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{{Short description|Pseudoscientific system of alternative medicine}}
[[Image:Rhustox.jpg|thumb|Homeopathic remedy ''Rhus toxicodendron'', derived from [[Toxicodendron radicans|poison ivy]].]]
{{for|the journal|Homeopathy (journal){{!}}''Homeopathy'' (journal)}}
'''Homeopathy''' (also homœopathy or homoeopathy; from the Greek ὅμοιος, hómoios, "similar" + πάθος, páthos, "suffering" or "disease") is a controversial form of complementary and [[alternative medicine]] first used in the late 18th century by German physician [[Samuel Hahnemann]].<ref name="homhist1"/> His early work was advanced by later homeopaths such as [[James Tyler Kent]], but Hahnemann's most famous textbook [[The Organon of the Healing Art]] remains in wide use today. The legal status of homeopathy varies from country to country, but homeopathic remedies are not tested and regulated under the same laws as conventional drugs. Usage is also variable and ranges from only two percent of people in [[UK|Britain]] and the [[United States]] using homeopathy in any one year,<ref name="tindleprev"/><ref>{{cite journal |author=Thomas K, Coleman P |title=Use of complementary or alternative medicine in a general population in Great Britain. Results from the National Omnibus survey |journal=Journal of public health (Oxford, England) |volume=26 |issue=2 |pages=152–7 |year=2004 |pmid=15284318 |url=http://jpubhealth.oxfordjournals.org/cgi/reprint/26/2/152}}</ref> to [[India]], where homeopathy now forms part of [[traditional medicine]] and is used by approximately 15 percent of the population.<ref>{{cite journal |author=Singh P, Yadav RJ, Pandey A |title=Utilization of indigenous systems of medicine & homoeopathy in India |journal=Indian J. Med. Res. |volume=122 |issue=2 |pages=137–42 |year=2005 |pmid=16177471}}</ref>
{{pp-vandalism|small=yes}}
{{good article}}
{{Use Oxford spelling|date=September 2016}}
{{Use mdy dates|date=August 2017}}
{{Infobox alternative medicine
| name = Homeopathy
| synonyms = Homoeopathy
| pronounce = {{IPAc-en|audio=En-uk-homeopathy.ogg|ˌ|h|oʊ|m|i|ˈ|ɒ|p|ə|θ|i}}
| image = Saxonia Museum fuer saechsische Vaterlandskunde III 19.jpg
| image_size = 250
| alt = Samuel Hahnemann
| caption = [[Samuel Hahnemann]], originator of homeopathy
| claims = "Like cures like", dilution increases potency, disease caused by [[#Miasms and disease|miasm]]s
| topics = [[Alternative medicine]]
| orig-date = 1796
| origprop = [[Samuel Hahnemann]]
| laterprop = {{Plain list|
* [[James Tyler Kent]]
* [[Royal S. Copeland]]
* [[George Vithoulkas]]
}}
| seealso = [[Humorism]], [[heroic medicine]]
| MeshID = D006705
}}
{{Alternative medical systems|fringe}}


'''Homeopathy''' or '''homoeopathy''' is a [[pseudoscientific]]<ref>{{multiref
Homeopathic remedies are based on substances that, in undiluted form, cause symptoms similar to the disease they aim to treat.<ref>{{cite news | title= Dynamization and Dilution | publisher= Creighton University Department of Pharmacology | url =http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm | accessdate = 2007-10-09 }}</ref> These substances are then diluted in a process of serial dilution, with shaking at each stage, that homeopaths believe removes side-effects but retains therapeutic powers - even past the point where no [[molecule]]s of the original substance are likely to remain.<ref name="homsim">{{cite news | title= Similia similibus curentur (Like cures like) | publisher= Creighton University Department of Pharmacology | url =http://altmed.creighton.edu/Homeopathy/philosophy/similia.htm | accessdate = 2007-08-20 }}</ref> Hahnemann proposed that this process aroused and enhanced "spirit-like medicinal powers held within a drug".<ref>[http://www.hpathy.com/philosophy/hahnemann-organon261to270.asp ''Organon of Medicine,''] Samuel Hahnemann, combined 5th/6th edition</ref> Sets of remedies used in homeopathy are recorded in homeopathic [[materia medica]], with practitioners selecting treatments according to consultations that try to produce a picture of both the physical and psychological state of the patient.
|1=
Specific effects of homoeopathic remedies seem implausible <ref name="shang"/> and directly opposed to modern [[pharmacology|pharmaceutical]] knowledge.<ref>{{cite journal |author=Ernst E |title=Is homeopathy a clinically valuable approach? |journal=Trends Pharmacol. Sci. |volume=26 |issue=11 |pages=547–8 |year=2005 |pmid=16165225}}; {{cite journal |author=Johnson T, Boon H |title=Where does homeopathy fit in pharmacy practice? |journal=American journal of pharmaceutical education |volume=71 |issue=1 |pages=7 |year=2007 |pmid=17429507 |url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17429507}}</ref> Claims for the efficacy of homeopathy are unsupported by the collected weight of [[scientific method|scientific]] and [[clinical medicine|clinical]] studies.<ref name="brienlewithbryant">{{cite journal |author=Brien S, Lewith G, Bryant T |title=Ultramolecular homeopathy has no observable clinical effects. A randomized, double-blind, placebo-controlled proving trial of Belladonna 30C |journal=British journal of clinical pharmacology |volume=56 |issue=5 |pages=562–568 |year=2003 |pmid=14651731 }}</ref><ref name="asthma">{{cite journal |author=McCarney RW, Linde K, Lasserson TJ |title=Homeopathy for chronic asthma |journal=Cochrane database of systematic reviews (Online) |issue=1 |pages=CD000353 |year=2004 |pmid=14973954 |doi=10.1002/14651858.CD000353.pub2 }}</ref><ref name="dementia">{{cite journal |author=McCarney R, Warner J, Fisher P, Van Haselen R |title=Homeopathy for dementia |journal=Cochrane database of systematic reviews (Online) |issue=1 |pages=CD003803 |year=2003 |pmid=12535487 }}; {{cite web|url=http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=197&sectionId=27 |title=Homeopathy results |accessdate=2007-07-25 |publisher=[[National Health Service]] }}</ref><ref>{{cite web |url=http://www.ama-assn.org/ama/pub/category/13638.html |title=Report 12 of the Council on Scientific Affairs (A–97) |accessdate=2007-07-25 |publisher=[[American Medical Association]] }}; {{cite journal |author=Linde K, Jonas WB, Melchart D, Willich S |title=The methodological quality of randomized controlled trials of homeopathy, herbal medicines and acupuncture |journal=International journal of epidemiology |volume=30 |issue=3 |pages=526–531 |year=2001 |pmid=11416076 }}; {{cite journal |title=Homeopathy for childhood and adolescence ailments: systematic review of randomized clinical trials |author=Altunç U, Pittler MH, Ernst E |journal=Mayo Clin Proc. |date=2007 |volume=82 |issue=1 |pages=69–75 |pmid= 17285788}}</ref> This lack of convincing evidence supporting its efficacy, along with its stance against modern scientific ideas, have caused homeopathy to be regarded as "[[placebo]] therapy at best and [[quackery]] at worst" in the words of a recent medical review.<ref name=Ernst>{{cite journal |author=Ernst E, Pittler MH |title=Efficacy of homeopathic arnica: a systematic review of placebo-controlled clinical trials |journal=Archives of surgery (Chicago, Ill. : 1960) |volume=133 |issue=11 |pages=1187–90 |year=1998 |pmid=9820349}}</ref> Meta-analyses, which compare the results of many studies, face difficulty in controlling for the combination of [[publication bias]] and the fact that studies of homeopathy are generally flawed in design.<ref name="pmid11416076"/><ref name=pmid9310601>{{cite journal |author=Linde K, Clausius N, Ramirez G, ''et al'' |title=Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials |journal=Lancet |volume=350 |issue=9081 |pages=834–43 |year=1997 |pmid=9310601}}</ref> However, a recent [[meta-analysis]] comparing homeopathic clinical trials with those of conventional medicines has shown that any effects are unlikely to be beyond that of placebo.<ref name="shang">{{cite journal |author=Shang A, Huwiler-Müntener K, Nartey L, ''et al'' |title=Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy |journal=Lancet |volume=366 |issue=9487 |pages=726–732 |year=2005 |pmid=16125589 |doi=10.1016/S0140-6736(05)67177-2 }}</ref> Homeopaths are also accused of giving 'false hope' to patients who might otherwise seek effective conventional treatments. Many homeopaths advise against standard medical procedures such as vaccination,<ref>{{cite journal |author=Ernst E |title=Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination |journal=Vaccine |volume=20 Suppl 1 |issue= |pages=S90–3; discussion S89 |year=2001 |pmid=11587822}}</ref><ref name=pmid9243229/><ref name=pmid8554846/> and some homeopaths even advise against the use of [[malaria|anti-malarial]] drugs.<ref name=malaria1 /><ref name="pmid11082104" /><ref name=malaria2 />
|2={{cite book |author=Tuomela, R |title=Rational Changes in Science |chapter=Science, Protoscience, and Pseudoscience |publisher=Springer |year=1987 |isbn=978-94-010-8181-8 |veditors=Pitt JC, Marcello P |series=Boston Studies in the Philosophy of Science |volume=98 |pages=83–101 |doi=10.1007/978-94-009-3779-6_4 |author-link=Raimo Tuomela|issn = 0068-0346}}
<br /><br />
|3={{cite journal |vauthors=Mukerji N, Ernst E |title=Why homoeopathy is pseudoscience |journal=Synthese |date=14 September 2022 |volume=200 |issue=5 |eissn=1573-0964 |doi=10.1007/s11229-022-03882-w |pmid=|s2cid=252297716 |url= |doi-access=free}}
<br /><br />
|4={{cite book |vauthors=Baran GR, Kiana MF, Samuel SP |title=Healthcare and Biomedical Technology in the 21st Century |chapter=Science, Pseudoscience, and Not Science: How do They Differ? |publisher=Springer |year=2014 |pages=19–57 |doi=10.1007/978-1-4614-8541-4_2 |isbn=978-1-4614-8540-7 |quote=within the traditional medical community it is considered to be quackery }}
<br /><br />
|5={{cite book |author=Ladyman J |veditors=Pigliucci M, Boudry M |year=2013 |pages=48–49 |publisher=University of Chicago Press |chapter=Chapter 3: Towards a Demarcation of Science from Pseudoscience |title=Philosophy of Pseudoscience: Reconsidering the Demarcation Problem |quote=Yet homeopathy is a paradigmatic example of pseudoscience. It is neither simply bad science nor science fraud, but rather profoundly departs from scientific method and theories while being described as scientific by some of its adherents (often sincerely). |isbn=978-0-226-05196-3}}}}</ref> system of [[alternative medicine]]. It was conceived in 1796 by the German physician [[Samuel Hahnemann]]. Its practitioners, called '''homeopaths''' or homeopathic physicians,<ref>{{Cite web |title=Homeopathic Physician Licensure |url=https://www.cga.ct.gov/2010/rpt/2010-R-0315.htm |access-date=2023-11-25 |website=OLR Research Report}}</ref> believe that a substance that causes symptoms of a disease in healthy people can cure similar symptoms in sick people; this doctrine is called ''[[similia similibus curentur]]'', or "like cures like".<ref name="Hahnemann" /> Homeopathic preparations are termed ''remedies'' and are made using [[homeopathic dilution]]. In this process, the selected substance is repeatedly diluted until the final product is chemically indistinguishable from the [[diluent]]. Often not even a single molecule of the original substance can be expected to remain in the product.<ref>{{Cite web |title=Homeopathy |url=https://www.rpharms.com/resources/quick-reference-guides/homeopathy |access-date=2019-11-17 |website=[[Royal Pharmaceutical Society]]}}</ref> Between each dilution homeopaths may hit and/or shake the product, claiming this makes the diluent "remember" the original substance after its removal. Practitioners claim that such preparations, upon oral intake, can treat or cure disease.<ref>{{Cite web |date=2017-10-18 |title=Homeopathy |url=https://www.nhs.uk/conditions/homeopathy/ |access-date=2019-11-10 |website=nhs.uk |language=en}}</ref>

All relevant scientific knowledge about physics, chemistry, biochemistry and biology contradicts homeopathy.<ref>{{multiref
|1=
|2={{cite journal |last1=Shang |first1=Aijing |last2=Huwiler-Müntener |first2=Karin |last3=Nartey |first3=Linda |last4=Jüni |first4=Peter |last5=Dörig |first5=Stephan |last6=Sterne |first6=Jonathan AC |last7=Pewsner |first7=Daniel |last8=Egger |first8=Matthias |title=Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy |journal=The Lancet |volume=366 |pages=726–32 |year=2005 |doi=10.1016/S0140-6736(05)67177-2 |pmid=16125589 |issue=9487|s2cid=17939264 }}
<br /><br />
|3={{cite journal|last=Ernst|first=E.|date=December 2012|title=Homeopathy: a critique of current clinical research|url=http://www.csicop.org/si/show/homeopathy_a_critique_of_current_clinical_research|journal=[[Skeptical Inquirer]]|volume=36|issue=6}}
<br /><br />
|4={{cite web|title=Homeopathy|url=http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/pharmacologicalandbiologicaltreatment/homeopathy|access-date=October 12, 2014|publisher=American Cancer Society|archive-date=March 16, 2013|archive-url=https://web.archive.org/web/20130316003948/http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/pharmacologicalandbiologicaltreatment/homeopathy}}
<br /><br />
|5=UK Parliamentary Committee Science and Technology Committee. [http://www.parliament.uk/business/committees/committees-a-z/commons-select/science-and-technology-committee/inquiries/homeopathy-/ "Evidence Check 2: Homeopathy"]
<br /><br />
|6={{cite journal|last1=Grimes|first1=D.R.|year=2012|title=Proposed mechanisms for homeopathy are physically impossible|journal=Focus on Alternative and Complementary Therapies|volume=17|issue=3|pages=149–55|doi=10.1111/j.2042-7166.2012.01162.x}}
<br /><br />
|7={{cite web|date=September 2017|title=Homeopathic products and practices: assessing the evidence and ensuring consistency in regulating medical claims in the EU|url=http://www.easac.eu/fileadmin/PDF_s/reports_statements/EASAC_Homepathy_statement_web_final.pdf|access-date=1 October 2017|work=European Academies' Science Advisory Council|page=1|quote=... we agree with previous extensive evaluations concluding that there are no known diseases for which there is robust, reproducible evidence that homeopathy is effective beyond the placebo effect.}}
<br /><br />
|8={{cite book
|author=Oliver Wendell Holmes Sr.
|title=Homoeopathy and its kindred delusions: Two lectures delivered before the Boston Society for the Diffusion of Useful Knowledge
|url=https://archive.org/details/64340260R.nlm.nih.gov
|location=Boston
|year=1842
|author-link=Oliver Wendell Holmes Sr
}} as reprinted in
{{cite book
|author=Oliver Wendell Holmes Sr.
|title=Currents and counter-currents in medical science
|year=1861
|publisher=Ticknor and Fields
|pages=72–188
|url=https://catalog.hathitrust.org/Record/011611362
|oclc=1544161
|ol=14731800M
|author-link=Oliver Wendell Holmes Sr
}}
}}</ref> Homeopathic remedies are typically [[Biochemistry|biochemically]] inert, and have no effect on any known disease.<ref name="shang" /><ref name="pmid124926032">{{cite journal|last1=Ernst|first1=E.|author-link=Edzard Ernst|year=2002|title=A systematic review of systematic reviews of homeopathy|journal=British Journal of Clinical Pharmacology|volume=54|issue=6|pages=577–82|doi=10.1046/j.1365-2125.2002.01699.x|pmc=1874503|pmid=12492603}}</ref><ref name="inquiry_4504">{{cite web|date=February 22, 2010|title=Evidence Check 2: Homeopathy – Science and Technology Committee|url=https://publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/4504.htm|access-date=April 5, 2014|publisher=[[House of Commons of the United Kingdom|British House of Commons]] Science and Technology Committee}}</ref> Its theory of disease, centered around principles Hahnemann termed [[#Miasms and disease|miasms]], is inconsistent with subsequent identification of viruses and bacteria as [[germ theory of disease|causes of disease]]. Clinical trials have been conducted and generally demonstrated no objective effect from homeopathic preparations.<ref name="Caulfield20053">{{cite journal|last1=Caulfield|first1=Timothy|author-link=Timothy Caulfield|last2=Debow|first2=Suzanne|year=2005|title=A systematic review of how homeopathy is represented in conventional and CAM peer reviewed journals|journal=BMC Complementary and Alternative Medicine|volume=5|page=12|doi=10.1186/1472-6882-5-12|pmc=1177924|pmid=15955254 |doi-access=free }}</ref><ref name="sbm-fun">{{Cite news|last=Gorski|first=David|authorlink= David Gorski|date=October 13, 2008|title=Fun with homeopaths and meta-analyses of homeopathy trials|language=en-US|website=Science-Based Medicine|url=https://sciencebasedmedicine.org/fun-with-homeopaths-and-meta-analyses-of-homeopathy-trials/|access-date=2019-11-09}}</ref><ref name="Shelton" />{{rp|206|date=November 2012}}<ref name="Ernst20102">{{cite journal|last1=Ernst|first1=E.|author-link1=Edzard Ernst|year=2010|title=Homeopathy: What does the "best" evidence tell us?|url=https://www.mja.com.au/journal/2010/192/8/homeopathy-what-does-best-evidence-tell-us|journal=Medical Journal of Australia|volume=192|issue=8|pages=458–60|doi=10.5694/j.1326-5377.2010.tb03585.x|pmid=20402610|s2cid=42180344}}</ref> The fundamental [[Evidence and efficacy of homeopathy|implausibility of homeopathy as well as a lack of demonstrable effectiveness]] has led to it being characterized within the scientific and medical communities as [[quackery]] and [[fraud]].<ref name="Baran2014">{{cite book |vauthors=Baran GR, Kiana MF, Samuel SP |title=Healthcare and Biomedical Technology in the 21st Century |chapter=Science, Pseudoscience, and Not Science: How do They Differ? |publisher=Springer |year=2014 |pages=19–57 |doi=10.1007/978-1-4614-8541-4_2 |isbn=978-1-4614-8540-7 |quote=within the traditional medical community it is considered to be quackery }}</ref><ref name="Walport-Nonsense">{{cite news|last1=Collins|first1=Nick|date=April 18, 2013|title=Homeopathy is nonsense, says new chief scientist|work=[[The Daily Telegraph]]|url=https://www.telegraph.co.uk/health/healthnews/10003680/Homeopathy-is-nonsense-says-new-chief-scientist.html|access-date=September 9, 2013|archive-url=https://web.archive.org/web/20130420234704/http://www.telegraph.co.uk/health/healthnews/10003680/Homeopathy-is-nonsense-says-new-chief-scientist.html|archive-date=April 20, 2013}}</ref><ref name="oxcompus">{{cite book|author=Paul S. Boyer|url=https://archive.org/details/oxfordcompaniont00paul_0|title=The Oxford companion to United States history|year=2001|isbn=978-0-19-508209-8|page=[https://archive.org/details/oxfordcompaniont00paul_0/page/630 630]|publisher=Oxford University Press |quote=After 1847, when regular doctors organized the American Medical Association (AMA), that body led the war on "quackery", especially targeting dissenting medical groups such as homeopaths, who prescribed infinitesimally small doses of medicine. Ironically, even as the AMA attacked all homeopathy as quackery, educated homeopathic physicians were expelling untrained quacks from their ranks.|access-date=January 15, 2013|url-access=registration}}</ref>

Homeopathy achieved its greatest popularity in the 19th century. It was introduced to the United States in 1825, and the first American homeopathic school opened in 1835. Throughout the 19th century, dozens of homeopathic institutions appeared in Europe and the United States. During this period, homeopathy was able to appear relatively successful, as other forms of treatment could be harmful and ineffective. By the end of the century the practice began to wane, with the last exclusively homeopathic medical school in the United States closing in 1920. During the 1970s, homeopathy made a significant comeback, with sales of some homeopathic products increasing tenfold. The trend corresponded with the rise of the [[New Age movement]], and may be in part due to [[chemophobia]], an irrational aversion to synthetic chemicals, and the longer consultation times homeopathic practitioners provided.

In the 21st century, a series of [[Meta-analysis|meta-analyses]] have shown that the therapeutic claims of homeopathy lack scientific justification. As a result, national and international bodies have recommended the withdrawal of government funding for homeopathy in healthcare. National bodies from Australia, the United Kingdom, Switzerland and France, as well as the [[European Academies' Science Advisory Council]] and the [[Russian Academy of Sciences]] have all concluded that homeopathy is ineffective, and recommended against the practice receiving any further funding.<ref name="Conversation-NHMRC">{{cite news |url=http://theconversation.com/no-evidence-homeopathy-is-effective-nhmrc-review-25368 |title=No evidence homeopathy is effective: NHMRC review |work=The Conversation |date=April 8, 2014 |last=Musgrave|first=I |access-date=January 10, 2015 }}</ref><ref>{{Cite web|title=Swiss make New Year's regulations |date=January 2012 |url=http://www.swissinfo.ch/eng/swiss-make-new-year-s-regulations/31867422 |publisher=Swiss Info |access-date=December 16, 2015}}</ref><ref>{{cite news|title=Homeopathic remedies are 'nonsense and risk significant harm' say 29 European scientific bodies|url=https://www.independent.co.uk/news/uk/home-news/homeopathy-nonsense-risk-harm-29-european-academies-science-advisory-council-remedies-a7963786.html|access-date=October 10, 2017|newspaper=The Independent|date=September 23, 2017}}</ref><ref>{{Cite web|date=2017-02-07|title=Memorandum #2. Homeopathy as pseudoscience|url=http://klnran.ru/en/2017/02/memorandum02-homeopathy/|access-date=June 25, 2019|website=[[Commission on Pseudoscience]]}}</ref> The [[NHS England|National Health Service in England]] no longer provides funding for homeopathic remedies and asked the [[Department of Health and Social Care|Department of Health]] to add homeopathic remedies to the list of forbidden prescription items.<ref>{{cite news|date=July 21, 2017|title=NHS to ban homeopathy and herbal medicine, as 'misuse of resources'|newspaper=Daily Telegraph|url=https://www.telegraph.co.uk/news/2017/07/21/nhs-ban-homeopathy-herbal-medicine-misuse-resources/ |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/news/2017/07/21/nhs-ban-homeopathy-herbal-medicine-misuse-resources/ |archive-date=January 11, 2022 |url-access=subscription |url-status=live|access-date=July 21, 2017}}{{cbignore}}</ref><ref name="TNHS">{{cite news|last1=Donnelly|first1=Laura|date=5 June 2018|title=High Court backs NHS decision to stop funding homeopathy|newspaper=Daily Telegraph|url=https://www.telegraph.co.uk/science/2018/06/05/high-court-backs-nhs-decision-stop-funding-homeopathy/ |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/science/2018/06/05/high-court-backs-nhs-decision-stop-funding-homeopathy/ |archive-date=January 11, 2022 |url-access=subscription |url-status=live|access-date=26 August 2018}}{{cbignore}}</ref><ref name="bbc-blacklist">{{Cite news |url=https://www.bbc.co.uk/news/health-34744858 |title=Homeopathy 'could be blacklisted' |last=Gallagher |first=James |date=2015-11-13 |work=BBC News |access-date=2017-12-05 |language=en-GB}}</ref> France removed funding in 2021,<ref name="GuardianFrance">{{Cite news |url=https://www.theguardian.com/world/2019/jul/10/france-to-stop-reimbursing-patients-for-homeopathic-treatment |title=France to stop reimbursing patients for homeopathy |agency=Agence France-Presse |date=2019-07-10 |work=The Guardian |access-date=2019-07-30 |language=en-GB |issn=0261-3077}}</ref><ref name="FranceEndFunding2021">{{cite web |url=https://www.francetvinfo.fr/sante/medicament/homeopathie/homeopathie-2021-signe-la-fin-du-remboursement_4240961.html |title=Homéopathie: 2021 signe la fin du remboursement |publisher=France Info | date=January 2021 | access-date=18 November 2023 }}</ref> while Spain has also announced moves to ban homeopathy and other pseudotherapies from health centers.<ref name="El Pais 2019-07-30">{{Cite news |url=https://elpais.com/elpais/2018/11/14/inenglish/1542203925_514487.html |title=Spain moves to ban pseudo-therapies from universities and health centers |last=Güell |first=Oriol |date=2018-11-14 |work=El País |access-date=2019-07-30 |language=en |issn=1134-6582}}</ref>


==History==
==History==
Homeopathy was created in 1796 by [[Samuel Hahnemann]].<ref>{{Cite journal|last=Loudon|first=Irvine|date=December 2006|title=A brief history of homeopathy|journal=Journal of the Royal Society of Medicine|volume=99|issue=12|pages=607–610|doi=10.1177/014107680609901206|issn=0141-0768|pmc=1676328|pmid=17139061}}</ref> Hahnemann rejected the mainstream medicine of the late 18th century as irrational and inadvisable, because it was largely ineffective and often harmful.<ref name="Lasagna">
[[Image:Beydeman Gomeopatiya vzir.jpg|thumb|left|1857 painting by Alexander Beydeman showing historical figures and personifications of homeopathy observing the perceived brutality of medicine of the 19th century]]
{{cite book
|author =Lasagna L
|title =The doctors' dilemmas
|location =New York
|publisher =Collier Books
|year =1970
|orig-date =1962
|page =33
|isbn =978-0-8369-1669-0
}}</ref><ref name="isbn0-393-06661-4">{{cite book |author1=Edzard Ernst |author-link1=Edzard Ernst|author2=Singh, Simon |author-link2=Simon Singh|title=Trick or Treatment: The Undeniable Facts about Alternative Medicine |publisher=W. W. Norton |location=New York |year=2008 |isbn=978-0-393-06661-6 |title-link=Trick or Treatment: The Undeniable Facts about Alternative Medicine }}</ref> He advocated the use of single drugs at lower doses and promoted an immaterial, [[vitalism|vitalistic]] view of how living organisms function.<ref name="Pray2003">{{cite book|author=W. Steven Pray|title=a History of Nonprescription Product Regulation|url=https://books.google.com/books?id=uadgq04eLr0C&pg=PA192|access-date=January 21, 2013|date=August 1, 2003|publisher=Psychology Press|isbn=978-0-7890-1538-9|page=192}}</ref> The term ''homeopathy'' was coined by Hahnemann and first appeared in print in 1807.<ref>
{{cite journal|author=Dean ME|year=2001|title=Homeopathy and "the progress of science"|url=http://www.shpltd.co.uk/dean-homeopathy.pdf|journal=Hist Sci|volume=39|issue=125 Pt 3|pages=255–83|bibcode=2001HisSc..39..255E|doi=10.1177/007327530103900301|pmid=11712570|archive-url=https://web.archive.org/web/20060101084902/http://www.shpltd.co.uk/dean-homeopathy.pdf|archive-date=January 1, 2006|access-date=March 31, 2009|s2cid=23943688}}
</ref> He also coined the expression "[[allopathic medicine]]", which was used to pejoratively refer to traditional Western medicine.<ref name="Whorton2004">{{cite book|author=Whorton JC|url=https://books.google.com/books?id=RU0DndWVSPoC&pg=PA18|title=Nature Cures: The History of Alternative Medicine in America|publisher=[[Oxford University Press US]]|year=2004|isbn=978-0-19-517162-4|location=New York|pages=18, 52}}</ref>


===Precursors===
===Concept===
[[File:Samuel Hahnemann Monument, Scott Circle.jpg|thumb|[[Samuel Hahnemann Monument]], Washington, D.C., with the inscription ''Similia Similibus Curentur'' – "Like cures Like"]]
The "system of similars" emphasized in homeopathy was first described by doctors of the ''[[vitalist]]'' school of medicine, including the controversial [[Renaissance]] physician [[Paracelsus]].<ref>{{cite web |url=http://www.nlm.nih.gov/exhibition/paracelsus/paracelsus_3.html |title=The Chemical Philosophy |accessdate=2007-10-01 |date=1998-04-27 |work=U.S. National Library of Medicine |publisher=[[National Institutes of Health]] }}</ref> Prior to the conception of homeopathy, Austrian physician [[Anton von Störck|Anton Freiherr von Störck]]<ref>{{cite web |url=http://ccrhindia.org/abouthomoeopathy.htm |title=About Homoeopathy |accessdate=2007-09-30 |publisher=ccrhindia.org }}</ref> and Scottish physician [[John Brown (doctor)|John Brown]] also held medical beliefs resembling those of [[Samuel Hahnemann]], who is credited with the development of modern homeopathy in the late 18th and early 19th centuries.<ref>{{cite journal |title=Letters, A critical overview of homeopathy.|journal=Annals |first=Giovanni |last=Federspil |coauthors=Fabio Presotto, Roberto Vettor |url=http://www.annals.org/cgi/reprint/139/8/W-75.pdf| format=PDF |accessdate=2007-10-01 }}</ref>
Hahnemann conceived of homeopathy while translating a medical treatise by the Scottish physician and chemist [[William Cullen]] into German. Being sceptical of Cullen's theory that [[cinchona]] cured [[malaria]] because it was bitter, Hahnemann ingested some bark specifically to investigate what would happen. He experienced fever, shivering and [[arthralgia|joint pain]]: symptoms similar to those of malaria itself. From this, Hahnemann came to believe that all effective drugs produce symptoms in healthy individuals similar to those of the diseases that they treat.<ref name="UllmanReichenberg-Ullman1994">{{cite book|author1=Robert W. Ullman|author2=Judyth Reichenberg-Ullman|title=The patient's guide to homeopathic medicine |url=https://archive.org/details/patientsguidetoh00robe |url-access=registration|access-date=January 24, 2013|date=October 1, 1994|publisher=Picnic Point Press|isbn=978-0-9640654-2-0|pages=[https://archive.org/details/patientsguidetoh00robe/page/1 1]–2}}</ref> This led to the name ''"homeopathy"'', which comes from the {{lang-grc-gre|ὅμοιος}} ''hómoios'', "-like" and {{lang|el|πάθος}} ''páthos'', "suffering".<ref>{{Cite journal|last1=Merrell|first1=Woodson C.|last2=Shalts|first2=Edward|date=2002|title=Homeopathy|journal=The Medical Clinics of North America|volume=86|issue=1|pages=47–62|doi=10.1016/s0025-7125(03)00071-3|issn=0025-7125|pmid=11795090}}</ref>


