Homeopathy

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Frontpage DER SPIEGEL 28/2010

Homeopathy fan Prince Charles inspecting a pharmacy company, creating homeopathic remedies

Homeopathy is a pseudo-scientific method used for the treatment of almost any disease. It was invented by Samuel Hahnemann, a doctor and occultist from Saxony, around 1800 and, largely unaltered, persists to this day. Homeopathy relies on two general basic principles. One of them, known as the "law of similars", reads "let like be cured by like." Hahnemann determined that, according to the law of similars, every disease was curable by substances which cause similar symptoms when taken by a healthy patient. The other principle is called potentialization (actually meaning dilution). Homeopathic remedies are supposed to be more effective the more they are diluted into solutions according to particular procedures. None of these two principles was confirmed experimentally until now.

Believers in homeopathy are frequently, consciously or unconsciously, overall skeptical towards scientific medicine: the (mostly irrational) fear of "harmful chemistry" is inseparably connected to a "nocebo effect" which impairs the effect of well approved conventional methods.

Also see: Allopathy

Variants of Homeopathy

Different variants of the original classic homeopathy developed in the course of time. Today, there are low-potentizers and high-potentizers, monotherapists and polypragmatists, homeopathic phytotherapists and anthroposophic homeopaths, etc.

• Classic homeopathy is the form of homeopathy strictly complying to Samuel Hahnemann's teachings. According to Hahnemann, no more than one remedy is to be administered for all physical or mental diseases at any given time. A classical homeopath thus will look for the one remedy he believes to be the appropriate similar. The most well-known current representative is Georgos Vithoulkas.
• Constitutional homeopathy applies mixtures of homeopathic remedies based on respective diagnoses. Also see: Constitutional homeopathy
• Clinical homeopathy describes the application of homeopathic remedies in so-called low potencies (D1-D12) for certain diagnoses.
• Miasmatic homeopathy describes different variants of constitutional homeopathy with an emphasis on the therapy of chronic diseases in due consideration of Hahneman's miasmatic theory.
• Micro-immune therapy is a method which potentises cytokines applied sublingually. Providers of this therapy assume that this will place a high concentration of immune system components under the patient's tongue. The therapy aims at modulating the immune system with the potentized effect of cytokines. Maurice Jenaer is regarded the founder of micro-immune therapy. One supplier of micro-immunal therapeutic agents is Labo'Life company which also holds a patent on "specific nucleid acids". Details on effect and composition of the remedies are not available.
• Biochemical homeopathy refers to a variant of homeopathy which uses nosodes and potentized toxins (also see the Horvi-Enzyme-Therapy). The method apparently is only used by its inventor, biochemist and non-medical practitioner Karin Lenger from Offenbach.
• Newer interpretations and derivatives of homeopathy are gaining ground. Borderlines towards faith healing or energy medicine are rather blurred. Representatives of this therapy mostly refused by classical homeopaths believe an introduction of remedies into the patient's body following anamnesis and repertorization was not necessary. They believe physical proximity between patient and remedy was sufficient to develop effects. Remedies could thus e.g. be kept on the body or placed under the patient's pillow. A glass of water is also said to show homeopathic effects when merely placed on a sheet of paper with the name of the remedy. The paper will then transfer its information to the water. Some methods typically applied in this spectrum are Harmopathy, New Homeopathy according to Erich Körbler, Seghal's method, Herscue's method, process-oriented homeopathy, quantum logical homeopathy, creative homeopathy, impulse homeopathy, Similis cards, Silent Healing or the Sankaran method (also called "Bombay method" or "systematic homeopathy"). Tele-homeopathy is another variant of homeopathy whose inventor claims it was effective as a remote treatment via internet (e-mail or Skype) or via telephone.
• Homoeosiniatry is a method combining the elements of homeopathy and traditional Chinese medicine. Both acupuncture and homeopathic remedies are being applied.
• Digital homeopathy as an alternative expression for Holopathy.
• Banerji protocol-method
• C4-Homeopathy
• "resonance healing" according to Peter Chappell

Electro-homeopathy is no homeopathic method with which it only shares the name, but refers to a variant of spagyrics. Some electrically operated equipment for diagnostics or therapy will be connected to homeopathy by their inventors and suppliers. Cem Tech, Transmaterial Catalyst or Wave Transfer are some examples of such devices.

In accordance with the patients to be treated, there is a homeopathy aiming at curing human beings, but also animal and plant homeopathy. Plant homeopathy comprises methods influencing plant growth with homeopathic products (e.g. a product named Biplantol).

