05/09/2020 Homeopathy - Wikipedia

Homeopathy

Homeopathy or homoeopathy is a pseudoscientific[1][2][3][4] system of alternative medicine. It was created in 1796

by the German physician Samuel Hahnemann. Its practitioners, called homeopaths, believe that a substance that
Homeopathy
causes symptoms of a disease in healthy people would cure similar symptoms in sick people; this doctrine is called Alternative medicine
similia similibus curentur, or "like cures like".[5] Homeopathic preparations are termed remedies and are made using Homoeopathy
homeopathic dilution. In this process, a chosen substance is repeatedly and thoroughly diluted. The final product is
chemically indistinguishable from the diluent, which is usually either distilled water, ethanol or sugar; often, not even
a single molecule of the original substance can be expected to remain in the product.[6] Between the dilution iterations
homeopaths practice hitting and/or violently shaking the product, and claim that it makes the diluent remember the
original substance after its removal. Practitioners claim that such preparations, upon oral intake, can treat or cure
disease.[7]

All relevant scientific knowledge about physics, chemistry, biochemistry and biology[8][9][10][11][12][13] gained since at
least the mid-19th century[14] confirms that homeopathic remedies have no active content. They are biochemically
inert, and have no effect on any known disease.[8][15][16] Hahnemann's theory of disease, centered around principles
he 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.[17][18][19]:206[20] 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
nonsense.[3][21][22]

After assessments of homeopathy, national and international bodies have recommended the withdrawal of
government funding. Australia, the United Kingdom, Switzerland and France,[23] as well as the European Academies'
Science Advisory Council, and the Commission on Pseudoscience and Research Fraud of Russian Academy of Sciences Samuel Hahnemann, originator of
each concluded that homeopathy is ineffective, and recommended against the practice receiving any further homeopathy
funding.[24][25][26][27] Notably, France and England, where homeopathy was formerly prevalent, are in the process of
Pronunciation /ˌhoʊmiˈɒpəθi/ ( listen)
removing all public funding. The National Health Service in England ceased funding homeopathic remedies in
November 2017[28][29] and asked the Department of Health in the UK to add homeopathic remedies to the blacklist of Claims "Like cures like",
forbidden prescription items,[30] and France will remove funding by 2021.[31] In November 2018, Spain also dilution increases
announced moves to ban homeopathy and other pseudotherapies.[32] potency, disease
caused by miasms.
Related fields Alternative medicine
Contents Year 1796
History proposed
Historical context Original Samuel Hahnemann
Concept proponents
Provings Subsequent James Tyler Kent,
Miasms and disease proponents Constantine Hering,
19th century: rise to popularity and early criticism Royal S. Copeland,
George Vithoulkas is a Greek t
Revival in the 20th century and practitioner of homeopathy.
George Vithoulkas
21st century MeSH D006705
Preparations and treatment See also Humorism, heroic
Consultation medicine
Preparation
Dilutions
Provings
Evidence and efficacy
Lack of scientific evidence
Plausibility of dilutions
Efficacy
Explanations of perceived effects
Purported effects in other biological systems
Ethics and safety
Regulation and prevalence
Regulation
Prevalence
Veterinary use
Public opposition
See also
References
External links

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History

Historical context

Homeopathy, the longest established alternative medicine to come out of Europe, was created in 1796 by Samuel
Hahnemann.[33] Hahnemann rejected the mainstream medicine of the late 18th century as irrational and inadvisable
because it was largely ineffective and often harmful.[34][35] He advocated the use of single drugs at lower doses and
promoted an immaterial, vitalistic view of how living organisms function.[36] The term homeopathy was coined by
Hahnemann and first appeared in print in 1807.[37] He also coined the expression "allopathic medicine", which was used
to pejoratively refer to traditional Western medicine.[38]
Homeopathy Looks at the Horrors of
Allopathy, an 1857 painting by Concept
Alexander Beydeman, showing
historical figures and
Hahnemann conceived of homeopathy while translating a medical treatise by the
personifications of homeopathy
Scottish physician and chemist William Cullen into German. Being sceptical of
observing the brutality of medicine
Cullen's theory that cinchona cured malaria because it was bitter, Hahnemann
of the 19th century.
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, in accord with the "law of similars" that had been proposed by ancient physicians.[39] This led to
the name "homeopathy", which comes from the Greek: ὅμοιος hómoios, "-like" and πάθος páthos, "suffering".[40]

