Homeopathy refers to a widely practiced method of medicinal self-healing.
Homeopathic practitioners administer very small doses of therapeutic animal,
plant, or mineral substances to cure a set of physical, mental, and emotional
symptoms, as opposed to the conventional approach of curing a particular illness
The roots of the word, homeopathy, are derived from Greek and roughly
translate to "similar" and "feeling." One of the primary homeopathic principles
is called the Law of Similars or "likes ... cured by likes." The homeopathic
approach uses medicinal substances or remedies that temporarily exacerbate the
symptoms the patient wishes to alleviate. According to the Law of Similars, the
chosen substance produces the same signs and symptoms that the patient exhibits;
these are the symptoms that would develop in a healthy subject receiving this
substance (Jacobs and Moskowitz 1996). A second important homeopathic principle
is that high dilutions of a single substance, called "potencies," produce
therapeutic effects that imitate the body's self-healing mechanisms. These
effects continue even when there are no remaining molecules of the initial
substance. This causes a puzzling effect for most scientists and researchers
(Jacobs and Moskowitz 1996; Kondrot et al. 2000; Schwartz et al. 2000).
Although homeopathy is popular, its practice remains controversial in large
part because the high dilution mechanisms of action are largely unknown
(Schwartz et al. 2000) and many of the studies to confirm efficacy have had
conflicting results and have lacked methodological rigor.
Samuel Hahnemann, MD (1755-1843), a German physician and chemist, discovered
the homeopathic principle as a result of an experiment in which he ingested a
small dose of cinchona (Peruvian bark). He soon began to experience
palpitations, aching bones, numbness, and other symptoms that he recognized as
indicators of intermittent fever. These were the very symptoms that cinchona was
supposed to cure. This was the beginning of a series of experiments dating from
1790 to 1810, in which Hahnemann demonstrated that substances derived from
certain plants, animals, and minerals temporarily could cause a set of symptoms
in healthy people. Conversely, he discovered that in extremely minute doses,
these same substances cure the corresponding symptoms in sick people (Jacobs and
Although Hahnemann successfully treated and prevented a scarlet fever
epidemic, bringing attention and fame to homeopathy, his methods and philosophy
were ridiculed by conventional physicians prior to 1822. By the mid-1820s, he
had published detailed symptomatology of more than 90 medicinal substances in
six editions of his Materia Medica Pura, a document that was to
become a widely respected treatise. Homeopathy flourished in Europe and the
United States in the latter part of the 19th century. In the United States,
homeopathy influenced the establishment of hospitals, medical schools, and
asylums for the mentally ill (Jacobs and Moskowitz 1996).
Technical achievements in conventional medicine (such as surgery and
microbiology), combined with the rising popularity of antibiotics and synthetic
pharmaceuticals, as well as specific actions of the American Medical Association
to discourage the practice of homeopathy in the United States, led to the
decline of homeopathy in the early and mid-20th century (Jacobs and Moskowitz
Homeopathy has recently experienced a resurgence, which may be related to the
crisis in health care and a renewed interest in alternative medicine and
self-care. In the United States, homeopathic remedies listed in the
Homeopathic Pharmacopoeia of the United States are recognized and
regulated by the Food and Drug Administration (FDA) and are widely sold in
pharmacies and health-food stores. Homeopathy is also popular in Europe, Latin
America, and Asia. In Germany, one-quarter of all physicians use homeopathy; in
France, approximately one-third of general practice physicians apply this method
of healing. In India, the modality is practiced by more than 100,000 homeopaths
and is used in the national health service (Jacobs and Moskowitz
Homeopathy is based on eight scientific principles:
- The most important law in homeopathy is the Law of Similars. In order
for a substance to act homeopathically, the individual's symptoms have to be
closely matched to the symptoms that the remedy can temporarily create.
Otherwise, the remedy will not have the desired effect (Jacobs and Moskowitz
- Homeopaths who adhere to the classical Hahnemannian method employ a
single remedy at a time in order to identify the best possible match with the
patient's symptoms. Those who subscribe to this approach take care not to repeat
the dosage too soon, if at all, in order to avoid interfering with the initial
action of the remedy (Jacobs and Moskowitz 1996; Kondrot et al.
- The therapeutic dosage should be the lowest possible dose that creates
the desired symptoms and minimizes side effects. If possible, remedies should
not be repeated (Kondrot et al. 2000). Large dosages or dosages over an extended
period of time should not be necessary and may even be counterproductive (Jacobs
and Moskowitz 1996).