The doctrine that those drugs are effective which produce symptoms similar to the symptoms caused by the diseases they treat, called "the law of similars", was expressed by Hahnemann with the Latin phrase ''[[similia similibus curentur]]'', or "like cures like".<ref name="Hahnemann" /> Hahnemann's law of similars is unproven and does not derive from the [[scientific method]].<ref name="Kirk">{{cite journal|date=December 1894|editor2=John Hugh McQuillen|editor3=George Jacob Ziegler|editor4=James William White|editor5=Edward Cameron Kirk|editor6=Lovick Pierce Anthony|title=A wail from the waste-basket|url=http://quod.lib.umich.edu/d/dencos/acf8385.0036.001/1050:349?didno=ACF8385.0036.001;rgn=full+text;view=image|journal=[[The Dental Cosmos]]|type=editorial|volume=36|issue=12|pages=1030–32|editor=J. D. White}}</ref> An account of the effects of eating cinchona bark noted by [[Oliver Wendell Holmes Sr.|Oliver Wendell Holmes]], published in 1861, failed to reproduce the symptoms Hahnemann reported.<ref name="Holmes" />{{rp|128}} Subsequent scientific work showed that cinchona cures malaria because it contains [[quinine]], which kills the ''[[Plasmodium falciparum]]'' parasite that causes the disease; the mechanism of action is unrelated to Hahnemann's ideas.<ref name="Atwood-BTTF1">{{cite web |url=http://www.sciencebasedmedicine.org/homeopathy-and-evidence-based-medicine-back-to-the-future-part-i/ |title=Homeopathy and evidence-based medicine: back to the future |publisher=[[Science Based Medicine]] |date=January 4, 2008 |access-date=September 9, 2013 |last=Atwood |first=Kimball}}</ref>
At the time of the inception of homeopathy, mainstream medicine employed such measures as [[bloodletting]] and purging, the use of [[laxative]]s and [[enema]]s, and the administration of complex mixtures, such as [[theriac]], which was made from 64 substances including opium, myrrh, and viper's flesh.<ref>* {{Harvard reference
| Author=Hodgson, Barbara
| Last=Hodgson
| First=Barbara
| Title=In the Arms of Morpheus: The Tragic History of Morphine, Laudanum and Patent Medicines
| Publisher=Firefly Books
| Year=2001
| ID=ISBN 1552975401
}} page 18</ref><ref>Griffin, J. P., [http://www.blackwell-synergy.com/doi/pdf/10.1111/j.1365-2125.2004.02147.x?cookieSet=1 ''Venetian treacle and the foundation of medicines regulation''] (PDF), ''British Journal of Clinical Pharmacology'' 58:3, Page 317. {{doi|10.1111/j.1365-2125.2004.02147.x}}</ref> Such measures often worsened symptoms and sometimes proved fatal.<ref name="kaufmanm"/> While the virtues of these treatments had been extolled for centuries,<ref> {{cite web|url=http://www.queens.cam.ac.uk/Queens/Record/1998/History/Shakespeare2.html |title=Shakespeare and Queens' (Part II) |accessdate=2007-10-14 |last=Wright |first=Iaian |publisher=Queens' College Cambridge }}</ref> Hahnemann rejected such methods as irrational and unadvisable.<ref name=Lasagna>{{cite book | last = Lasagna | first = Louis | authorlink = | coauthors = | title = The doctors' dilemmas | publisher = Collier Books | date = | location = | pages = 33 | url = http://books.google.com/books?id=CiLMdjrSFeEC&pg=PA33&lpg=PA33&dq=hahnemann+purge&source=web&ots=jFxu5xUDAo&sig=1PEUjXN-yruevcw--aZOvqpSJ_E#PPA35 | doi = | id = | isbn = }}</ref> Instead, he favored the use of single drugs at lower doses and promoted an immaterial, [[vitalism|vitalistic]] view of how living organisms function, believing that diseases have [[Spirituality|spiritual]], as well as physical causes.<ref name=PANicholls>{{cite book |last=Nicholls |first=Philip A.|title=Homeopathy and the Medical Profession |publisher=Croom Helm Ltd |date=March 1988 |isbn=978-0709918363 }}</ref><ref name=OrganonH>{{cite book |last=Hahnemann |first=Dr Samuel |authorlink=Samuel Hahnemann |title=Organon of medicine |publisher = <!--Supply one on all references please!! --> |date=1818 |location=Leipzig |url=http://homeoint.org/books/hahorgan/orgapref.htm}}</ref><ref>{{cite web|url=http://www.minutus.org/library/article_read.asp?id=13 |title= Appeal to Thinking Philanthropist Respecting the Mode of Propagation of the Asiatic Choler |accessdate=2007-08-13 |last=Hahnemann |first=Samuel |date=1831 }}</ref> (At the time, [[vitalism]] was part of mainstream science; in the twentieth century, however, medicine discarded vitalism, with the development of [[microbiology]], the [[germ theory of disease]],<ref>{{cite journal |author=Baxter AG |title=Louis Pasteur's beer of revenge |journal=Nat. Rev. Immunol. |volume=1 |issue=3 |pages=229–32 |year=2001 |pmid=11905832}}</ref> and advances in [[chemistry]].<ref>{{cite journal |author=Coley NG |title=Medical chemists and the origins of clinical chemistry in Britain (circa [[1750]]–[[1850]]) |journal=Clin. Chem. |volume=50 |issue=5 |pages=961–72 |year=2004 |pmid=15105362 |url=http://www.clinchem.org/cgi/content/full/50/5/961}}</ref><ref>{{cite journal |author=Ramberg PJ |title=The death of vitalism and the birth of organic chemistry: Wohler's urea synthesis and the disciplinary identity of organic chemistry |journal=Ambix |volume=47 |issue=3 |pages=170–95 |year=2000 |pmid=11640223}}</ref>) Hahnemann also advocated various lifestyle improvements to his patients, including exercise, diet, and cleanliness.<ref name="Lasagna"/><ref>http://homeoint.org/books4/bradford/chapter35.htm Thomas L Bradford, ''The Life and Letters of Hahnemann,'' Ch.35</ref>


====Provings====
===Hahnemann's conception of homeopathy===
Hahnemann began to test what effects various substances may produce in humans, a procedure later called "homeopathic proving". These tests required subjects to test the effects of ingesting substances by recording all their symptoms as well as the ancillary conditions under which they appeared.<ref name="Haehl1922">{{cite book|author=Richard Haehl|title=Samuel Hahnemann: His Life and Work: Based on Recently Discovered State Papers, Documents, Letters, Etc|url=https://books.google.com/books?id=Q80gR6OxDVsC&pg=PA101|access-date=January 24, 2013|year=1922|publisher=B. Jain Publishers|isbn=978-81-7021-693-3|page=101}}</ref> He published a collection of provings in 1805, and a second collection of 65 preparations appeared in his book, ''Materia Medica Pura'' (1810).<ref name="Kirschmann2004">{{cite book|author=Anne Taylor Kirschmann|title=A vital force: women in American homeopathy |url=https://archive.org/details/vitalforcewomeni0000kirs|url-access=registration|access-date=January 28, 2013|year=2004|publisher=Rutgers University Press|isbn=978-0-8135-3320-9|page=[https://archive.org/details/vitalforcewomeni0000kirs/page/11 11]}}</ref>
[[Image:Samuel Hahnemann.png|thumb|[[Samuel Hahnemann]], considered to be the father of homeopathy]]


As Hahnemann believed that large doses of drugs that caused similar symptoms would only aggravate illness, he advocated for extreme dilutions. A technique was devised for making dilutions that Hahnemann claimed would preserve the substance's therapeutic properties while removing its harmful effects.<ref name="Dynamization and Dilution">{{cite web |title=Dynamization and dilution |work=Complementary and Alternative Medicine |publisher=[[Creighton University]] Department of Pharmacology |url=http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm |archive-url=https://web.archive.org/web/20020826082134/http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm |archive-date=August 26, 2002 |access-date=March 24, 2009}}</ref> Hahnemann believed that this process enhanced "the spirit-like medicinal powers of the crude substances".<ref name="Organon_5th_269">{{cite book |author=Hahnemann S |title=The organon of the healing art |year=1833 |publisher=Keats Pub. |edition=5th |at=aphorism 269 |isbn=978-0-87983-228-5}}.
Samuel Hahnemann conceived of homeopathy while translating a medical treatise by Scottish physician and chemist [[William Cullen]] into German.<ref name="homhist1"/> He was skeptical of Cullen’s explanation of [[cinchona]] bark’s mechanism of action in treating [[malaria]], so he decided to test its effects by taking it himself. Upon ingesting the bark, he experienced [[fever]], [[shivering]] and [[arthralgia|joint pain]], symptoms similar to those of [[malaria]], which the bark was ordinarily used to treat. From this, Hahnemann came to believe that all effective drugs produce symptoms in healthy individuals similar to those of the diseases that they are intended to treat. This later became known as the "law of similars", the most important concept of homeopathy.<ref name=homhist1>{{cite news |title=History of Homeopathy |publisher=Creighton University Department of Pharmacology |url=http://altmed.creighton.edu/Homeopathy/history.htm |accessdate=2007-07-23 }}</ref> The term "homeopathy" was coined by Hahnemann and first appeared in print in 1807, although he began outlining his theories of "medical similars" in a series of articles and monographs in 1796.<ref>{{cite journal |title=Homeopathy and "the progress of science" |journal=History of science; an annual review of literature, research and teaching |date=2001 |first=Michael |last=Emmans Dean |volume=39 |issue=125 Pt 3 |pages=255–83 |id=PMID 11712570 |url=http://www.shpltd.co.uk/dean-homeopathy.pdf |format=PDF |accessdate=2007-10-02 }}</ref>
{{cite book |author=Hahnemann S |title=The organon of the healing art |publication-date=1921 |year=1842 |publisher=Keats Pub. |edition=6th |at=aphorism 270 |isbn=978-0-87983-228-5}}</ref> He gathered and published an overview of his new medical system in his book, ''[[The Organon of the Healing Art]]'' (1810), with a sixth edition published in 1921 that homeopaths still use today.<ref name="homhist1">
{{cite web |title=History of Homeopathy |publisher=Creighton University Department of Pharmacology |url=http://altmed.creighton.edu/Homeopathy/history.htm |access-date=July 23, 2007 |date=July 2007 |archive-url=https://web.archive.org/web/20070705095116/http://altmed.creighton.edu/Homeopathy/history.htm |archive-date=July 5, 2007}}</ref>


====Miasms and disease====
Hahnemann began to test the symptoms which substances can produce, a procedure which would later become known as "proving".<ref name=homproving>{{cite web |url=http://altmed.creighton.edu/Homeopathy/philosophy/provings.htm |title=Homeopathic Provings |accessdate=2007-10-02 |publisher=Creighton University School of Medicine }}</ref> The time-consuming tests required subjects to clearly record all of their symptoms as well as the ancillary conditions under which they appeared. Hahnemann used this data to find suitable substances for the treatment of particular diseases.<ref name="homproving"/> The first collection of provings was published in 1805 and a second collection of 65 remedies appeared in the ''Materia Medica Pura'' in [[1810]].<ref>{{cite book |last=Kirschmann |first=Anne Taylor |title=A Vital Force: Women in American Homeopathy |publisher=Rutgers University Press |date=December 2003 |isbn=978-0813533209 }}</ref> Hahnemann believed that large doses of things that caused similar symptoms would only aggravate illness, and so he advocated extreme dilutions of the substances. He devised a technique for making dilutions that he believed would preserve a substance's therapeutic properties while removing its harmful effects.<ref name=homeodilut>{{cite web |url=http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm |title=Homeopathic Dynamization and Dilution |accessdate=2007-10-02 |publisher=Creighton University School of Medicine }}</ref> He gathered and published a complete overview of his new medical system in his 1810 book, ''[[The Organon of the Healing Art]]'', whose 6th edition, published in [[1921]], is still used by homeopaths today.<ref name="homhist1"/>
In the ''Organon'', Hahnemann introduced the concept of "miasms" as the "infectious principles" underlying chronic disease<ref name="ClarkeClarke2001">{{cite book |author=John Henry Clarke |title=Homeopathy explained |url=https://books.google.com/books?id=ZUGIWuo4qc8C&pg=PA22 |access-date=January 12, 2013 |date=January 1, 2001 |publisher=Nanopathy |pages=22–|id=GGKEY:JWCD56EF80T }}</ref> and as "peculiar morbid derangement[s] of vital force".<ref name="Grimes2012">{{cite journal
|author=Grimes, D. R.
|title=Proposed mechanisms for homeopathy are physically impossible
|journal=[[Focus on Alternative and Complementary Therapies]]
|date=2012
|volume=17
|issue=3
|page=154|doi=10.1111/j.2042-7166.2012.01162.x
}}</ref> Hahnemann associated each miasm with specific diseases, and thought that initial exposure to miasms causes local symptoms, such as skin or venereal diseases. His assertion was that if these symptoms were suppressed by medication, the cause went deeper and began to manifest itself as diseases of the internal organs.<ref name="miasms" /> Homeopathy maintains that treating diseases by directly [[Symptomatic treatment|alleviating their symptoms]], as is sometimes done in conventional medicine, is ineffective because all "disease can generally be traced to some latent, deep-seated, underlying chronic, or inherited tendency".<ref>
{{cite journal
|url =http://homeoint.org/cazalet/ward/historycase.htm
|author =Ward JW
|title=Taking the history of the case
|journal=Pacific Coast Journal of Homeopathy
|date=July 1937
|access-date =October 22, 2007
}}</ref> The underlying imputed miasm still remains, and deep-seated ailments can be corrected only by removing the deeper disturbance of the vital force.<ref name="homphilo">
{{cite web
|title=Cause of disease in homeopathy
|publisher=Creighton University Department of Pharmacology
|url=http://altmed.creighton.edu/Homeopathy/philosophy/cause.htm
|access-date=July 23, 2007
|archive-url=https://web.archive.org/web/20091231160035/http://altmed.creighton.edu/Homeopathy/philosophy/cause.htm
|archive-date=December 31, 2009
}}</ref>


Hahnemann's [[hypotheses]] for miasms originally presented only three local symptoms: psora (the itch), [[syphilis]] (venereal disease) or [[sycosis]] (fig-wart disease).<ref>{{cite EB1911 |wstitle=Homoeopathy |volume=13 |page=645 |first=William Tod |last=Helmuth}}</ref> Of these the most important was ''psora'', described as being related to any itching diseases of the skin and was claimed to be the foundation of many further disease conditions. Hahnemann believed it to be the cause of such diseases as [[epilepsy]], [[cancer]], [[jaundice]], [[deafness]], and [[cataracts]].<ref name="Hahnemann_Chronic">
===Rise to popularity and early criticism===
{{cite book
During the 19th century homeopathy grew in popularity: in 1830, the first homeopathic schools opened, and throughout the 19th century dozens of homeopathic institutions appeared in Europe and the United States.<ref name=Julian>{{cite web|url=http://www.wholehealthnow.com/homeopathy_pro/homeopathy_1825_1849.html |title=Homeopathy Timeline |accessdate=2007-07-23 |last=Winston |first=Julian |date=2006 |work="The Faces of Homoeopathy" |publisher=Whole Health Now }}</ref> Because of mainstream medicine's reliance on [[blood-letting]] and untested, often dangerous medicines, patients of homeopaths often had better outcomes than those of mainstream doctors.<ref name="pmid8885813">{{cite journal |author=Ernst E, Kaptchuk TJ |title=Homeopathy revisited |journal=Arch. Intern. Med. |volume=156 |issue=19 |pages=2162–4 |year=1996 |pmid=8885813 }}</ref> Homeopathic treatments, even if ineffective, would almost surely cause no harm, making the users of homeopathic medicine less likely to be killed by the medicine that was supposed to be helping them.<ref name="homhist1"/> The relative success of homeopathy in the 18th century may have led to the abandonment of the ineffective and harmful treatments of bloodletting and purging and to have begun the move towards more effective, scientific medicine.<ref name=kaufmanm>{{cite book |last = Kaufman |first=Martin |title = Homeopathy in America: The Rise and Fall of a Medical Heresy |publisher=The Johns Hopkins University Press |date=1971-10-01 |isbn=978-0801812385 }}</ref>
|author =Hahnemann S
|title =Die chronischen Krankheiten, ihre eigenthümliche Natur und homöopathische Heilung [The chronic diseases, their specific nature and homoeopathic treatment]
|url =https://books.google.com/books?id=Xfk3AAAAMAAJ
|location =[[Dresden]] and [[Leipzig]]
|publisher =Arnoldische Buchhandlung
|year =1828
}}{{Page needed|date=March 2011}}</ref> Since Hahnemann's time, other miasms have been proposed, some replacing illnesses previously attributed to the psora, including [[tuberculosis]] and [[cancer]] miasms.<ref name="miasms">
{{cite web
|work = Classical homeopathy
|title = Miasms in homeopathy
|url = http://homepage.ntlworld.com/homeopathy_advice/Theory/Intermediate/miasm.html
|author = King S
|access-date = March 25, 2009
|archive-url = https://web.archive.org/web/20090307120146/http://homepage.ntlworld.com/homeopathy_advice/Theory/Intermediate/miasm.html
|archive-date = March 7, 2009
}}</ref>


Hahnemann's miasm theory remains disputed and controversial within homeopathy even in modern times. The theory of miasms has been criticized as an explanation developed to preserve the system of homeopathy in the face of treatment failures, and for being inadequate to cover the many hundreds of sorts of diseases, as well as for failing to explain disease predispositions, as well as [[genetics]], environmental factors, and the unique disease history of each patient.<ref name="Shelton">{{cite book |last=Shelton |first=JW |year=2004 |title=Homeopathy: How it really works |url=https://archive.org/details/homeopathyhowitr0000shel |url-access=registration |location=Amherst, New York |publisher=[[Prometheus Books]] |isbn=978-1-59102-109-4}}</ref>{{rp|148–9|date=November 2012}}
In the early 19th century, homeopathy began to be criticized: [[John Forbes (physician)|Sir John Forbes]], physician to [[Queen Victoria]], said the extremely small doses of homeopathy were regularly derided as useless, laughably ridiculous and "an outrage to human reason."<ref>Sir John Forbes, ''Homeopathy, Allopathy and Young Physic'', London, 1846</ref> Professor Sir [[James Young Simpson]] said of the highly diluted drugs: "no poison, however strong or powerful, the billionth or decillionth of which would in the least degree affect a man or harm a fly."<ref>James Y Simpson, ''Homoeopathy, Its Tenets and Tendencies, Theoretical, Theological and Therapeutical'', Edinburgh: Sutherland & Knox, 1853, 11</ref> Nineteenth century American physician and author [[Oliver Wendell Holmes, Sr.]] was also a vocal critic of homeopathy and published an essay in 1842 entitled ''Homœopathy, and its Kindred Delusions''.<ref>{{cite book
|title=Homœopathy, and its Kindred Delusions; two lectures delivered before the Boston society for the diffusion of useful knowledge.
|first=Oliver Wendell
|last=Holmes
|location=Boston, MA
|publisher=William D. Ticknor
|year=1842
|oclc=166600876
}} Found online at,{{cite web|url=http://homeoint.org/cazalet/holmes/index.htm |title=Homeopathy and Its Kindred Delusions |accessdate=2007-07-25 |last=Holmes |first=Oliver Wendell}}</ref> The last school in the U.S. exclusively teaching homeopathy closed down in [[1920]].<ref name="homhist1"/>


===19th century: rise to popularity and early criticism===
==General philosophy==
[[File:Beydeman Gomeopatiya vzir.jpg|thumb|left|''[[Homeopathy Looks at the Horrors of Allopathy]]'', an 1857 painting by Alexander Beydeman, showing historical figures and personifications of homeopathy observing the [[heroic medicine|brutality of medicine]] of the 19th century]]Homeopathy achieved its greatest popularity in the 19th century. It was introduced to the United States in 1825 by Hans Birch Gram, a student of Hahnemann.<ref name="Miller">{{cite book |last=Miller |first=Timothy |author-link=Timothy Miller |title=America's alternative religions |publisher=State University of New York Press, Albany |date=1995 |pages=[https://archive.org/details/americasalternat00mill/page/80 80] |isbn=978-0-7914-2397-4 |url=https://archive.org/details/americasalternat00mill/page/80 }}</ref> The first homeopathic school in the United States opened in 1835 and the [[American Institute of Homeopathy]] was established in 1844. Throughout the 19th century, dozens of homeopathic institutions appeared in Europe and the United States,<ref name="Julian">{{cite web
Homeopathy is a [[vitalism|vitalist]] philosophy in that it regards diseases and sickness to be caused by disturbances in a hypothetical [[vital force]] or [[spiritual energy|life force]] in humans and that these disturbances manifest themselves as unique symptoms. Homeopathy contends that the vital force has the ability to react and adapt to internal and external causes, which homeopaths refer to as the "law of susceptibility". The law of susceptibility states that a negative state of mind can attract hypothetical disease entities called "miasms" to invade the body and produce symptoms of diseases,<ref name="homhist1"/> However, Hahnemann rejected the notion of a disease as a separate thing or invading entity<ref>{{cite web|url=http://julianwinston.com/archives/articles/winston_organon_outline.php |title=OUTLINE OF THE ORGANON |accessdate=2007-08-04 |last=Winston |first=Julian }}</ref> and insisted that it was always part of the "living whole".<ref>{{cite web |url=http://www.homeopathyhome.com/reference/organon/organon.html |title=Organon Of Medicine |accessdate=2007-08-04 |last=Hahnemann |first=Samuel }}</ref>
|url = http://www.wholehealthnow.com/homeopathy_pro/homeopathy_1825_1849.html
|title = Homeopathy Timeline
|access-date = July 23, 2007
|website= Whole Health Now
|archive-date = December 15, 2018
|archive-url = https://web.archive.org/web/20181215122834/http://www.wholehealthnow.com/homeopathy_pro/homeopathy_1825_1849.html
}}</ref> and by 1900, there were 22 homeopathic colleges and 15,000 practitioners in the United States.<ref name="Time19951125" />


Because medical practice of the time relied on treatments which were often ineffective and harmful, patients of homeopaths often had better outcomes than those being treated by medical practitioners.<ref name="pmid8885813">{{cite journal |last1=Ernst |first1=E. |last2=Kaptchuk |first2=TJ |title=Homeopathy revisited |journal=Archives of Internal Medicine |volume=156 |issue=19 |pages=2162–4 |year=1996 |pmid=8885813 |doi=10.1001/archinte.156.19.2162}}</ref> Though ineffective, homeopathic preparations are rarely detrimental, thus users are less likely to be harmed by the treatment that is supposed to be helping them.<ref name="homhist1" /> The relative success of homeopathy in the 19th century may have led to the abandonment of the ineffective and harmful treatments of [[bloodletting]] and purging and begun the move towards more effective, [[science-based medicine]].<ref name="kaufmanm">
===Law of similars===
{{cite book
Hahnemann observed from his experiments with Cinchona bark, used as a treatment of malaria, that the side effects he experienced from the quinine in the Cinchona bark were similar to the symptoms of malaria. He reasoned that treatments for diseases must produce symptoms similar to of those disease being treated when taken by healthy individuals. From this Hahnemann conceived of the "law of similars", otherwise known as "like cures like" ({{lang-la|similia similibus curentur}}). Hahnemann believed that by inducing artificial symptoms of a disease, the artificial symptoms would create another disturbance in the vital force thus pushing out the old disturbance and that the body would naturally recover from the artificially induced disturbance. The basic idea is that to cure a person suffering from an illness, one should administer a dilute dose of a substance that produces the same symptoms of the illness being treated in healthy individuals.<ref name="homhist1"/>
|author =Kaufman M
|title =Homeopathy in America: The rise and fall of a medical heresy
|publisher =[[The Johns Hopkins University Press]]
|year =1971
|isbn =978-0-8018-1238-5
}}{{Page needed|date=March 2011}}</ref> One reason for the growing popularity of homeopathy was its apparent success in treating people suffering from infectious disease epidemics.<ref>
{{cite book
|author =Coulter HL
|year =1973
|title =Divided Legacy
|pages =II:544–46; III:267–70, 298–305
|location =Berkeley
|publisher =North Atlantic
|oclc =9538442
}}</ref> During 19th-century epidemics of diseases such as [[cholera]], death rates in homeopathic hospitals were often lower than in conventional hospitals, where the treatments used at the time were often harmful and did little or nothing to combat the diseases.<ref>Death rates in conventional hospitals were typically two- to eight-fold higher than in homeopathic hospitals for patients with these infectious diseases; see
{{cite book
|title =The logic of figures or comparative results of homeopathic and other treatments
|author =Bradford TL
|publisher =Kessinger
|year =2007
|orig-date =1900
|isbn =978-1-4304-8892-7
}}{{Page needed|date=March 2011}}</ref>


Even during its rise in popularity, homeopathy was criticized by scientists and physicians. [[John Forbes (physician)|Sir John Forbes]], physician to [[Victoria of the United Kingdom|Queen Victoria]], said in 1843 that the extremely small doses of homeopathy were regularly derided as useless and considered it "an outrage to human reason".<ref name="John_Forbes">
===Miasms and disease===
{{cite book
Hahnemann found as early as 1816 that his patients who he treated through homeopathy still suffered from chronic diseases that he was unable to cure.<ref>{{cite web | url=http://www.lyghtforce.com/HomeopathyOnline/Issue2/educate.html |accessdate=[[2007-10-12]] |author=David Little | title=The Classical View on Miasms | publisher = Homeopathy Online}}</ref> In 1828,<ref>The Chronic Diseases, their Nature and Homoeopathic Treatment, [[Dresden]] and Leipsic, Arnold. Vols. 1, 2, 3, 1828; vol. 4, 1830</ref> he introduced the concept of miasms, which he regarded as underlying causes for many known diseases. A miasm is often defined by homeopaths as an imputed ''"peculiar morbid derangement of our vital force."''<ref>{{cite web |url=http://www.homeopathyhome.com/reference/organon/10.html |author=Samuel Hahnemann |title=Organon, 5th edition, para 29 |publisher=Homeopathy Home.com. |accessdate=2007-10-22 }}</ref> Hahnemann associated each miasm with specific diseases, with each miasm seen as the root cause of several diseases. According to Hahnemann, initial exposure to miasms causes local symptoms, such as skin or venereal diseases, but if these symptoms are suppressed by medication, the cause goes deeper and begins to manifest itself as diseases of the internal organs.<ref name="ntlworld"/> Homeopathy contends that treating diseases by directly opposing their symptoms, as is sometimes done in conventional medicine, is not so effective because all ''"disease can generally be traced to some latent, deep-seated, underlying chronic, or inherited tendency."''<ref>{{cite web |url=http://homeoint.org/cazalet/ward/historycase.htm |author=Dr J W Ward |title=Taking the History of the Case |publisher=Pacific Coast Jnl of Homeopathy, July 1937 |accessdate=2007-10-22}}</ref> The underlying imputed miasm still remains, and deep-seated ailments can only be corrected by removing the deeper disturbance of the vital force.<ref name=homphilo>{{cite news |title=Cause of Disease in homeopathy |date= |publisher=Creighton University Department of Pharmacology |url=http://altmed.creighton.edu/Homeopathy/philosophy/cause.htm |accessdate=2007-07-23 }}</ref>
|author =Forbes J
|title =Homeopathy, allopathy and young physic
|location =London
|year =1846
}}</ref> [[James Young Simpson]] said in 1853 of the highly diluted drugs: "No poison, however strong or powerful, the billionth or decillionth of which would in the least degree affect a man or harm a fly."<ref>
{{cite book
|author =Simpson JY
|title =Homoeopathy, its tenets and tendencies, theoretical, theological and therapeutical
|location =Edinburgh
|publisher =Sutherland & Knox
|year =1853
|page =11
}}</ref> Nineteenth-century American physician and author [[Oliver Wendell Holmes Sr.|Oliver Wendell Holmes]] was also a vocal critic of homeopathy and published an essay entitled ''[[Homœopathy and Its Kindred Delusions]]'' (1842).<ref name="Holmes" /> The members of the French Homeopathic Society observed in 1867 that some leading homeopaths of Europe not only were abandoning the practice of administering infinitesimal doses but were also no longer defending it.<ref>
{{cite journal
|title =Homœopathists vs homœopathy
|editor =Allen JA
|journal =Chic Med J
|pages =268–69
|year =1867
|volume =24
|issue =6
|pmid =37412875
|pmc =9801777
|url =https://books.google.com/books?id=R08VAAAAYAAJ&q=leading+europe+abandoning&pg=PA268
}}</ref> The last school in the United States exclusively teaching homeopathy closed in 1920.<ref name="homhist1" />


=== Revival in the 20th century ===
Hahnemann's miasm theory remains disputed and controversial within homeopathy even in modern times. In [[1978]], [[Anthony Campbell]], then a consultant physician at The Royal London Homeopathic Hospital, criticized statements by George Vithoulkas claiming that [[syphilis]], when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the central nervous system. This conflicts with scientific studies, which indicate that penicillin treatment produces a complete cure of syphilis in more than 90% of cases.<ref>{{cite journal |author=Birnbaum NR, Goldschmidt RH, Buffett WO |title=Resolving the common clinical dilemmas of syphilis |url=http://www.aafp.org/afp/990415ap/2233.html |journal=American family physician |volume=59 |issue=8 |pages=2233-40, 2245-6 |year=1999 |pmid=10221308}}</ref> Campbell described this as "a thoroughly irresponsible statement which could mislead an unfortunate layman into refusing orthodox treatment" and said that it was not an isolated case, but part of a lengthy section arguing against conventional medicine.<ref>[http://www.minimum.com/reviews/science-homeopathy.htm Critical review of ''The Science of Homeopathy''] from the ''British Homoeopathic Journal'' Volume 67, Number 4, October 1978</ref> This echoes the idea in homeopathy that using medication to suppress the symptoms of a disease would only drive the underlying disease deeper into the body.
According to academics {{Interlanguage link|Paul U. Unschuld|lt=|de||WD=}} and [[Edzard Ernst]], the [[Nazi]] regime in Germany was fond of homeopathy, and spent large sums of money on researching its mechanisms, but without gaining a positive result.<ref>{{Cite news|last=Ernst|first=Edzard|title=Standing up for the truth about homeopathy and Nazi medicine|url=https://www.irishtimes.com/culture/books/standing-up-for-the-truth-about-homeopathy-and-nazi-medicine-1.2138835|access-date=2020-10-26|newspaper=The Irish Times|language=en}}</ref> Unschuld also states that homeopathy never subsequently took root in the [[United States]], but remained more deeply established in European thinking.<ref name="Unschuld2009">{{cite book|author=Paul Ulrich Unschuld|title=What Is Medicine?: Western and Eastern Approaches to Healing|url=https://books.google.com/books?id=bPMTlS1pzEUC&pg=PA171|access-date=September 7, 2013|date=August 9, 2009|publisher=University of California Press|isbn=978-0-520-94470-1|page=171}}</ref> In the United States, the ''[[Federal Food, Drug, and Cosmetic Act|Food, Drug, and Cosmetic Act]]'' of 1938 (sponsored by [[Royal S. Copeland|Royal Copeland]], a [[United States Senate|Senator]] from [[New York (state)|New York]] and homeopathic physician) recognized homeopathic preparations as drugs. In the 1950s, there were only 75 solely homeopathic practitioners in the U.S.<ref>
{{cite news
|title =Homeopathic Hassle
|url =http://www.time.com/time/magazine/article/0,9171,891760,00.html
|archive-url =https://web.archive.org/web/20081214115339/http://www.time.com/time/magazine/article/0,9171,891760,00.html
|archive-date =December 14, 2008
|magazine =[[Time (magazine)|Time]]
|date =August 20, 1956
}}</ref> By the mid to late 1970s, homeopathy made a significant comeback and the sales of some homeopathic companies increased tenfold.<ref name="rader">
{{cite news
|date =March 1, 1985
|publisher =FDA Consumer Magazine
|author =Rader WM
|url =http://www.homeowatch.org/history/fdac1.html
|title =Riding the coattails of homeopathy's revival
}}</ref>


Some homeopaths credit the revival to Greek homeopath [[George Vithoulkas]], who conducted a "great deal of research to update the scenarios and refine the theories and practice of homeopathy" in the 1970s,<ref name="pmid12614092">{{Cite journal |volume=138 |issue=5 |pages=393–99 |last=Jonas |first=WB |author2=TJ Kaptchuk |author3=K Linde |title=A critical overview of homeopathy |journal=Annals of Internal Medicine |year=2003 |doi=10.7326/0003-4819-138-5-200303040-00009|pmid=12614092 |s2cid=22787732 }}</ref><ref>{{cite book |first=Andrew |last=Lockie |title=Encyclopedia of Homeopathy |url=https://archive.org/details/encyclopediahome00lock_433 |url-access=limited |publisher=[[Dorling Kindersley]] |year=2000 |location=New York |edition=1st |page=[https://archive.org/details/encyclopediahome00lock_433/page/n20 19] |isbn=978-0-7566-1871-1 }}</ref> but Ernst and [[Simon Singh]] consider it to be linked to the rise of the [[New Age movement]].<ref name="isbn0-393-06661-4" /> [[Bruce Hood (psychologist)|Bruce Hood]] has argued that the increased popularity of homeopathy in recent times may be due to the comparatively long consultations practitioners are willing to give their patients, and to a [[appeal to nature|preference for "natural" products]], which people think are the basis of homeopathic preparations.<ref name="Hood2009">{{cite book|author=Bruce M. Hood|title=SuperSense|url=https://archive.org/details/supersensewhyweb00hood|url-access=registration|access-date=September 7, 2013|date=April 7, 2009|publisher=HarperCollins|isbn=978-0-06-186793-4|page=[https://archive.org/details/supersensewhyweb00hood/page/157 157]}}</ref>
Originally Hahnemann presented only three miasms, of which the most important was "psora" ([[Greek language|Greek]] for ''itch''), described as being related to any itching diseases of the skin, supposed to be derived from suppressed scabies, and claimed to be the foundation of many further disease conditions. Hahnemann claimed psora to be the cause of such diseases as [[epilepsy]], [[cancer]], [[jaundice]], [[deafness]], and [[cataracts]].<ref name="OrganonH"/> Since Hahnemann's time, other miasms have been proposed, some replacing one or more of psora's proposed functions, including [[Tuberculosis|tubercular]] miasms and [[cancer]] miasms.<ref name=ntlworld>{{cite web|url=http://homepage.ntlworld.com/homeopathy_advice/Theory/Intermediate/miasm.html |title=Miasms in homeopathy |accessdate=2007-07-24 }}</ref>


Towards the end of the century opposition to homeopathy began to increase again; with [[William T. Jarvis]], the President of the [[National Council Against Health Fraud]], saying that "Homeopathy is a fraud perpetrated on the public with the government's blessing, thanks to the abuse of political power of Sen. Royal S. Copeland."<ref>{{cite web|author=William T. Jarvis|author-link=William T. Jarvis|title=Response to Isadora Stehlin "Homeopathy: real medicine or empty promises?" (originally published in ''FDA Consumer'' April 1997)|date=December 15, 2001|url=http://www.homeowatch.org/articles/fdac2.html}}</ref>
==Development of remedies==
[[Image:Mortar2.jpg|thumb|left|Mortar and pestle used for grinding insoluble solids into homeopathic remedies including quartz and oyster shells.]]