Hering's Law of Cure

A so-called Hering's Law of cure was suggested by Constantin Hering, a Saxonian supporter of Hahnemann in the 19th century. Hering believed a recovery happened when an extinction of symptoms was effected in the following directions:

• from inside to the outside
• from above to below
• from now to earlier

No scientific basis

After some 200 years of research of homeopaths and non-homeopaths, no scientific proof of an efficacy of homeopathy - beyond the placebo effect - has been established, and mechanism of actions postulated are classified as disproven today. According to the present level of knowledge, homeopathy must be seen as a placebo therapy which, however, does not mean it is completey ineffective. One can indeed assume that, particularly given a charismatic therapist and a corresponding therapeutic ritual, it can achieve an effect with corresponding patients compared to no treatment (i.e. inactivity). Dangers may result from homeopathy when homeopath and patient will overestimate the placebo effects and thus refrain from treatments with reproducible proof of efficacy beyond the placebo effect.

The following aspects speak against homeopathy: there is no evidence of efficacy, the pseudo-scientific dogmatic character of homeopathy schools (which are actually orthodox medical practitioners), the complete lack of prevention of disease as well as inherent contradictions like the irreproducible cinchona experiment to which Hahnemann refers alternatively. Homeopaths do not like to tell how long a therapy shall be carried out. From a chemical scientific point of view the method of potentialization (which rather is a dilution) cannot be accomodated to reality.

An alleged lack of side effects is often mentioned as an argument speaking for homeopathy. It is being argued that hardly any side effects are to be expected from strong dilutions. This argument, however, contradicts the assumption that dilution increases the effect of a substance and thus must be seen as an inherent contradiction of homeopathy. Another argument in favour of homeopathy often voiced is the strengthening of human abilities of self-healing. Supporters have, as of yet, failed to provide any respective evidence.

Contrary to frequent views of homeopathy offering a holistic treatment, this alternative form of medical treatment must be considered as a symptom-based therapy exclusively based on symptoms discernible to and described by the patient. The aetiology of diseases (cause study) is vastly ignored.

Hahnemann and modern homeopaths base their theories on healing laws which include the concept that homeopathic therapies were healing a human being from top to bottom and from inside to outside, beginning with the latest symptom. Such ideas are not based on any models of biology or disease.

The Medical Faculty of Marburg University, in magazine Ärzteblatt dated March 3, 1993, declared homeopathy a false doctrine: Its mechanism of action was a deception of the patient, enforced by self-deception on the part of the therapist.

Pseudo-scientific explanatory approaches

From a scientific view, homeopathy is not plausible:It contradicts logic, the laws of nature, and medical knowledge past and present. High potencies of D23 or C12 or more do not contain any molecule of raw material. How are drops supposed to work which only consist of solvents? There is no water memory which could assimilate "information".

Within the framework of scientific medicine, it is not reasonable to explain the functionality of methods which are not in a position to prove their efficacy. Any exploration of mechanisms of action in homeopathy are not reasonable as long as there is no indication of homeopathy having any efficacy in the first place. Therefore, all attempts at explaining homeopathy are scientifically unfounded and must be classified as pseudo-science.

This, however, does not prevent homeopaths from devising mechanisms of action regarding homeopathy, nor from publishing these. The range covered spans from animist concepts of animated matter in which dilution will release the positive spirits (or vibrations) of substances to a pseudo-scientific re-interpretation of quantum mechanic and nuclear physical concepts (cf. quantum mysticism). Contemporary homeopaths and supporters of homeopathy often refer to quantum mechanics in physics in order to explain the alleged effects of homeopathic remedies. Quantum effects, however, only matter on a subatomic and perhaps probably on an atomic level. They are not relevant for the macroscopic world or for biological systems like virus, individual cells or upwards. Two persons often mentioned in this context are Anton Zeilinger, a quantum physicist from Vienna, and psychologist Harald Walach, a professor at European University Viadrina in Frankfort.