Hahnemann's law of similars is an ipse dixit that does not derive from the scientific method.[41] An account of the effects
of eating cinchona bark noted by Oliver Wendell Holmes, and published in 1861, failed to reproduce the symptoms
Hahnemann reported.[14]: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.[42]

Provings
Samuel Hahnemann Monument,
Hahnemann began to test what effects substances may have produced in humans, a procedure later called "homeopathic Washington D.C. with "Similia
proving". These tests required subjects to test the effects of ingesting substances by clearly recording all of their Similibus Curentur" - Like cures
symptoms as well as the ancillary conditions under which they appeared.[43] He published a collection of provings in Like.
1805, and a second collection of 65 preparations appeared in his book, Materia Medica Pura (1810).[44]

Because Hahnemann believed that large doses of drugs that caused similar symptoms would only aggravate illness, 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.[45] Hahnemann believed that this process aroused and enhanced "the spirit-like medicinal powers of the crude substances".[46] He gathered and
published a complete overview of his new medical system in his book, The Organon of the Healing Art (1810), whose 6th edition, published in 1921, is still
used by homeopaths today.[47]

Miasms and disease

In the Organon, Hahnemann introduced the concept of "miasms" as "infectious principles" underlying chronic
disease[48] and as "peculiar morbid derangement[s] of vital force".[49] Hahnemann associated each miasm with specific
diseases, and thought that initial exposure to miasms causes local symptoms, such as skin or venereal diseases. His
A homeopathic preparation made
assertion was that if these symptoms were suppressed by medication, the cause went deeper and began to manifest itself
from marsh tea: the "15C" dilution
as diseases of the internal organs.[50] Homeopathy maintains that treating diseases by directly alleviating their
shown here means the original
symptoms, as is sometimes done in conventional medicine, is ineffective because all "disease can generally be traced to
solution was diluted to 1/1030 of its
some latent, deep-seated, underlying chronic, or inherited tendency".[51] The underlying imputed miasm still remains, original strength. Given that there
and deep-seated ailments can be corrected only by removing the deeper disturbance of the vital force.[52] are many orders of magnitude fewer
than 1030 molecules in the small
Hahnemann's hypotheses for miasms originally presented only three local symptoms: psora (the itch), syphilis (venereal sample, the likelihood that it
disease) or sycosis (fig-wart disease).[53] Of these the most important was psora, described as being related to any itching contains even one molecule of the
diseases of the skin and was claimed to be the foundation of many further disease conditions. Hahnemann believed it to original herb is extremely low.
be the cause of such diseases as epilepsy, cancer, jaundice, deafness, and cataracts.[54] Since Hahnemann's time, other
miasms have been proposed, some replacing one or more of psora's proposed functions, including tuberculosis and
cancer miasms.[50]

The law of susceptibility implies that a negative state of mind can attract miasms to invade the body and produce symptoms of diseases.[55] Hahnemann
rejected the notion of a disease as a separate thing or invading entity, and insisted it was always part of the "living whole".[56]

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.[19]:148–9

19th century: rise to popularity and early criticism

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.[57] The first homeopathic school in the US opened in 1835, and in 1844, the first US national medical association, the American Institute of
Homeopathy, was established. Throughout the 19th century, dozens of homeopathic institutions appeared in Europe and the United States,[58] and by 1900,

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there were 22 homeopathic colleges and 15,000 practitioners in the United States.[59]

Because medical practice of the time relied on ineffective and often dangerous treatments, patients of homeopaths often had better outcomes than those of
the doctors.[60] Homeopathic preparations, even if ineffective, would almost surely cause no harm, making the users of homeopathic preparations less likely
to be killed by the treatment that was supposed to be helping them.[47] 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.[61]
One reason for the growing popularity of homeopathy was its apparent success in treating people suffering from infectious disease epidemics.[62] 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.[63]