- Provings are experimental methods for studying the medicinal
action of a particular substance (Jacobs and Moskowitz 1996). According to these
methods, each homeopathic remedy represents the totality of observable responses
of all the people to whom the particular substance has been administered. These
provings have been carefully compiled and analyzed. Because the focus is on
studying a single remedy and its effects, classically trained practitioners
consider combination remedies to be untested and, thus, their effectiveness to
be unproven (Kondrot et al. 2000).
- As with acupuncture and herbalism, homeopathy rests on the foundation
that a vital force, or life energy, exists within each organism and is
the source of health (Jacobs and Moskowitz 1996). Illness is a disruption of
this energy (Kondrot et al. 2000). External symptoms associated with a condition
or illness are the body's attempt to heal itself. Homeopathic remedies work to
induce this self-healing process. It should be understood, however, that
homeopathy is primarily a method of diagnosis and treatment rather than a
philosophy. According to its founder it can, and should, be evaluated by how
well it works (Jacobs and Moskowitz 1996; Kondrot et al. 2000).
- The principle of the Totality of Symptoms holds that illness is a
composite of the physical, mental, and emotional responses of each patient
(Jacobs and Moskowitz 1996). Determination of the most appropriate remedy is a
function of assessing a person's principal physical symptoms as well as his or
her mental and emotional symptoms. Treatment is highly individualized because
the practitioner is interested in understanding how each person uniquely
responds to a particular remedy (Kondrot et al. 2000).
- The Laws of Cure are based on the idea that human beings are
integrated energy systems. As such, the practitioner must glean as much
information as possible from the patient, including the timing of the first
appearance of the symptoms, if and when any symptoms occur in clusters, and any
possible association between clusters of symptoms and the patient's state of
health and functionality (Jacobs and Moskowitz 1996). In recovery, symptoms move
throughout the body. There are four directions of movement: from vital organs to
less vital organs, from interior to exterior, from head to foot, and in the
reverse order in which they appeared (Jacobs and Moskowitz 1996; Kondrot et al.
- Homeopathic remedies are prepared according to the Law of Dilution and
Succussion. Remedies are diluted to produce fewer adverse side effects while
still maintaining their medicinal properties. They are then succussed, or
shaken, to stimulate the active ingredients in the solution (Kondrot et al.
2000). Plants, animal products, and other soluble substances are diluted in
alcohol and insoluble remedies are pulverized and diluted with lactose. The
preparations are vigorously shaken to form the "mother tinctures," which are
further diluted to potencies of 1 to 10 (noted as "X") or 1 to 100 (noted as
"C"). Successive rounds of dilution and agitation of the medium are performed to
yield potencies of 2X, 3X, 4X or 2C, 3C, 4C and on, up to 50,000C (noted as 50M)
(Jacobs and Moskowitz 1996).
|Mechanism of Action|
The homeopathic mechanism of action, particularly with regard to the
therapeutic effectiveness of high-dilution remedies, is not clearly understood
(Dietz 1999). Some scientists familiar with developments in quantum physics
believe that the electromagnetic energy in the homeopathic medicines interacts
with the body in some manner. Physical chemistry researchers have hypothesized a
"memory of water" theory, which holds that the process of diluting the remedies
in water or alcohol causes a seemingly permanent change in the structure of the
solution even after the medicine dissolves (Jacobs and Moskowitz 1996). The
systemic memory resonance hypothesis is an attempt to explain how a solution can
continue to have the therapeutic properties of the starting substance when
molecules of the starting substance are no longer present. This theory holds
that complex patterns of energy and information are stored in the body,
specifically in physical, chemical, and biological systems. The thought is that
information never disappears completely, even when a substance is withdrawn
(Schwartz et al. 2000). Yet another hypothesis is that homeopathy works on a
bioenergetic level to restore homeostasis (Kondrot et al. 2000).
The principle of similars is not as controversial as the high-dilution
principle. It is, in fact, well accepted in certain areas of conventional
medicine and scientific investigation (Schwartz et al.
The clinical procedure involves an extensive interview with the patient
(uninterrupted by the practitioner as much as possible except for promptings for
additional information). The purpose of the interview is to gather complete
information about the physical, mental, and emotional condition of the patient.
The initial visit also includes a physical examination and laboratory tests, if
needed. The practitioner then prioritizes the reported symptoms, investigates
further as needed, analyzes all the information, and makes a treatment
recommendation (Jacobs and Moskowitz 1996).