An alleged water memory, which Jacques Benveniste imagined to have detected, is often cited as evidence. It has been evident since 1995 at the latest that Benvenistes results are not reproducible. Still the claim is maintained that high dilutions contained information, although neither an information carrier nor a code can be conceived. Therefore, it does not come as a surprise that also the most recent "evidence" employing rat intestines, celebrated as a breakthrough, was finally proven wrong and proved to be untenable. An extensive appreciation of this pseudo-research at Leipzig University may be found here: add source[4]. Whatever information the structure of water is supposed to contain according to the concept of its supporters, it additionally needed to be transferred to the sugar pills on which the drop of homeopathic water is applied. Water memory would have to "survive" ingestion and absorption by the gastrointestinal system, as well as transport to the body tissues by blood. Biologists have neither found a "water memory" nor discovered homeopathic signals or receptors, nor anything which plausibly was in a position to serve as a receptor for water structures.

Diluted water, too, is being offered as a homeopathic remedy (1 gram of diluted water costs about 1 pound, see illustration on the right), rendering the concept just as dubious as the assertions of some homeopaths that remedies placed beneath the pillow or carried on the body were also able to take an effect.

Dangers of Homeopathy

As scientific article and media have established repeatedly, homeopathic remedies are not free of risks. Homeopathic cures may, for instance, relay the application of adequate efficient therapies, or may prevent their use completely.

Homeopathy and malaria prophylaxis and anti-tick globules

It has been repeatedly observed in Germany that homeopaths will use a remedy by the name of "Malaria 2000", using it as a prophylactic with patients who intend to enter countries where malaria happens to be endemic. On quite a regular basis, hospitals will treat patients suffering from malaria who report to have done a prophylaxis with this remedy but contracted the disease all the same. There was at least one fatal case in which a patient died after having undergone a prophylaxis with Malaria 2000.

On its website, a public radio station in Bavaria quotes the Munich Institute for Tropical Diseases which established several fatalities of persons having relied on a homeopathic malaria prophylaxis. In publications, the Drug Commissions of Pharmacists and the German Medical Association explicitly cautioned against such homeopathic malaria prophylaxes: Already on March 19, 1998, the Drug Commission of Pharmacists cautioned against a homeopathic malaria prophylaxis. It is explicitly pointed out that malaria is a serious and in some cases life-threatening medical condition which "may not be met by non-specific homeopathic remedies with which patients believe to be able to acquire an increased immunity towards malaria pathogens. There are cases on record in scientific literature in which such a "prophylaxis" failed. We therefore strongly advise against dispensing homeopathic remedies for malaria prophylaxis". The warning issued by the Drug Commission of German Medical Doctors (AMK), published in German Medical News issue no. 95 dated August 19, 1998, is even more explicit and insistent. AMK refers to the homeopathic malaria prophylaxis provided by one particular company, writing: [...] Practising physicians prescribing homeopathic malaria prophylaxes to patients will face consequences under professional codes of practice and will be prosecuted criminally. Malaria is a serious disease which may be life-threatening, [...] Due to acute dangers for patients relying on the homeopathic remedy received, AMK views this as malpractice and, to protect patients, strictly advises against prescribing such remedies.

On the other hand, disease prophylaxis per se is controversial within the homeopathy scene, since no homeopathic remedies can be found in the absence of recognizable symptoms. Such malaria prophylaxes also emerged in England, causing British NHS to suspend payments to homeopathic facilities in 2008.

So-called anti-tick globules to prevent Lyme disease - in a natural way, as an Arnsberg pharmacy advises sub rosa - must be seen in a similarly critical way. The pharmacy claims to have developed a particular mixture in cooperation with a manufacturer of homeopathics; the mixture contains nosodes which are supposed to be a homeopathic equivalent to vaccination. There is an explicit reference to diseases like tick-borne encephalitis and Lyme disease. The globules are said to additionally contain ledum palustre (Marsh Labrador tea) which is supposed to effect changes in body odour and thus protect patients.

The application of homeopathic Spenglersan Kolloid M remedies for malaria prophylaxis documentedly was not in a position to prevent malaria. Swedish doctors published case reports and cautioned.

In 2009, the World Health Organization WHO explicitly warned against homeopathy as a treatment option for malaria, HIV infection, tuberculosis, influenza, and diarrhoea in children.

Homeopathic Antidots

Supporters of homeopathy are afraid of apparently unwelcome effects of their therapies, particularly in terms of a too intense initial worsening following a homeopathic medication. In such cases, so-called homeopathic antidotes may be applied. For this purpose patients are advised it was sufficient to render the remedy ineffective simply by ingesting [...] some strong coffee or taking smells at camphor (tiger balm, Vic-vapo-rup...) [...].

According to so-called women's magazine "FÜR SIE" (i.e. "for her"), mobile phones "impaired" the efficacy of homeopathic remedies. Before ingesting such a remedy, mobile phones therefore should be put aside. Similarly, electromagnetic fields of radio alarm clocks, computers, and microwave ovens may impair the efficacy of remedies.