From its inception, however, homeopathy was criticized by mainstream science. Sir John Forbes, physician to Queen Victoria, said in 1843 that the extremely
small doses of homeopathy were regularly derided as useless, "an outrage to human reason".[64] 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."[65] 19th-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).[14] The members of the French Homeopathic Society observed in 1867 that some leading homeopathists of Europe not only were
abandoning the practice of administering infinitesimal doses but were also no longer defending it.[66] The last school in the US exclusively teaching
homeopathy closed in 1920.[47]

Revival in the 20th century

According to Paul Ulrich Unschuld, the Nazi regime in Germany was fascinated by homeopathy, and spent large sums of money on researching its
mechanisms, but without gaining a positive result. Unschuld further argues that homeopathy never subsequently took root in the United States, but
remained more deeply established in European thinking.[67] 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 pure homeopaths
practising in the U.S.[68] By the mid to late 1970s, homeopathy made a significant comeback and sales of some homeopathic companies increased tenfold.[69]

Some homeopaths give credit for the revival to Greek homeopath George Vithoulkas, who performed a "great deal of research to update the scenarios and
refine the theories and practice of homeopathy", beginning in the 1970s,[70][71] but Ernst and Singh consider it to be linked to the rise of the New Age
movement.[35] 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 an irrational preference for "natural" products, which people think are the basis of homeopathic
preparations.[72]

21st century

Since the beginning of the 21st century, a series of meta-analyses have further shown that the therapeutic claims of homeopathy lack scientific
justification.[73] This had lead 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 be a beneficiary of NHS funding due its lack of scientific
credibility;[73] funding ceased in 2017.[28] They also asked the Department of Health in the UK to add homeopathic remedies to the blacklist of forbidden
prescription items,[30]

In 2015, the National Health and Medical Research Council of Australia found there were 'there are no health conditions for which there is reliable evidence
that homeopathy is effective".[74] The federal government only ended up accepting three of the 45 recommendations made by the 2018 review of Pharmacy
Remuneration and Regulation in 2018.[75] The Food and Drug Administration (FDA) held a hearing in 2015, requesting public comment on the regulation of
homeopathic drugs.[76] In 2017 the FDA announced it would strengthen regulation of homeopathic products.[77]

In July 2019, the French healthcare minister announced that social security reimbursements for homeopathic drugs will be phased out before 2021.[31]
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.[78] Spain has also announced moves to ban homeopathy and other pseudotherapies.[32]

Preparations and treatment

Homeopathic preparations are referred to as "homeopathic remedies".[79] 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.[80] 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.[81][82] There are over 118 repertories published in
English with Kents being one of the most used.[83]

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 and symptoms, with an emphasis on "modalities" (if they change
depending on the weather and other external factors).[84] They also take information on mood, likes and dislikes, their
physical, mental and emotional states, life circumstances, any physical or emotional illnesses and their personalty.[85] Homeopathic preparation Rhus
This "symptom picture" is matched to the "drug picture" in the materia medica or repertory and is used to specify certain toxicodendron, derived from poison
homeopathic remedies. In classical homeopathy, the practitioner attempts to match a single preparation to the totality of ivy.
symptoms (the simlilum), while "clinical homeopathy" involves combinations of preparations based on the various
symptoms of an illness.[70]

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Preparation

Homeopathy uses animal, plant, mineral, and synthetic substances in its preparations, generally referring to them using
Latin or faux-Latin names.[86] 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.[87] In the USA the common name must be displayed, although the Latin one a preparation made from D dilutions
can also be present.[86] of dangerous materials like
botulism, E-coli, thymus gland of
Isopathy is a therapy derived from homeopathy where the preparations come from diseased or pathological products unspecified origin, pneumonia,
such as fecal, urinary, respiratory discharges, blood, and tissue.[81] They are called nosodes (from the Greek nosos, pseudomona, proteus, salmonella,
disease) wiuth preparations made from "healthy" specimens being termed "sarcodes". Many so-called "homeopathic scarlet fever, staph, strep and
vaccines" are a form of isopathy.[88] Tautopathy is a form of isopathy where the preparations are composed of drugs or tuberculosis bacteria. Ethanol is
listed as being redundantly diluted in
vaccines that a person has consumed in the past, in the belief that this can reverse lingering damage caused by the initial
alcohol.
use.[89] There is no convincing scientific evidence for isopathy as an effective method of treatment.[90]

