there are contradictions in
this sphere of remedies, for e.g. desire as well as aggravation to fish in
Natrum muriaticum.
4th step is to know the causation of disease typical of
different remedies i.e. the ailments from in the remedy.
E.g. Ailments from mortification - Staphysagria
Ailments from suppressed diarrhea - Abrotanum
Ailments from injury - Nat-sulph.
When we have mastered the above points then we have to proceed to learn
the physical symptoms to which the remedy specially applies.
For eg: Cardiovascular system of Veratrum viride,
Cerebro- spinal system of Zincum
metallicum.
Also we must study the affinity of drugs for particular organs and
tissue. For e.g. Kali carbonicum and its affinity for serous membranes.
We must be able to visualize the characteristic symptoms of a drug, like
the cracked tongue in the center of Rhus venenata,
zigzag sensation of Calc.
5th step is to select the few peculiar, strange keynote
symptoms out of the bulk of symptoms of a remedy. These may form similes, as we
have
The Ragged Philosopher - Sulphur.
The Human Barometer - Merc-sol.
6th step is to get clearly in the mind the bodily functions
such as micturition, defecation, digestion, menstruation and pregnancy.
7th step is to understand the alternating conditions e.g.
headache alternating with piles - Aloe,
cough alternating with eruptions - Croton tigrinum
and the concomitants of the remedy e.g.
coryza accompanied by diarrhoea -Sanguinaria canadensis. In the second
edition of the Kent's repertory, these are given under a separate heading as
alternations, but in the third edition
it is scattered through the book.
8th step is to study the pharmacology of drug including its
effects in potentized form.
e.g.
Opium - It contains two main groups of alkaloids. Phenanthrenes include morphine,
codeine, and thebaine and are the main narcotic constituents. Isoquinolines
such as
papaverine have no significant central_nervous_system effects. Morphine
is by far the most prevalent and important alkaloid in opium, consisting of
10%-16% of the total, and
responsible for most of its effects such as lung edema, respiratory
difficulties, coma, or cardiac or respiratory collapse.
In Cannabis the most prevalent group of psychoactive substances is
delta- tetrahydrocannabinol. Other psychoactive substances are Tetrahydrocannabivarin, Cannabivarin,
Cannabidiol, but it is only found in small amounts.
Effects of tetrahydrocannabivarin are altered consciousness and
perception, anxiety, paranoia, increased libido, increased heart rate, dryness
of mouth.
Cannabinoids affect the basal ganglia, cerebellum and the hippocampus
bringing about a change in movement and co-ordination.
9th step is to study the particular sphere of action of
drugs.
For e.g. the action of Natrum muriaticum on the pituitary - thyroid
axis.
The action of Nitric acid on mucocutaneous junction.
The action of Pulsatilla on venous system.
THEORETICAL MODELS
Hahnemann himself hated speculation. His approach was
purely empirical, and he was not given to theorize about the
nature of homeopathic effects. We do not have a proper the-
ory of homeopathy from him. He satisfied himself by call-
ing the effect of his remedies “spirit-like,” brought about by
a “vital force” or a “dynamis” (the Greek term for “power”).
This will not do for a modern understanding, since sci-
ence is built on an intricate interplay between theory and
data. Data only make sense in the light of a theory, and the-
ories can only be supported or refuted by data.