===21st century: renewed criticism===
===Dilution and succussion===


Since the beginning of the 21st century, a series of [[Meta-analysis|meta-analyses]] have further shown that the therapeutic claims of homeopathy lack scientific justification.<ref name="champe">{{cite journal |last1=Crockett |first1=Chambers |title=Death by homeopathy: issues for civil, criminal and coronial law and for health service policy |pmid=22558899 |journal=Journal of Law, Medicine & Ethics |volume=19 |issue=3 |pages=454–78 |year=2012 }}</ref> This had led to a decrease or suspension of funding by many governments. In a 2010 report, the [[Science and Technology Select Committee|Science and Technology Committee of the United Kingdom House of Commons]] recommended that homeopathy should no longer receive [[National Health Service]] (NHS) funding due its lack of scientific credibility;<ref name="champe" /> NHS funding for homeopathy ceased in 2017.<ref name="TNHS" /> They also asked the [[Department of Health and Social Care|Department of Health]] in the UK to add homeopathic remedies to the list of forbidden prescription items.<ref name="bbc-blacklist" />
In producing treatments for diseases, homeopaths use a process called "dynamization" or "potentization" where the remedy is diluted into alcohol or water and then vigorously shaken by ten hard strikes against an elastic body in a process called "succussion". Hahnemann thought that the use of remedies which present symptoms similar to those of disease in healthy individuals would only intensify the symptoms and exacerbate the condition, so he advocated the dilution of the remedies to the point the symptoms were no longer experienced. During the process of potentization, homeopaths believe that the vital energy of the diluted substance is activated and its energy released by vigorous shaking of the substance. For this purpose, Hahnemann had a saddle maker construct a special wooden striking board covered in leather on one side and stuffed with horsehair.<ref>{{cite web |url=http://www.igm-bosch.de/english/f10.htm |title= Online Museum |publisher=The Institute for the History of Medicine |accessdate=2007-10-22 }}</ref> Insoluble solids, such as [[quartz]] and [[oyster]] shell, are diluted by grinding them with [[lactose]] (''[[trituration]]'').


In 2015, the [[National Health and Medical Research Council]] of Australia found that "there are no health conditions for which there is reliable evidence that homeopathy is effective".<ref>{{cite web |title=The Australian report |url=https://www.hri-research.org/resources/homeopathy-the-debate/the-australian-report-on-homeopathy/ |website=HRI Research |access-date=13 August 2018|date=April 6, 2017 }}</ref> The federal government only ended up accepting three of the 45 recommendations made by the 2018 review of Pharmacy Remuneration and Regulation.<ref>{{cite news|last1=Abusson|first1=Kate|date=3 May 2018|title=Pharmacies avoid homeopathy ban as government parks recommendations|work=Sydney Morning Herald|url=https://www.smh.com.au/national/pharmacies-avoid-homeopathy-ban-as-government-parks-recommendations-20180503-p4zd94.html|access-date=13 August 2018}}</ref> The same year the US [[Food and Drug Administration]] (FDA) held a hearing requesting public comment on the regulation of homeopathic drugs.<ref name="Science42115">{{cite news|author1=Kelly Servick|date=April 21, 2015|title=FDA takes new look at homeopathy|work=Science|url=https://www.science.org/content/article/fda-takes-new-look-homeopathy|access-date=April 23, 2015|quote=Under FDA guidelines issued in 1988, a company can sell homeopathic products over the counter without demonstrating their safety or efficacy, and―unlike dietary supplements―their packaging can include claims about treating specific conditions, as long as they are "self-limiting" and not chronic. Such conditions include sprains, colds, or allergies.}}</ref> In 2017 the FDA announced it would strengthen regulation of homeopathic products.<ref name="Frazier FDA to Reg">{{cite journal|last1=Frazier|first1=Kendrick|author-link=Kendrick Frazier|date=2018|title=FDA to Regulate Some Homeopathic Products; CFI Hails Move|journal=[[Skeptical Inquirer]]|volume=42|issue=2|page=12}}</ref>
Three potency scales are in regular use in homeopathy. Hahnemann pioneered and always favored the centesimal or "C scale", diluting a substance 1 part in a 100 of diluent at each stage. A 2C dilution is one where a substance is diluted to one part in one hundred,<!-- standardized terminology should be used throughout, is it 1 part in a 100 or one part in one hundred ??? --> then one part of that diluted solution is diluted to one part in one hundred. This works out to one part of the original solution to ten thousand parts (100x100) of diluent. A 6C dilution repeats the process six times, ending up with one part in 1,000,000,000,000. (100x100x100x100x100x100, or 100<sup>6</sup>) Other dilutions follow the same pattern. In homeopathy, a solution is described as higher potency the more dilute it is. Higher potencies - ''i.e.'' more dilute substances - are considered to be stronger deep-acting remedies.


The American non-profit [[Center for Inquiry]] (CFI) filed a lawsuit in 2018 against the [[CVS Pharmacy|CVS]] pharmacy for consumer fraud over its sale of homeopathic medicines.<ref name="CVS">{{cite press release|author=<!--Staff writer(s); no by-line.-->|title=CENTER FOR INQUIRY SUES CVS FOR FRAUD OVER SALE OF HOMEOPATHIC FAKE MEDICINE|url=https://centerforinquiry.org/press_releases/cfi-sues-cvs/|publisher=Center for Inquiry|date=9 July 2018|access-date=9 July 2018}}</ref> It claimed that CVS was selling homeopathic products on an easier-to-obtain basis than standard medication.<ref>{{cite web|last1=Bellamy|first1=Jann|title=CVS sued for deceiving consumers in sale of homeopathic remedies|url=https://sciencebasedmedicine.org/cvs-sued-for-deceiving-consumers-in-sale-of-homeopathic-remedies/|access-date=22 January 2019|website=Science Based Medicine|date=July 19, 2018}}</ref> In 2019, CFI brought a similar lawsuit against [[Walmart]] for "committing wide-scale consumer fraud and endangering the health of its customers through its sale and marketing of homeopathic medicines".<ref>{{cite magazine|last=Fidalgo|first=Paul|date=September 2019|title=CFI sues Walmart for fraud for selling homeopathic fake medicine|magazine=[[Skeptical Inquirer]]|location=Amherst, NY|publisher=Center for Inquiry}}</ref><ref>{{cite web|last1=Vyse|first1=Stuart|author-link=Stuart Vyse|title=What Should Become of a Monument to Pseudoscience?|url=https://skepticalinquirer.org/exclusive/what-should-become-of-a-monument-to-pseudoscience/|access-date=2 December 2019|website=Skeptical Inquirer|date=July 10, 2019|publisher=Center for Inquiry}}</ref> They also conducted a survey in which they found consumers felt ripped off when informed of the lack of evidence for the efficacy of homeopathic remedies, such as those sold by Walmart and CVS.<ref name="CFISurvey SI 2019">{{cite journal|last1=Frazier|first1=Kendrick|authorlink= Kendrick Frazier|date=2019|title=CFI survey on Homeopathy: Consumers feel scammed by Walmart and CVS|journal=Skeptical Inquirer|volume=43|issue=6|page=7}}</ref><ref name="CFI 2019 Survey">{{cite web|last1=Fidalgo|first1=Paul|title=CONSUMERS FEEL "SCAMMED" BY WALMART AND CVS OVER HOMEOPATHIC FAKE MEDICINE, SURVEY SHOWS|url=https://centerforinquiry.org/press_releases/consumers-feel-scammed-by-walmart-and-cvs-over-homeopathic-fake-medicine/|access-date=9 November 2019|website=Center for Inquiry|date=September 17, 2019}}</ref>
Hahnemann advocated 30C dilutions for most purposes (a dilution by a factor of 10<sup>60</sup>) and a common homeopathic treatment for the flu is a 200C dilution of duck liver, called ''Oscillococcinum'' in homeopathy. Comparing these levels of dilution to the [[Avogadro's number|number of molecules present]] in the initial solution, a 12C solution contains on average only about one molecule of the original substance. The chances of a single molecule of the original substance remaining in a 15C dilution would be roughly 1 in 2 million, and less than one in a billion billion billion billion (10<sup>36</sup>) for a 30C solution. For a perspective on these numbers, there are in the order of 10<sup>32</sup> molecules of water in an [[Olympic size swimming pool]] and if such a pool were filled with a 15C homeopathic remedy, to expect to get a single molecule from the original substance, one would need to swallow 1% of the volume of such a pool, or roughly 25 metric tons of water.<ref name=dynam>{{cite web|url=http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm|title=Dynamization and Dilution |accessdate=2007-07-24 }}</ref>


In 2021, the French healthcare minister phased out social security reimbursements for homeopathic drugs.<ref name="GuardianFrance" /><ref name="FranceEndFunding2021" /> France has long had a stronger belief in the virtues of homeopathic drugs than many other countries and the world's biggest manufacturer of alternative medicine drugs, [[Boiron]], is located in that country.<ref>{{cite news |url=https://www.reuters.com/article/us-france-health-homeopathy/france-will-end-healthcare-refunds-for-homeopathic-drugs-idUSKCN1U42B6 |title=France will end healthcare refunds for homeopathic drugs |website=[[Reuters]] |date=July 9, 2019}}</ref> Spain has also announced moves to ban homeopathy and other pseudotherapies.<ref name="El Pais 2019-07-30" /> In 2016, the [[University of Barcelona]] cancelled its master's degree in Homeopathy citing "lack of scientific basis", after advice from the Spanish Ministry of Health.<ref>{{cite news|last1=Ansede|first1=Manuel|date=March 4, 2016|title=La Universidad de Barcelona fulmina su máster de homeopatía|newspaper=El País|url=http://elpais.com/elpais/2016/03/01/ciencia/1456856774_534268.html}}</ref> Shortly afterwards the [[University of Valencia]] announced the elimination of its Masters in Homeopathy.<ref>{{cite web|date=April 7, 2016|title=El Máster de Homeopatía de la Universidad de Valencia cancela su edición para el próximo curso.|url=http://www.abc.es/sociedad/abci-master-homeopatia-universidad-valencia-cancela-edicion-para-proximo-curso-201604072200_noticia.html|publisher=Diario ABC}}</ref>
For more perspective, 1ml of a solution which has gone through a 30C dilution would have been diluted into a volume of water equal to that of a cube of 1,000,000,000,000,000,000 meters per side, or about 106 light years. Thus, homeopathic remedies of the standard dilutions contain, with overwhelming probability, only water (or alcohol). Practitioners of homeopathy believe that this water retains some 'essential property' of the original substance, due to the shaking after each dilution.<ref>{{cite book |last=Resch |first=G, |coauthors=Gutmann, V |title=Scientific Foundations of Homoeopathy |year=1987 |publisher=Barthel & Barthel Publishing}}</ref> Hahnemann believed that the dynamization or shaking of the solution caused a "spirit like" healing force to be released from within the substance. He thought that even after every molecule of the previous substance has been removed from the water, the spiritual healing force still remained.<ref name="dynam"/>


==Preparations and treatment==
Some homeopaths developed a decimal scale (D or X), diluting the substance to ten times its original volume each stage. The D or X scale dilution is therefore half that of the same value of the C scale; for example, "12x" is the same level of dilution as "6C". Hahnemann never used this scale but it was very popular throughout the 19th century and still is in Europe. This potency scale appears to have been introduced in the [[1830s]] by the American homeopath, Dr. Constantine Hering.<ref name=Dudgeon>{{cite book |last=Robert |first=Ellis Dudgeon |title=Lectures on the Theory & Practice of Homeopathy | date=1853 |location=London |pages=526–7 |url=http://books.google.com/books/pdf/Lectures_on_the_theory_and_practice_of_h.pdf?id=UKZ_lqlWPhUC&output=pdf&sig=X5aw7kl9oK-_8kXvc7022__2wVo |format=PDF|isbn=81-7021-311-8 }}</ref> In the last ten years of his life Hahnemann also developed a quintamillesimal (Q) or LM scale diluting the drug 1 part in 50,000 parts of diluent.<ref>{{cite web|url=http://www.simillimum.com/education/little-library/the-works-of-great-homoeopaths/ham/article04.php |title= Hahnemann's Advanced Methods |accessdate=2007-08-04 |last=Little |first=David |work=Simillimum.com }}</ref> A Q scale dilution is 2.35 times that of a C scale one, for example "20Q" is the same potency as "47C".
{{see also|List of homeopathic preparations}}[[File:Rep1.JPG|thumb|Homeopathic repertory by [[James Tyler Kent]]]]


Homeopathic preparations are referred to as "homeopathic remedies".<ref name="Consumer Reports">{{cite news |date=December 21, 2015 |title=Homeopathic drugs: No better than placebos? |newspaper=[[The Washington Post]] |url=https://www.washingtonpost.com/national/health-science/homeopathic-drugs-no-better-than-placebos/2015/12/18/037b3976-7750-11e5-a958-d889faf561dc_story.html |access-date=December 22, 2015 }}</ref> Practitioners rely on two types of reference when prescribing: ''[[Materia medica]]'' and repertories. A homeopathic ''materia medica'' is a collection of "drug pictures", organized alphabetically. A homeopathic repertory is a quick reference version of the ''materia medica'' that indexes the symptoms and then the associated remedies for each. In both cases different compilers may dispute particular inclusions in the references.<ref>Jonas: Mosby's Dictionary of Complementary and Alternative Medicine. (c) 2005, Elsevier</ref> The first symptomatic homeopathic ''materia medica'' was arranged by Hahnemann. The first homeopathic repertory was Georg Jahr's ''Symptomenkodex'', published in German in 1835, and translated into English as the ''Repertory to the more Characteristic Symptoms of Materia Medica'' in 1838. This version was less focused on disease categories and was the forerunner to later works by [[James Tyler Kent]].<ref name="pmid16322800">{{cite journal|last1=Bellavite|first1=Paolo|last2=Conforti|first2=Anita|last3=Piasere|first3=Valeria|last4=Ortolani|first4=Riccardo|year=2005|title=Immunology and Homeopathy. 1. Historical Background|journal=Evidence-Based Complementary and Alternative Medicine|volume=2|issue=4|pages=441–52|doi=10.1093/ecam/neh141|pmc=1297514|pmid=16322800}}</ref><ref>
Not all homeopaths advocate extremely high dilutions. Many of the early homeopaths were originally doctors and generally tended to use lower dilutions such as "3x" or "6x", rarely going beyond "12x". A good example of this approach is that of Dr. Richard Hughes, who dismissed the extremely high dilutions as unnecessary. This was the dominant pattern in [[Europe]] throughout the [[1820s]] to [[1930s]], but in America many practitioners developed and preferred the higher dilutions. This trend became especially exemplified by James Tyler Kent and dominated US homeopathy from the [[1850s]] until its demise in the [[1940s]]. The split between lower and higher dilutions also followed ideological lines with the former stressing pathology and a strong link to conventional medicine, while the latter emphasized vital force, miasms and a [[Spirituality|spiritual]] take on sickness.<ref>{{cite book |last=Edwin Wheeler |first=Charles |title=Dr. Hughes: Recollections of Some Masters of Homeopathy |publisher=Health Through Homeopathy |date=1941 }}</ref><ref>{{cite book |last=Bodman |first=Frank |title=he Richard Hughes Memorial Lecture |publisher=BHJ |date=1970 |pages=179–193 }}</ref> From a modern regulatory viewpoint, any product that contains detectable levels of active ingredients cannot be classified as a homeopathic remedy.<ref name=Laso>{{cite journal |author=Cuesta Laso LR, Alfonso Galán MT |title=Possible dangers for patients using homeopathy: may a homeopathic medicinal product contain active substances that are not homeopathic dilutions? |journal=Medicine and law |volume=26 |issue=2 |pages=375–86 |year=2007 |pmid=17639858}}</ref>
{{cite book|author=Mathur KN|title=Prinzipien der homöopathischen Verschreibung: Synopsis weltweiter klinischer Erfahrungen|publisher=Georg Thieme Verlag|year=2003|isbn=978-3-8304-9021-0|pages=122–23|language=de|oclc=76518035}}</ref> There are over 118 repertories published in English, with Kent's being one of the most used.<ref>{{Cite web|title=Repertories today and yesterday|url=http://www.homeopathycenter.org/homeopathy-today/repertories-today-and-yesterday|archive-url=https://web.archive.org/web/20170414063600/http://www.homeopathycenter.org/homeopathy-today/repertories-today-and-yesterday|archive-date=April 14, 2017|access-date=2020-08-31|website=National Center for Homeopathy}}</ref>

=== Consultation ===
Homeopaths generally begin with a consultation, which can be a 10–15 minute appointment or last for over an hour, where the patient describes their [[medical history]]. The patient describes the "modalities", or if their symptoms change depending on the weather and other external factors.<ref name="Vickers 1115–11182">{{Cite journal|last1=Vickers|first1=Andrew|last2=Zollman|first2=Catherine|date=1999-10-23|title=Homoeopathy|journal=BMJ: British Medical Journal|volume=319|issue=7217|pages=1115–1118|doi=10.1136/bmj.319.7217.1115|issn=0959-8138|pmc=1116906|pmid=10531108}}</ref> The practitioner also solicits information on mood, likes and dislikes, physical, mental and emotional states, life circumstances, and any physical or emotional illnesses.<ref name="Stehlin">
{{cite web|author=Stehlin I|year=1996|title=Homeopathy: Real medicine or empty promises?|url=http://findarticles.com/p/articles/mi_m1370/is_n10_v30/ai_18979004/|archive-url=https://web.archive.org/web/20090924121418/http://findarticles.com/p/articles/mi_m1370/is_n10_v30/ai_18979004/|archive-date=September 24, 2009|access-date=October 1, 2007|publisher=U.S. [[Food and Drug Administration]]}}</ref> This information (also called the "symptom picture") is matched to the "drug picture" in the ''materia medica'' or repertory and used to determine the appropriate homeopathic remedies. In classical homeopathy, the practitioner attempts to match a single preparation to the totality of symptoms (the ''simlilum''), while "clinical homeopathy" involves combinations of preparations based on the illness's symptoms.<ref name="pmid12614092" />

=== Preparation ===
[[File:Ambalaj Oscillococcinum.jpg|thumb|left|upright|''[[Oscillococcinum]]'', a homeopathic remedy in pill form]]Homeopathy uses animal, plant, mineral, and synthetic substances in its preparations, generally referring to them using [[Latin]] names.<ref name="WHO Safety">{{Cite web|title=Safety issues in the preparation of homeopathic medicines|url=https://www.who.int/medicines/areas/traditional/Homeopathy.pdf|website=World Health Organization}}</ref> Examples include ''[[arsenicum album]]'' (arsenic oxide), ''natrum muriaticum'' ([[sodium chloride]] or table salt), ''[[Lachesis muta]]'' (the venom of the [[Lachesis (genus)|bushmaster snake]]), ''[[opium]]'', and ''thyroidinum'' ([[thyroid hormone]]). Homeopaths say this is to ensure accuracy.<ref>{{Cite web|title=FAQs|url=https://www.theaahp.org/consumer-information/faqs/|access-date=2020-08-31|website=The American Association of Homeopathic Pharmacists|language=en}}</ref> In the USA the common name must be displayed, although the Latin one can also be present.<ref name="WHO Safety" /> Homeopathic pills are made from an inert substance (often sugars, typically lactose), upon which a drop of liquid homeopathic preparation is placed and allowed to evaporate.<ref name="Ernst2005">{{cite journal|last1=Ernst|first1=E|year=2005|title=Is homeopathy a clinically valuable approach?|url=http://www.dcscience.net/ernst-tips-sept-2005.pdf|journal=Trends in Pharmacological Sciences|volume=26|issue=11|pages=547–48|citeseerx=10.1.1.385.5505|doi=10.1016/j.tips.2005.09.003|pmid=16165225}}</ref><ref>{{cite journal|last1=Sagar|first1=SM|year=2007|title=Homeopathy: Does a teaspoon of honey help the medicine go down?|journal=Current Oncology|volume=14|issue=4|pages=126–27|doi=10.3747/co.2007.150|pmc=1948865|pmid=17710203}}</ref>

Isopathy is a therapy derived from homeopathy in which the preparations come from diseased or pathological products such as fecal, urinary and respiratory discharges, blood, and tissue.<ref name="pmid16322800" /> They are called nosodes (from the Greek ''nosos'', disease) with preparations made from "healthy" specimens being termed "sarcodes". Many so-called "homeopathic vaccines" are a form of isopathy.<ref>{{cite book|author=Kayne SB|url=https://books.google.com/books?id=w2IFcHJYTSYC|title=Homeopathic pharmacy: theory and practice|publisher=Elsevier Health Sciences|year=2006|isbn=978-0-443-10160-1|edition=2|page=171}}</ref> Tautopathy is a form of isopathy where the preparations are composed of drugs or [[vaccine]]s that a person has consumed in the past, in the belief that this can reverse the supposed lingering damage caused by the initial use.<ref>{{Cite book|last=Owen|first=David|url=https://books.google.com/books?id=UZ72uQy385wC&q=Tautopathy&pg=PA56|title=Principles and Practice of Homeopathy: The Therapeutic and Healing Process|date=2007-01-01|publisher=Elsevier Health Sciences|isbn=978-0-443-10089-5|page=56|language=en}}</ref> There is no convincing scientific evidence for isopathy as an effective method of treatment.<ref>{{Cite book|last1=Lack|first1=Caleb W.|url=https://books.google.com/books?id=Miy2CwAAQBAJ&q=isopathy+pseudoscience&pg=PA206|title=Critical Thinking, Science, and Pseudoscience: Why We Can't Trust Our Brains|last2=Rousseau|first2=Jacques|date=2016-03-08|publisher=Springer Publishing Company|isbn=978-0-8261-9426-8|page=206|language=en}}</ref>

Some modern homeopaths use preparations they call "imponderables" because they do not originate from a substance but some other phenomenon presumed to have been "captured" by alcohol or [[lactose]].<!--See next two sources, and the rest of the journal issue they came from for more information--> Examples include [[X-ray]]s<ref>
{{cite journal
|vauthors=Lee J, Thompson E |title =X-ray drug picture
|journal =The Homeopath
|volume =26
|issue =2
|pages =43–48
|year =2007
|issn =0263-3256
}}</ref> and [[sunlight]].<ref>
{{cite journal
|vauthors=Lee J, Thompson E |title =Postironium – the vastness of the universe knocks me off my feet
|journal =The Homeopath
|volume =26
|issue =2
|pages =49–54
|year =2007
|issn =0263-3256
}}</ref> Another derivative is [[electrohomeopathy]], where an electric bio-energy of therapeutic value is supposedly extracted from plants. Popular in the late nineteenth century, electrohomeopathy is extremely pseudo-scientific.<ref>{{cite journal|last1=Kempf|first1=EJ|year=1906|title=European Medicine: A Résumé of Medical Progress During the Eighteenth and Nineteenth Centuries|journal=Medical Library and Historical Journal|volume=4|issue=1|pages=86–100|pmc=1692573|pmid=18340908}}</ref> In 2012, the Allahabad High Court in Uttar Pradesh, India, handed down a decree stating that electrohomeopathy was quackery and no longer recognized it as a system of medicine.<ref name="toie">{{cite news|date=5 March 2012|title=Electro-homeopathy clinics to be sealed after Holi|work=[[The Times of India]]|url=https://timesofindia.indiatimes.com/city/kanpur/Holi-Electro-homeopathy-clinics-to-be-sealed-after-the-festival/articleshow/12140070.cms|access-date=13 August 2018}}</ref>

Other minority practices include paper preparations, in which the terms for substances and dilutions are written on pieces of paper and either pinned to the patients' clothing, put in their pockets, or placed under glasses of water that are then given to the patients. [[Radionics]], the use of [[electromagnetic radiation]] such as [[radio wave]]s, can also be used to manufacture preparations. Such practices have been strongly criticized by classical homeopaths as unfounded, speculative, and verging upon magic and superstition.<ref>
{{cite web
|url =http://www.askdrshah.com/images/lancet.pdf
|title=Call for introspection and awakening
|publisher =Life Force Center
|access-date =July 24, 2007
|author =Shah R
|archive-url =https://web.archive.org/web/20070202082349/http://www.askdrshah.com/images/lancet.pdf |archive-date=February 2, 2007}}</ref><ref name="Barwell">
{{cite journal
|url = http://www.homeopathy.ac.nz/editorials/2000/vol-20-no-3-june-2000-the-wo-wo-effect/
|title = The wo-wo effect
|access-date = April 2, 2009
|author = Barwell B
|journal = Homoeopathica
|volume = 20
|issue = 3
|year = 2000
|archive-url = https://web.archive.org/web/20090726180731/http://www.homeopathy.ac.nz/editorials/2000/vol-20-no-3-june-2000-the-wo-wo-effect/
|archive-date = July 26, 2009
|df = mdy-all
}}</ref> Flower preparations are produced by placing flowers in water and exposing them to sunlight. The most famous of these are the [[Bach flower remedies]], which were developed by [[Edward Bach]].<ref>{{cite journal|last1=Vanhaselen|first1=R|year=1999|title=The relationship between homeopathy and the Dr Bach system of flower remedies: A critical appraisal|journal=British Homoeopathic Journal|volume=88|issue=3|pages=121–27|doi=10.1054/homp.1999.0308|pmid=10449052}}</ref>

=== Dilutions ===
{{Main|Homeopathic dilutions}}

[[File:Arnica montana homéopathie zoom.jpg|thumb|This bottle is labelled ''[[Arnica montana]]'' (wolf's bane) D6, i.e. the nominal dilution is one [[parts per million|part in a million]] (10<sup>'''-6'''</sup>).]]Hahnemann claimed that undiluted doses caused reactions, sometimes dangerous ones, and thus that preparations be given at the lowest possible dose.<ref name="Kayne 53">
{{cite book|author=Kayne SB|url=https://books.google.com/books?id=w2IFcHJYTSYC&q=homeopathic%20proving%20method&pg=PA53|title=Homeopathic pharmacy: theory and practice|publisher=Elsevier Health Sciences|year=2006|isbn=978-0-443-10160-1|edition=2|page=53}}</ref> A solution that is more dilute is described as having a higher "potency", and thus are claimed to be stronger and deeper-acting.<ref>
{{cite web|title=Glossary of Homeopathic Terms|url=http://altmed.creighton.edu/Homeopathy/Glossary.htm|archive-url=https://web.archive.org/web/20121016234338/http://altmed.creighton.edu/Homeopathy/glossary.htm|archive-date=October 16, 2012|access-date=February 15, 2009|publisher=Creighton University Department of Pharmacology|df=mdy-all}}</ref> The general method of dilution is [[serial dilution]], where solvent is added to part of the previous mixture, but the "Korsakovian" method may also be used. In the Korsakovian method, the vessel in which the preparations are manufactured is emptied, refilled with solvent, with the volume of fluid adhering to the walls of the vessel deemed sufficient for the new batch.<ref name="Shelton" />{{rp|270|date=January 2015}} The Korsakovian method is sometimes referred to as K on the label of a homeopathic preparation.<ref>{{cite web|date=January 22, 2011|title=Homeopathy: Diluted out of existence?|url=http://www.scilogs.com/in_scientio_veritas/homeopathy-diluted-out-of-existence/|access-date=June 15, 2015|publisher=scilogs.com/in_scientio_veritas}}</ref><ref>{{cite web|title=Homeopathic Medicine Potency or Dilution|url=http://www.ritecare.com/homeopathic/guide_potency.asp|archive-url=https://web.archive.org/web/20150821064849/http://www.ritecare.com/homeopathic/guide_potency.asp|archive-date=August 21, 2015|access-date=June 15, 2015|publisher=ritecare.com}}</ref> Another method is Fluxion, which dilutes the substance by continuously passing water through the vial.<ref>{{Cite journal|last=Winston|first=Julian|date=1989-04-01|title=A brief history of potentizing machines|url=http://www.sciencedirect.com/science/article/pii/S000707858980050X|journal=British Homoeopathic Journal|language=en|volume=78|issue=2|pages=59–68|doi=10.1016/S0007-0785(89)80050-X|s2cid=71942187 |issn=0007-0785}}</ref> Insoluble solids, such as [[granite]], [[diamond]], and [[platinum]], are diluted by grinding them with lactose ("[[trituration]]").<ref name="Shelton" />{{rp|23}}