History of Homeopathy

At the time of its emerge, homeopathy must be conceded quite "scientific" a character, in accordance with definitions valid at that time. After all, Hahnemann proceeded empirically, checking theses in self-experiments. Due to the increase in knowledge occured since, this theory appears interesting merely from a medico-historical point of view. Due to the lack of evidence regarding efficacy, homeopathy cannot be regarded as a serious medical method. At Hahnemann's times, neither clinical thermometers had been invented nor had knowledge of bacteria been acquired, instead there were weird explanations (e.g. miasma theories of pathogenic vapours emanating from the soil), so Hahnemann's model must be seen as quite sensible from a historical point of view. From today's view, after more than two centuries of an enormous gain in knowledge, one can assume that even Hahnemann, given today's knowledge, felt inclined to ridicule his apologists. Thus homeopathy was fiercely criticized already more than 100 years ago (see links). The law of similars does not go back to Hahnemann; analogical concepts already existed prior to Hahnemann (e.g. in England).

It is furthermore remarkable that some of the recommendations given in Hahnemann's Organon are not being propagated broadly any longer, such as applying hot turpentine to scaldings. While Hahnemann's teachings thus are, quite appropriately, partly rejected as outdated and unfounded, particulary with treatments showing immediate effect or failure, other parts of his teachings are still being marketed profitably, in particular those allowing for a placebo effect.

Homeopathic doctors in Europe

Approximately 5,000 doctors are said to have acquired a qualification as a homeopath in Germany. Netzzeitung (an online paper) says that presently about 1 in every 40 doctors hold additional qualifications in "homeopathy" in Germany. According to ECHAMP, about 2.5% of doctors in Germany, 8.3% in Italy, and 14% in Slovakia have a qualification in "homeopathy". On the other hand, this quota is below 0.03% in Sweden, where only ten of almost 30,000 have an additional homeopathic qualification.

Throughout Europe, 56,000 doctors were holding respective qualifications. An acceptance of homeopathy so glaringly different in two industrialized nations like Germany and Sweden with a comparable health status indicates, on the one hand, that homeopathy may be seen as dispensable without difficulty and without causing a relevant effect on a population's health. On the other hand it shows that the popularity of homeopathy is not as much connected to scientific arguments or a probable efficacy, but rather to Weltanschauung, prejudice or tradition, since conclusive scientific arguments and proof of efficacy supporting the implementation of homeopathy would have also convinced Swedish physicians.

The business with homeopathics

Germany and France are the most important markets for both homeopathic and anthroposophic-homeopathic remedies in Europe. Almost 60% of all medicines of these therapy concepts produced in Europe were sold in these two countries add source[27], with a Europe-wide increase of 60% between 1995 and 2005. German sales saw a turnover plus amounting to 80%, while figures in France increased by 300%. Europe-wide sales volumes amount to 1.7 billion Euros, about 7% of all non-prescription drugs. In 2005, produce revenues amounted to approx. 930 million Euros, with 810 million Euros thereof for medicine.

Measured by producer's prices, about 268 million Euros of the EU sales were effected in Germany, and 294 million Euros in France. According to information from weekly periodical "Der Spiegel", sales volumes for homeopathic remedies amounted to 400 million Euros in 2009. According to information from Federal Association of Pharmaceutical Industry, statutory health insurance companies paid 9 million Euros for homeopathic remedies. However, follow-up costs incurring due to ineffective homeopathic therapies are not included in this figure. Costs for homeopathic first and follow-up anamneses are not included, either, since these usually have to be paid by patients.

In Germany, German Homeopathic Union (DHU) are the leading providers. This corporation with more than 400 employees emerged from Schwabe company founded in 1961.

The most commonly used homeopathic in the USA is Oscilococcinum C200. This remedy also goes by the name of "20 million canard". Annual turnover for this product adds up to 20 million dollars. The remedy is produced from duck liver, but the complete sales volume does not need more than one single liver - with considerable left-overs remaining from this one piece: A dilution of C200 means a liver to solution ratio of 1 to 10 and 400 ciphers.