HOMEOPATHY RESEARCH
821
T
ABLE
3. S
YSTEMATIC
R
EVIEWS OF
C
LINICAL
T
RIALS ON
H
OMEOPATHY FOR
S
PECIFIC
C
ONDITIONS
(C
ONTINUED
)
Homeopathy type/ N and
Author (ref.) Indication control studies trial types Results Conclusions
Taylor et al. Allergic Isopathic
4 RCTs Pooled analysis of
Isopathic nosodes
(98)* conditions nosodes/ 100-mm visual
different from
placebo analogue scores; placebo
on both
scores were subjective and
9.8 mm (CI, objective measures
4.2–15.4) better
with isopathy
Jacobs et al. Childhood
Classical/ 3 RCTs Combined mean
Individualized homeopathic
(95)* diarrhea placebo effect size
treatment decreases the
differences in duration and number of
duration of stools in children with
diarrhea between acute diarrhea, but
groups 0.66 days sample sizes small
(CI, 0.16–1.15;
p 0.008)
Jacobs Rheumatic Various/ 4 CCTs
Three of four No specific
et al. (
d
) diseases placebo trials positive; conclusion on
quality poor homeopathy (no
convincing evidence
for alternative
therapies for
rheumatism)
RCT, nonrandomized, controlled trial; CCT, nonrandomized, controlled
trial; CS, cohort study; UCS, uncontrolled study; RR, rate
ratio; CI, confidence interval; OR, odds ratio.
*Meta-analytic overviews of researchers of their own trials on the
topic.
Adapted from ref. 86: Jonas WB, Kaptchuk TJ, Linde K. A critical
overview of homeopathy. Ann Intern Med 2003;138:393–399,
with permission.
a
Ernst E. Homeopathic prophylaxis of headaches and migraine? A systematic
review. J Pain Symptom Manage 1999;18:353–357.
b
Ernst E. Does homeopathic Arnica montana reduce delayed onset muscle
soreness? A meta-analysis. Perfusion 1997;11:29–35.
c
Vickers AJ, Smith C. Homeopathic Oscillococcinum for preventing and
treating influenza and influenza-like syndromes. Cochrane
Database Syst 2000; rev. vol.: CD001957.
d
Jacobs JW, Rasker JJ, Van Riel PL, et al. Alternative treatment methods in rheumatic diseases: A literature review. Ned Tijdschr
Geneeskd 1991;135:317–322.
#
Becker-Witt C, Lüdtke R, Baur R,
Willich SN. Homeopathic
medical practice: Long-term results of a cohort study with 3981
patients. BMC Public Health 2005, submitted.
Theories, in the sense of full-fledged models explaining
homeopathy from production to therapeutic effects, do not
exist. However, there are speculative attempts to explain
parts of the puzzle.
157,158
These attempts can be broadly di-
vided into two classes: local mechanistic models and non-
local models.
Local models
Local models start from the assumption that the produc-
tion process produces some kind of template, image or im-
print of the original substance, and that this “information”
is the active ingredient. Memory of water is claimed as one
potential mechanism.
159,160
Exactly how this memory
should operate is not clear. Several possibilities have been
proposed: A selection of water isotopes specific to an orig-
inally dissolved substance
161
; an ordering of water mole-
cules to macrostructures, called clathrates,
159,162–164
that
contain the information about substances in the geometry of
their ordering; and a selective change in hydrogen bonding,
long-range coherence between water molecules that gives
potencies laser-like behavior
165
are a few of the more promi-
nent ideas. Some of these have been theoretically discussed
at a high level of specification, some of them remain purely
speculative. However, none have been proven. For instance,
the lifespan of water macrostructures is in the region of pi-
coseconds, which is far too short to guarantee stability.
166
Even if these theories could be proven a couple of problems
remain: Some remedies are not produced by succussion at
all, but by trituration with milk sugar. Would the theories
also hold for this special case? Some theories discuss only
water. In homeopathy, there is nearly always a variable mix
of water and alcohol. Would the chemistry and physics be
the same? Hahnemann, in later days, ordered his patients
just to sniff medications (i.e., open bottles and smell them)
and allow only volatile molecules to make contact. Would
those theories also explain this curious situation? If a mate-
rial information carrier could be demonstrated, precisely
how would the organism use this information to produce
health again? It has been observed that the data are com-
patible with a network theory of health, claiming that some
“ordering information” is given to the organism that allows
it to come out of a state of suboptimal equilibrium, which
is the chronically ill state.
167,168
This model would demand
only a minimal energetic impulse or even no impulse at all
but just the right information to get the system stimulated.
Local models claim that such information is contained in
homeopathic remedies.