Three main [[Logarithmic scale|logarithmic]] dilution scales are in regular use in homeopathy. Hahnemann created the "centesimal" or "C scale", diluting a substance by a factor of 100 at each stage. There is also a decimal dilution scale (notated as "X" or "D") in which the preparation is diluted by a factor of 10 at each stage.<ref>{{cite web|url=http://www.ritecare.com/homeopathic/guide_potency.asp|title=Homeopathic Medicine Potency or Dilution|archive-url=https://web.archive.org/web/20150821064849/http://www.ritecare.com/homeopathic/guide_potency.asp|archive-date=August 21, 2015|access-date=June 15, 2015}}</ref> The centesimal scale was favoured by Hahnemann for most of his life, although in his last ten years Hahnemann developed a quintamillesimal (Q) scale which diluted the drug 1 part in 50,000.<ref>{{Cite journal|last1=Adler|first1=U. C.|last2=Adler|first2=M. S.|date=2006|title=Hahnemann's experiments with 50 millesimal potencies: a further review of his casebooks|journal=Homeopathy|volume=95|issue=3|pages=171–181|doi=10.1016/j.homp.2006.03.003|issn=1475-4916|pmid=16815521|s2cid=3760829 }}</ref> A 2C dilution works out to one part of the original substance in 10,000 parts of the solution. In standard chemistry, this produces a substance with a concentration of 0.01% ([[Concentration#Volume-volume percentage|volume-volume percentage]]). A 6C dilution ends up with the original substance diluted by a factor of 100<sup>−6</sup> (one part in one trillion). The end product is usually so diluted as to be indistinguishable from the diluent (pure water, sugar or alcohol).<ref name="Dynamization and Dilution" /><ref name="homsim">
{{cite web
|title = Similia similibus curentur (Like cures like)
|publisher = Creighton University Department of Pharmacology
|url = http://altmed.creighton.edu/Homeopathy/philosophy/similia.htm
|access-date = August 20, 2007
|archive-url = https://web.archive.org/web/20070808051756/http://altmed.creighton.edu/Homeopathy/philosophy/similia.htm
|archive-date = August 8, 2007
|df = mdy-all
}}</ref> The greatest dilution reasonably likely to contain at least one molecule of the original substance is approximately 12C.<ref>{{cite web|last1=Page 3|title=Alternative Medicine: Homeopathy-A Review|url=http://www.ijopjournal.com/File_Folder/57-69.pdf|archive-url=https://web.archive.org/web/20150903231608/http://www.ijopjournal.com/File_Folder/57-69.pdf|archive-date=September 3, 2015|access-date=August 10, 2015|publisher=International Journal of Pharmacotherapy|df=mdy-all}}</ref>

Hahnemann advocated dilutions of 1 part to 10<sup>60</sup> or 30C.<ref name="Organon_6th_128">
{{cite book
|author =Hahnemann S
|title =The Organon of the Healing Art
|year =1921
|publisher =Keats Pub.
|edition =6th
|at =aphorism 128
|isbn =978-0-87983-228-5
}}</ref> Hahnemann regularly used dilutions of up to 30C but opined that "there must be a limit to the matter".<ref name="Haehl1922" />{{rp|322|date=January 2015}} To counter the reduced potency at high dilutions he formed the view that vigorous shaking by striking on an elastic surface – a process termed ''succussion'' – was necessary.<ref name="Kayne 53" /> Homeopaths are unable to agree on the number and force of strikes needed, and there is no way that the claimed results of succussion can be tested.<ref name="Shelton" />{{rp|67–69|date=January 2015}}

Critics of homeopathy commonly emphasize the dilutions involved in homeopathy, using analogies.<ref name="Appendix2">For further discussion of homeopathic dilutions and the mathematics involved, see [[Homeopathic dilutions]].</ref> One mathematically correct example is that a 12C solution is equivalent to "a pinch of salt in both the North and South Atlantic Oceans".<ref name="Bambridge">
{{cite book|author=Bambridge AD|title=Homeopathy investigated|publisher=Diasozo Trust|year=1989|isbn=978-0-948171-20-8|location=[[Kent, England|Kent]], England}}</ref><ref name="Andrews">
{{cite web|author=Andrews P|year=1990|title=Homeopathy and Hinduism|url=http://www.watchman.org/na/homeopth.htm|publisher=[[Watchman Fellowship]]|periodical=The Watchman Expositor|volume=7|issue=3}}</ref><ref>
A 12C solution produced using [[sodium chloride]] (also called ''natrum muriaticum'' in homeopathy) is the equivalent of dissolving 0.36&nbsp;mL of table salt, weighing about 0.77&nbsp;g, into a volume of water the size of the Atlantic Ocean, since the volume of the Atlantic Ocean and its adjacent seas is 3.55×10<sup>8</sup>&nbsp;km<sup>3</sup> or 3.55×10<sup>20</sup>&nbsp;L :
{{cite book|url=https://books.google.com/books?id=6J0TAAAAYAAJ&q=355+x+106+km3+in+the+whole|title=The geology of the Atlantic Ocean|vauthors=Emery KO, Uchupi E|publisher=Springer|year=1984|isbn=978-0-387-96032-6}}</ref> One-third of a [[Drop (volume)|drop]] of some original substance diluted into all the water on Earth would produce a preparation with a concentration of about 13C.<ref name="Appendix2" /><ref>The volume of all water on earth is about 1.36×10<sup>9</sup>&nbsp;km<sup>3</sup>:
{{cite web
|url = http://ga.water.usgs.gov/edu/waterdistribution.html
|title = Earth's water distribution
|website= [[United States Geological Survey]]
|date = August 28, 2006
|access-date = March 14, 2008
|archive-date = June 29, 2012
|archive-url = https://web.archive.org/web/20120629055146/http://ga.water.usgs.gov/edu/waterdistribution.html
}}</ref><ref>Gleick PH, ''Water resources'', In
{{cite book
|title =Encyclopedia of climate and weather
|editor1 =Schneider SH
|publisher =[[Oxford University Press]]
|location =New York
|volume =2
|year =1996
|pages =817–823
}}</ref> [[Robert L. Park]] points out that a 200C dilution of duck liver, marketed under the name [[Oscillococcinum]], would require 10<sup>320</sup> universes worth of molecules to contain just one original molecule in the final substance.<ref>{{cite book
|title =Superstition: Belief in the Age of Science
|url =https://archive.org/details/superstitionbeli00park
|url-access =limited
|author =Robert L. Park
|author-link =Robert L. Park
|publisher =Princeton University Press
|year =2008
|pages =[https://archive.org/details/superstitionbeli00park/page/n157 145]–46
|isbn=978-0-691-13355-3}}</ref> The high dilutions characteristically used are often considered to be the most controversial and implausible aspect of homeopathy.<ref>{{cite journal |last1=Fisher |first1=P |title=The Memory of Water: a scientific heresy? |journal=Homeopathy |volume=96 |issue=3 |pages=141–2 |year=2007 |pmid=17678808 |doi=10.1016/j.homp.2007.05.008|s2cid=3737723 }}</ref>


===Provings===
===Provings===
Homeopaths claim that they can determine the properties of their preparations by following a method which they call "proving".<ref>{{cite journal |last1=Dantas |first1=F |last2=Fisher |first2=P |last3=Walach |first3=H |last4=Wieland |first4=F |last5=Rastogi |first5=D |last6=Teixeira |first6=H |last7=Koster |first7=D |last8=Jansen |first8=J |last9=Eizayaga |first9=J |title=A systematic review of the quality of homeopathic pathogenetic trials published from 1945 to 1995 |journal=Homeopathy |volume=96 |issue=1 |pages=4–16 |year=2007 |pmid=17227742 |doi=10.1016/j.homp.2006.11.005|s2cid=3689226 }}</ref> As performed by Hahnemann, provings involved administering various preparations to healthy volunteers. The volunteers were then observed, often for months at a time. They were made to keep extensive journals detailing all of their symptoms at specific times throughout the day. They were forbidden from consuming coffee, tea, spices, or wine for the duration of the experiment; playing chess was also prohibited because Hahnemann considered it to be "too exciting", though they were allowed to drink beer and encouraged to exercise in moderation.<ref>{{cite book|last1=Bradford|first1=Thomas Lindsley|title=The Life and Letters of Dr. Samuel Hahnemann|date=1895|publisher=Boericke & Tafel|location=Philadelphia|isbn=978-1-330-00150-9|pages=[https://archive.org/details/lifelettersofdrs00brad/page/103 103]–04|url=https://archive.org/details/lifelettersofdrs00brad|access-date=August 27, 2015}}</ref> At first Hahnemann used undiluted doses for provings, but he later advocated provings with preparations at a 30C dilution,<ref name="Organon_6th_128" /> and most modern provings are carried out using ultra-dilute preparations.<ref>
In order to determine which specific remedies could be used to treat which diseases, Hahnemann experimented on himself for several years as well as with patients. His experiments did not initially consist of giving remedies to the sick, because he thought that the most similar remedy, by virtue of its ability to induce symptoms similar to the disease itself, would make it impossible to determine which symptoms came from the remedy and which from the disease itself. Therefore, sick people were excluded from the provings. The method used for determining which remedies were suitable for specific diseases was called "proving". A homeopathic proving is the method by which the [[Profile (engineering)|profile]] of a [[homeopathic remedy]] is determined.<ref>{{cite journal |author=Dantas F, Fisher P, Walach H, ''et al'' |title=A systematic review of the quality of homeopathic pathogenetic trials published from 1945 to 1995 |journal=Homeopathy : the journal of the Faculty of Homeopathy |volume=96 |issue=1 |pages=4–16 |year=2007 |pmid=17227742}}</ref> The word 'proving' derives from the [[Germany|German]] word 'Prüfung' meaning 'test'.
{{cite book|url=https://books.google.com/books?id=w2IFcHJYTSYC&q=homeopathic+proving+method&pg=PA52|title=Homeopathic pharmacy: theory and practice|author=Kayne SB|publisher=Elsevier Health Sciences|year=2006|isbn=978-0-443-10160-1|edition=2|page=52}}</ref>

Provings are claimed to have been important in the development of the [[clinical trial]], due to their early use of simple control groups, systematic and quantitative procedures, and some of the first application of [[statistics]] in medicine.<ref>
{{cite book
|author=Cassedy JH
|title=American Medicine and Statistical Thinking, 1800–1860
|publisher=iUniverse
|year=1999
|isbn=978-1-58348-428-9
}}{{Page needed|date=March 2011}}</ref> The lengthy records of [[self-experimentation]] by homeopaths have occasionally proven useful in the development of modern drugs: For example, evidence that [[nitroglycerin]] might be useful as a treatment for [[angina pectoris|angina]] was discovered by looking through homeopathic provings, though homeopaths themselves never used it for that purpose at that time.<ref name="pmid2866851">
{{cite journal
|author=Fye WB
|title=Nitroglycerin: a homeopathic remedy
|journal=Circulation
|volume=73
|issue=1
|pages=21–29
|year=1986
|pmid=2866851
|doi=10.1161/01.CIR.73.1.21
|doi-access=free
}}</ref> The first recorded provings were published by Hahnemann in his 1796 ''Essay on a New Principle''.<ref>
{{cite journal
|author=Hahnemann S
|title=Versuch über ein neues Prinzip zur Auffindung der Heilkräfte der Arzneisubstanzen, nebst einigen Blicken auf die bisherigen
|journal=[[Journal der Practischen Heilkunde]]
|editor=C. W. Hufelands
|language=de
|volume=II
|issue=3
|year=1796
}}</ref> His ''Fragmenta de Viribus'' (1805)<ref>
{{cite book
|title=Fragmenta de Viribus medicamentorum Positivis
|author=Hahnemann S
|language=la
|location=Leipzig
|year=1805
}}</ref> contained the results of 27 provings, and his 1810 ''Materia Medica Pura'' contained 65.<ref>
{{cite book
|title=Materia medica pura; sive, Doctrina de medicamentorum viribus in corpore humano sano observatis; e Germanico sermone in Latinum conversa
|vauthors=Hahnemann S, Stapf E, Gross G, de Brunnow EG |language=la
|location=Dresden
|publisher=Arnold
|year=1826–1828
|oclc=14840659
}}</ref> For James Tyler Kent's 1905 ''Lectures on Homoeopathic Materia Medica'', 217 preparations underwent provings and newer substances are continually added to contemporary versions.<ref>{{Cite book|last=Kent|first=James Tyler|url=https://books.google.com/books?id=c-ArAQAAMAAJ|title=Lectures on Homoeopathic Materia Medica|date=1905|publisher=Boericke & Tafel|isbn=978-0-7222-9856-5|language=en}}</ref><ref>{{Cite book|last=Kent|first=James Tyler|url=https://books.google.com/books?id=RZtEPAAACAAJ|title=Lectures on Homoeopathic Materia Medica: Together With Kent's "New Remedies" Incorporated and Arranged in One Alphabetical Order|date=2020-03-31|publisher=B. Jain Publishers (P) Limited|isbn=978-81-319-0259-2|language=en}}</ref>

Though the proving process has superficial similarities with clinical trials, it is fundamentally different in that the process is subjective, not [[Blind test|blinded]], and modern provings are unlikely to use pharmacologically active levels of the substance under proving.<ref name="Creighton">{{cite web |url=http://altmed.creighton.edu/Homeopathy/science/validity.htm |title=Are the principles of Homeopathy scientifically valid? |publisher=Creighton University School of Medicine |archive-url=https://web.archive.org/web/20120816233729/http://altmed.creighton.edu/Homeopathy/science/validity.htm |archive-date=August 16, 2012 |df=mdy-all }}</ref> As early as 1842, Oliver Holmes had noted that provings were impossibly vague, and the purported effect was not repeatable among different subjects.<ref name="Holmes" />

== Evidence and efficacy ==
{{main|Evidence and efficacy of homeopathy}}
Outside of the [[alternative medicine]] community, scientists have long considered homeopathy a sham<ref name="aaci2">{{cite journal|last1=Caulfield|first1=Timothy|last2=Rachul|first2=Christen|year=2011|title=Supported by science?: What Canadian naturopaths advertise to the public|journal=Allergy, Asthma & Clinical Immunology|volume=7|issue=1 |page=14|doi=10.1186/1710-1492-7-14|pmc=3182944|pmid=21920039|quote=Within the non-CAM scientific community, homeopathy has long been viewed as a sham|author-link1=Timothy Caulfield |doi-access=free }}</ref> or a [[pseudoscience]],<ref name="Tuomela p83-101">{{cite book |author=Tuomela, R |title=Rational Changes in Science |chapter=Science, Protoscience, and Pseudoscience |publisher=Springer |year=1987 |isbn=978-94-010-8181-8 |veditors=Pitt JC, Marcello P |series=Boston Studies in the Philosophy of Science |volume=98 |pages=83–101 |doi=10.1007/978-94-009-3779-6_4 |author-link=Raimo Tuomela|issn = 0068-0346}}</ref><ref name="Why">{{cite journal |vauthors=Mukerji N, Ernst E |title=Why homoeopathy is pseudoscience |journal=Synthese |date=14 September 2022 |volume=200 |issue=5 |eissn=1573-0964 |doi=10.1007/s11229-022-03882-w |pmid=|s2cid=252297716 |url= |doi-access=free }}</ref><ref name="Baran20142">{{cite book|vauthors=Baran GR, Kiana MF, Samuel SP|title=Healthcare and Biomedical Technology in the 21st Century |chapter=Science, Pseudoscience, and Not Science: How do They Differ? |publisher=Springer|year=2014|isbn=978-1-4614-8540-7|pages=19–57|doi=10.1007/978-1-4614-8541-4_2|quote=within the traditional medical community it is considered to be quackery}}</ref><ref name="Ladyman2">{{cite book|author=Ladyman J|title=Philosophy of Pseudoscience: Reconsidering the Demarcation Problem|publisher=University of Chicago Press|year=2013|isbn=978-0-226-05196-3|veditors=Pigliucci M, Boudry M|pages=48–49|chapter=Chapter 3: Towards a Demarcation of Science from Pseudoscience|quote=Yet homeopathy is a paradigmatic example of pseudoscience. It is neither simply bad science nor science fraud, but rather profoundly departs from scientific method and theories while being described as scientific by some of its adherents (often sincerely).}}</ref> and the medical community regards it as [[quackery]].<ref name="Baran20142" /> There is an overall absence of sound [[statistical evidence]] of therapeutic efficacy, which is consistent with the lack of any [[Biological plausibility|biologically plausible]] pharmacological [[Active ingredient|agent]] or mechanism.<ref name="pmid124926032" /> Proponents argue that homeopathic medicines must work by some, as yet undefined, biophysical mechanism.<ref name="Vickers 1115–11182" /> No homeopathic preparation has been shown to be different from [[placebo]].<ref name="pmid124926032" />

=== Lack of scientific evidence ===
The lack of convincing scientific evidence supporting its efficacy<ref name="Adler2">{{Cite news|author=Adler J|date=February 4, 2004|title=No way to treat the dying|magazine=[[Newsweek]]|url=http://www.newsweek.com/id/105581}}</ref> and its use of preparations without active ingredients have led to characterizations of homeopathy as pseudoscience and quackery,<ref name="Dearden2">{{cite news|last=Dearden|first=Lizzie|date=February 7, 2017|title=Russian Academy of Sciences says homeopathy is dangerous 'pseudoscience' that does not work|newspaper=[[The Independent]]|url=https://www.independent.co.uk/news/world/europe/russia-academy-of-sciences-homeopathy-treaments-pseudoscience-does-not-work-par-magic-a7566406.html|access-date=February 7, 2017}}</ref><ref name="pmid146761792">{{cite journal|last1=Atwood|first1=KC|year=2003|title="Neurocranial restructuring" and homeopathy, neither complementary nor alternative|journal=Archives of Otolaryngology–Head & Neck Surgery|volume=129|issue=12|pages=1356–57|doi=10.1001/archotol.129.12.1356|pmid=14676179}}</ref><ref name="NdububaQuack2">{{cite journal|last1=Ndububa|first1=VI|year=2007|title=Medical quackery in Nigeria; why the silence?|journal=Nigerian Journal of Medicine|volume=16|issue=4|pages=312–17|doi=10.4314/njm.v16i4.37328|pmid=18080586|doi-access=free}}</ref> or, in the words of a 1998 medical review, "placebo therapy at best and quackery at worst".<ref name="Ernst2">{{cite journal|last1=Ernst|first1=E|last2=Pittler|first2=MH|year=1998|title=Efficacy of homeopathic arnica: a systematic review of placebo-controlled clinical trials|journal=Archives of Surgery|volume=133|issue=11|pages=1187–90|doi=10.1001/archsurg.133.11.1187|pmid=9820349|doi-access=free}}</ref> The [[Russian Academy of Sciences]] considers homeopathy a "dangerous 'pseudoscience' that does not work", and "urges people to treat homeopathy 'on a par with magic{{'"}}.<ref name="Dearden2" /> The Chief Medical Officer for England, [[Sally Davies (doctor)|Dame Sally Davies]], has stated that homeopathic preparations are "rubbish" and do not serve as anything more than placebos.<ref>{{cite news|last=Silverman|first=Rosa|title=Homeopathy is 'rubbish', says chief medical officer|work=[[The Daily Telegraph]]|location=London|url=https://www.telegraph.co.uk/health/healthnews/9822744/Homeopathy-is-rubbish-says-chief-medical-officer.html|archive-url=https://web.archive.org/web/20130126102237/http://www.telegraph.co.uk/health/healthnews/9822744/Homeopathy-is-rubbish-says-chief-medical-officer.html|archive-date=January 26, 2013|access-date=January 24, 2013|issn=0307-1235|oclc=49632006}}</ref> In 2013, [[Mark Walport]], the UK [[Government Chief Scientific Adviser]] and head of the [[Government Office for Science]] said "homeopathy is nonsense, it is non-science."<ref name="Collins2">{{cite news|author=Nick Collins|date=April 18, 2013|title=Homeopathy is nonsense, says new chief scientist|work=[[The Daily Telegraph]]|url=https://www.telegraph.co.uk/health/healthnews/10003680/Homeopathy-is-nonsense-says-new-chief-scientist.html|archive-url=https://web.archive.org/web/20130420234704/http://www.telegraph.co.uk/health/healthnews/10003680/Homeopathy-is-nonsense-says-new-chief-scientist.html|archive-date=April 20, 2013}}</ref> His predecessor, [[John Beddington]], also said that homeopathy "has no underpinning of scientific basis" and is being "fundamentally ignored" by the Government.<ref>{{Cite web|last=Gray|first=Richard|date=April 9, 2013|title=Homeopathy on the NHS is 'mad' says outgoing scientific adviser|url=https://www.telegraph.co.uk/news/health/news/9982234/Homeopathy-on-the-NHS-is-mad-says-outgoing-scientific-adviser.html |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/news/health/news/9982234/Homeopathy-on-the-NHS-is-mad-says-outgoing-scientific-adviser.html |archive-date=January 11, 2022 |url-access=subscription |url-status=live|access-date=2020-10-28|website=The Telegraph|language=en-GB}}{{cbignore}}</ref>

Jack Killen, acting deputy director of the [[National Center for Complementary and Alternative Medicine]], says homeopathy "goes beyond current understanding of chemistry and physics". He adds: "There is, to my knowledge, no condition for which homeopathy has been proven to be an effective treatment."<ref name="Adler2" /> [[Ben Goldacre]] says that homeopaths who misrepresent scientific evidence to a [[Scientific literacy|scientifically illiterate]] public, have "... walled themselves off from academic medicine, and critique has been all too often met with avoidance rather than argument".<ref name="Goldacre20072">{{cite journal|last1=Goldacre|first1=Ben|year=2007|title=Benefits and risks of homoeopathy|journal=The Lancet|volume=370|issue=9600|pages=1672–73|doi=10.1016/S0140-6736(07)61706-1|pmid=18022024|s2cid=43588927}}</ref> Homeopaths often prefer to ignore [[Meta-analysis|meta-analyses]] in favour of [[Cherry picking (fallacy)|cherry picked]] positive results, such as by promoting a particular [[observational study]] (one which Goldacre describes as "little more than a customer-satisfaction survey") as if it were more informative than a series of randomized controlled trials.<ref name="Goldacre20072" />

In an article entitled "Should We Maintain an Open Mind about Homeopathy?"<ref name="Baum_&_Ernst2">{{cite journal|last1=Baum|first1=Michael|last2=Ernst|first2=Edzard|year=2009|title=Should We Maintain an Open Mind about Homeopathy?|journal=The American Journal of Medicine|volume=122|issue=11|pages=973–74|doi=10.1016/j.amjmed.2009.03.038|pmid=19854319|quote=Homeopathy is among the worst examples of faith-based medicine... These axioms [of homeopathy] are not only out of line with scientific facts but also directly opposed to them. If homeopathy is correct, much of physics, chemistry, and pharmacology must be incorrect... To have an open mind about homeopathy or similarly implausible forms of alternative medicine (e.g., Bach Flower remedies, spiritual healing, crystal therapy) is, therefore, not an option}}</ref> published in the ''[[American Journal of Medicine]]'', [[Michael Baum (surgeon)|Michael Baum]] and [[Edzard Ernst]]{{spaced ndash}}writing to other physicians{{spaced ndash}}wrote that "Homeopathy is among the worst examples of faith-based medicine... These axioms [of homeopathy] are not only out of line with scientific facts but also directly opposed to them. If homeopathy is correct, much of physics, chemistry, and pharmacology must be incorrect...".

=== Plausibility of dilutions ===
[[File:LedumPalustre15CH.jpg|right|thumb|A homeopathic preparation made from [[marsh tea]]: the "15C" dilution shown here means the original solution was diluted to 1/10<sup>30</sup> of its original strength.]]
The exceedingly low concentration of homeopathic preparations, which often lack even a single [[molecule]] of the diluted substance,<ref name="Ernst2005" /> has been the basis of questions about the effects of the preparations since the 19th century.<ref name="GrimesFACT">{{cite journal|last1=Grimes|first1=D.R.|year=2012|title=Proposed mechanisms for homeopathy are physically impossible|journal=Focus on Alternative and Complementary Therapies|volume=17|issue=3|pages=149–55|doi=10.1111/j.2042-7166.2012.01162.x}}</ref> The laws of chemistry give this dilution limit, which is related to the [[Avogadro constant|Avogadro number]], as being roughly equal to 12C homeopathic dilutions (1 part in 10<sup>24</sup>).<ref name="Appendix2" /><ref name="Sbarrett2">{{cite web|author=Barrett S|date=December 28, 2004|title=Homeopathy: the ultimate fake|url=http://www.quackwatch.org/01QuackeryRelatedTopics/homeo.html|access-date=July 25, 2007|publisher=[[Quackwatch]]}}</ref><ref name="dynam2">{{cite web|author=Faziola L|title=Dynamization and dilution|url=http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm|access-date=July 24, 2007|work=Homeopathy Tutorial|publisher=Creighton University School of Medicine|archive-date=August 26, 2002|archive-url=https://web.archive.org/web/20020826082134/http://altmed.creighton.edu/Homeopathy/philosophy/dilution.htm}}</ref> [[James Randi]] and the [[10:23 campaign]] groups have highlighted the lack of [[active ingredient]]s by taking large 'overdoses'.<ref name="Jones2">Sam Jones, [https://www.theguardian.com/lifeandstyle/2010/jan/29/sceptics-homeopathy-mass-overdose-boots "Homeopathy protesters to take 'mass overdose' outside Boots"], ''[[The Guardian]]'', January 29, 2010</ref> None of the hundreds of demonstrators in the UK, Australia, New Zealand, Canada and the US were injured and "no one was cured of anything, either".<ref name="Jones2" />

Modern advocates of homeopathy have proposed a concept of "[[water memory]]", according to which water "remembers" the substances mixed in it, and transmits the effect of those substances when consumed. This concept is inconsistent with the current understanding of matter, and water memory has never been demonstrated to have any detectable effect, biological or otherwise.<ref name="NatureWhenToBelieve2">{{cite journal|author=Maddox J|year=1988|title=When to believe the unbelievable|journal=Nature|type=editorial|volume=333|issue=6176|pages=1349–56|bibcode=1988Natur.333Q.787.|doi=10.1038/333787a0|pmid=<!--none-->|s2cid=4369459|doi-access=free}}</ref><ref name="delusion2">{{cite journal|last1=Maddox|first1=J|last2=Randi|first2=J|last3=Stewart|first3=W|year=1988|title="High-dilution" experiments a delusion|journal=Nature|volume=334|issue=6180|pages=287–91|bibcode=1988Natur.334..287M|doi=10.1038/334287a0|pmid=2455869|s2cid=9579433}}</ref> Existence of a [[Biological activity|pharmacological effect]] in the absence of any true active ingredient is inconsistent with the [[law of mass action]] and the observed [[dose-response relationship]]s characteristic of therapeutic drugs.<ref name="Levy2">{{cite journal|last1=Levy|first1=G|year=1986|title=Kinetics of drug action: An overview|journal=Journal of Allergy and Clinical Immunology|volume=78|issue=4 Pt 2|pages=754–61|doi=10.1016/0091-6749(86)90057-6|pmid=3534056}}</ref> Homeopaths contend that their methods produce a therapeutically active preparation, selectively including only the intended substance, though in reality any water will have been in contact with millions of different substances throughout its history, and homeopaths cannot account for the selected homeopathic substance being isolated as a special case in their process.<ref name="Smith20122">{{cite journal|author=Smith K|year=2012|title=Homeopathy is Unscientific and Unethical|journal=Bioethics|volume=26|issue=9|pages=508–12|doi=10.1111/j.1467-8519.2011.01956.x|s2cid=143067523|url=https://zenodo.org/record/1035885 }}</ref>

Practitioners also hold that higher dilutions produce stronger medicinal effects. This idea is also inconsistent with observed dose-response relationships, where effects are dependent on the concentration of the active ingredient in the body.<ref name="Levy2" /> Some contend that the phenomenon of [[hormesis]] may support the idea of dilution increasing potency,<ref>{{cite journal|author1=Oberbaum, M|author2=Singer, SR|author3=Samuels, N.|date=Jul 2010|title=Hormesis and homeopathy: bridge over troubled waters|journal=Hum Exp Toxicol|volume=29|issue=7|pages=567–71|doi=10.1177/0960327110369777|pmid=20558608|s2cid=8107797|doi-access=free|bibcode=2010HETox..29..567O }}</ref><ref>{{cite journal|last1=Khuda-Bukhsh|first1=Anisur Rahman|date=2003|title=Towards understanding molecular mechanisms of action of homeopathic drugs: an overview|journal=Molecular and Cellular Biochemistry|volume=253|issue=1/2|pages=339–45|doi=10.1023/A:1026048907739|pmid=14619985|s2cid=10971539}}</ref> but the dose-response relationship outside the zone of hormesis declines with dilution as normal, and nonlinear pharmacological effects do not provide any credible support for homeopathy.<ref name="Smith20122" />

===Efficacy===
{| class="wikitable floatright" style="width:40%;"
|+ Explanations for efficacy of homeopathic preparations:<ref name="Shelton" />{{rp|155–167|date=November 2012}}<ref name="BrienRheumatology">{{cite journal |url= |title=Homeopathy has clinical benefits in rheumatoid arthritis patients that are attributable to the consultation process but not the homeopathic remedy: a randomized controlled clinical trial |author1=Brien S |author2=Lachance S |author3=Prescott P |author4=McDermott C |author5=Lewith G |journal=Rheumatology |date=June 2011 |volume=50 |issue=6 |pages=1070–82 |doi=10.1093/rheumatology/keq234 |pmid=21076131 |pmc=3093927}}</ref>
|-
| The [[placebo effect]]
| The intensive consultation process and expectations for the homeopathic preparations may cause the effect
|-
| Therapeutic effect of the consultation
| The care, concern, and reassurance a patient experiences when opening up to a compassionate caregiver can have a positive effect on the patient's well-being.
|-
| Unassisted [[healing|natural healing]]
| Time and the body's ability to heal without assistance can eliminate many diseases of their own accord.
|-
| Unrecognized treatments
| An unrelated food, exercise, environmental agent, or treatment for a different ailment, may have occurred.
|-
| [[Regression toward the mean|Regression towards the mean]]
| Since many diseases or conditions are cyclical, symptoms vary over time and patients tend to seek care when discomfort is greatest; they may feel better anyway but because of the timing of the visit to the homeopath they attribute improvement to the preparation taken.
|-
| Non-homeopathic treatment
| Patients may also receive standard medical care at the same time as homeopathic treatment, and the former is responsible for improvement.
|-
| Cessation of unpleasant treatment
| Often homeopaths recommend patients stop getting medical treatment such as surgery or drugs, which can cause unpleasant side-effects; improvements are attributed to homeopathy when the actual cause is the cessation of the treatment causing side-effects in the first place, but the underlying disease remains untreated and still dangerous to the patient.
|}

