Homeopathy Celebrates 214th birthday
Homeopathy (from the Greek homeo meaning similar and pathos meaning suffering) is a system of medicine based on treating “like with like”. According to the World Health Organization, it is the second most widely used medical system in the world. Homeopathic remedies are extremely dilute. As a result, homeopathy is one of the most controversial Complementary and Alternative Medicine (CAM) modalities, because it is difficult to understand how such dilute substances might work.
A German physician, Dr. Samuel Hahnemann, developed the principles of homeopathy in the late 1700's, using “provings”. Hahneman's “provings” consisted of giving various substances to both himself and healthy volunteers, and noting the effects in detail. If a full dose caused side effects similar to the symptoms of a disease, he hypothesized that very dilute doses could be used to treat that disease. One of his primary purposes was to find a less toxic form of healing than the blood letting, purging, and use of toxic sulfur and mercury which were typically employed at the time. In the early 1900's the use of homeopathy shrank quickly, however, and by the late 1940's homeopathy was no longer taught in the U.S. Homeopathy remained very popular in Europe, however, with use especially common in Britain, France, the Netherlands, and Germany. Use in the U.S. has also increased recently. Between 1990 and 1997 those reporting use of homeopathy in the U.S. increased from 0.7% to 3.4%.
Theory of Disease and Therapy
The basic underlying principle of homeopathy is the Law of Similars or "like cures like". This principle holds that diseases can be treated by giving extremely dilute substances that at higher concentrations produce effects in healthy persons that are similar to the symptoms of the diseases. For example, if high doses of a substance cause malaria-like symptoms, then extreme dilutions of that substance might be an effective treatment for malaria.
Homeopathic remedies are prepared by standardized serial dilutions of various plants, minerals or animal matter with vigorous shaking in between (succusions). It is believed that these shakings extract the "vital nature" of the substances, imprinting them on the water dilute. Serial dilutions are performed as either 1:10 (noted as "D" dilutions) or 1:100 (noted as "C" dilutions). When dilutions greater than 24D or 12C are prepared, basic chemistry holds that it is unlikely than even a single molecule of the original substance is still present in the remedy, leading many to question how such a therapy could work. Homeopathic theory explains that the vigorous shaking or succusions leave an imprint of the substance being diluted, and that it is this imprint which can stimulate healing in the body, stimulating the body's own healing responses. Another key concept of homeopathy is that treatment should be selected based upon a total picture of the individual, not only physical symptoms but emotions, mental states, and lifestyle as well.
Regulation of Commercial Homeopathic Preparations
Since 1938, the U.S. Congress has directed the FDA to regulate homeopathic remedies under a set of laws that set them apart from conventional drugs and as well as from dietary supplements. Although no testing of safety or efficacy is required, homeopathic remedies must meet standards for strength, quality, purity, and packaging.
In 1988, the FDA also required that homeopathic remedies list the specific diseases they are intended to treat on their label. The guidelines for homeopathic remedies are found in an official guide, the Homeopathic Pharmacopoeia of the United States, which is authored by a nongovernmental, nonprofit organization of industry representatives and homeopathic experts.
Research on Homeopathy
A large number of randomized, placebo-controlled trials have been done on homeopathy with conflicting results. While a surprising number of well designed trials have suggested that homeopathy is better than placebo, many others have shown no effect. The evidence for homeopathy in the treatment of any particular condition has been inconclusive.
Research in the field is further complicated by the fact that for a given disease there is wide variation from practitioner to practitioner and from case to case in terms of what remedies are prescribed. Until homeopathy is better understood, physicians should be open-minded about homeopathy's possible value and should maintain open communication with their patients who use it.