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[91] and sunlight.[92] Another derivitive is
electrohomoeopathy, where an electric bio-energy of therapeutic value is supposedly extracted from plants. Popular in the late nineteenth century,
electrohomeopathy is considered pseudo scientific and has been described as "utter idiocy".[93] In 2012, the Allahabad High Court in Uttar Pradesh, India,
handed down a decree which stated that electrohomeopathy was an unrecognized system of medicine which was quackery.[94]

Other minority practices include paper preparations, where the substance and dilution 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.[95][96] 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.[97]

Dilutions

Hahnemann found that undiluted doses caused reactions, sometimes dangerous ones, so specified that preparations be
given at the lowest possible dose. He found that this reduced potency as well as side-effects, but formed the view that
vigorous shaking by striking on an elastic surface – a process termed succussion by homeopaths – nullified this.[98] It
has been said that he came to this conclusion after deciding preparations subjected to agitation in transit, such as in
saddle bags or in a carriage, were more "potent".[19]:16 Hahnemann had a saddle-maker construct a special wooden
striking board covered in leather on one side and stuffed with horsehair.[99]:31 The process of dilution and succussion is
termed "dynamization" or "potentization" by homeopaths.[100][101] In industrial manufacture this may be done by
machine. There are differences of opinion on the number and force of strikes, and some practitioners dispute the need
for succussion. There are no laboratory assays and the importance and techniques for succussion cannot be determined
with any certainty from the literature.[19]:67–69 Mortar and pestle used for grinding
insoluble solids, such as platinum,
Serial dilution is achieved by taking an amount of the mixture and adding solvent, but the "Korsakovian" method may into homeopathic preparations
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.[19]:270 Insoluble
solids, such as granite, diamond, and platinum, are diluted by grinding them with lactose ("trituration").[19]:23 Fluxion, which dilutes the substance by
continuously passing water through the vial,[102] and radionic preparation methods of preparation do not require succussion.[19]:171

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.[103] The
centesimal scale was favoured by Hahnemann for most of his life. In his 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.[104]

A 2C dilution requires a substance to be diluted to one part in 100, and then some of that diluted solution diluted by a further factor of 100. This works out to
one part of the original substance in 10,000 parts of the solution.[105] A 6C dilution repeats this process six times, ending up with the original substance
diluted by a factor of 100−6 (one part in one trillion). Higher dilutions follow the same pattern. In homeopathy, a solution that is more dilute is described as
having a higher "potency", and more dilute substances are considered by homeopaths to be stronger and deeper-acting.[106] The Korsakovian method is
sometimes referred to as K on the label of a homeopathic preparation, e.g. 200CK is a 200C preparation made using the Korsakovian method.[107][108]

The end product is usually so diluted as to be indistinguishable from the diluent (pure water, sugar or alcohol).[45][109][110]
Hahnemann advocated dilutions of 1 part to 1060, that is 30C, for most purposes.[100] Hahnemann regularly used dilutions up to
300C but opined that "there must be a limit to the matter, it cannot go on indefinitely".[43]:322 The greatest dilution reasonably
likely to contain at least one molecule of the original substance is around 12C.[111] 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.[112][113] The process of homeopathic dilution results in no objectively detectable active ingredient in most cases, but
some preparations (e.g. calendula and arnica creams) do contain pharmacologically active doses.
Homeopathic pills,
homeopathic preparation
Critics of homeopathy commonly attempt to illustrate the dilutions involved in homeopathy with analogies.[114] An example
oscillococcinum given states that a 12C solution is equivalent to a "pinch of salt in both the North and South Atlantic Oceans",[115][116] which is
approximately correct.[117] 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.[114][118][119] A 200C dilution of duck liver, marketed under the name
Oscillococcinum, would require 10320 universes worth of molecules to simply have just one original molecule in the final substance.[120] The high dilutions
characteristically used are often considered to be the most controversial and implausible aspect of homeopathy.[121]

Not all homeopaths advocate high dilutions. Preparations at concentrations below 4X are considered an important part of homeopathic heritage.[122] Many
of the early homeopaths were originally doctors and generally used lower dilutions such as "3X" or "6X", rarely going beyond "12X". The split between lower
and higher dilutions followed ideological lines. Those favouring low dilutions stressed pathology and a stronger link to conventional medicine, while those