No individual homeopathic preparation has been unambiguously shown by research to be different from placebo.<ref name="pmid124926032" /> The [[Methodology|methodological]] quality of the early primary research was low, with problems such as weaknesses in [[study design]] and reporting, small [[sample size]], and [[selection bias]]. Since better quality trials have become available, the evidence for efficacy of homeopathy preparations has diminished; the highest-quality trials indicate that the preparations themselves exert no intrinsic effect.<ref name="Caulfield20053" /><ref name="Shelton2">{{cite book|last=Shelton|first=JW|url=https://archive.org/details/homeopathyhowitr0000shel|title=Homeopathy: How it really works|publisher=[[Prometheus Books]]|year=2004|isbn=978-1-59102-109-4|location=Amherst, New York|url-access=registration}}</ref>{{rp|206|date=November 2012}}<ref name="Linde19992">{{cite journal|last1=Linde|first1=K|last2=Scholz|first2=M|last3=Ramirez|first3=G|last4=Clausius|first4=N|last5=Melchart|first5=D|last6=Jonas|first6=WB|year=1999|title=Impact of study quality on outcome in placebo-controlled trials of homeopathy|journal=Journal of Clinical Epidemiology|volume=52|issue=7|pages=631–36|doi=10.1016/S0895-4356(99)00048-7|pmid=10391656}}</ref> A review conducted in 2010 of all the pertinent studies of "best evidence" produced by the [[Cochrane Collaboration]] concluded that this evidence "fails to demonstrate that homeopathic medicines have effects beyond placebo."<ref name="Ernst20102" />

In 2009, the United Kingdom's [[House of Commons of the United Kingdom|House of Commons]] Science and Technology Committee concluded that there was no compelling evidence of effect other than placebo.<ref name="inquiry_cfm">UK Parliamentary Committee Science and Technology Committee. [http://www.parliament.uk/business/committees/committees-a-z/commons-select/science-and-technology-committee/inquiries/homeopathy-/ "Evidence Check 2: Homeopathy"]</ref> The Australian [[National Health and Medical Research Council]] completed a comprehensive review of the effectiveness of homeopathic preparations in 2015, in which it concluded that "there were no health conditions for which there was reliable evidence that homeopathy was effective."<ref name="NHMRC2">{{cite book|author1=National Health and Medical Research Council|url=https://www.nhmrc.gov.au/guidelines-publications/cam02|title=NHMRC statement on homeopathy and NHMRC information paper – Evidence on the effectiveness of homeopathy for treating health conditions|date=2015|publisher=National Health and Medical Research Council|isbn=978-1-925129-29-8|location=Canberra|page=16|quote=There is no reliable evidence that homoeopathy is effective for treating health conditions.|author1-link=National Health and Medical Research Council|access-date=August 18, 2016|archive-url=https://web.archive.org/web/20170419065845/https://www.nhmrc.gov.au/guidelines-publications/cam02|archive-date=April 19, 2017|df=mdy-all}}</ref> The European Academies' Science Advisory Council (EASAC) published its official analysis in 2017 finding a lack of evidence that homeopathic products are effective, and raising concerns about quality control.<ref name="EASAC2017">{{cite web|date=September 2017|title=Homeopathic products and practices: assessing the evidence and ensuring consistency in regulating medical claims in the EU|url=http://www.easac.eu/fileadmin/PDF_s/reports_statements/EASAC_Homepathy_statement_web_final.pdf|access-date=1 October 2017|work=European Academies' Science Advisory Council|page=1|quote=... we agree with previous extensive evaluations concluding that there are no known diseases for which there is robust, reproducible evidence that homeopathy is effective beyond the placebo effect.}}</ref> In contrast a 2011 book was published, purportedly financed by the Swiss government, that concluded that homeopathy was effective and cost efficient.<ref>{{Cite book|last1=Bonhöft|first1=Gudrun|title=Homeopathy in healthcare: effectiveness, appropriateness, safety, costs.|last2=Matthiessen|first2=Peter|publisher=Springer|year=2012}}</ref> Although hailed by proponents as proof that homeopathy works,<ref name="ShawMisconduct2">{{cite journal|author=Shaw, David|date=May 2012|title=The Swiss report on homeopathy: a case study of research misconduct|journal=[[Swiss Medical Weekly]]|volume=142|pages=w13594|doi=10.4414/smw.2012.13594|pmid=22653406|doi-access=free}}</ref> it was found to be scientifically, logically and ethically flawed, with most authors having a [[conflict of interest]].<ref name="ShawMisconduct2" /> The [[Swiss Federal Office of Public Health]] later released a statement saying the book was published without the consent of the Swiss government.<ref>{{cite journal|author=Gurtner, Felix|date=December 2012|title=The report "Homeopathy in healthcare: effectiveness, appropriateness, safety, costs" is not a "Swiss report"|journal=[[Swiss Medical Weekly]]|volume=142|pages=w13723|doi=10.4414/smw.2012.13723|pmid=23255156|doi-access=free}}</ref>

[[Meta-analysis|Meta-analyses]], essential tools to summarize evidence of therapeutic efficacy,<ref name="PRISMA2">{{cite journal|last1=Liberati|first1=A|last2=Altman|first2=DG|last3=Tetzlaff|first3=J|last4=Mulrow|first4=C|last5=Gøtzsche|first5=PC|last6=Ioannidis|first6=J PA|last7=Clarke|first7=M|last8=Devereaux|first8=PJ|last9=Kleijnen|first9=J|last10=Moher|first10=D|year=2009|title=The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration|journal=PLOS Medicine|volume=6|issue=7|pages=e1000100|doi=10.1371/journal.pmed.1000100|pmc=2707010|pmid=19621070|doi-access=free}}</ref> and [[systematic review]]s have found that the methodological quality in the majority of randomized trials in homeopathy have shortcomings and that such trials were generally of lower quality than trials of conventional medicine.<ref>{{cite journal|last1=Jonas|first1=WB|last2=Anderson|first2=RL|last3=Crawford|first3=CC|last4=Lyons|first4=JS|date=2001|title=A systematic review of the quality of homeopathic clinical trials|journal=BMC Complementary and Alternative Medicine|volume=1|page=12|doi=10.1186/1472-6882-1-12|pmc=64638|pmid=11801202 |doi-access=free }}</ref><ref name="pmid114160762">{{cite journal|last1=Linde|first1=K|last2=Jonas|first2=WB|last3=Melchart|first3=D|last4=Willich|first4=S|year=2001|title=The methodological quality of randomized controlled trials of homeopathy, herbal medicines and acupuncture|journal=International Journal of Epidemiology|volume=30|issue=3|pages=526–31|doi=10.1093/ije/30.3.526|pmid=11416076|author-link1=Klaus Linde|doi-access=free}}</ref> A major issue has been [[publication bias]], where positive results are more likely to be published in journals.<ref>{{cite journal|author=Jeffrey D. Scargle|year=2000|title=Publication Bias: The "file-drawer problem" in scientific inference|url=http://www.scientificexploration.org/journal/jse_14_1_scargle.pdf|journal=[[Journal of Scientific Exploration]]|volume=14|issue=2|pages=94–106|arxiv=physics/9909033|bibcode=1999physics...9033S|access-date=January 19, 2011|archive-date=January 22, 2015|archive-url=https://web.archive.org/web/20150122021757/http://scientificexploration.org/journal/jse_14_1_scargle.pdf}}</ref>{{unreliable source?|date=February 2020}}<ref name="pmid160607222">{{cite journal|last1=Ioannidis|first1=John P. A.|year=2005|title=Why most published research findings are false|journal=PLOS Medicine|volume=2|issue=8|pages=e124|doi=10.1371/journal.pmed.0020124|pmc=1182327|pmid=16060722 |doi-access=free }}</ref><ref name="pmid18258002">{{cite journal|last1=Kleijnen|first1=J|last2=Knipschild|first2=P|last3=Ter Riet|first3=G|year=1991|title=Clinical trials of homoeopathy|journal=BMJ|volume=302|issue=6772|pages=316–23|doi=10.1136/bmj.302.6772.316|pmc=1668980|pmid=1825800}}</ref> This has been particularly marked in alternative medicine journals, where few of the published articles (just 5% during the year 2000) tend to report [[null result]]s.<ref name="Goldacre20072" /> A systematic review of the available systematic reviews confirmed in 2002 that higher-quality trials tended to have less positive results, and found no convincing evidence that any homeopathic preparation exerts clinical effects different from placebo.<ref name="pmid124926032" /> The same conclusion was also reached in 2005 in a meta-analysis published in ''The Lancet''. A 2017 systematic review and meta-analysis found that the most reliable evidence did not support the effectiveness of non-individualized homeopathy.<ref>{{Cite journal|last1=Mathie|first1=Robert T.|last2=Ramparsad|first2=Nitish|last3=Legg|first3=Lynn A.|last4=Clausen|first4=Jürgen|last5=Moss|first5=Sian|last6=Davidson|first6=Jonathan R. T.|last7=Messow|first7=Claudia-Martina|last8=McConnachie|first8=Alex|date=March 24, 2017|title=Randomised, double-blind, placebo-controlled trials of non-individualised homeopathic treatment: systematic review and meta-analysis|journal=Systematic Reviews|volume=6|issue=1|page=63|doi=10.1186/s13643-017-0445-3|issn=2046-4053|pmc=5366148|pmid=28340607 |doi-access=free }}</ref>

Health organizations, including the UK's [[National Health Service]],<ref name="nhs_choices2">{{cite web|title=Health A-Z -- Homeopathy|url=http://www.nhs.uk/conditions/Homeopathy/Pages/Introduction.aspx|access-date=April 22, 2013|publisher=National Health Service}}</ref> the [[American Medical Association]],<ref name="amapseudo2">{{cite web|author=AMA Council on Scientific Affairs|year=1997|title=Alternative medicine: Report 12 of the Council on Scientific Affairs (A–97)|url=http://www.ama-assn.org/ama/no-index/about-ama/13638.shtml|archive-url=https://web.archive.org/web/20090614085504/http://www.ama-assn.org/ama/no-index/about-ama/13638.shtml|archive-date=June 14, 2009|access-date=March 25, 2009|publisher=[[American Medical Association]]}}</ref> the [[FASEB]],<ref name="Weissmann2">{{cite journal|last1=Weissmann|first1=G|year=2006|title=Homeopathy: Holmes, Hogwarts, and the Prince of Wales|journal=The FASEB Journal|volume=20|issue=11|pages=1755–58|doi=10.1096/fj.06-0901ufm|pmid=16940145|s2cid=9305843|doi-access=free}}</ref> and the [[National Health and Medical Research Council]] of Australia,<ref name="NHMRC2" /> have issued statements saying that there is no good-quality evidence that homeopathy is effective as a treatment for any health condition.<ref name="nhs_choices2" /> In 2009, [[World Health Organization]] official [[Mario Raviglione]] criticized the use of homeopathy to treat [[tuberculosis]]; similarly, another WHO spokesperson argued there was no evidence homeopathy would be an effective treatment for [[Diarrhea|diarrhoea]].<ref>{{cite news|date=August 20, 2009|title=Homeopathy not a cure, says WHO|work=BBC News|url=http://news.bbc.co.uk/2/hi/8211925.stm|access-date=October 20, 2014}}</ref> They warned against the use of homeopathy for serious conditions such as [[Major depressive disorder|depression]], [[HIV/AIDS|HIV]] and [[malaria]].<ref>{{cite journal|last=Mashta|first=O|date=August 24, 2009|title=WHO warns against using homoeopathy to treat serious diseases|journal=BMJ|volume=339|issue=aug24 2|pages=b3447|doi=10.1136/bmj.b3447|pmid=19703929|s2cid=9303173}}</ref> The [[American College of Medical Toxicology]] and the [[American Academy of Clinical Toxicology]] recommend that no one use homeopathic treatment for disease or as a preventive health measure.<ref name="toxicfive2">{{cite web|author1=American College of Medical Toxicology|author1-link=American College of Medical Toxicology|author2=American Academy of Clinical Toxicology|author2-link=American Academy of Clinical Toxicology|date=February 2013|title=Five things physicians and patients should question|url=http://www.choosingwisely.org/doctor-patient-lists/american-college-of-medical-toxicology-and-the-american-academy-of-clinical-toxicology/|access-date=December 5, 2013|work=[[Choosing Wisely]]: an initiative of the [[ABIM Foundation]]|publisher=American College of Medical Toxicology and American Academy of Clinical Toxicology}}, which cites {{cite journal|last1=Woodward|first1=KN|date=May 2005|title=The potential impact of the use of homeopathic and herbal remedies on monitoring the safety of prescription products|journal=Human & Experimental Toxicology|volume=24|issue=5|pages=219–33|doi=10.1191/0960327105ht529oa|pmid=16004184|bibcode=2005HETox..24..219W |s2cid=34767417}}</ref> These organizations report that no evidence exists that homeopathic treatment is effective, but that there is evidence that using these treatments produces harm and can bring indirect health risks by delaying conventional treatment.<ref name="toxicfive2" />

===Purported effects in other biological systems===
While some articles have suggested that homeopathic solutions of high dilution can have statistically significant effects on organic processes including the growth of [[grain]]<ref>{{cite book
|author =Kolisko L
|trans-title =Physiological and physical evidence of the effectiveness of the smallest entities |title=Physiologischer und physikalischer Nachweis der Wirksamkeit kleinster Entitäten
|language =de
|location =Stuttgart
|year =1959
}}</ref> and [[enzyme|enzyme reactions]], such evidence is disputed since attempts to replicate them have failed.<ref name="pmid11316508">{{cite journal |last1=Walach |first1=H |last2=Köster |first2=H |last3=Hennig |first3=T |last4=Haag |first4=G |title=The effects of homeopathic belladonna 30CH in healthy volunteers – a randomized, double-blind experiment |journal=Journal of Psychosomatic Research |volume=50 |issue=3 |pages=155–60 |year=2001 |pmid=11316508 |doi=10.1016/S0022-3999(00)00224-5}}</ref><ref name="pmid8255290">{{cite journal |last1=Hirst |first1=SJ |last2=Hayes |first2=NA |last3=Burridge |first3=J |last4=Pearce |first4=FL |last5=Foreman |first5=JC |title=Human basophil degranulation is not triggered by very dilute antiserum against human IgE |journal=Nature |volume=366 |issue=6455 |pages=525–27 |year=1993 |pmid=8255290 |doi=10.1038/366525a0|bibcode=1993Natur.366..525H |s2cid=4314547 }}</ref><ref name="pmid1376282">{{cite journal |last1=Ovelgönne |first1=J. H. |last2=Bol |first2=AWJM |last3=Hop |first3=WCJ |last4=Wijk |first4=R |title=Mechanical agitation of very dilute antiserum against IgE has no effect on basophil staining properties |journal=Experientia |volume=48 |issue=5 |pages=504–08 |year=1992 |pmid=1376282 |doi=10.1007/BF01928175|s2cid=32110713 }}</ref><ref name="pmid16722785">{{cite journal |last1=Witt |first1=Claudia M |last2=Bluth |first2=M |last3=Hinderlich |first3=S |last4=Albrecht |first4=H |last5=Ludtke |first5=R |last6=Weisshuhn |first6=Thorolf ER |last7=Willich |first7=Stefan N |title=Does potentized HgCl<sub>2</sub> (mercurius corrosivus) affect the activity of diastase and amylase? |journal=Journal of Alternative and Complementary Medicine |volume=12 |pages=359–65 |year=2006 |doi=10.1089/acm.2006.12.359 |pmid=16722785 |issue=4}}</ref><ref name="pmid16036166">{{cite journal |last1=Guggisberg |first1=A |last2=Baumgartner |first2=S |last3=Tschopp |first3=C |last4=Heusser |first4=P |title=Replication study concerning the effects of homeopathic dilutions of histamine on human basophil degranulation in vitro |journal=Complementary Therapies in Medicine |volume=13 |issue=2 |pages=91–100 |year=2005 |pmid=16036166 |doi=10.1016/j.ctim.2005.04.003}}</ref><ref>{{cite journal|last1=Vickers|first1=AJ|title=Independent replication of pre-clinical research in homeopathy: a systematic review.|journal=Forschende Komplementärmedizin|date=December 1999|volume=6|issue=6|pages=311–20|doi=10.1159/000021286|pmid=10649002|s2cid=22051466}}</ref> In 2001 and 2004, [[Madeleine Ennis]] published a number of studies that reported that homeopathic dilutions of [[histamine]] exerted an effect on the activity of [[basophil]]s.<ref>{{cite journal|last1=Brown|first1=V|last2=Ennis|first2=M|date=April 2001|title=Flow-cytometric analysis of basophil activation: inhibition by histamine at conventional and homeopathic concentrations|journal=Inflammation Research|volume=50|issue=Suppl 2|pages=S47–48|doi=10.1007/PL00022402|pmid=11411598|s2cid=10880180}}</ref><ref>{{cite journal|last1=Cumps|first1=J.|last2=Ennis|first2=M.|last3=Mannaioni|first3=P. F.|last4=Roberfroid|first4=M.|last5=Sainte-Laudy|first5=J.|last6=Wiegant|first6=F.A.C.|last7=Belon|first7=P.|date=April 1, 2004|title=Histamine dilutions modulate basophil activation|journal=Inflammation Research|volume=53|issue=5|pages=181–88|doi=10.1007/s00011-003-1242-0|pmid=15105967|s2cid=8682416}}</ref> In response to the first of these studies, ''[[Horizon (BBC TV series)|Horizon]]'' aired a programme in which British scientists attempted to replicate Ennis' results; they were unable to do so.<ref>{{cite web|title=Homeopathy: The Test|url=http://www.bbc.co.uk/science/horizon/2002/homeopathytrans.shtml|access-date=April 29, 2015|publisher=BBC}}</ref> A 2007 systematic review of high-dilution experiments found that none of the experiments with positive results could be reproduced by all investigators.<ref>{{cite journal|last1=Witt|first1=CM|last2=Bluth|first2=M|last3=Albrecht|first3=H|last4=Weisshuhn|first4=TE|last5=Baumgartner|first5=S|last6=Willich|first6=SN|title=The in vitro evidence for an effect of high homeopathic potencies--a systematic review of the literature|journal=Complementary Therapies in Medicine|date=June 2007|volume=15|issue=2|pages=128–38|pmid=17544864|doi=10.1016/j.ctim.2007.01.011}}</ref>

In 1988, French immunologist [[Jacques Benveniste]] published a paper in the journal ''[[Nature (journal)|Nature]]'' while working at [[INSERM]].<ref>{{Cite journal|last1=Davenas|first1=E.|last2=Beauvais|first2=F.|last3=Amara|first3=J.|last4=Oberbaum|first4=M.|last5=Robinzon|first5=B.|last6=Miadonnai|first6=A.|last7=Tedeschi|first7=A.|last8=Pomeranz|first8=B.|last9=Fortner|first9=P.|last10=Belon|first10=P.|last11=Sainte-Laudy|first11=J.|date=1988|title=Human basophil degranulation triggered by very dilute antiserum against IgE|url=http://www.nature.com/articles/333816a0|journal=Nature|language=en|volume=333|issue=6176|pages=816–818|doi=10.1038/333816a0|pmid=2455231|bibcode=1988Natur.333..816D|s2cid=12992106|issn=0028-0836}}</ref> The paper purported to have discovered that basophils released histamine when exposed to a homeopathic dilution of anti-immunoglobulin E antibody. Skeptical of the findings, ''Nature'' assembled an independent investigative team to determine the accuracy of the research. After investigation the team found that the experiments were "statistically ill-controlled", "interpretation has been clouded by the exclusion of measurements in conflict with the claim", and concluded, "We believe that experimental data have been uncritically assessed and their imperfections inadequately reported."<ref name="delusion">
{{cite journal |last1=Maddox |first1=J |last2=Randi |first2=J |last3=Stewart |first3=W |title="High-dilution" experiments a delusion |journal=Nature |volume=334 |issue=6180 |pages=287–91 |year=1988 |pmid=2455869 |doi=10.1038/334287a0 |bibcode=1988Natur.334..287M |s2cid=9579433 }}</ref><ref name="Sullivan 1988-07-27">
{{cite news
|author =Sullivan W
|title =Water that has a memory? Skeptics win second round
|date =July 27, 1988
|work =[[The New York Times]]
|url =https://www.nytimes.com/1988/07/27/us/water-that-has-a-memory-skeptics-win-second-round.html
|access-date =October 3, 2007
|author-link =Walter S. Sullivan
}}</ref><ref>Benveniste defended his results by comparing the inquiry to the Salem witch hunts and asserting that "It may be that all of us are wrong in good faith. This is no crime but science as usual and only the future knows."</ref>

== Ethics and safety ==
[[File:Rhustox.jpg|thumb|Homeopathic preparation ''Rhus toxicodendron'', derived from [[Toxicodendron radicans|poison ivy]]]]The provision of homeopathic preparations has been described as unethical.<ref name="unethical">{{cite journal |last1=Shaw |first1=DM |title=Homeopathy is where the harm is: Five unethical effects of funding unscientific 'remedies' |journal=Journal of Medical Ethics |volume=36 |issue=3 |pages=130–31 |year=2010 |pmid=20211989 |doi=10.1136/jme.2009.034959 |s2cid=206996446 |doi-access=free }}</ref><ref name="Shaw2010">{{cite journal |last=Shaw |first=David |title=Homeopathy and medical ethics |journal=Focus on Alternative and Complementary Therapies |publisher=Wiley |volume=16 |issue=1 |date=4 November 2010 |issn=1465-3753 |doi=10.1111/j.2042-7166.2010.01051.x |pages=17–21}}</ref> [[Michael Baum (surgeon)|Michael Baum]], professor emeritus of surgery and visiting professor of medical humanities at [[University College London]] (UCL), has described homeopathy as a "cruel deception".<ref name="Janes">{{cite news |author=Hilly Janes |url=http://www.timesonline.co.uk/tol/life_and_style/article4682309.ece |title=The Lifestyle 50: The top fifty people who influence the way we eat, exercise and think about ourselves |work=[[The Times]] |date=September 6, 2008 |archive-url=https://web.archive.org/web/20110727183929/http://www.timesonline.co.uk/tol/life_and_style/article4682309.ece |archive-date=July 27, 2011}}</ref> [[Edzard Ernst]], the first professor of [[alternative medicine|complementary medicine]] in the United Kingdom and a former homeopathic practitioner,<ref name="Ernst_memo">[https://publications.parliament.uk/pa/cm200910/cmselect/cmsctech/memo/homeopathy/ucm1602.htm Memorandum submitted by Edzard Ernst HO 16] to the [[House of Lords]]</ref><ref>
{{cite news
|title=The alternative professor
|url=https://www.theguardian.com/science/2003/sep/25/scienceinterviews.health
|author=Boseley S
|newspaper=[[The Guardian]]
|date=July 21, 2008
|location=London
}}</ref><ref name="Con?">{{cite news
|url=https://www.independent.co.uk/life-style/health-and-wellbeing/features/complementary-therapies-the-big-con-813248.html
|title=Complementary therapies: The big con?
|work=The Independent
|access-date=May 4, 2010
|location=London
|date=April 22, 2008
|archive-url=https://web.archive.org/web/20090427070400/http://www.independent.co.uk/life-style/health-and-wellbeing/features/complementary-therapies-the-big-con-813248.html
|archive-date=April 27, 2009
}}</ref> has expressed his concerns about [[pharmacist]]s who violate their ethical code by failing to provide customers with "necessary and relevant information" about the true nature of the homeopathic products they advertise and sell.<ref>
{{cite news
|title=Pharmacists urged to 'tell the truth' about homeopathic remedies
|url=https://www.theguardian.com/science/2008/jul/21/pharmacists.homeophathy
|author=Sample I
|newspaper=[[The Guardian]]
|date=July 21, 2008
|location=London
}}</ref> In 2013 the [[Advertising Standards Authority (United Kingdom)|UK Advertising Standards Authority]] concluded that the [[Society of Homeopaths]] were targeting vulnerable ill people and discouraging the use of essential medical treatment while making misleading claims of efficacy for homeopathic products.<ref name="ASA">{{cite web|date=July 3, 2013|title=ASA adjudication on Society of Homeopaths|url=http://www.asa.org.uk/Rulings/Adjudications/2013/7/Society-of-Homeopaths/SHP_ADJ_157043.aspx|archive-url=https://web.archive.org/web/20130706020223/http://asa.org.uk/Rulings/Adjudications/2013/7/Society-of-Homeopaths/SHP_ADJ_157043.aspx|archive-date=July 6, 2013|access-date=July 4, 2013|publisher=ASA|df=mdy-all}}</ref> In 2015 the [[Federal Court of Australia]] imposed penalties on a homeopathic company for making false or misleading statements about the efficacy of the whooping cough vaccine and recommending homeopathic remedies as an alternative.<ref name="ACCC">{{cite web|title=Court imposes penalty for false or misleading claims by Homeopathy Plus and Ms Frances Sheffield |url=https://www.accc.gov.au/media-release/court-imposes-penalty-for-false-or-misleading-claims-by-homeopathy-plus-and-ms-frances-sheffield|publisher=ACCC|access-date=March 31, 2016|date=October 14, 2015}}</ref>[[File:1belladonna.jpg|thumb|Old homeopathic [[Deadly nightshade|belladonna]] preparation|alt=|left]]A 2000 review by homeopaths reported that homeopathic preparations are "unlikely to provoke severe adverse reactions".<ref>{{cite journal|last1=Dantas|first1=F|last2=Rampes|first2=H|year=2000|title=Do homeopathic medicines provoke adverse effects? A systematic review|journal=British Homoeopathic Journal|volume=89|pages=S35–S38|doi=10.1054/homp.1999.0378|pmid=10939781|s2cid=24738819}}</ref> In 2012, a systematic review evaluating evidence of homeopathy's possible [[adverse effect]]s concluded that "homeopathy has the potential to harm patients and consumers in both direct and indirect ways".<ref name="sr2012">{{cite journal|last1=Posadzki|first1=P|last2=Alotaibi|first2=A|last3=Ernst|first3=E|year=2012|title=Adverse effects of homeopathy: A systematic review of published case reports and case series|journal=International Journal of Clinical Practice|volume=66|issue=12|pages=1178–88|doi=10.1111/ijcp.12026|pmid=23163497|s2cid=2930768|doi-access=free}}</ref> A 2016 systematic review and meta-analysis found that, in homeopathic clinical trials, adverse effects were reported among the patients who received homeopathy about as often as they were reported among patients who received placebo or conventional medicine.<ref>{{cite journal|last1=Stub|first1=T|last2=Musial|first2=F|last3=Kristoffersen|first3=AA|last4=Alræk|first4=T|last5=Liu|first5=J|date=June 2016|title=Adverse effects of homeopathy, what do we know? A systematic review and meta-analysis of randomized controlled trials|url=https://munin.uit.no/bitstream/10037/10908/4/article.pdf|journal=Complementary Therapies in Medicine|volume=26|pages=146–63|doi=10.1016/j.ctim.2016.03.013|pmid=27261996|hdl=10037/10908}}</ref>

Some homeopathic preparations involve poisons such as [[Atropa belladonna|Belladonna]], [[arsenic]], and [[Toxicodendron radicans|poison ivy]]. In rare cases, the original ingredients are present at detectable levels. This may be due to improper preparation or intentional low dilution. Serious adverse effects such as seizures and death have been reported or associated with some homeopathic preparations.<ref name="sr2012" /> Instances of [[arsenic poisoning]] have occurred.<ref name="J Toxicology: Arsenic toxicity" /> In 2009, the FDA advised consumers to stop using three discontinued cold remedy [[Zicam]] products because it could cause permanent damage to users' sense of smell.<ref>Sources:

* {{cite news|author=Julianne Pepitone|date=June 16, 2009|title=Zicam may damage sense of smell – FDA|publisher=[[CNNMoney.com]]|url=https://money.cnn.com/2009/06/16/news/companies/zicam_sense_of_smell/index.htm?section=money_latest}}
* {{cite web|date=June 16, 2009|title=Information on Zicam Cold Remedy nasal gel, Zicam Cold Remedy nasal swabs, and Zicam Cold Remedy swabs, kids size|url=https://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm166834.htm|publisher=[[Food and Drug Administration (United States)|FDA]]}}</ref> In 2016 the FDA issued a safety alert to consumers<ref name="FDAconsumers">{{cite web |url=https://www.fda.gov/safety/medwatch/safetyinformation/safetyalertsforhumanmedicalproducts/ucm523435.htm |title=Homeopathic Teething Tablets and Gels: FDA Warning – Risk to Infants and Children |publisher=FDA |date=September 30, 2016 |access-date=October 17, 2016}}</ref> warning against the use of homeopathic teething gels and tablets following reports of adverse events after their use.<ref name="FDANewsRelease">{{cite web |url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm523468.htm |title=FDA warns against the use of homeopathic teething tablets and gels |publisher=FDA |date=September 30, 2016 |access-date=October 17, 2016}}</ref> A previous FDA investigation had found that these products were improperly diluted and contained "unsafe levels of belladonna" and that the reports of serious adverse events in children using this product were "consistent with belladonna toxicity".<ref name="arstechnicaFDA">{{cite web |url=http://arstechnica.co.uk/science/2016/10/fda-homeopathic-teething-gels-may-have-killed-10-babies-sickened-400/ |title=FDA: Homeopathic teething gels may have killed 10 babies, sickened 400 |publisher=Ars Technica UK |date=October 13, 2016 |access-date=October 17, 2016 |author=Mole, Beth}}</ref>

