In the final part of our series,
Dr Tanvir Jamil looks at the evidence for homoeopathy
Much scepticism surrounds homoeopathy with its two main tenets of 'like cures like' and 'less is more' (dilution). A prominent German doctor, Samuel Hahemann, discovered the basics during an epidemic of swamp fever in the late 18th century. He found cinchona bark, the standard treatment, gave symptoms of swamp fever if taken in high enough doses. Hahemann experimented further with many other substances to observe their action on healthy individuals
a process called 'proving'. When patients were treated with the resulting 'remedies' it was found some symptoms actually worsened. Dilution of the original dosage often produced cure without side-effects. Modern-day homoeopathy now covers around 2,000 remedies (plant, mineral and occasionally animal) which are described
in the standard text Materia Medica. Many practitioners
also use the Repertory, an encyclopaedia of symptoms
with a list of suitable remedies.
How is it practised?
Dilution (or potency) of remedies is varied according to the malady being treated. A homoeopath may start with a lower potency, say 6c (a dilution of 1x10 to the 6), and work up to 30c (a higher dilution of 1x10 to the 30). Some remedies go up to dilutions of 10M (1x1,000 to the 10).
Pills may be degraded by sunlight, X-rays, strong smells and contact with sweat. They are sucked, not swallowed, and the patient must not take anything by mouth 20 minutes before and after a pill.
How can it work?
Proponents often cite modern-day 'attenuated' vaccines as an example. These are viruses so highly diluted that they do not cause disease but stimulate the body's defences.
Some theories used to explain homoeopathy's effects include:
· Remedies stimulate the body into repairing itself
· The body may be extremely sensitive to the homoeopathic remedy needed to effect cure, illustrated by the high dilutions used
· High dilution or 'high potency' remedies may act on energy flow in the body and not on physical processes
· The theory is that succussion (shaking the remedy during dilution) potentiates its effects by leaving an 'imprint' of the remedy in the solution some say homoeopathic substances are involved not in chemical processes but merely in the transmission of information at a molecular level.
Homoeopathy is one of the few fields of complementary medicine in which some serious research has been carried out.
· Reilly DT et al. Is homoeopathy a placebo response? Controlled trial of homoeopathic potency with pollen in hayfever as a model. Lancet 1986; 2:881-6. A double-blind crossover study on hayfever showing a statistical superiority of homoeopathic treatment to placebo.
· Klijnen J et al. Clinical trials of homoeopathy.
BMJ 1991; 302:316-23. A meta-analysis study of homoeopathic trials indicating that out of 105 trials 81 gave positive results in favour of homoeopathy compared with placebo.
· Reilly DT et al. Is evidence for homoeopathy reproducible? Lancet 1994; 344:1601-6 . Twenty-eight patients with allergic asthma were randomly allocated to receive either a homoeopathic remedy or placebo. A significant difference in therapies appeared within one week of starting therapy and persisted for eight weeks.
· Stevenison C, et al. ' Homoeopathic arnica and prevention of pain and bruising: a randomised placebo-controlled trial in hand surgery'. J. R. Soc Med. 2003; 96:60-65. Sixty-four patients undergoing carpal tunnel surgery were randomised to take three tablets daily of homeopathic arnica 30c or 6c or placebo for seven days before and 14 days after surgery. There were no group differences on the primary outcome measures of pain and bruising at four days after surgery.
What is it good for?
· Pain relief headaches (migraine and tension);
· Psychological problems anxiety; stress; insomnia
· Allergies hayfever; eczema; sinus and catarrhal problems; urticaria
· Skin mouth ulcers; pruritus; psoriasis
· Abdominal problems irritable bowel syndrome; constipation; haemorrhoids
· Urinary problems bedwetting in children; cystitis
· Pregnancy nausea and vomiting; labour pain
· Gynaecological problems PMT; menopausal symptoms; candida; dysmenorrhoea
· Mouth problems halitosis; stomatitis; ulcers; candida
· Children's problems nappy rash; sleep problems; teething; colic
· Injuries and accidents bites/stings; bruises; burns/scalds; sprains/strains; sunburn; travel sickness
· Foot problems chilblains; athlete's foot
· Nausea and vomiting from anaesthesia/motion
· Very few
· No interaction with patient's existing medication
· Most remedies are much cheaper than conventional drugs
· GPs able to
write medication on FP10
· Not usually available on the NHS unless the patient's own GP is a homoeopath
· Orthodox doctors find 'less is
more concept' difficult to accept
Royal London Homoeopathic Hospital
0207 391 8833The British Homoeopathic Association