The combined data of homeopathy research are not com-
patible with that argument, at least not at the moment. If this
were the case, we would expect a similar situation as in con-
ventional pharmacology, namely, that a series of studies suc-
ceed in distilling out an effect from such information com-
pared to what happens with controls. What we see in variable
models is strong effects in either direction that, when
summed up, often cancel each other out. While the devia-
tions from expectation are frequently very strong, defying
the argument of random fluctuation, these deviations are
rather unsystematic and, up to now, have not been suffi-
ciently stable in any single model to convince critics.
Nonlocal models
It was this situation that has led some researchers to
postulate nonlocal mechanisms,
169–179
in line with Hahne-
mann’s general way of theorizing.
180
Several of these mod-
els exist and vary in their degree of explicitness and general
approach, and also in the way they include the remedy and
the practitioner in the equation. Generally speaking, the
starting point for these theories is the observation that, in
quantum mechanics, so-called nonlocal correlations in well-
defined quantum systems are operative. While these decay
through interaction with the environment, it might be the
case that under similar, isomorphic conditions nonlocal cor-
relations are established in analogy to holistic quantum cor-
relations. A theoretical framework exists that predicts such
nonlocal correlations,
181
and some efforts have been made
to apply such a scenario to homeopathy.
177
While some ob-
servations speak in favor of such models,
182
direct experi-
mental evidence for the existence of nonlocal correlations
outside the realm of quantum mechanics is still wanted.
These models have a common consequence: If homeo-
pathic effects are the result of nonlocal correlations, by de-
finition, they cannot be distilled out as causal signals, like
in drug therapy. Attempts at strict and direct replication, are
doomed to failure. This has to do with a rather technical ar-
gument that prohibits the use of nonlocal correlations as di-
rect signals.
179
(Otherwise, time-reversal paradoxes could
be created that contradict special relativity.) As long as the
original context is not disturbed and no signal can be dis-
tilled out of a setup using such correlations, they could be
a very elegant way of coordinating behavior.
The practical consequence of this theory is that clinical
research is best conducted by not disturbing the normal clin-
ical practice through experimental interventions such as
blinding and randomization and that the placebo-controlled
trial is probably a suboptimal method of testing, not only
for homeopathy but also for conventional pharmacology. A
serious problem with the nonlocal model is that it may not
be directly testable in the clinical setting and so cannot be
proven as an explanation for homeopathy. Only indirect ex-
perimentation is a potential avenue to prove it and this has
yet to be established.
CONCLUSIONS
Our health system has become more effective for treat-
ing acute diseases. The downside of it is that chronic dis-
eases have moved into the foreground of health care. Even
WALACH ET AL.
822
if future medical interventions will be able to solve these
problems, it is questionable whether our societies will be
able to afford these treatments.
183
In this situation, home-
opathy might be an attractive alternative, since it is a min-
imal intervention with no known and documented side-ef-
fects, capitalizing on the individual organism’s capacity to
self-heal. Focused conventional intervention, when applied
in the complex networks of living organisms, is bound to
produce an array of unwanted effects. Thus, the homeopathic
strategy may also be helpful for reducing adverse effects
from treatment.
184,185
Homeopathy may thus offer an alternative, if we are will-
ing to set aside the need to know whether its effects are spe-
cific. What strategies are the most useful to both study and
use homeopathy? We offer a few suggestions about what
routes research should and could take in the future:
1. Clinical research is probably most effective if it uses ex-
actly this strength of homeopathy to regulate the system
with minimal side-effects and tries to document options
and limitations. This could be done in large outcomes
studies. These studies should look at homeopathy as it is
practiced and provide data on the real-life effects in pa-
tients. If well-described cohorts are used, and these co-
horts are followed for a long time and compared to con-
ventionally treated ones, this will allow us to estimate the
usefulness of homeopathy in practice. Ideally, such an
approach would be combined with economic research on
costs and feasibility.
2. The next step would be pragmatic comparisons between
homeopathy and conventional treatments, which ideally,
of course, would be conducted as randomized trials.
Since patients seeking homeopathic care often would not
like to be randomized, nonrandomized comparisons
would also have to be conducted.