Patients who choose to use homeopathy rather than [[evidence-based medicine]] risk missing timely diagnosis and effective treatment, thereby worsening the outcomes of serious conditions such as cancer.<ref name="Mayo Clinic Proceedings: trials" /><ref name="pmid12974558">{{cite journal |last1=Malik |first1=IA |last2=Gopalan |first2=S |title=Use of CAM results in delay in seeking medical advice for breast cancer |journal=European Journal of Epidemiology |volume=18 |issue=8 |pages=817–22 |year=2002 |pmid=12974558 |doi=10.1023/A:1025343720564 |s2cid=19059757 |quote=CAM use [in the developing countries this study solely considered] was associated with delay in seeking medical advice (OR: 5.6; 95% CI: 2.3, 13.3) and presentation at an advanced stage of disease}}</ref><ref name="pmid8554846" /><ref name="BBC malaria" /> The Russian [[Commission on Pseudoscience]] has said homeopathy is not safe because "patients spend significant amounts of money, buying medicines that do not work and disregard already known effective treatment."<ref>{{Cite web|date=2017-02-07|title=Memorandum #2. Homeopathy as pseudoscience|url=http://klnran.ru/en/2017/02/memorandum02-homeopathy/|access-date=March 19, 2021|website=[[Commission on Pseudoscience]]}}</ref> Critics have cited cases of patients failing to receive proper treatment for diseases that could have been easily managed with conventional medicine and who have died as a result.<ref name="Baby_Gloria">Case of Baby Gloria, who died in 2002:
*{{cite news
|title = Homeopath Thomas Sam guilty of daughter Gloria's death
|newspaper = [[The Daily Telegraph (Sydney)|The Daily Telegraph]]
|location = Sydney
|date = June 5, 2009
|url = http://www.dailytelegraph.com.au/news/homeopath-thomas-sam-guilty-of-daughter-glorias-death/story-e6freuy9-1225723018271
|access-date = March 17, 2010
|archive-date = November 18, 2012
|archive-url = https://web.archive.org/web/20121118064506/http://www.dailytelegraph.com.au/news/homeopath-thomas-sam-guilty-of-daughter-glorias-death/story-e6freuy9-1225723018271
}}
*{{cite news
|title = Parents guilty of manslaughter over daughter's eczema death
|newspaper = [[The Canberra Times]]
|date = June 5, 2009
|url = http://www.canberratimes.com.au/news/national/national/general/parents-guilty-of-manslaughter-over-daughters-eczema-death/1533293.aspx
|archive-url = https://web.archive.org/web/20100625160931/http://www.canberratimes.com.au/news/national/national/general/parents-guilty-of-manslaughter-over-daughters-eczema-death/1533293.aspx
|archive-date = June 25, 2010
|df = mdy-all
}}</ref><ref name="Dingle">{{cite web |author1=Alastair Neil Hope |author2=State Coroner |url=https://www.scribd.com/doc/68731728/Coroner-Dingle-Finding |title=Coroner's inquest into the death of Penelope Dingle. Ref No: 17/10 }}</ref> They have also condemned the "marketing practice" of criticizing and downplaying the effectiveness of medicine.<ref name="Goldacre20072" /><ref name="Dingle" /> Homeopaths claim that use of conventional medicines will "push the disease deeper" and cause more serious conditions, a process referred to as "suppression".<ref>
{{cite book
|author=Schmukler AV
|year=2006
|url=https://books.google.com/books?id=E1fVzLCmk5gC&q=suppression+homeopathy&pg=PA16
|title=Homeopathy: An A to Z Home Handbook
|publisher=Llewellyn Worldwide
|page=16
|isbn=978-0-7387-0873-7
}}</ref> In 1978, [[Anthony Campbell (physician)|Anthony Campbell]], a consultant physician at the Royal London Homeopathic Hospital, criticized statements by [[George Vithoulkas]] claiming that [[syphilis]], when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the [[central nervous system]].<ref>{{cite journal|author=Campbell A|date=October 1978|title=The science of homoeopathy, by G. Vithoulkas|journal=British Homoeopathic Journal|type=book review|volume=67|issue=4|pages=299–301|doi=10.1016/S0007-0785(78)80061-1|s2cid=69144584 }}</ref> Vithoulkas' claims echo the idea that treating a disease with external medication used to treat the symptoms would only drive it deeper into the body and conflict with scientific studies, which indicate that [[penicillin]] treatment produces a complete cure of syphilis in more than 90% of cases.<ref name="Birnbaum">{{cite journal|vauthors=Birnbaum NR, Goldschmidt RH, Buffett WO|year=1999|title=Resolving the common clinical dilemmas of syphilis|url=http://www.aafp.org/afp/990415ap/2233.html|journal=American Family Physician|volume=59|issue=8|pages=2233–40, 2245–46|pmid=10221308|access-date=September 3, 2007|archive-date=June 6, 2011|archive-url=https://web.archive.org/web/20110606033808/http://www.aafp.org/afp/990415ap/2233.html}}</ref>

The use of homeopathy as a preventive for serious infectious diseases, called [[homeoprophylaxis]], is especially controversial.<ref name="BBC-malaria">{{cite news|date=January 5, 2011|title=Is bad homeopathic advice putting travellers at risk?|work=Newsnight|agency=BBC|url=http://news.bbc.co.uk/1/hi/programmes/newsnight/9341713.stm|access-date=January 10, 2015}}</ref> Some homeopaths (particularly those who are non-physicians) advise their patients against [[vaccine|immunization]].<ref name="pmid8554846" /><ref name="pmid9243229">{{cite journal |last1=Ernst |first1=E. |title=The attitude against immunisation within some branches of complementary medicine |journal=European Journal of Pediatrics |volume=156 |issue=7 |pages=513–15 |year=1997 |pmid=9243229 |doi=10.1007/s004310050650|s2cid=25420567 |doi-access=free }}</ref><ref>{{cite journal |last1=Ernst |first1=E |title=Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination |journal=Vaccine |volume=20 |pages=S90–93; discussion S89 |year=2001 |doi=10.1016/S0264-410X(01)00290-0 |pmid=11587822}}</ref> Others have suggested that vaccines be replaced with homeopathic "nosodes".<ref>
{{cite journal
|author =Pray WS
|title =The challenge to professionalism presented by homeopathy
|journal =American Journal of Pharmaceutical Education
|volume =60
|pages =198–204
|year =1996
|issue =2
|doi =10.1016/S0002-9459(24)04582-0
}}</ref> While Hahnemann was opposed to such preparations, modern homeopaths often use them although there is no evidence to indicate they have any beneficial effects.<ref>
{{cite journal
|title =A challenge to the credibility of homeopathy
|journal =American Journal of Pain Management
|year =1992
|author =Pray WS
|issue =2
|pages =63–71
}}</ref><ref>{{cite journal |last1=English |first1=J |title=The issue of immunization |journal=British Homoeopathic Journal |volume=81 |pages=161–63 |year=1992 |doi=10.1016/S0007-0785(05)80171-1 |issue=4|s2cid=71502677 }}</ref> Promotion of homeopathic alternatives to vaccines has been characterized as dangerous, inappropriate and irresponsible.<ref name="CBC-Irresponsible">{{cite web|date=November 28, 2014|title=Vaccine alternatives offered by homeopaths 'irresponsible'|url=http://www.cbc.ca/news/health/vaccine-alternatives-offered-by-homeopaths-irresponsible-1.2852408|access-date=January 10, 2015|work=Marketplace|publisher=CBC}}</ref><ref name="BBC-Poling">{{cite news|author=Poling, Samantha|date=September 13, 2010|title=Doctors warn over homeopathic 'vaccines'|agency=BBC|url=https://www.bbc.co.uk/news/uk-scotland-11277990|access-date=January 10, 2015}}</ref> In December 2014, the Australian homeopathy supplier [[Homeopathy Plus!]] was found to have acted deceptively in promoting homeopathic alternatives to vaccines.<ref name="ACCC-HPlus">{{cite web|date=December 23, 2014|title=Court finds Homeopathy Plus! vaccine claims misleading|url=https://www.accc.gov.au/media-release/court-finds-homeopathy-plus-vaccine-claims-misleading|access-date=January 10, 2015|publisher=Australian Competition and Consumer Commission}}</ref> In 2019, an investigative journalism piece by the [[The Daily Telegraph|''Telegraph'']] revealed that homeopathy practitioners were actively discouraging patients from vaccinating their children.<ref>{{Cite news|last1=Rushton|first1=Katherine|last2=Foggo|first2=Daniel|last3=Barnes|first3=Sophie|date=2019-11-01|title=Homeopaths warning mothers not to have children vaccinated, investigation reveals|language=en-GB|work=[[The Daily Telegraph]]|url=https://www.telegraph.co.uk/news/2019/11/01/homeopaths-warning-mothers-not-have-children-vaccinated-investigation/ |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/news/2019/11/01/homeopaths-warning-mothers-not-have-children-vaccinated-investigation/ |archive-date=January 11, 2022 |url-access=subscription |url-status=live|access-date=2019-11-03|issn=0307-1235}}{{cbignore}}</ref> Cases of homeopaths advising against the use of anti-malarial drugs have also been identified,<ref name="BBC malaria" /><ref name="Guardian malaria" /><ref name="pmid11082104" /> putting visitors to the tropics in severe danger.<ref name="BBC malaria">
{{cite news
|author =Jones M
|title =Malaria advice 'risks lives'
|date =July 14, 2006
|periodical =[[Newsnight]]
|publisher =[[BBC Television]]
|url =http://news.bbc.co.uk/2/hi/programmes/newsnight/5178122.stm
|access-date =March 24, 2009
}}</ref><ref name="Guardian malaria">
{{cite news
|author =Jha A
|title =Homeopaths 'endangering lives' by offering malaria remedies
|date =July 14, 2006
|url =https://www.theguardian.com/science/story/0,,1820103,00.html
|newspaper =[[The Guardian]]
|location =London
}}</ref><ref name="pmid11082104">{{cite journal |last1=Starr |first1=M. |title=Malaria affects children and pregnant women most |journal=BMJ |volume=321 |page=1288 |year=2000 |doi=10.1136/bmj.321.7271.1288 |issue=7271|pmc=1119021 |pmid=11082103}}</ref><ref name="Coffman">{{cite web|author=Coffman, Becky |url=https://www.cdc.gov/malaria/stories/homeopathic_drugs.html |url-status=dead |archive-url=https://web.archive.org/web/20140324180407/https://www.cdc.gov/malaria/stories/homeopathic_drugs.html |archive-date=March 24, 2014 |title=A cautionary tale: the risks of unproven antimalarials |publisher=[[Centers for Disease Control]] |date=January 28, 2019 }}{{cbignore}}</ref>

A 2006 review recommends that pharmacy colleges include a required course where ethical dilemmas inherent in recommending products lacking proven safety and efficacy data be discussed and that students should be taught where unproven systems such as homeopathy depart from evidence-based medicine.<ref>
{{cite journal
|author=Pray WS
|title=Ethical, scientific, and educational concerns with unproven medications
|journal=American Journal of Pharmaceutical Education
|volume=70
|issue=6
|page=141
|year=2006
|pmid=17332867
|pmc=1803699
|doi=10.5688/aj7006141
}}</ref>

==Regulation and prevalence==
{{Main|Regulation and prevalence of homeopathy}}
[[File:Bristol Homeopathic.jpg|thumb|Hampton House, the former site of [[Bristol Homeopathic Hospital]]]]

Homeopathy is fairly common in some countries while being uncommon in others; is highly regulated in some countries and mostly unregulated in others. It is practiced worldwide and professional qualifications and licences are needed in most countries.<ref name="Who Legal">{{Cite web|date=2001|title=Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review|url=http://apps.who.int/medicinedocs/pdf/h2943e/h2943e.pdf|archive-url=https://web.archive.org/web/20090927001352/http://apps.who.int/medicinedocs/pdf/h2943e/h2943e.pdf|archive-date=September 27, 2009|access-date=2020-09-01|website=World Health Organization}}</ref> A 2019 WHO report found that 100 out of 133 Member States surveyed in 2012 acknowledged that their population used homeopathy, with 22 saying the practice was regulated and 13 providing health insurance coverage.<ref name="WHO traditional">{{Cite web|date=4 June 2019|title=WHO global report on traditional and complementary medicine 2019|url=https://www.who.int/traditional-complementary-integrative-medicine/WhoGlobalReportOnTraditionalAndComplementaryMedicine2019.pdf?ua=1|access-date=2020-09-04|website=WHO|language=en}}</ref> In some countries, there are no specific legal regulations concerning the use of homeopathy, while in others, licences or degrees in conventional medicine from accredited universities are required. In 2001 homeopathy had been integrated into the national health care systems of many countries, including India, Mexico, Pakistan, Sri Lanka, and the United Kingdom.<ref name="Who Legal" />

=== Regulation ===
Some homeopathic treatment is covered by the public health service of several European countries, including Scotland,<ref>{{cite news |last1=Green |first1=Chris |title=Scotland urged to stop funding homeopathy on NHS |url=https://inews.co.uk/news/health/scotland-urged-stop-funding-homeopathy-nhs-522057 |access-date=18 January 2020 |publisher=iNews |date=2 August 2017}}</ref> and [[Luxembourg]].<ref>{{cite web |last1=Clarinval |first1=France |title=Homeopathy to remain reimbursable in Luxembourg |url=https://today.rtl.lu/news/luxembourg/a/1393668.html |website=today.rt.lu |publisher=RTL Today |access-date=4 May 2020}}</ref> It used to be covered in France until 2021.<ref name="FranceEndFunding2021" /> In other countries, such as Belgium, homeopathy is not covered. In Austria, the public health service requires scientific proof of effectiveness in order to reimburse medical treatments and homeopathy is listed as not reimbursable,<ref>
{{cite web|author=[[Central Association of Austrian Social Insurance Authorities|Hauptverband der österreichischen Sozialversicherungsträger]]|date=March 31, 2004|title=Liste nicht erstattungsfähiger Arzneimittelkategorien gemäß § 351c Abs. 2 ASVG (List of treatments not reimbursable by social service providers in Austria)|url=https://www.avsv.at/avi/dokument/dokumentanzeige.xhtml?dokid=2004%3D34&dokStat=0&csrId=1736&tlId=1231413537940|archive-url=https://web.archive.org/web/20110706091417/https://www.avsv.at/avi/dokument/dokumentanzeige.xhtml?dokid=2004%3D34&dokStat=0&csrId=1736&tlId=1231413537940|archive-date=July 6, 2011|language=de|df=mdy-all}}</ref> but exceptions can be made;<ref>
{{cite court|litigants=Rechtssatz (legal rule)|court=Oberster Gerichtshof (Austrian supreme court)|opinion=RS0083796 {{in lang|de}}|date=February 28, 1994|url=http://www.ris.bka.gv.at/Dokumente/Justiz/JJR_19940228_OGH0002_010OBS00103_9300000_001/JJR_19940228_OGH0002_010OBS00103_9300000_001.pdf|format=PDF}}</ref> private health insurance policies sometimes include homeopathic treatments.<ref name="Who Legal" /> In 2018, Austria's [[Medical University of Vienna]] stopped teaching homeopathy.<ref name="Undark 2020-09-02">{{Cite web|date=2020-03-16|title=In Germany, a Heated Debate Over Homeopathy|url=https://undark.org/2020/03/16/homeopathy-globuli-germany/|access-date=2020-09-02|website=Undark Magazine|language=en-US}}</ref> The Swiss government withdrew coverage of homeopathy and four other complementary treatments in 2005, stating that they did not meet efficacy and cost-effectiveness criteria,<ref name="EndofHomeopathy">{{cite journal|author=<!-- No author listed -->|year=2005|title=The end of homoeopathy|journal=The Lancet|volume=366|issue=9487|page=690|doi=10.1016/S0140-6736(05)67149-8|pmid=16125567|s2cid=6115077|doi-access=free}}</ref> but following a referendum in 2009 the five therapies were reinstated for a further 6-year trial period.<ref>{{cite web|author=Dacey J|date=January 14, 2011|title=Alternative therapies are put to the test|url=http://www.swissinfo.ch/eng/swiss_news/Alternative_therapies_are_put_to_the_test.html?cid=29242484|access-date=January 17, 2011|publisher=swissinfo.ch|archive-date=April 22, 2014|archive-url=https://web.archive.org/web/20140422184705/http://www.swissinfo.ch/eng/swiss_news/Alternative_therapies_are_put_to_the_test.html?cid=29242484|url-status=dead}}</ref> In Germany, homeopathic treatments are covered by 70 percent of government medical plans, and available in almost every pharmacy.<ref name="Undark 2020-09-02" /> In January 2024, [[Federal Ministry of Health (Germany)|German health minister]] [[Karl Lauterbach]] announced plans to withdraw all statutory health insurance coverage for homeopathic and anthroposophic treatments, citing a lack of scientific evidence for their efficacy.<ref>{{cite web|author=Tagesschau|date=January 11, 2024|title="Homöopathie macht als Kassenleistung keinen Sinn"|url=https://www.tagesschau.de/inland/innenpolitik/lauterbach-homoeopathie-kassenleistung-100.html|access-date=January 18, 2024|publisher=tagesschau.de}}</ref>

The English NHS recommended against prescribing homeopathic preparations in 2017.<ref name="NHS Homeo" /> In 2018, prescriptions worth £55,000 were written in defiance of the guidelines, representing less than 0.001% of the total NHS prescribing budget.<ref>{{Cite web|date=2017-10-18|title=Homeopathy|url=https://www.nhs.uk/conditions/homeopathy/|access-date=2020-01-18|website=nhs.uk|language=en}}</ref><ref>{{Cite news|last1=Donnelly|first1=Laura|last2=Taylor|first2=Rosie|date=2019-04-05|title=NHS still spending £55,000 a year on homeopathy, despite ban|language=en-GB|work=The Telegraph|url=https://www.telegraph.co.uk/news/2019/04/05/nhs-still-spending-55000-year-homeopathy-despite-ban/ |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/news/2019/04/05/nhs-still-spending-55000-year-homeopathy-despite-ban/ |archive-date=January 11, 2022 |url-access=subscription |url-status=live|access-date=2020-01-18|issn=0307-1235}}{{cbignore}}</ref> In 2016 the UK's [[Committee of Advertising Practice]] compliance team wrote to homeopaths<ref name="NightingaleASA_CAP">{{cite web|date=September 29, 2016|title=Diluting misleading claims – ASA update|url=http://www.nightingale-collaboration.org/news/185-diluting-misleading-claims-asa-update.html|access-date=September 30, 2016|publisher=Nightingale Collaboration}}</ref> in the UK to "remind them of the rules that govern what they can and can't say in their marketing materials".<ref name="ASA_CAP">{{cite web|date=September 29, 2016|title=Advertising standards for homeopathy|url=https://www.asa.org.uk/News-resources/Media-Centre/2016/Advertising-standards-for-homeopathy.aspx|access-date=September 30, 2016|publisher=Advertising Standards Authority}}</ref> The letter told homeopaths to "ensure that they do not make any direct or implied claims that homeopathy can treat medical conditions" and asks them to review their marketing communications "including websites and social media pages" to ensure compliance.<ref name="LetterToHomeopaths">{{cite web|author=CAP Compliance Team|date=September 28, 2016|title=Advertising standsards for homeopaths|url=https://www.asa.org.uk/News-resources/Media-Centre/2016/~/media/Files/CAP/News/Letter%20to%20Homeopaths.pdf|archive-url=https://web.archive.org/web/20161003143347/https://www.asa.org.uk/News-resources/Media-Centre/2016/~/media/Files/CAP/News/Letter%20to%20Homeopaths.pdf|archive-date=October 3, 2016|access-date=September 30, 2016|publisher=Committee of Advertising Practice|df=mdy-all}}</ref> Homeopathic services offered at [[Bristol Homeopathic Hospital]] in the UK ceased in October 2015.<ref name="GoodThinking">{{cite web|date=June 5, 2015|title=Bristol Homeopathic Hospital To Cease Offering Homeopathic Treatments|url=http://goodthinkingsociety.org/bristol-homeopathic-hospital-cease-offering-homeopathic-treatments/|access-date=April 29, 2016|publisher=Good Thinking}}</ref><ref name="BristolPost-10-06-2015">{{cite news|last1=Cardwell|first1=Mark|date=June 10, 2015|title=Homeopathy services will no longer be available at Bristol NHS Trust hospitals|work=Bristol Post|url=http://www.bristolpost.co.uk/Homeopathy-services-longer-available-NHS-Bristol/story-26666377-detail/story.html|access-date=April 29, 2016|archive-url=https://web.archive.org/web/20150928025310/http://www.bristolpost.co.uk/Homeopathy-services-longer-available-NHS-Bristol/story-26666377-detail/story.html|archive-date=September 28, 2015|df=mdy-all}}</ref>

Member states of the [[European Union]] are required to ensure that homeopathic products are registered, although this process does not require any proof of efficacy.<ref name="Commander Snake">{{Cite web|last=Commander|first=Emily|date=2018-10-01|title=Snake oil or science? Homeopathy in Europe|url=https://www.euronews.com/2018/10/01/snake-oil-or-science-homeopathy-in-europe|access-date=2020-09-04|website=euronews|language=en}}</ref> In Spain, the [[Association for the protection of patients from pseudo-scientific therapies]] is lobbying to get rid of the easy registration procedure for homeopathic remedies.<ref name="Commander Snake" /> In Bulgaria, Hungary, Latvia, Romania and Slovenia homeopathy, by law, can only be practiced by medical practitioners. However, in Slovenia if doctors practice homeopathy their medical license will be revoked.<ref name="Commander Snake" /> In Germany, to become a homeopathic physician, one must attend a three-year training program, while France, Austria and Denmark mandate licences to diagnose any illness or dispense of any product whose purpose is to treat any illness.<ref name="Who Legal" /> Homeopaths in the UK are under no legal regulations, meaning anyone can call themselves homeopaths and administer homeopathic remedies.<ref name="NHS Homeo">{{Cite web|date=2017-10-18|title=Homeopathy|url=https://www.nhs.uk/conditions/homeopathy/|access-date=2020-09-02|website=nhs.uk|language=en}}</ref>[[File:India - Varanasi pharmacy - 0830.jpg|left|thumb|Homeopathics at a homeopathic pharmacy in [[Varanasi]], India]]
[[File:A local store of Homeopathic medicines at Jagadishpur Hat, West Bengal.jpg|thumb|Homeopathic medicines at a store in [[West Bengal]], India]]
The [[Indian government]] recognizes homeopathy as one of its national systems of medicine and they are sold with medical claims.<ref>{{cite web
|url = http://india.gov.in/citizen/health/healthcare_system.php
|title = Alternative System of Health Care
|publisher = Government of India
|access-date = January 15, 2010
|archive-url = https://web.archive.org/web/20100102154756/http://india.gov.in/citizen/health/healthcare_system.php
|archive-date = January 2, 2010
}}</ref><ref name="WHO traditional" /> It has established the [[Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy]] (AYUSH) under the [[Ministry of Health and Family Welfare (India)|Ministry of Health & Family Welfare]].<ref>{{cite news|url=http://indianmedicine.nic.in/index.asp?lang=1|title=AYUSH|publisher=[[Government of India]]. website|archive-url=https://archive.today/20130822171213/http://indianmedicine.nic.in/index.asp?lang=1|archive-date=August 22, 2013|df=mdy-all}}</ref> The south Indian state of [[Kerala]] also has a cabinet-level AYUSH department.<ref>{{cite web|url=http://www.homoeoscan.com/2015/06/Kerala-AYUSH-department-Final-nod.html|title=Kerala AYUSH department- Final nod|date=June 4, 2015|website=Homoeoscan|access-date=October 1, 2017}}</ref> The [[Central Council of Homoeopathy]] was established in 1973 to monitor higher education in homeopathy, and the [[National Institute of Homoeopathy]] in 1975.<ref>{{cite web|title=Professional Councils |url=http://www.ugc.ac.in/inside/pcouncil.html#CCH |publisher=[[University Grants Commission (India)|University Grants Commission]] (UGC) website |archive-url=https://web.archive.org/web/20100106075646/http://www.ugc.ac.in/inside/pcouncil.html |archive-date=January 6, 2010 }}</ref> Principals and standards for homeopathic products are covered by the ''[[Homoeopathic pharmacopoeia of India]]''.<ref name="WHO Safety" /> A minimum of a recognized diploma in homeopathy and registration on a state register or the Central Register of Homoeopathy is required to practice homeopathy in India.<ref>{{cite web
|url = http://www.cchindia.com/central_act3.htm
|title = The Homoeopathy Central Council Act, 1973, s. 15 and Sch. II
|publisher = Central Council of Homeopathy, India
|access-date = January 18, 2010
|archive-url = https://web.archive.org/web/20091123105853/http://www.cchindia.com/central_act3.htm
|archive-date = November 23, 2009
|df = mdy-all
}}</ref>

Some [[medical school]]s in Pakistan,<ref>{{Cite web |url=https://www.thenews.com.pk/print/436504-govt-asked-to-set-up-university-to-promote-homoeopathy |title=Govt asked to set up university to promote homoeopathy}}</ref> India,<ref>{{cite news|last1=MANDHANI|first1=APOORVA|title=Gujarat HC Quashes Rules Permitting Common Counselling By State For Management Quota Seats in Ayurveda Colleges [Read Judgment]|url=http://www.livelaw.in/gujarat-hc-quashes-rules-permitting-common-counselling-state-management-quota-seats-ayurveda-colleges-read-judgment/|publisher=Live Law|date=August 8, 2017}}</ref><ref>{{cite news|title=Alternative Medicine: Emerging Careers|url=https://www.northeasttoday.in/alternative-medicine-emerging-careers/|publisher=northeasttoday.in|date=March 23, 2017|access-date=March 4, 2021|archive-date=January 8, 2018|archive-url=https://web.archive.org/web/20180108062819/https://www.northeasttoday.in/alternative-medicine-emerging-careers/}}</ref> and Bangladesh,<ref>{{Cite web |url=https://books.google.com/books?id=7u8QjjEwif4C&q=bachelor+of+homoeopathy+medicine+and+surgery+in+bangladesh |title=Statistical Yearbook of Bangladesh|year=2012}}</ref><ref>{{Cite web |url=https://www.homoeopathicboardbd.org/ |title=Bangladesh Homoeopathy Board – Bangladesh Homoeopathy Board}}</ref> offer an undergraduate degree programme in homeopathy.<ref>{{Cite book |url=https://books.google.com/books?id=3RYrDwAAQBAJ&q=Bachelor+of+Homoeopathy+Medicine+and+Surgery&pg=PT77 |title=Educational Equivalency Analysis: India & USA Degrees: 108 India Degrees and Equivalency to USA degrees |isbn=978-93-5278-117-1 |last1=Raghu Korrapati |first1=Dr |date=2017-07-06|publisher=Diamond Pocket Books Pvt }}</ref> Upon completion the college may award a ''{{visible anchor|Bachelor of Homoeopathy Medicine and Surgery}}'' (''B.H.M.S.'').

In the United States each state is responsible for the laws and licensing requirements for homeopathy.<ref>{{Cite web|title=Practicing & Studying Homeopathy|url=https://www.homeopathycenter.org/practicing-studying-homeopathy/|access-date=2020-09-02|website=The National Center for Homeopathy|language=en|archive-date=April 14, 2021|archive-url=https://web.archive.org/web/20210414135845/https://www.homeopathycenter.org/practicing-studying-homeopathy/}}</ref> In 2015, the FDA held a hearing on homeopathic product regulation.<ref>{{cite journal|last1=Frazier|first1=Kendrick|authorlink= Kendrick Frazier|year=2015|title=CFI testimony urges FDA to regulate homeopathic products|journal=Skeptical Inquirer|volume=39|issue=4|pages=6–7}}</ref> At the hearing, representatives from the [[Center for Inquiry]] and the [[Committee for Skeptical Inquiry]] summarized the harm that is done to the general public from homeopathics and proposed regulatory actions:<ref name="fdahearing">{{cite web|author=De Dora, Michael|date=April 20, 2015|title=Homeopathic product regulation: evaluating the Food and Drug Administration's regulatory framework after a quarter-century. Testimony of the Center for Inquiry to the Food and Drug Administration|url=https://www.fda.gov/downloads/Drugs/NewsEvents/UCM443495.pdf|publisher=FDA}}</ref> In 2016 the United States [[Federal Trade Commission]] (FTC) issued an "Enforcement Policy Statement Regarding Marketing Claims for Over-the-Counter Homeopathic Drugs" which specified that the FTC will apply the same standard to homeopathic drugs that it applies to other products claiming similar benefits.<ref name="FTC2016">{{cite web|title=FTC: Enforcement Policy Statement on Marketing Claims for OTC Homeopathic Drugs|url=https://www.ftc.gov/system/files/documents/public_statements/996984/p114505_otc_homeopathic_drug_enforcement_policy_statement.pdf|access-date=November 18, 2016|publisher=Federal Trade Commission}}</ref> A related report concluded that claims of homeopathy effectiveness "are not accepted by most modern medical experts and do not constitute competent and reliable scientific evidence that these products have the claimed treatment effects."<ref name="WSReport">{{cite web|title=Homeopathic Medicine & Advertising Workshop Report|url=https://www.ftc.gov/system/files/documents/reports/federal-trade-commission-staff-report-homeopathic-medicine-advertising-workshop/p114505_otc_homeopathic_medicine_and_advertising_workshop_report.pdf|access-date=November 18, 2016|publisher=Federal Trade Commission}}</ref> In 2019, the FDA removed an enforcement policy that permitted unapproved homeopathics to be sold.<ref>{{Cite web|title=FDA Toughens Enforcement of Homeopathic Products|url=https://www.natlawreview.com/article/fda-toughens-enforcement-homeopathic-products|access-date=2020-09-02|website=The National Law Review|language=en}}</ref> Currently no homeopathic products are approved by the FDA.<ref>{{Cite journal|last=Research|first=Center for Drug Evaluation and|date=2020-07-22|title=Homeopathic Products|url=https://www.fda.gov/drugs/information-drug-class/homeopathic-products|journal=FDA|language=en}}</ref>

Homeopathic remedies are regulated as natural health products in Canada.<ref name="WHO Safety" /> [[Ontario]] became the first province in the country to regulate the practice of homeopathy, a move that was widely criticized by scientists and doctors.<ref>{{Cite news|title='A pseudo-science': Outrage after Ontario government funds college program in homeopathy|url=https://nationalpost.com/news/canada/a-diploma-in-magical-thinking-critics-want-funding-pulled-for-ontario-colleges-homeopathy-course|access-date=2020-09-02|website=National Post|date=February 8, 2018|language=en-CA|last1=Kirkey|first1=Sharon}}</ref> [[Health Canada]] requires all products to have a licence before being sold and applicants have to submit evidence on "the safety, efficacy and quality of a homeopathic medicine".<ref>{{Cite web|last=Canada|first=Health|date=2006-10-26|title=Evidence for Homeopathic Medicines|url=https://www.canada.ca/en/health-canada/services/drugs-health-products/natural-non-prescription/legislation-guidelines/guidance-documents/evidence-homeopathic-medicines.html|access-date=2020-09-04|website=aem}}</ref> In 2015 the [[Canadian Broadcasting Corporation]] tested the system by applying for and then receiving a government approved licence for a made-up drug aimed at kids.<ref>{{Cite web|date=Mar 13, 2015|title=Drugstore remedies: Licence to Deceive|url=https://www.cbc.ca/marketplace/episodes/2014-2015/drugstore-remedies-licence-to-deceive|website=CBC}}</ref>

In Australia, the sale of homeopathic products is regulated by the [[Therapeutic Goods Administration]].<ref>{{Cite web|date=2008-09-01|title=Regulation of homoeopathic and anthroposophic medicines in Australia|url=https://www.tga.gov.au/consultation/regulation-homoeopathic-and-anthroposophic-medicines-australia|access-date=2020-09-01|website=Therapeutic Goods Administration (TGA)|language=en}}</ref> In 2015, the [[National Health and Medical Research Council]] of Australia concluded that there is "no reliable evidence that homeopathy is effective and should not be used to treat health conditions that are chronic, serious, or could become serious". They recommended anyone considering using homeopathy should first get advice from a registered health practitioner.<ref name="NHMRC2" /> A 2017 review into Pharmacy Remuneration and Regulation recommended that products be banned from pharmacies;<ref>{{Cite web|date=2017|title=Review of Pharmacy Remuneration and Regulation Final Report|url=https://www1.health.gov.au/internet/main/publishing.nsf/content/7E5846EB2D7BA299CA257F5C007C0E21/$File/review-of-pharmacy-remuneration-and-regulation-final-report.pdf|access-date=September 1, 2020|archive-date=March 4, 2021|archive-url=https://web.archive.org/web/20210304103416/https://www1.health.gov.au/internet/main/publishing.nsf/content/7E5846EB2D7BA299CA257F5C007C0E21/$File/review-of-pharmacy-remuneration-and-regulation-final-report.pdf}}</ref> while noting the concerns the government did not adopt the recommendation.<ref>{{Cite web|date=2018|title=AUSTRALIAN GOVERNMENT RESPONSE TO THE REVIEW OF PHARMACY REMUNERATION AND REGULATION|url=https://www1.health.gov.au/internet/main/publishing.nsf/content/7E5846EB2D7BA299CA257F5C007C0E21/%24File/Pharmacy-Review-Aus-Gov-Response-3-May-2018.pdf|access-date=September 1, 2020|archive-date=March 3, 2021|archive-url=https://web.archive.org/web/20210303041051/https://www1.health.gov.au/internet/main/publishing.nsf/content/7E5846EB2D7BA299CA257F5C007C0E21/$File/Pharmacy-Review-Aus-Gov-Response-3-May-2018.pdf}}</ref> In New Zealand there are no regulations specific to homeopathy<ref>{{Cite web|title=Natural health products|url=https://www.health.govt.nz/our-work/regulation-health-and-disability-system/natural-health-products|access-date=2020-09-01|website=Ministry of Health NZ|language=en}}</ref> and the [[New Zealand Medical Association]] does not oppose the use of homeopathy,<ref>{{Cite web|date=2017|title=Doctors and CAM (complementary and alternative medicine)|url=https://www.mcnz.org.nz/assets/standards/7eb60db2d2/Doctors-and-CAM-Complementary-and-alternative-medicine.pdf|website=MEDICAL COUNCIL OF NEW ZEALAND|access-date=September 1, 2020|archive-date=January 29, 2021|archive-url=https://web.archive.org/web/20210129025723/https://www.mcnz.org.nz/assets/standards/7eb60db2d2/Doctors-and-CAM-Complementary-and-alternative-medicine.pdf}}</ref> a stance that has been called unethical by some doctors.<ref>{{cite journal|last=Holt|first=Shaun|author2=Gilbey, Andrew|author3=Colquhoun|author4=David|author5=Baum, Michael|author6=Ernst, Edzard|date=15 April 2011|title=Call for doctors not to practice homeopathy or refer to homeopaths|journal=New Zealand Medical Journal|volume=124|issue=1332|pages=87–88|pmid=21747430|issn=1175-8716}}</ref>