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favouring high dilutions emphasized vital force, miasms and a spiritual interpretation of disease.[123][124] Some products
with such relatively lower dilutions continue to be sold, but like their counterparts, they have not been conclusively
demonstrated to have any effect beyond that of a placebo.[125][126]

Provings

Homeopaths say that they can determine the properties of their preparations by following a method which they call
"proving".[127] 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.[128] At first
Hahnemann used undiluted doses for provings, but he later advocated provings with preparations at a 30C dilution,[100]
and most modern provings are carried out using ultra-dilute preparations.[129]

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.[130]
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.[131]
The first recorded provings were published by Hahnemann in his 1796 Essay on a New Principle.[132] His Fragmenta de
Viribus (1805)[133] contained the results of 27 provings, and his 1810 Materia Medica Pura contained 65.[134] For James
Tyler Kent's 1905 Lectures on Homoeopathic Materia Medica, 217 preparations underwent provings and newer This bottle is labelled Arnica
substances are continually added to contemporary versions. montana (wolf's bane) D6, i.e. the
nominal dilution is one part in a
Though the proving process has superficial similarities with clinical trials, it is fundamentally different in that the process million (10-6).
is subjective, not blinded, and modern provings are unlikely to use pharmacologically active levels of the substance under
proving.[135] As early as 1842, Oliver Holmes had noted that provings were impossibly vague, and the purported effect
was not repeatable among different subjects.[14]

Evidence and efficacy

Outside of the alternative medicine community, scientists have long considered homeopathy a sham[136] or a
pseudoscience,[1][2][3][4] and the mainstream medical community regards it as quackery.[3] 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.[15] Proponents argue that homeopathic medicines must work by some, as yet
undefined, biophysical mechanism.[137]

Lack of scientific evidence

The lack of convincing scientific evidence supporting its efficacy[138] and its use of preparations without active
ingredients have led to characterizations of homeopathy as pseudoscience and quackery,[139][140][141][142][143] or, in the
words of a 1998 medical review, "placebo therapy at best and quackery at worst".[144] The Russian Academy of Sciences
considers homeopathy a "dangerous 'pseudoscience' that does not work", and "urges people to treat homeopathy 'on a Homeopathic repertory by James
par with magic' ".[139] The Chief Medical Officer for England, Dame Sally Davies, has stated that homeopathic Tyler Kent
preparations are "rubbish" and do not serve as anything more than placebos.[145] In 2013, Mark Walport, the UK
Government Chief Scientific Adviser and head of the Government Office for Science said "homoeopathy is nonsense, it is
non-science."[146] His predecessor, John Beddington, referring to his views that homeopathy "has no underpinning of scientific basis" being "fundamentally
ignored" by the Government.[147]

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."[138] 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".[148] 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.[148]

In an article entitled "Should We Maintain an Open Mind about Homeopathy?"[149] 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

The very low concentration of homeopathic preparations, which often lack even a single molecule of the diluted substance,[112] has been the basis of
questions about the effects of the preparations since the 19th century.[12] The extreme dilutions used in homeopathic preparations usually leave not one
molecule of the original substance in the final product. 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] The laws of chemistry state that there is a limit to the dilution that can be made without losing the original substance altogether.[112]
This limit, which is related to Avogadro's number, is roughly equal to homeopathic dilutions of 12C or 24X (1 part in 1024).[114][151][152]

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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.[153][154] 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[155]

Homeopaths contend that their methods produce a therapeutically active preparation, selectively including only the intended substance, though critics note
that any water will have been in contact with millions of different substances throughout its history, and homeopaths have not been able to account for a
reason why only the selected homeopathic substance would be a special case in their process.[2]

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.[155] Some contend that the phenomenon of hormesis may support the
idea of dilution increasing potency,[156][157] 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.[158]

Efficacy

No individual homeopathic preparation has been unambiguously shown by research to be different from placebo.[15] The
methodological quality of the primary research was generally low, with such problems 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.[159][19]:206[160] A review conducted in 2010 of all the pertinent studies of "best evidence" produced by the Cochrane
Collaboration concluded that "the most reliable evidence – that produced by Cochrane reviews – fails to demonstrate that
homeopathic medicines have effects beyond placebo."[20]