Homeopathy is financially interesting for doctors

It is getting more and more attractive for physicians to bill health funds for homeopathic services, as German medical journal Ärztezeitung already reported in 2007. Commission includes amounts of € 90 for a first anamnesis, € 20 for repertorisations, € 20 for analysis, and € 45 for follow-up anamneses. For the same amount of € 175, medical specialists will treat five "conventional" patients for three months, regardless how often these patients will consult them. Social health insurance patients were able to claim homeopathic services in case of such forms of disease "in which a cure or palliation may be expected from a specific therapeutical response of self-healing powers still potentially available".

Homeopathy and controversial measles parties

As became known in 2005, supporters of homeopathy do not reject so-called measles parties in general. A respective newspaper article said: Homeopathic doctors do not reject "measles parties" in general. Considering possible side effects of vaccination against the risks of a disease, an infection caused deliberately was "worth considering" at an age between about three and eight years, Munich paediatrician Dr. Steffen Rabe commented.

It was a result of vaccinating campaigns that more infants and adults fall ill during outbreaks of measles today, compared with earlier times. However, these persons have a ten times higher risk of developing complications like e.g. meningitis, Rabe explained. "The increase in measles infections in infants is a direct consequence of vaccination policies", Rabe said. According to his view, the final decision regarding a participation of a child in any "measles party" rested with its parents.

In case of an infection with measles, the paediatrician recommends a complete abstinence of antipyretics, since these probably increased the risk of complications. "The patient rather needs rest." In many cases, the illness responded well to a treatment with classic homeopathy.

Studies on homeopathy

The early studies

In Hahnemann's lifetime already, his teachings were controversial and caused lively discussions, and the first tests of homeopathics proceeded negatively. Repetitions of Hahnemann's original "medicine tests" could not confirm his specifications. The famous cinchona experiment the teachings are based on was a misapprehension: Although cinchona reduces the body temperature, Hahnemann felt feverish after ingesting it. Possibly this was due to an allergic reaction. The non-blinded "drug examinations", which do not exclude a possible placebo effect by facilitating a comparison to a fake medication, are not acceptable scientifically, either.

In 1835, the first double-blind drug study took place. The same year, Georg Löhner, a theologian and editor, published test results which he had obtained in cooperation with physicians, pharmacists, and further dignitaries in the town of Nuremberg. They examined 55 volunteers and did not establish any effect of homeopathic dilution. This publication was met with fierce and polemic resistance by homeopathic magazines of that time, e.g. by "Hygea - central organ for the homeopathic or specific art of healing".

Homeopathy studies in the time of National Socialism

Further studies of homeopathy took place in the times of National Socialism. The regime intended a reorientation of public health care, the "new German medicine". Additionally, National Socialist circles voiced increasing criticisms of what they perceived as "Jewish medicine". Drug studies were done at different homeopathic hospitals by the state health office (Reichsgesundheitsamt - RGA) between 1936 and 1939, much of them placebo checked. They aimed at investigating the reliability of previous drug studies, and also the valence of "pharmacologic images" based on them. Members of this study group were homeopath Hanns Rabe (1890-1959), internal specialist Werner Siebert (1897-1951), and professors of pharmacology Gustav Kuschinsky (1904-1992) and Richard Bonsmann. Also significantly involved in these test was doctor and homeopath Fritz Donner (1896-1979), then working in Berlin at the homeopathic ward of Rudolf-Virchow-Hospital. Donner's voluminous records of RGA investigations became known as Donner Report on Homeopathy, and the original copy is available at the "Homeopathic Archives" of the Institute of Medical History of Robert Bosch Foundations in Stuttgart today.

These goverment-sponsored studies, however, had no positive results for homeopathy. As one example, double-blinded experiments were carried out regarding Silicea C30. Their results: Verum and placebo caused exactly the same number of symptoms. The homeopaths participating were not able to distinguish verum from placebo.

More clinical studies were effected in Robert-Koch-Hospital in Berlin in 1938/39, again presenting negative results. Rabe, a homeopath, reacted to them assuming that [...] homeopathy [is] no pharmaco-therapeutic method as has been contended as of yet, but a form of psychotherapy [...]. In a protocol, Fritz Donner wrote: One would have to reply truthfully that nothing came out of the drug studies, and that, during the clinical studies, there was no single case in which a patient showed a respective reaction whatsoever indicating a therapeutic effect of the remedies applied.

Nevertheless, the official announcement disclosed that certain difficulties had manifested so that it was necessary to restart. Further research, however, was prevent by the war. Donner was far more outspoken later on during the 1960ies: He called the study a complete fiasco for homeopathy.

Versions of this article in other languages

• Deutsch: Homöopathie
• Nederlands: Homeopathie