=== Prevalence ===

Homeopathy is one of the most commonly used forms of alternative medicines and it has a large worldwide market.<ref name="WHO Safety" /> The exact size is uncertain, but information available on homeopathic sales suggests it forms a large share of the medical market.<ref name="WHO Safety" />

In 1999, about 1000 UK doctors practiced homeopathy, most being general practitioners who prescribe a limited number of remedies. A further 1500 homeopaths with no medical training are also thought to practice. Over ten thousand German and French doctors use homeopathy.<ref name="Vickers 1115–11182" /> In the United States a National Health Interview Survey estimated 5 million adults and 1 million children used homeopathy in 2011. An analysis of this survey concluded that most cases were self-prescribed for colds and musculoskeletal pain.<ref>{{Cite web|title=Homeopathy|url=https://www.nccih.nih.gov/health/homeopathy|access-date=2020-09-02|website=NCCIH|language=en}}</ref> Major retailers like [[Walmart]], [[CVS Pharmacy|CVS]], and [[Walgreens]] sell homeopathic products that are packaged to resemble conventional medicines.<ref name="Undark 2020-09-02" />

The homeopathic drug market in Germany is worth about 650 million euro with a 2014 survey finding that 60 percent of Germans reported trying homeopathy.<ref name="Undark 2020-09-02" /> A 2009 survey found that only 17 percent of respondents knew how homeopathic medicine was made.<ref name="Undark 2020-09-02" /> France spent more than US$408 million on homeopathic products in 2008.<ref name="WHO Safety" /> In the United States the homeopathic market is worth about $3 billion-a-year;<ref>{{Cite web|last=Fox|first=Maggie|date=2017|title=Homeopathic products useless and often even harmful, FDA says|url=https://www.nbcnews.com/health/health-news/fda-crack-down-snake-oil-homeopathy-n830756|access-date=2020-09-04|website=NBC News|language=en}}</ref> with 2.9 billion spent in 2007.<ref name="WHO Safety" /> Australia spent US$7.3 million on homeopathic medicines in 2008.<ref name="WHO Safety" />

In India, a 2014 national health survey found that homeopathy was used by about 3% of the population.<ref>{{cite journal |last1=Rudra |first1=Shalini |last2=Kalra |first2=Aakshi |last3=Kumar |first3=Abhishek |last4=Joe |first4=William |date=2017 |title=Utilization of alternative systems of medicine as health care services in India: Evidence on AYUSH care from NSS 2014 |journal=PLOS ONE |volume=12|issue=5 |pages=e0176916 |doi=10.1371/journal.pone.0176916 |pmid=28472197 |pmc=5417584 |bibcode=2017PLoSO..1276916R |doi-access=free }}</ref> Homeopathy is used in China, although it arrived a lot later than in many other countries, partly due to the restriction on foreigners that persisted until late in the nineteenth century.<ref>{{Cite journal|last=Lu|first=Di|date=2019-09-20|title='Homoeopathy flourishes in the far East': A forgotten history of homeopathy in late nineteenth-century China|url=https://royalsocietypublishing.org/doi/10.1098/rsnr.2018.0041|journal=Notes and Records: The Royal Society Journal of the History of Science|volume=73|issue=3|pages=329–351|doi=10.1098/rsnr.2018.0041|s2cid=80714173}}</ref> Throughout Africa there is a high reliance on traditional medicines, which can be attributed to the cost of modern medicines and the relative prevalence of practitioners. Many African countries do not have any official training facilities.<ref name="Who Legal" />

==Veterinary use==
[[File:Homeopathic cures for small animals.jpg|thumb|Homeopathic cures for small animals on the [[Isle of Man]]]]
Using homeopathy as a treatment for animals is termed "veterinary homeopathy" and dates back to the inception of homeopathy; Hahnemann himself wrote and spoke of the use of homeopathy in animals other than humans.<ref name="Saxton2007">{{cite journal|last1=Saxton|first1=J|year=2007|title=The diversity of veterinary homeopathy|journal=Homeopathy|volume=96|issue=1|page=3|doi=10.1016/j.homp.2006.11.010|pmid=17227741|s2cid=3715861}}</ref> The use of homeopathy in the [[organic farming]] industry is heavily promoted.<ref>{{Cite journal|last1=Doehring|first1=C.|last2=Sundrum|first2=A.|date=2016-12-17|title=Efficacy of homeopathy in livestock according to peer-reviewed publications from 1981 to 2014|journal=The Veterinary Record|volume=179|issue=24|page=628|doi=10.1136/vr.103779|issn=0042-4900|pmc=5256414|pmid=27956476}}</ref> Given that homeopathy's effects in humans are due to the placebo effect and the counseling aspects of the consultation, such treatments are even less effective in animals.<ref>{{Cite journal|last1=Lees|first1=P.|last2=Pelligand|first2=L.|last3=Whiting|first3=M.|last4=Chambers|first4=D.|last5=Toutain|first5=P-L.|last6=Whitehead|first6=M.L.|date=2017-08-19|title=Comparison of veterinary drugs and veterinary homeopathy: part 2|journal=[[The Veterinary Record]]|volume=181|issue=8|pages=198–207|doi=10.1136/vr.104279|issn=0042-4900|pmc=5738588|pmid=28821700|quote=In human medicine, there may be a place for the counselling/psychotherapeutic aspects of homeopathic consults and the placebo effects generated by homeopathic products in patients who believe in such treatments, but in veterinary medicine these factors are unlikely to benefit patients, and the use of homeopathic products in veterinary medicine is contrary to best evidence, irrational, and inconsistent with current scientific and medical knowledge}}</ref> Studies have also found that giving animals placebos can play active roles in influencing pet owners to believe in the effectiveness of the treatment when none exists.<ref name="Hektoen" /> This means that animals given homeopathic remedies will continue to suffer, resulting in [[animal welfare]] concerns.<ref>{{Cite journal|last1=Lees|first1=P.|last2=Pelligand|first2=L.|last3=Whiting|first3=M.|last4=Chambers|first4=D.|last5=Toutain|first5=P-L.|last6=Whitehead|first6=M. L.|date=2017-08-12|title=Comparison of veterinary drugs and veterinary homeopathy: part 1|journal=The Veterinary Record|volume=181|issue=7|pages=170–176|doi=10.1136/vr.104278|issn=0042-4900|pmc=5738587|pmid=28801498}}</ref><ref>{{Cite journal|last1=Whitehead|first1=M L|last2=Lees|first2=P|last3=Toutain|first3=P L|date=2018|title=Veterinary homeopathy regulation in the UK – a cause for concern.|url=https://www.researchgate.net/publication/329152074|journal=Regulatory Rapporteur|volume=15|pages=21–25}}</ref>

Little existing research on the subject is of a high enough scientific standard to provide reliable data on efficacy.<ref name="Hektoen">{{cite journal|last1=Hektoen|first1=L|year=2005|title=Review of the current involvement of homeopathy in veterinary practice and research|journal=[[Veterinary Record]]|volume=157|issue=8|pages=224–29|doi=10.1136/vr.157.8.224|pmid=16113167|s2cid=12525634}}</ref><ref>{{cite journal|last1=Mathie|first1=RT|last2=Clausen|first2=J|date=October 18, 2014|title=Veterinary homeopathy: systematic review of medical conditions studied by randomised placebo-controlled trials|journal=The Veterinary Record|volume=175|issue=15|pages=373–81|doi=10.1136/vr.101767|pmid=25324413|s2cid=22894207}}</ref><ref>{{cite journal|last1=Mathie|first1=RT|last2=Clausen|first2=J|date=September 15, 2015|title=Veterinary homeopathy: systematic review of medical conditions studied by randomised trials controlled by other than placebo.|journal=[[BMC Veterinary Research]]|volume=11|page=236|doi=10.1186/s12917-015-0542-2|pmc=4570221|pmid=26371366 |doi-access=free }}</ref> A 2016 review of peer-reviewed articles from 1981 to 2014 by scientists from the [[University of Kassel]], Germany, concluded that there is not enough evidence to support homeopathy as an effective treatment of infectious diseases in livestock.<ref>{{Cite journal|last1=Doehring|first1=C.|last2=Sundrum|first2=A.|date=December 12, 2016|title=Efficacy of homeopathy in livestock according to peer-reviewed publications from 1981 to 2014|journal=Veterinary Record|language=en|volume=179|issue=24|pages=vetrec–2016–103779|doi=10.1136/vr.103779|issn=2042-7670|pmc=5256414|pmid=27956476}}</ref> The UK's [[Department for Environment, Food and Rural Affairs]] (Defra) has adopted a robust position against use of "alternative" pet preparations including homeopathy.<ref>{{cite web |url=https://www.gov.uk/government/news/alternative-pet-remedies-government-clampdown |title=Alternative pet remedies: Government clampdown}}</ref> The British Veterinary Association's position statement on alternative medicines says that it "cannot endorse" homeopathy,<ref name="BVA">{{cite web|title=Veterinary medicines|url=http://www.bva.co.uk/News-campaigns-and-policy/Policy/Medicines/Veterinary-medicines/|access-date=January 5, 2015|publisher=British Veterinary Association}}</ref> and the Australian Veterinary Association includes it on its list of "ineffective therapies".<ref name="AVA">{{cite web|title=Ineffective therapies|url=http://www.ava.com.au/12057|archive-url=https://web.archive.org/web/20150207080041/http://www.ava.com.au/12057|archive-date=February 7, 2015|access-date=January 5, 2015|publisher=Australian veterinary association}}</ref>

==See also==
* [[Fringe science]]
* [[List of topics characterized as pseudoscience]]
* [[Scientific skepticism]]

==References==
{{Reflist| refs=
<ref name="Hahnemann">{{cite book |title=The homœopathic medical doctrine, or "Organon of the healing art" |publisher=W. F. Wakeman |author=Hahnemann, Samuel |author-link=Samuel Hahnemann |year=1833 |location=Dublin |pages=[https://books.google.com/books?id=EnEFAAAAQAAJ&pg=PR3 iii], [https://books.google.com/books?id=EnEFAAAAQAAJ&pg=PA48 48–49] |quote=Observation, reflection, and experience have unfolded to me that the best and true method of cure is founded on the principle, ''[[similia similibus curentur]]''. To cure in a mild, prompt, safe, and durable manner, it is necessary to choose in each case a medicine that will excite an affection similar (''{{lang|el|ὅμοιος πάθος}}'') to that against which it is employed.}} Translator: Charles H. Devrient, Esq.</ref>
<ref name="Holmes">
{{cite book
|author=Oliver Wendell Holmes Sr.
|title=Homoeopathy and its kindred delusions: Two lectures delivered before the Boston Society for the Diffusion of Useful Knowledge
|url=https://archive.org/details/64340260R.nlm.nih.gov
|location=Boston
|year=1842
|author-link=Oliver Wendell Holmes Sr
}} as reprinted in
{{cite book
|author=Oliver Wendell Holmes Sr.
|title=Currents and counter-currents in medical science
|year=1861
|publisher=Ticknor and Fields
|pages=72–188
|url=https://catalog.hathitrust.org/Record/011611362
|oclc=1544161
|ol=14731800M
|author-link=Oliver Wendell Holmes Sr
}}</ref>
<ref name="Time19951125">{{cite news |vauthors=Toufexis A, Cole W, Hallanan DB |url=http://www.time.com/time/magazine/article/0,9171,983466,00.html |archive-url=https://web.archive.org/web/20090614091356/http://www.time.com/time/magazine/article/0,9171,983466,00.html |archive-date=June 14, 2009 |title=Is homeopathy good medicine? |magazine=[[Time (magazine)|Time]] |date=September 25, 1995}}</ref>
<ref name="shang">{{cite journal |last1=Shang |first1=Aijing |last2=Huwiler-Müntener |first2=Karin |last3=Nartey |first3=Linda |last4=Jüni |first4=Peter |last5=Dörig |first5=Stephan |last6=Sterne |first6=Jonathan AC |last7=Pewsner |first7=Daniel |last8=Egger |first8=Matthias |title=Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy |journal=The Lancet |volume=366 |pages=726–32 |year=2005 |doi=10.1016/S0140-6736(05)67177-2 |pmid=16125589 |issue=9487|s2cid=17939264 }}</ref>
<ref name="J Toxicology: Arsenic toxicity">{{cite journal |last1=Chakraborti |first1=D |last2=Mukherjee |first2=SC |last3=Saha |first3=KC |last4=Chowdhury |first4=UK |last5=Rahman |first5=MM |last6=Sengupta |first6=MK |title=Arsenic toxicity from homeopathic treatment |journal=Journal of Toxicology. Clinical Toxicology |volume=41 |issue=7 |pages=963–67 |year=2003 |pmid=14705842 |doi=10.1081/CLT-120026518|s2cid=25453468 }}</ref>

<ref name="Mayo Clinic Proceedings: trials">{{cite journal |last1=Altunc |first1=U. |last2=Pittler |first2=M. H. |last3=Ernst |first3=E |title=Homeopathy for childhood and adolescence ailments: systematic review of randomized clinical trials |journal=Mayo Clinic Proceedings |volume=82 |issue=1 |pages=69–75 |year=2007 |pmid=17285788 |doi=10.4065/82.1.69 |quote=However, homeopathy is not totally devoid of risks... it may delay effective treatment or diagnosis|citeseerx=10.1.1.456.5352 }}</ref>
<ref name="pmid8554846">{{cite journal |last1=Ernst |first1=E |author-link=Edzard Ernst |last2=White |first2=AR |title=Homoeopathy and immunization |journal=The British Journal of General Practice |volume=45 |issue=400 |pages=629–30 |year=1995 |pmid=8554846 |pmc=1239445}}</ref>
}}

==External links==
{{commons category}}
{{EB1911 poster|Homoeopathy}}
* [https://www.nhs.uk/conditions/homeopathy/ Homeopathy] ([[NHS Choices]], UK)

{{Homoeopathy}}
{{pseudoscience}}


{{Authority control}}
During the process of proving, Hahnemann used healthy volunteers who were given remedies, often in molecular doses, and the resulting symptoms were compiled by observers into a "Drug Picture". During the process the volunteers were observed for months at a time and were made to keep extensive journals detailing all of their symptoms at specific times during the day. During the tests volunteers were forbidden from consuming coffee, tea, spices, or wine. They were also not allowed to play chess, because Hahnemann considered it to be "too exciting", however they were allowed to drink beer and were encouraged to moderately exercise. After the experiments were over, Hahnemann made the volunteers offer their hands and take an oath swearing that what they reported in their journals was the truth, at which time he would interrogate them extensively concerning their symptoms.


[[Category:Homeopathy| ]]
Provings have been described as important in the development of the [[clinical trial]], due to their early use of simple control groups, systematic and quantitative procedures, and some of the first application of statistics in medicine.<ref>{{cite book |last =Cassedy |first=James H. |title=American Medicine and Statistical Thinking, [[1800]]–1860 |publisher=iUniverse |date=June 1999 |isbn = 978-1583484289 }}</ref> The lengthy records of self-experimentation by homeopaths have occasionally proven useful in the development of modern drugs: For example, evidence [[nitroglycerin]] might be useful as a treatment for [[angina pectoris|angina]] was discovered by looking through homeopathic provings, though homeopaths themselves never used it for that purpose at that time.<ref name="pmid2866851">{{cite journal |author=Fye WB |title=Nitroglycerin: a homeopathic remedy |journal=Circulation |volume=73 |issue=1 |pages=21–9 |year=1986 |pmid=2866851 |url=http://circ.ahajournals.org/cgi/reprint/73/1/21.pdf|format=PDF}}</ref>
[[Category:Pseudoscience]]
The first recorded provings were published by Hahnemann in his 1796 ''Essay on a New Principle''. His ''Fragmenta de viribus'' (1805)<ref> {{cite web|url=http://www.homeorizon.com/mainpagegeneral.asp?t=fragmenta.htm |title=''Fragmenta de Viribus Medicamentorum Positivis Sive in sano Corpore Humano Observatis''|accessdate=2007-10-16 |first=Homeorizon Team }}</ref> contained the results of 27 provings, and his 1810 ''[[Materia Medica Pura]]'' contained 65.<ref> {{cite web|url=http://www.hpathy.com/materiamedica/hahnemann-materia-pura/index.asp |title=Materia Medica Pura |accessdate=2007-10-16 |last=Hahnemann |first=Samuel |publisher=hpathy.com }}</ref> 217 remedies underwent provings%2
[[Category:Obsolete medical theories]]
[[Category:1796 introductions]]
[[Category:Health fraud]]

Latest revision as of 19:20, 4 November 2024

Homeopathy
Alternative medicine
Homoeopathy
Samuel Hahnemann
Samuel Hahnemann, originator of homeopathy
Pronunciation
Claims"Like cures like", dilution increases potency, disease caused by miasms
Related fieldsAlternative medicine
Original proponentsSamuel Hahnemann
Subsequent proponents
MeSHD006705
See alsoHumorism, heroic medicine

Homeopathy or homoeopathy is a pseudoscientific[1] system of alternative medicine. It was conceived in 1796 by the German physician Samuel Hahnemann. Its practitioners, called homeopaths or homeopathic physicians,[2] believe that a substance that causes symptoms of a disease in healthy people can cure similar symptoms in sick people; this doctrine is called similia similibus curentur, or "like cures like".[3] Homeopathic preparations are termed remedies and are made using homeopathic dilution. In this process, the selected substance is repeatedly diluted until the final product is chemically indistinguishable from the diluent. Often not even a single molecule of the original substance can be expected to remain in the product.[4] Between each dilution homeopaths may hit and/or shake the product, claiming this makes the diluent "remember" the original substance after its removal. Practitioners claim that such preparations, upon oral intake, can treat or cure disease.[5]

All relevant scientific knowledge about physics, chemistry, biochemistry and biology contradicts homeopathy.[6] Homeopathic remedies are typically biochemically inert, and have no effect on any known disease.[7][8][9] Its theory of disease, centered around principles Hahnemann termed miasms, is inconsistent with subsequent identification of viruses and bacteria as causes of disease. Clinical trials have been conducted and generally demonstrated no objective effect from homeopathic preparations.[10][11][12]: 206 [13] The fundamental implausibility of homeopathy as well as a lack of demonstrable effectiveness has led to it being characterized within the scientific and medical communities as quackery and fraud.[14][15][16]

Homeopathy achieved its greatest popularity in the 19th century. It was introduced to the United States in 1825, and the first American homeopathic school opened in 1835. Throughout the 19th century, dozens of homeopathic institutions appeared in Europe and the United States. During this period, homeopathy was able to appear relatively successful, as other forms of treatment could be harmful and ineffective. By the end of the century the practice began to wane, with the last exclusively homeopathic medical school in the United States closing in 1920. During the 1970s, homeopathy made a significant comeback, with sales of some homeopathic products increasing tenfold. The trend corresponded with the rise of the New Age movement, and may be in part due to chemophobia, an irrational aversion to synthetic chemicals, and the longer consultation times homeopathic practitioners provided.

In the 21st century, a series of meta-analyses have shown that the therapeutic claims of homeopathy lack scientific justification. As a result, national and international bodies have recommended the withdrawal of government funding for homeopathy in healthcare. National bodies from Australia, the United Kingdom, Switzerland and France, as well as the European Academies' Science Advisory Council and the Russian Academy of Sciences have all concluded that homeopathy is ineffective, and recommended against the practice receiving any further funding.[17][18][19][20] The National Health Service in England no longer provides funding for homeopathic remedies and asked the Department of Health to add homeopathic remedies to the list of forbidden prescription items.[21][22][23] France removed funding in 2021,[24][25] while Spain has also announced moves to ban homeopathy and other pseudotherapies from health centers.[26]

History

Homeopathy was created in 1796 by Samuel Hahnemann.[27] Hahnemann rejected the mainstream medicine of the late 18th century as irrational and inadvisable, because it was largely ineffective and often harmful.[28][29] He advocated the use of single drugs at lower doses and promoted an immaterial, vitalistic view of how living organisms function.[30] The term homeopathy was coined by Hahnemann and first appeared in print in 1807.[31] He also coined the expression "allopathic medicine", which was used to pejoratively refer to traditional Western medicine.[32]

Concept

Samuel Hahnemann Monument, Washington, D.C., with the inscription Similia Similibus Curentur – "Like cures Like"

Hahnemann conceived of homeopathy while translating a medical treatise by the Scottish physician and chemist William Cullen into German. Being sceptical of Cullen's theory that cinchona cured malaria because it was bitter, Hahnemann ingested some bark specifically to investigate what would happen. He experienced fever, shivering and joint pain: symptoms similar to those of malaria itself. From this, Hahnemann came to believe that all effective drugs produce symptoms in healthy individuals similar to those of the diseases that they treat.[33] This led to the name "homeopathy", which comes from the ‹See Tfd›Greek: ὅμοιος hómoios, "-like" and πάθος páthos, "suffering".[34]

The doctrine that those drugs are effective which produce symptoms similar to the symptoms caused by the diseases they treat, called "the law of similars", was expressed by Hahnemann with the Latin phrase similia similibus curentur, or "like cures like".[3] Hahnemann's law of similars is unproven and does not derive from the scientific method.[35] An account of the effects of eating cinchona bark noted by Oliver Wendell Holmes, published in 1861, failed to reproduce the symptoms Hahnemann reported.[36]: 128  Subsequent scientific work showed that cinchona cures malaria because it contains quinine, which kills the Plasmodium falciparum parasite that causes the disease; the mechanism of action is unrelated to Hahnemann's ideas.[37]

Provings

Hahnemann began to test what effects various substances may produce in humans, a procedure later called "homeopathic proving". These tests required subjects to test the effects of ingesting substances by recording all their symptoms as well as the ancillary conditions under which they appeared.[38] He published a collection of provings in 1805, and a second collection of 65 preparations appeared in his book, Materia Medica Pura (1810).[39]

As Hahnemann believed that large doses of drugs that caused similar symptoms would only aggravate illness, he advocated for extreme dilutions. A technique was devised for making dilutions that Hahnemann claimed would preserve the substance's therapeutic properties while removing its harmful effects.[40] Hahnemann believed that this process enhanced "the spirit-like medicinal powers of the crude substances".[41] He gathered and published an overview of his new medical system in his book, The Organon of the Healing Art (1810), with a sixth edition published in 1921 that homeopaths still use today.[42]

Miasms and disease

In the Organon, Hahnemann introduced the concept of "miasms" as the "infectious principles" underlying chronic disease[43] and as "peculiar morbid derangement[s] of vital force".[44] Hahnemann associated each miasm with specific diseases, and thought that initial exposure to miasms causes local symptoms, such as skin or venereal diseases. His assertion was that if these symptoms were suppressed by medication, the cause went deeper and began to manifest itself as diseases of the internal organs.[45] Homeopathy maintains that treating diseases by directly alleviating their symptoms, as is sometimes done in conventional medicine, is ineffective because all "disease can generally be traced to some latent, deep-seated, underlying chronic, or inherited tendency".[46] The underlying imputed miasm still remains, and deep-seated ailments can be corrected only by removing the deeper disturbance of the vital force.[47]

Hahnemann's hypotheses for miasms originally presented only three local symptoms: psora (the itch), syphilis (venereal disease) or sycosis (fig-wart disease).[48] Of these the most important was psora, described as being related to any itching diseases of the skin and was claimed to be the foundation of many further disease conditions. Hahnemann believed it to be the cause of such diseases as epilepsy, cancer, jaundice, deafness, and cataracts.[49] Since Hahnemann's time, other miasms have been proposed, some replacing illnesses previously attributed to the psora, including tuberculosis and cancer miasms.[45]

Hahnemann's miasm theory remains disputed and controversial within homeopathy even in modern times. The theory of miasms has been criticized as an explanation developed to preserve the system of homeopathy in the face of treatment failures, and for being inadequate to cover the many hundreds of sorts of diseases, as well as for failing to explain disease predispositions, as well as genetics, environmental factors, and the unique disease history of each patient.[12]: 148–9 

19th century: rise to popularity and early criticism

Homeopathy Looks at the Horrors of Allopathy, an 1857 painting by Alexander Beydeman, showing historical figures and personifications of homeopathy observing the brutality of medicine of the 19th century

Homeopathy achieved its greatest popularity in the 19th century. It was introduced to the United States in 1825 by Hans Birch Gram, a student of Hahnemann.[50] The first homeopathic school in the United States opened in 1835 and the American Institute of Homeopathy was established in 1844. Throughout the 19th century, dozens of homeopathic institutions appeared in Europe and the United States,[51] and by 1900, there were 22 homeopathic colleges and 15,000 practitioners in the United States.[52]

Because medical practice of the time relied on treatments which were often ineffective and harmful, patients of homeopaths often had better outcomes than those being treated by medical practitioners.[53] Though ineffective, homeopathic preparations are rarely detrimental, thus users are less likely to be harmed by the treatment that is supposed to be helping them.[42] The relative success of homeopathy in the 19th century may have led to the abandonment of the ineffective and harmful treatments of bloodletting and purging and begun the move towards more effective, science-based medicine.[54] One reason for the growing popularity of homeopathy was its apparent success in treating people suffering from infectious disease epidemics.[55] During 19th-century epidemics of diseases such as cholera, death rates in homeopathic hospitals were often lower than in conventional hospitals, where the treatments used at the time were often harmful and did little or nothing to combat the diseases.[56]

Even during its rise in popularity, homeopathy was criticized by scientists and physicians. Sir John Forbes, physician to Queen Victoria, said in 1843 that the extremely small doses of homeopathy were regularly derided as useless and considered it "an outrage to human reason".[57] James Young Simpson said in 1853 of the highly diluted drugs: "No poison, however strong or powerful, the billionth or decillionth of which would in the least degree affect a man or harm a fly."[58] Nineteenth-century American physician and author Oliver Wendell Holmes was also a vocal critic of homeopathy and published an essay entitled Homœopathy and Its Kindred Delusions (1842).[36] The members of the French Homeopathic Society observed in 1867 that some leading homeopaths of Europe not only were abandoning the practice of administering infinitesimal doses but were also no longer defending it.[59] The last school in the United States exclusively teaching homeopathy closed in 1920.[42]

Revival in the 20th century

According to academics Paul U. Unschuld [de] and Edzard Ernst, the Nazi regime in Germany was fond of homeopathy, and spent large sums of money on researching its mechanisms, but without gaining a positive result.[60] Unschuld also states that homeopathy never subsequently took root in the United States, but remained more deeply established in European thinking.[61] In the United States, the Food, Drug, and Cosmetic Act of 1938 (sponsored by Royal Copeland, a Senator from New York and homeopathic physician) recognized homeopathic preparations as drugs. In the 1950s, there were only 75 solely homeopathic practitioners in the U.S.[62] By the mid to late 1970s, homeopathy made a significant comeback and the sales of some homeopathic companies increased tenfold.[63]

Some homeopaths credit the revival to Greek homeopath George Vithoulkas, who conducted a "great deal of research to update the scenarios and refine the theories and practice of homeopathy" in the 1970s,[64][65] but Ernst and Simon Singh consider it to be linked to the rise of the New Age movement.[29] Bruce Hood has argued that the increased popularity of homeopathy in recent times may be due to the comparatively long consultations practitioners are willing to give their patients, and to a preference for "natural" products, which people think are the basis of homeopathic preparations.[66]

Towards the end of the century opposition to homeopathy began to increase again; with William T. Jarvis, the President of the National Council Against Health Fraud, saying that "Homeopathy is a fraud perpetrated on the public with the government's blessing, thanks to the abuse of political power of Sen. Royal S. Copeland."[67]

21st century: renewed criticism

Since the beginning of the 21st century, a series of meta-analyses have further shown that the therapeutic claims of homeopathy lack scientific justification.[68] This had led to a decrease or suspension of funding by many governments. In a 2010 report, the Science and Technology Committee of the United Kingdom House of Commons recommended that homeopathy should no longer receive National Health Service (NHS) funding due its lack of scientific credibility;[68] NHS funding for homeopathy ceased in 2017.[22] They also asked the Department of Health in the UK to add homeopathic remedies to the list of forbidden prescription items.[23]

In 2015, the National Health and Medical Research Council of Australia found that "there are no health conditions for which there is reliable evidence that homeopathy is effective".[69] The federal government only ended up accepting three of the 45 recommendations made by the 2018 review of Pharmacy Remuneration and Regulation.[70] The same year the US Food and Drug Administration (FDA) held a hearing requesting public comment on the regulation of homeopathic drugs.[71] In 2017 the FDA announced it would strengthen regulation of homeopathic products.[72]

The American non-profit Center for Inquiry (CFI) filed a lawsuit in 2018 against the CVS pharmacy for consumer fraud over its sale of homeopathic medicines.[73] It claimed that CVS was selling homeopathic products on an easier-to-obtain basis than standard medication.[74] In 2019, CFI brought a similar lawsuit against Walmart for "committing wide-scale consumer fraud and endangering the health of its customers through its sale and marketing of homeopathic medicines".[75][76] They also conducted a survey in which they found consumers felt ripped off when informed of the lack of evidence for the efficacy of homeopathic remedies, such as those sold by Walmart and CVS.[77][78]

In 2021, the French healthcare minister phased out social security reimbursements for homeopathic drugs.[24][25] France has long had a stronger belief in the virtues of homeopathic drugs than many other countries and the world's biggest manufacturer of alternative medicine drugs, Boiron, is located in that country.[79] Spain has also announced moves to ban homeopathy and other pseudotherapies.[26] In 2016, the University of Barcelona cancelled its master's degree in Homeopathy citing "lack of scientific basis", after advice from the Spanish Ministry of Health.[80] Shortly afterwards the University of Valencia announced the elimination of its Masters in Homeopathy.[81]

Preparations and treatment

Homeopathic repertory by James Tyler Kent

Homeopathic preparations are referred to as "homeopathic remedies".[82] Practitioners rely on two types of reference when prescribing: Materia medica and repertories. A homeopathic materia medica is a collection of "drug pictures", organized alphabetically. A homeopathic repertory is a quick reference version of the materia medica that indexes the symptoms and then the associated remedies for each. In both cases different compilers may dispute particular inclusions in the references.[83] The first symptomatic homeopathic materia medica was arranged by Hahnemann. The first homeopathic repertory was Georg Jahr's Symptomenkodex, published in German in 1835, and translated into English as the Repertory to the more Characteristic Symptoms of Materia Medica in 1838. This version was less focused on disease categories and was the forerunner to later works by James Tyler Kent.[84][85] There are over 118 repertories published in English, with Kent's being one of the most used.[86]

Consultation

Homeopaths generally begin with a consultation, which can be a 10–15 minute appointment or last for over an hour, where the patient describes their medical history. The patient describes the "modalities", or if their symptoms change depending on the weather and other external factors.[87] The practitioner also solicits information on mood, likes and dislikes, physical, mental and emotional states, life circumstances, and any physical or emotional illnesses.[88] This information (also called the "symptom picture") is matched to the "drug picture" in the materia medica or repertory and used to determine the appropriate homeopathic remedies. In classical homeopathy, the practitioner attempts to match a single preparation to the totality of symptoms (the simlilum), while "clinical homeopathy" involves combinations of preparations based on the illness's symptoms.[64]

Preparation

Oscillococcinum, a homeopathic remedy in pill form

Homeopathy uses animal, plant, mineral, and synthetic substances in its preparations, generally referring to them using Latin names.[89] Examples include arsenicum album (arsenic oxide), natrum muriaticum (sodium chloride or table salt), Lachesis muta (the venom of the bushmaster snake), opium, and thyroidinum (thyroid hormone). Homeopaths say this is to ensure accuracy.[90] In the USA the common name must be displayed, although the Latin one can also be present.[89] Homeopathic pills are made from an inert substance (often sugars, typically lactose), upon which a drop of liquid homeopathic preparation is placed and allowed to evaporate.[91][92]

Isopathy is a therapy derived from homeopathy in which the preparations come from diseased or pathological products such as fecal, urinary and respiratory discharges, blood, and tissue.[84] They are called nosodes (from the Greek nosos, disease) with preparations made from "healthy" specimens being termed "sarcodes". Many so-called "homeopathic vaccines" are a form of isopathy.[93] Tautopathy is a form of isopathy where the preparations are composed of drugs or vaccines that a person has consumed in the past, in the belief that this can reverse the supposed lingering damage caused by the initial use.[94] There is no convincing scientific evidence for isopathy as an effective method of treatment.[95]

Some modern homeopaths use preparations they call "imponderables" because they do not originate from a substance but some other phenomenon presumed to have been "captured" by alcohol or lactose. Examples include X-rays[96] and sunlight.[97] Another derivative is electrohomeopathy, where an electric bio-energy of therapeutic value is supposedly extracted from plants. Popular in the late nineteenth century, electrohomeopathy is extremely pseudo-scientific.[98] In 2012, the Allahabad High Court in Uttar Pradesh, India, handed down a decree stating that electrohomeopathy was quackery and no longer recognized it as a system of medicine.[99]

Other minority practices include paper preparations, in which the terms for substances and dilutions are written on pieces of paper and either pinned to the patients' clothing, put in their pockets, or placed under glasses of water that are then given to the patients. Radionics, the use of electromagnetic radiation such as radio waves, can also be used to manufacture preparations. Such practices have been strongly criticized by classical homeopaths as unfounded, speculative, and verging upon magic and superstition.[100][101] Flower preparations are produced by placing flowers in water and exposing them to sunlight. The most famous of these are the Bach flower remedies, which were developed by Edward Bach.[102]

Dilutions

This bottle is labelled Arnica montana (wolf's bane) D6, i.e. the nominal dilution is one part in a million (10-6).