The homeopathic remedy is available to patients in various preparations,
including fluids, sucrose pellets, lactose tablets, mother tinctures, and
ointments (Jacobs and Moskowitz 1996; Kondrot et al. 2000), as well as different
levels of potencies (Jacobs and Moskowitz 1996). The patient's progress is
re-evaluated after four to six weeks (Kondrot et al. 2000); he or she may need
to try several remedies before an appropriate match is obtained (Jacobs and
Scientists are reluctant to conclude that homeopathic remedies are generally
effective. To ascertain effectiveness, it is necessary to examine individual
substances and their outcomes (Cucherat et al. 2000). Various studies and
randomized clinical trials have considered the safety and/or efficacy of
particular homeopathic remedies. Some have confirmed effectiveness; others have
not (Dietz 1999).
A randomized controlled study, for example, found that the homeopathic remedy
was as effective as the conventional approach for the treatment of vertigo. Both
produced a reduction in the average frequency, duration, and intensity of
vertiginous attacks. The homeopathic remedy was slightly superior in decreasing
the frequency of such attacks (Weiser et al. 1998).
Studies published in the British Medical Journal (BMJ) and the
Lancet have reported mixed results with homeopathic preparations of the
herb Arnica montana. In 1991, the BMJ reported on four different
studies in which the methodology proved to be unsound; thus, conclusions about
efficacy could not be determined. However, in a 1997 meta-analysis published in
the Lancet, homeopathic arnica was studied for treatment of pain,
sprains, bruises, hematomas, hemarthrosis, and complications from surgery; six
trials (of which three were good quality) suggested a positive clinical effect,
one trial reported neutral results, and three had negative clinical outcomes
A randomized, controlled trial published in the Lancet showed that use
of dilute preparations of primary allergens brought about short-term relief in
patients with allergy-induced asthma (Reilly et al. 1994). A clinical trial
evaluating a homeopathic remedy for pain associated with rheumatoid arthritis
showed improvement in the homeopathy group (Dietz 1999). Results of clinical
trials also suggest that homeopathic remedies may be effective for fibrositis
(fibromyalgia) (Fisher et al. 1989) and for allergies, especially hay
fever (Reilly et al. 1986). According to results from another study, homeopathic
remedies may be more effective than pharmaceuticals in reducing the number of
days in pain, shortening the duration of treatment, and preventing the
recurrence of otitis media (Freise et al. 1997).
Authors of a meta-analysis of clinical trials found that favorable results
could be obtained when treating the following conditions homeopathically:
dystocia, postoperative pain, knee-joint hematomas, sinusitis, diarrhea in
children, and influenza (Cucherat et al. 2000). Homeopathy may also be useful in
treating headaches (Whitmarsh 1997), irritable bowel syndrome (Ullman
1995), and osteoarthritis (van Haselen and Fisher 2000), but these conditions
require further study to confirm the efficacy of treatments.
Homeopathy may be useful as a therapy for disorders that do not respond well
to conventional treatment. Some of these disorders include chronic fatigue
syndrome, digestive problems, headache, hemorrhoids, insomnia, premenstrual
syndrome, AIDS-related symptoms, other viral illnesses, recurring infections,
multiple sclerosis, surgical wounds, fibroids, gallstones, and traumatic injury
(Jacobs and Moskowitz 1996). Homeopathy may also be useful during pregnancy,
when many pharmaceuticals are contraindicated, and for patients who are
sensitive to, or who refuse to take, conventional medications (Kondrot et al.
|Risks, Side Effects, Adverse
Homeopathy is generally considered safe due to the extreme dilution of the
remedies (Kondrot et al. 2000). Very few adverse events have been reported in
the literature (Jacobs and Moskowitz 1996). Occasionally, homeopathy may lead to
a temporary aggravation of the symptoms the remedy is intended to cure (Kondrot
et al. 2000). There have also been rare reports of nausea and hand tremors from
particular homeopathic remedies, as in the clinical trial for vertigo mentioned
earlier (Weiser et al. 1998). One warning in the literature concerns homeopathic
remedies that contain phosphorus or silica. These are alleged to be dangerous if
used inappropriately. All homeopathic remedies should be discontinued once the
presenting complaint has disappeared in order to minimize any possible risk of
side effects or other problems (Kondrot et al. 2000).