Government-level reviews have been conducted in recent years. 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.[11] 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
Old bottle of Hepar sulph
2017 finding a lack of evidence that homeopathic products are effective, and raising concerns about quality control.[13]
made from calcium sulfide
In contrast a 2011 book was published purportedly financed by the Swiss government that concluded that homeopathy was
effective and cost efficient.[162] It was hailed by proponents of homeopathy as proof that homeopathy works.[163] It was found to
be scientifically, logically and ethically flawed, with most authors having a conflict of interest.[163] The Swiss Federal Office of Public Health released a
statement saying the book was published without the consent of the Swiss government or administration.[164]

A 2001 systematic review found that the methodological quality in the majority of randomized trials in homeopathy had shortcomings. [165] A separate 2001
systematic review that assessed the quality of clinical trials of homeopathy found that such trials were generally of lower quality than trials of conventional
medicine.[166] Publication bias, where positive results are more likely to be published in journals,[167][168] 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.[148] Regarding the way in which
homeopathy is represented in the medical literature, a systematic review found signs of bias in the publications of clinical trials (towards negative
representation in mainstream medical journals, and vice versa in alternative medicine journals), but not in reviews.[159]

Meta-analyses are essential tools to summarize evidence of therapeutic efficacy.[169] Early systematic reviews and meta-analyses of trials evaluating the
efficacy of homeopathic preparations in comparison with placebo often tended to generate positive results.[170] Reports of three large meta-analyses warned
that firm conclusions could not be reached, largely due to methodological flaws in the primary studies and the difficulty in controlling for publication
bias.[171][172] The positive finding of one of the early meta-analyses, published in The Lancet in 1997,[172] was later reframed by the same research team as an
"overestimated the effects of homeopathic treatments."[160] 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.[15] The same conclusion was also reached in 2005 in a meta-analysis published in The Lancet.[8] A 2017 systematic review and meta-analysis found
that the most reliable evidence did not support the effectiveness of non-individualized homeopathy.[173]

Some clinical trials have tested individualized homeopathy. A 1998 review of 19 placebo-controlled trials showed a pooled odds ratio of 1.17 to 2.23 in favour
of individualized homeopathy over the placebo, but no difference was seen when the analysis was restricted to the methodologically best trials. The authors
concluded that "the results of the available randomized trials suggest that individualized homeopathy has an effect over placebo. The evidence, however, is
not convincing because of methodological shortcomings and inconsistencies."[174] A 2014 systematic review and meta-analysis found that individualized
homeopathic remedies may be slightly more effective than placebos, though the authors noted that their findings were based on low- or unclear-quality
evidence.[175] The same research team later reported that taking into account model validity did not significantly affect this conclusion.[176]

Health organization, including the UK's National Health Service,[177] the American Medical Association,[178] the FASEB,[179] 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.[177] 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.[180] They warned against the use of
homeopathy for serious conditions such as depression, HIV and malaria.[181] 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.[182] 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.[182]

Explanations of perceived effects

Science offers a variety of explanations for how homeopathy may appear to cure diseases or alleviate symptoms even though the preparations themselves are
inert:[19]:155–167

The placebo effect – the intensive consultation process and expectations for the homeopathic preparations may cause the effect.

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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.[183]
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.

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[184] and enzyme reactions, such evidence is disputed since attempts to
replicate them have failed.[185][186][187][188][189][190] 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.[191][192] 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.[193]A 2007 systematic review of high-dilution experiments found that none of the experiments with positive
results could be reproduced by all investigators.[194]

In 1988, French immunologist Jacques Benveniste published a paper in the journal Nature while working at INSERM.[195]
The paper purported to have discovered that basophils, released histamine when exposed to a homeopathic dilution of anti-
immunoglobulin E antibody. Sceptical 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."[154][196][197]

Old homeopathic belladonna

Ethics and safety preparation.