Hahnemann claimed that undiluted doses caused reactions, sometimes dangerous ones, and thus that preparations be given at the lowest possible dose.[103] A solution that is more dilute is described as having a higher "potency", and thus are claimed to be stronger and deeper-acting.[104] The general method of dilution is serial dilution, where solvent is added to part of the previous mixture, but the "Korsakovian" method may also be used. In the Korsakovian method, the vessel in which the preparations are manufactured is emptied, refilled with solvent, with the volume of fluid adhering to the walls of the vessel deemed sufficient for the new batch.[12]: 270  The Korsakovian method is sometimes referred to as K on the label of a homeopathic preparation.[105][106] Another method is Fluxion, which dilutes the substance by continuously passing water through the vial.[107] Insoluble solids, such as granite, diamond, and platinum, are diluted by grinding them with lactose ("trituration").[12]: 23 

Three main logarithmic dilution scales are in regular use in homeopathy. Hahnemann created the "centesimal" or "C scale", diluting a substance by a factor of 100 at each stage. There is also a decimal dilution scale (notated as "X" or "D") in which the preparation is diluted by a factor of 10 at each stage.[108] The centesimal scale was favoured by Hahnemann for most of his life, although in his last ten years Hahnemann developed a quintamillesimal (Q) scale which diluted the drug 1 part in 50,000.[109] A 2C dilution works out to one part of the original substance in 10,000 parts of the solution. In standard chemistry, this produces a substance with a concentration of 0.01% (volume-volume percentage). A 6C dilution ends up with the original substance diluted by a factor of 100−6 (one part in one trillion). The end product is usually so diluted as to be indistinguishable from the diluent (pure water, sugar or alcohol).[40][110] The greatest dilution reasonably likely to contain at least one molecule of the original substance is approximately 12C.[111]

Hahnemann advocated dilutions of 1 part to 1060 or 30C.[112] Hahnemann regularly used dilutions of up to 30C but opined that "there must be a limit to the matter".[38]: 322  To counter the reduced potency at high dilutions he formed the view that vigorous shaking by striking on an elastic surface – a process termed succussion – was necessary.[103] Homeopaths are unable to agree on the number and force of strikes needed, and there is no way that the claimed results of succussion can be tested.[12]: 67–69 

Critics of homeopathy commonly emphasize the dilutions involved in homeopathy, using analogies.[113] One mathematically correct example is that a 12C solution is equivalent to "a pinch of salt in both the North and South Atlantic Oceans".[114][115][116] One-third of a drop of some original substance diluted into all the water on Earth would produce a preparation with a concentration of about 13C.[113][117][118] Robert L. Park points out that a 200C dilution of duck liver, marketed under the name Oscillococcinum, would require 10320 universes worth of molecules to contain just one original molecule in the final substance.[119] The high dilutions characteristically used are often considered to be the most controversial and implausible aspect of homeopathy.[120]

Provings

Homeopaths claim that they can determine the properties of their preparations by following a method which they call "proving".[121] As performed by Hahnemann, provings involved administering various preparations to healthy volunteers. The volunteers were then observed, often for months at a time. They were made to keep extensive journals detailing all of their symptoms at specific times throughout the day. They were forbidden from consuming coffee, tea, spices, or wine for the duration of the experiment; playing chess was also prohibited because Hahnemann considered it to be "too exciting", though they were allowed to drink beer and encouraged to exercise in moderation.[122] At first Hahnemann used undiluted doses for provings, but he later advocated provings with preparations at a 30C dilution,[112] and most modern provings are carried out using ultra-dilute preparations.[123]

Provings are claimed to have been important in the development of the clinical trial, due to their early use of simple control groups, systematic and quantitative procedures, and some of the first application of statistics in medicine.[124] The lengthy records of self-experimentation by homeopaths have occasionally proven useful in the development of modern drugs: For example, evidence that nitroglycerin might be useful as a treatment for angina was discovered by looking through homeopathic provings, though homeopaths themselves never used it for that purpose at that time.[125] The first recorded provings were published by Hahnemann in his 1796 Essay on a New Principle.[126] His Fragmenta de Viribus (1805)[127] contained the results of 27 provings, and his 1810 Materia Medica Pura contained 65.[128] For James Tyler Kent's 1905 Lectures on Homoeopathic Materia Medica, 217 preparations underwent provings and newer substances are continually added to contemporary versions.[129][130]

Though the proving process has superficial similarities with clinical trials, it is fundamentally different in that the process is subjective, not blinded, and modern provings are unlikely to use pharmacologically active levels of the substance under proving.[131] As early as 1842, Oliver Holmes had noted that provings were impossibly vague, and the purported effect was not repeatable among different subjects.[36]

Evidence and efficacy

Outside of the alternative medicine community, scientists have long considered homeopathy a sham[132] or a pseudoscience,[133][134][135][136] and the medical community regards it as quackery.[135] There is an overall absence of sound statistical evidence of therapeutic efficacy, which is consistent with the lack of any biologically plausible pharmacological agent or mechanism.[8] Proponents argue that homeopathic medicines must work by some, as yet undefined, biophysical mechanism.[87] No homeopathic preparation has been shown to be different from placebo.[8]

Lack of scientific evidence

The lack of convincing scientific evidence supporting its efficacy[137] and its use of preparations without active ingredients have led to characterizations of homeopathy as pseudoscience and quackery,[138][139][140] or, in the words of a 1998 medical review, "placebo therapy at best and quackery at worst".[141] The Russian Academy of Sciences considers homeopathy a "dangerous 'pseudoscience' that does not work", and "urges people to treat homeopathy 'on a par with magic'".[138] The Chief Medical Officer for England, Dame Sally Davies, has stated that homeopathic preparations are "rubbish" and do not serve as anything more than placebos.[142] In 2013, Mark Walport, the UK Government Chief Scientific Adviser and head of the Government Office for Science said "homeopathy is nonsense, it is non-science."[143] His predecessor, John Beddington, also said that homeopathy "has no underpinning of scientific basis" and is being "fundamentally ignored" by the Government.[144]

Jack Killen, acting deputy director of the National Center for Complementary and Alternative Medicine, says homeopathy "goes beyond current understanding of chemistry and physics". He adds: "There is, to my knowledge, no condition for which homeopathy has been proven to be an effective treatment."[137] Ben Goldacre says that homeopaths who misrepresent scientific evidence to a scientifically illiterate public, have "... walled themselves off from academic medicine, and critique has been all too often met with avoidance rather than argument".[145] Homeopaths often prefer to ignore meta-analyses in favour of cherry picked positive results, such as by promoting a particular observational study (one which Goldacre describes as "little more than a customer-satisfaction survey") as if it were more informative than a series of randomized controlled trials.[145]

In an article entitled "Should We Maintain an Open Mind about Homeopathy?"[146] published in the American Journal of Medicine, Michael Baum and Edzard Ernst – writing to other physicians – wrote that "Homeopathy is among the worst examples of faith-based medicine... These axioms [of homeopathy] are not only out of line with scientific facts but also directly opposed to them. If homeopathy is correct, much of physics, chemistry, and pharmacology must be incorrect...".

Plausibility of dilutions

A homeopathic preparation made from marsh tea: the "15C" dilution shown here means the original solution was diluted to 1/1030 of its original strength.

The exceedingly low concentration of homeopathic preparations, which often lack even a single molecule of the diluted substance,[91] has been the basis of questions about the effects of the preparations since the 19th century.[147] The laws of chemistry give this dilution limit, which is related to the Avogadro number, as being roughly equal to 12C homeopathic dilutions (1 part in 1024).[113][148][149] James Randi and the 10:23 campaign groups have highlighted the lack of active ingredients by taking large 'overdoses'.[150] None of the hundreds of demonstrators in the UK, Australia, New Zealand, Canada and the US were injured and "no one was cured of anything, either".[150]

Modern advocates of homeopathy have proposed a concept of "water memory", according to which water "remembers" the substances mixed in it, and transmits the effect of those substances when consumed. This concept is inconsistent with the current understanding of matter, and water memory has never been demonstrated to have any detectable effect, biological or otherwise.[151][152] Existence of a pharmacological effect in the absence of any true active ingredient is inconsistent with the law of mass action and the observed dose-response relationships characteristic of therapeutic drugs.[153] Homeopaths contend that their methods produce a therapeutically active preparation, selectively including only the intended substance, though in reality any water will have been in contact with millions of different substances throughout its history, and homeopaths cannot account for the selected homeopathic substance being isolated as a special case in their process.[154]

Practitioners also hold that higher dilutions produce stronger medicinal effects. This idea is also inconsistent with observed dose-response relationships, where effects are dependent on the concentration of the active ingredient in the body.[153] Some contend that the phenomenon of hormesis may support the idea of dilution increasing potency,[155][156] but the dose-response relationship outside the zone of hormesis declines with dilution as normal, and nonlinear pharmacological effects do not provide any credible support for homeopathy.[154]

Efficacy

Explanations for efficacy of homeopathic preparations:[12]: 155–167 [157]
The placebo effect The intensive consultation process and expectations for the homeopathic preparations may cause the effect
Therapeutic effect of the consultation The care, concern, and reassurance a patient experiences when opening up to a compassionate caregiver can have a positive effect on the patient's well-being.
Unassisted natural healing Time and the body's ability to heal without assistance can eliminate many diseases of their own accord.
Unrecognized treatments An unrelated food, exercise, environmental agent, or treatment for a different ailment, may have occurred.
Regression towards the mean Since many diseases or conditions are cyclical, symptoms vary over time and patients tend to seek care when discomfort is greatest; they may feel better anyway but because of the timing of the visit to the homeopath they attribute improvement to the preparation taken.
Non-homeopathic treatment Patients may also receive standard medical care at the same time as homeopathic treatment, and the former is responsible for improvement.
Cessation of unpleasant treatment Often homeopaths recommend patients stop getting medical treatment such as surgery or drugs, which can cause unpleasant side-effects; improvements are attributed to homeopathy when the actual cause is the cessation of the treatment causing side-effects in the first place, but the underlying disease remains untreated and still dangerous to the patient.

No individual homeopathic preparation has been unambiguously shown by research to be different from placebo.[8] The methodological quality of the early primary research was low, with problems such as weaknesses in study design and reporting, small sample size, and selection bias. Since better quality trials have become available, the evidence for efficacy of homeopathy preparations has diminished; the highest-quality trials indicate that the preparations themselves exert no intrinsic effect.[10][158]: 206 [159] A review conducted in 2010 of all the pertinent studies of "best evidence" produced by the Cochrane Collaboration concluded that this evidence "fails to demonstrate that homeopathic medicines have effects beyond placebo."[13]

In 2009, the United Kingdom's House of Commons Science and Technology Committee concluded that there was no compelling evidence of effect other than placebo.[160] The Australian National Health and Medical Research Council completed a comprehensive review of the effectiveness of homeopathic preparations in 2015, in which it concluded that "there were no health conditions for which there was reliable evidence that homeopathy was effective."[161] The European Academies' Science Advisory Council (EASAC) published its official analysis in 2017 finding a lack of evidence that homeopathic products are effective, and raising concerns about quality control.[162] In contrast a 2011 book was published, purportedly financed by the Swiss government, that concluded that homeopathy was effective and cost efficient.[163] Although hailed by proponents as proof that homeopathy works,[164] it was found to be scientifically, logically and ethically flawed, with most authors having a conflict of interest.[164] The Swiss Federal Office of Public Health later released a statement saying the book was published without the consent of the Swiss government.[165]

Meta-analyses, essential tools to summarize evidence of therapeutic efficacy,[166] and systematic reviews have found that the methodological quality in the majority of randomized trials in homeopathy have shortcomings and that such trials were generally of lower quality than trials of conventional medicine.[167][168] A major issue has been publication bias, where positive results are more likely to be published in journals.[169][unreliable source?][170][171] This has been particularly marked in alternative medicine journals, where few of the published articles (just 5% during the year 2000) tend to report null results.[145] A systematic review of the available systematic reviews confirmed in 2002 that higher-quality trials tended to have less positive results, and found no convincing evidence that any homeopathic preparation exerts clinical effects different from placebo.[8] The same conclusion was also reached in 2005 in a meta-analysis published in The Lancet. A 2017 systematic review and meta-analysis found that the most reliable evidence did not support the effectiveness of non-individualized homeopathy.[172]

Health organizations, including the UK's National Health Service,[173] the American Medical Association,[174] the FASEB,[175] and the National Health and Medical Research Council of Australia,[161] have issued statements saying that there is no good-quality evidence that homeopathy is effective as a treatment for any health condition.[173] In 2009, World Health Organization official Mario Raviglione criticized the use of homeopathy to treat tuberculosis; similarly, another WHO spokesperson argued there was no evidence homeopathy would be an effective treatment for diarrhoea.[176] They warned against the use of homeopathy for serious conditions such as depression, HIV and malaria.[177] The American College of Medical Toxicology and the American Academy of Clinical Toxicology recommend that no one use homeopathic treatment for disease or as a preventive health measure.[178] These organizations report that no evidence exists that homeopathic treatment is effective, but that there is evidence that using these treatments produces harm and can bring indirect health risks by delaying conventional treatment.[178]

Purported effects in other biological systems

While some articles have suggested that homeopathic solutions of high dilution can have statistically significant effects on organic processes including the growth of grain[179] and enzyme reactions, such evidence is disputed since attempts to replicate them have failed.[180][181][182][183][184][185] In 2001 and 2004, Madeleine Ennis published a number of studies that reported that homeopathic dilutions of histamine exerted an effect on the activity of basophils.[186][187] In response to the first of these studies, Horizon aired a programme in which British scientists attempted to replicate Ennis' results; they were unable to do so.[188] A 2007 systematic review of high-dilution experiments found that none of the experiments with positive results could be reproduced by all investigators.[189]

In 1988, French immunologist Jacques Benveniste published a paper in the journal Nature while working at INSERM.[190] The paper purported to have discovered that basophils released histamine when exposed to a homeopathic dilution of anti-immunoglobulin E antibody. Skeptical of the findings, Nature assembled an independent investigative team to determine the accuracy of the research. After investigation the team found that the experiments were "statistically ill-controlled", "interpretation has been clouded by the exclusion of measurements in conflict with the claim", and concluded, "We believe that experimental data have been uncritically assessed and their imperfections inadequately reported."[191][192][193]

Ethics and safety

Homeopathic preparation Rhus toxicodendron, derived from poison ivy

The provision of homeopathic preparations has been described as unethical.[194][195] Michael Baum, professor emeritus of surgery and visiting professor of medical humanities at University College London (UCL), has described homeopathy as a "cruel deception".[196] Edzard Ernst, the first professor of complementary medicine in the United Kingdom and a former homeopathic practitioner,[197][198][199] has expressed his concerns about pharmacists who violate their ethical code by failing to provide customers with "necessary and relevant information" about the true nature of the homeopathic products they advertise and sell.[200] In 2013 the UK Advertising Standards Authority concluded that the Society of Homeopaths were targeting vulnerable ill people and discouraging the use of essential medical treatment while making misleading claims of efficacy for homeopathic products.[201] In 2015 the Federal Court of Australia imposed penalties on a homeopathic company for making false or misleading statements about the efficacy of the whooping cough vaccine and recommending homeopathic remedies as an alternative.[202]

Old homeopathic belladonna preparation

A 2000 review by homeopaths reported that homeopathic preparations are "unlikely to provoke severe adverse reactions".[203] In 2012, a systematic review evaluating evidence of homeopathy's possible adverse effects concluded that "homeopathy has the potential to harm patients and consumers in both direct and indirect ways".[204] A 2016 systematic review and meta-analysis found that, in homeopathic clinical trials, adverse effects were reported among the patients who received homeopathy about as often as they were reported among patients who received placebo or conventional medicine.[205]

Some homeopathic preparations involve poisons such as Belladonna, arsenic, and poison ivy. In rare cases, the original ingredients are present at detectable levels. This may be due to improper preparation or intentional low dilution. Serious adverse effects such as seizures and death have been reported or associated with some homeopathic preparations.[204] Instances of arsenic poisoning have occurred.[206] In 2009, the FDA advised consumers to stop using three discontinued cold remedy Zicam products because it could cause permanent damage to users' sense of smell.[207] In 2016 the FDA issued a safety alert to consumers[208] warning against the use of homeopathic teething gels and tablets following reports of adverse events after their use.[209] A previous FDA investigation had found that these products were improperly diluted and contained "unsafe levels of belladonna" and that the reports of serious adverse events in children using this product were "consistent with belladonna toxicity".[210]

Patients who choose to use homeopathy rather than evidence-based medicine risk missing timely diagnosis and effective treatment, thereby worsening the outcomes of serious conditions such as cancer.[211][212][213][214] The Russian Commission on Pseudoscience has said homeopathy is not safe because "patients spend significant amounts of money, buying medicines that do not work and disregard already known effective treatment."[215] Critics have cited cases of patients failing to receive proper treatment for diseases that could have been easily managed with conventional medicine and who have died as a result.[216][217] They have also condemned the "marketing practice" of criticizing and downplaying the effectiveness of medicine.[145][217] Homeopaths claim that use of conventional medicines will "push the disease deeper" and cause more serious conditions, a process referred to as "suppression".[218] In 1978, Anthony Campbell, a consultant physician at the Royal London Homeopathic Hospital, criticized statements by George Vithoulkas claiming that syphilis, when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the central nervous system.[219] Vithoulkas' claims echo the idea that treating a disease with external medication used to treat the symptoms would only drive it deeper into the body and conflict with scientific studies, which indicate that penicillin treatment produces a complete cure of syphilis in more than 90% of cases.[220]

The use of homeopathy as a preventive for serious infectious diseases, called homeoprophylaxis, is especially controversial.[221] Some homeopaths (particularly those who are non-physicians) advise their patients against immunization.[213][222][223] Others have suggested that vaccines be replaced with homeopathic "nosodes".[224] While Hahnemann was opposed to such preparations, modern homeopaths often use them although there is no evidence to indicate they have any beneficial effects.[225][226] Promotion of homeopathic alternatives to vaccines has been characterized as dangerous, inappropriate and irresponsible.[227][228] In December 2014, the Australian homeopathy supplier Homeopathy Plus! was found to have acted deceptively in promoting homeopathic alternatives to vaccines.[229] In 2019, an investigative journalism piece by the Telegraph revealed that homeopathy practitioners were actively discouraging patients from vaccinating their children.[230] Cases of homeopaths advising against the use of anti-malarial drugs have also been identified,[214][231][232] putting visitors to the tropics in severe danger.[214][231][232][233]

A 2006 review recommends that pharmacy colleges include a required course where ethical dilemmas inherent in recommending products lacking proven safety and efficacy data be discussed and that students should be taught where unproven systems such as homeopathy depart from evidence-based medicine.[234]

Regulation and prevalence

Hampton House, the former site of Bristol Homeopathic Hospital

Homeopathy is fairly common in some countries while being uncommon in others; is highly regulated in some countries and mostly unregulated in others. It is practiced worldwide and professional qualifications and licences are needed in most countries.[235] A 2019 WHO report found that 100 out of 133 Member States surveyed in 2012 acknowledged that their population used homeopathy, with 22 saying the practice was regulated and 13 providing health insurance coverage.[236] In some countries, there are no specific legal regulations concerning the use of homeopathy, while in others, licences or degrees in conventional medicine from accredited universities are required. In 2001 homeopathy had been integrated into the national health care systems of many countries, including India, Mexico, Pakistan, Sri Lanka, and the United Kingdom.[235]

Regulation

Some homeopathic treatment is covered by the public health service of several European countries, including Scotland,[237] and Luxembourg.[238] It used to be covered in France until 2021.[25] In other countries, such as Belgium, homeopathy is not covered. In Austria, the public health service requires scientific proof of effectiveness in order to reimburse medical treatments and homeopathy is listed as not reimbursable,[239] but exceptions can be made;[240] private health insurance policies sometimes include homeopathic treatments.[235] In 2018, Austria's Medical University of Vienna stopped teaching homeopathy.[241] The Swiss government withdrew coverage of homeopathy and four other complementary treatments in 2005, stating that they did not meet efficacy and cost-effectiveness criteria,[242] but following a referendum in 2009 the five therapies were reinstated for a further 6-year trial period.[243] In Germany, homeopathic treatments are covered by 70 percent of government medical plans, and available in almost every pharmacy.[241] In January 2024, German health minister Karl Lauterbach announced plans to withdraw all statutory health insurance coverage for homeopathic and anthroposophic treatments, citing a lack of scientific evidence for their efficacy.[244]

The English NHS recommended against prescribing homeopathic preparations in 2017.[245] In 2018, prescriptions worth £55,000 were written in defiance of the guidelines, representing less than 0.001% of the total NHS prescribing budget.[246][247] In 2016 the UK's Committee of Advertising Practice compliance team wrote to homeopaths[248] in the UK to "remind them of the rules that govern what they can and can't say in their marketing materials".[249] The letter told homeopaths to "ensure that they do not make any direct or implied claims that homeopathy can treat medical conditions" and asks them to review their marketing communications "including websites and social media pages" to ensure compliance.[250] Homeopathic services offered at Bristol Homeopathic Hospital in the UK ceased in October 2015.[251][252]

Member states of the European Union are required to ensure that homeopathic products are registered, although this process does not require any proof of efficacy.[253] In Spain, the Association for the protection of patients from pseudo-scientific therapies is lobbying to get rid of the easy registration procedure for homeopathic remedies.[253] In Bulgaria, Hungary, Latvia, Romania and Slovenia homeopathy, by law, can only be practiced by medical practitioners. However, in Slovenia if doctors practice homeopathy their medical license will be revoked.[253] In Germany, to become a homeopathic physician, one must attend a three-year training program, while France, Austria and Denmark mandate licences to diagnose any illness or dispense of any product whose purpose is to treat any illness.[235] Homeopaths in the UK are under no legal regulations, meaning anyone can call themselves homeopaths and administer homeopathic remedies.[245]

Homeopathics at a homeopathic pharmacy in Varanasi, India
Homeopathic medicines at a store in West Bengal, India

The Indian government recognizes homeopathy as one of its national systems of medicine and they are sold with medical claims.[254][236] It has established the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) under the Ministry of Health & Family Welfare.[255] The south Indian state of Kerala also has a cabinet-level AYUSH department.[256] The Central Council of Homoeopathy was established in 1973 to monitor higher education in homeopathy, and the National Institute of Homoeopathy in 1975.[257] Principals and standards for homeopathic products are covered by the Homoeopathic pharmacopoeia of India.[89] A minimum of a recognized diploma in homeopathy and registration on a state register or the Central Register of Homoeopathy is required to practice homeopathy in India.[258]

Some medical schools in Pakistan,[259] India,[260][261] and Bangladesh,[262][263] offer an undergraduate degree programme in homeopathy.[264] Upon completion the college may award a Bachelor of Homoeopathy Medicine and Surgery (B.H.M.S.).

In the United States each state is responsible for the laws and licensing requirements for homeopathy.[265] In 2015, the FDA held a hearing on homeopathic product regulation.[266] At the hearing, representatives from the Center for Inquiry and the Committee for Skeptical Inquiry summarized the harm that is done to the general public from homeopathics and proposed regulatory actions:[267] In 2016 the United States Federal Trade Commission (FTC) issued an "Enforcement Policy Statement Regarding Marketing Claims for Over-the-Counter Homeopathic Drugs" which specified that the FTC will apply the same standard to homeopathic drugs that it applies to other products claiming similar benefits.[268] A related report concluded that claims of homeopathy effectiveness "are not accepted by most modern medical experts and do not constitute competent and reliable scientific evidence that these products have the claimed treatment effects."[269] In 2019, the FDA removed an enforcement policy that permitted unapproved homeopathics to be sold.[270] Currently no homeopathic products are approved by the FDA.[271]

Homeopathic remedies are regulated as natural health products in Canada.[89] Ontario became the first province in the country to regulate the practice of homeopathy, a move that was widely criticized by scientists and doctors.[272] Health Canada requires all products to have a licence before being sold and applicants have to submit evidence on "the safety, efficacy and quality of a homeopathic medicine".[273] In 2015 the Canadian Broadcasting Corporation tested the system by applying for and then receiving a government approved licence for a made-up drug aimed at kids.[274]

In Australia, the sale of homeopathic products is regulated by the Therapeutic Goods Administration.[275] In 2015, the National Health and Medical Research Council of Australia concluded that there is "no reliable evidence that homeopathy is effective and should not be used to treat health conditions that are chronic, serious, or could become serious". They recommended anyone considering using homeopathy should first get advice from a registered health practitioner.[161] A 2017 review into Pharmacy Remuneration and Regulation recommended that products be banned from pharmacies;[276] while noting the concerns the government did not adopt the recommendation.[277] In New Zealand there are no regulations specific to homeopathy[278] and the New Zealand Medical Association does not oppose the use of homeopathy,[279] a stance that has been called unethical by some doctors.[280]

Prevalence

Homeopathy is one of the most commonly used forms of alternative medicines and it has a large worldwide market.[89] The exact size is uncertain, but information available on homeopathic sales suggests it forms a large share of the medical market.[89]

In 1999, about 1000 UK doctors practiced homeopathy, most being general practitioners who prescribe a limited number of remedies. A further 1500 homeopaths with no medical training are also thought to practice. Over ten thousand German and French doctors use homeopathy.[87] In the United States a National Health Interview Survey estimated 5 million adults and 1 million children used homeopathy in 2011. An analysis of this survey concluded that most cases were self-prescribed for colds and musculoskeletal pain.[281] Major retailers like Walmart, CVS, and Walgreens sell homeopathic products that are packaged to resemble conventional medicines.[241]

The homeopathic drug market in Germany is worth about 650 million euro with a 2014 survey finding that 60 percent of Germans reported trying homeopathy.[241] A 2009 survey found that only 17 percent of respondents knew how homeopathic medicine was made.[241] France spent more than US$408 million on homeopathic products in 2008.[89] In the United States the homeopathic market is worth about $3 billion-a-year;[282] with 2.9 billion spent in 2007.[89] Australia spent US$7.3 million on homeopathic medicines in 2008.[89]

In India, a 2014 national health survey found that homeopathy was used by about 3% of the population.[283] Homeopathy is used in China, although it arrived a lot later than in many other countries, partly due to the restriction on foreigners that persisted until late in the nineteenth century.[284] Throughout Africa there is a high reliance on traditional medicines, which can be attributed to the cost of modern medicines and the relative prevalence of practitioners. Many African countries do not have any official training facilities.[235]

Veterinary use

Homeopathic cures for small animals on the Isle of Man

Using homeopathy as a treatment for animals is termed "veterinary homeopathy" and dates back to the inception of homeopathy; Hahnemann himself wrote and spoke of the use of homeopathy in animals other than humans.[285] The use of homeopathy in the organic farming industry is heavily promoted.[286] Given that homeopathy's effects in humans are due to the placebo effect and the counseling aspects of the consultation, such treatments are even less effective in animals.[287] Studies have also found that giving animals placebos can play active roles in influencing pet owners to believe in the effectiveness of the treatment when none exists.[288] This means that animals given homeopathic remedies will continue to suffer, resulting in animal welfare concerns.[289][290]

Little existing research on the subject is of a high enough scientific standard to provide reliable data on efficacy.[288][291][292] A 2016 review of peer-reviewed articles from 1981 to 2014 by scientists from the University of Kassel, Germany, concluded that there is not enough evidence to support homeopathy as an effective treatment of infectious diseases in livestock.[293] The UK's Department for Environment, Food and Rural Affairs (Defra) has adopted a robust position against use of "alternative" pet preparations including homeopathy.[294] The British Veterinary Association's position statement on alternative medicines says that it "cannot endorse" homeopathy,[295] and the Australian Veterinary Association includes it on its list of "ineffective therapies".[296]

See also

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