Homeopathic treatments are considered to be safe, gentle, cost-effective, and
easy to administer (Jacobs and Moskowitz 1996; Kondrot et al. 2000). There are
few absolute contraindications about this modality in the scientific literature
(Kondrot et al. 2000). Because conventional medical treatment might be more
relevant in certain circumstances, homeopathy is inappropriate for the treatment
of chronic illness when the symptoms include advanced tissue damage, as in the
case of cirrhosis of the liver or severe cardiovascular disease (Jacobs and
Moskowitz 1996). Homeopathy is also inappropriate for patients who are dependent
on conventional medications such as corticosteroids, anticonvulsants, or
antipsychotic medications (Jacobs and Moskowitz 1996), or patients taking
antibiotics or chemotherapeutic drugs (Kondrot et al. 2000). Homeopathy is not a
substitute for patients who need conventional medical treatments such as
emergency surgery or treatment for fractures (Jacobs and Moskowitz 1996). In
addition, certain substances and treatments can neutralize a homeopathic remedy.
Neutralizers include coffee, certain herbs, recreational drugs, the use of
acupuncture, and vibrations due to dental drilling (Kondrot et al.
Many health problems can be treated with homeopathy when a trained
professional employs the appropriate diagnostic approach and therapeutic
guidance. In addition to conditions mentioned in the Clinical Applications
section, there are remedies for rashes, wounds, and chronic skin problems;
emotional issues and psychological disorders; menstrual and menopausal symptoms;
bites and stings of any type; bacterial, viral, and fungal infections;
childbirth, breast feeding, and postpartum care; bone, tendon, connective
tissue, joint, muscle, and ligament strains and injuries; pain of any kind;
gastrointestinal, nerve, pulmonary, renal, eye, ear, pelvic, bone, and
respiratory disorders. Homeopathy may also provide symptomatic relief and
adjunctive care for incurable conditions, such as cancer, diabetes, AIDS, and
schizophrenia (Kondrot et al. 2000).
The efficacy of homeopathic medicine as a modality remains controversial and
will probably continue to be so until more rigorous methodological studies prove
its mechanism of action and effectiveness (Cucherat et al. 2000). At present,
the primary scientific question concerns the dilution process used for
homeopathic remedies (described above in the section on Scientific Principles).
The dilution process reduces the concentration of the original substance to
below Avogadro's number, the point at which molecules continue to physically
exist (Jacobs and Moskowitz 1996).
Overall, there appears to be a significant amount of anecdotal evidence in
favor of homeopathy (Jacobs and Moskowitz 1996) and, depending on the remedy,
there may currently exist some scientific confirmation as well. More clinical
trials and scientific studies are needed.
Training, Certification, and Licensing
There are numerous schools and training programs for homeopathy. The Council
for Homeopathic Certification is the only organization in the United States that
certifies competency in homeopathy regardless of whether the practitioner has
been medically trained. Its certification designation is CCH (Certified in
Classical Homeopathy). Licensure requirements for homeopathy vary from state to
state. Homeopathy is currently licensed in Arizona, Connecticut, and Nevada. In
most other states, lay homeopaths can practice in an unlicensed capacity. For
doctors, homeopathy is viewed as a diagnosis and treatment modality and as such,
it is included in the license of physician. There is currently a movement to get
all homeopaths certified by the Council for Homeopathic Certification (Kondrot
et al. 2000).
For more information, contact the Council on Homeopathic Certification in San
Francisco, California or visit them on the web at www.homeopathy-council.org;
the National Center of Homeopathy in Alexandria, Virginia at 703-548-7790 or
visit the center on the web at www.homeopathic.org; Homeopathic Educational
Services in Berkeley, California at 510-649-0294 or visit them on the web at
www.homeopathic.com; and the International Foundation for Homeopathy at 2366
Eastlake Ave. E, Suite 325, Seattle, WA 98102.
Cucherat M, Haugh MC, Gooch M, Boissel JP. Evidence of clinical efficacy of
homeopathy: a meta-analysis of clinical trials. Eur J Clin Pharmacol.
Dietz V. Homeopathic and herbal preparations of Arnica montana for
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Guide to Alternative Medicine. Atlanta, Ga: American Health Consultants;
Fisher P, Greenwood A, Huskisson EC, Turner P, Belon P. Effect of homeopathic
treatment on fibrositis (primary fibromyalgia). BMJ.
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of conventional and homeopathic treatment. Biomedical Therapy.
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Reilly D, Taylor M, McSharry C, Aitchison T. Is homoeopathy a placebo
response? Controlled trial of homoeopathic potency, with pollen in hay fever as
model. Lancet. 1986;2(8512):881-886.
Schwartz GER, Russek LGS, Bell IR, Riley D. Plausibility of homeopathy and
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Ullman D. The Consumer's Guide to Homeopathy. New York, NY: GP
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piroxicam gel with a homeopathic gel in osteoarthritis of the
knee. Rheumatology (Oxford). 2000;39(7):714-719.
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