3. Placebo-controlled trials are the state of the art in clini-
cal research. Thus, researchers and some authorities will
want evidence from such trials. Before conducting such
studies, however, it would be advisable to build on ex-
tensive pilot data giving an indication of the anticipated
effect size, condition, outcome parameters, and length of
time of each study.
4. Ideally, the question regarding the nature of homeopathic
remedies is directed toward solid laboratory research with
plant, in vitro or in vivo models that are controlled, ob-
jective, and easily replicable. Since placebo-controlled
clinical trials presuppose that there is a causal signal to
be isolated in the first place, they may be the wrong
method of testing, if the nonlocality hypothesis is cor-
rect. Thus, it should be high priority to establish the na-
ture of homeopathic dilutions in fundamental experi-
mental laboratory models. It is mandatory to find a testing
system that is broadly accepted and can, in theory, be
handled by any competent researcher in the area. If one
wants to drill a large hole through a massive wall, it is
best to not start drilling a new hole every couple of inches
but to stick to one initial groove and carry on drilling.
This analogy applies here: One, or at the most, very few
different systems should be established and probed, ide-
ally, by independent researchers. If the prediction of a
subtle causal information carrier in homeopathic dilu-
tions is borne out, one would expect that a series of well-
controlled trials should be able to isolate such a signal,
even if it is very weak. If the hypothesis of a nonlocal
process is true, we would expect no strict replicability,
but a deviation toward the predicted and sometimes to-
ward the unpredicted direction, sometimes for the pri-
mary, sometimes for the secondary outcomes. Neverthe-
less, it should be possible to document deviations from
chance randomness, if two preconditions are observed:
(a) The testing system must not be too restricted. For in-
stance, deviations should not be forced to be one-
sided, but should comprise overall deviation statis-
tics, ideally combining an array of parameters, e.g.
different parameters of growth.
(b) It is unlikely that the effect will be seen in every test.
Thus, a testing model should be chosen that is com-
paratively low-cost to replicate and a meta-analytic ap-
proach should be used to synthesize long series of data.
Thus, experimental testing in simple models would allow
us to clarify the nature of homeopathic potencies.
5. In parallel, theory development should proceed. History
of science teaches that anomalous data are only incor-
porated into the corpus of science, once a sound theory
is available to understand the data. However, no theory
has ever changed the direction of science without good
data to support it. Thus, both developments need to go
hand-in-hand.
6. The big movement at the moment is toward healing in
integrative care, in which different healing modalities
have their special places. Homeopathy is not a cure-all.
What is needed is to find out in which areas homeopa-
thy works well, or better, than other modalities and to
seek cooperation with other modalities for optimal care.
For instance, it might be that homeopathy is especially
effective for children or for mitigating stress-related dis-
eases. In these cases, it would be worthwhile to establish
model clinics in which integrated care is practiced and
could be studied as a whole practice against other prac-
tices.
7. Only little attention has been paid to patient–practitioner
interaction. Part of the secret may be buried here, and in-
tensive qualitative and process-like studies might be able
to unveil some of it.
We believe that Hahnemann’s discovery is still worth-
while in the twenty-first century. To be recognized as such,
HOMEOPATHY RESEARCH
823
it is necessary that one legacy of Hahnemann’s is strictly
discarded, however—his tendency to quarrel and fight with
everyone who did not share his opinions. This was his
shadow side and it is still haunting homeopathy. And thus
homeopaths go on fighting—each other and colleagues of
different training and opinions, medical authorities and other
doctors, and the health system at large. This is a waste of
time and energy, and we suppose that homeopathy would
have been easier to integrate had it not been for this ten-
dency. It is time to drop this and to adopt a more mature
stance that is aware both of the strengths and the weaknesses
of homeopathy, and that is willing to look openly at both
and to learn continually from experience. The latter is a
theme, common both to science and homeopathy.
ACKNOWLEDGMENTS
The authors thank Cindy Crawford, B.A., for valuable
help in the background.
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