The provision of homeopathic preparations has been described as unethical.[198] Michael Baum, Professor Emeritus of
Surgery and visiting Professor of Medical Humanities at University College London (UCL), has described homoeopathy as a "cruel deception".[199] Edzard
Ernst, the first Professor of Complementary Medicine in the United Kingdom and a former homeopathic practitioner,[200][201][202] 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.[203] 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.[204] 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.[205]

A 2000 review by homeopaths reported that homeopathic preparations are "unlikely to provoke severe adverse reactions".[206] 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".[207] 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.[208]

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.[207] Instances of arsenic poisoning have occurred.[209] 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.[210] In 2016 the FDA issued a safety alert
to consumers[211] warning against the use of homeopathic teething gels and tablets following reports of adverse events after their use.[212] 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".[213]

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.[214][215][214][215][216][217] 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.[218][219] They have also condemned the "marketing practice"
of criticizing and downplaying the effectiveness of mainstream medicine.[148][219] Homeopaths claim that use of conventional medicines will "push the
disease deeper" and cause more serious conditions, a process referred to as "suppression".[220] 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.[221] 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.[222]

The use of homeopathy as a preventive for serious infectious diseases, called homeoprophylaxis, is especially controversial.[223] Some homeopaths
(particularly those who are non-physicians) advise their patients against immunization.[216][224][225] Others have suggested that vaccines be replaced with
homeopathic "nosodes".[226] While Hahnemann was opposed to such preparations, modern homeopaths often use them although there is no evidence to
indicate they have any beneficial effects.[227][228] Promotion of homeopathic alternatives to vaccines has been characterized as dangerous, inappropriate and
irresponsible.[229][230] In December 2014, the Australian homeopathy supplier Homeopathy Plus! was found to have acted deceptively in promoting
homeopathic alternatives to vaccines.[231] In 2019, an investigative journalism piece by the Telegraph revealed that homeopathy practitioners were actively
discouraging patients from vaccinating their children.[232] Cases of homeopaths advising against the use of anti-malarial drugs have also been
identified.[217][233][234]putting visitors to the tropics in severe danger.[217][233][234][235]

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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.[236]

Regulation and prevalence

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.[237] 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.[238] 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.[237]

Regulation
Hampton House, the former site of
Some homeopathic treatment is covered by the public health service of several European countries, including France Bristol Homeopathic Hospital.
(being phased out coverage in 2021),[31] Scotland,[239] and Luxembourg.[240] 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,[241] but exceptions can be made;[242] private health insurance policies
sometimes include homeopathic treatment.[237] In 2018, Austria’s Medical University of Vienna stopped teaching homeopathy.[243] 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,[244] but following a referendum in 2009 the five therapies have been reinstated for a further 6-year trial period from 2012.[245] In Germany,
homeopathic treatments are covered by 70 percent of government medical plans, and available in almost every pharmacy.[243]

The English NHS recommended against prescribing homeopathic preparations in 2017.[246] In 2018 prescriptions worth £55,000 were written in defiance of
the guidelines, representing less than 0.001% of the total NHS prescribing budget.[247][248] In 2016 the UK's Committee of Advertising Practice (CAP)
Compliance team wrote to homeopaths[249] in the UK to "remind them of the rules that govern what they can and can't say in their marketing materials".[250]
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.[251]

Member states or the European Union are required to ensure that homepathic products are registered, although this process does not require any proof of
efficacy.[252] In Spain lobby groups are trying to get rid of this easy registration procedure for homeopathic remedies.[252] In Bulgaria, Hungary, Latvia,
Romania and Slovenia homeopathy, by law, can only be practiced by medical practitioners. Although in Slovenia if doctors practice homeopathy, their
medical license will be revoked.[252] 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.[237] Homeopaths in the UK are under
no legal regulations, meaning anyone can call themselves homeopaths and administer homeopathic remedies.[246]

The Indian government recognizes homeopathy as one of its national systems of medicine;[253] it has established the
Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) under the Ministry of
Health & Family Welfare.[254] The south Indian state of Kerala also has a cabinet-level AYUSH department.[255] The
Central Council of Homoeopathy was established in 1973 to monitor higher education in homeopathy, and the National
Institute of Homoeopathy in 1975.[256] 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.[257]

In the United States each state is responsible for the laws and licensing requirements for homeopathy.[258] In 2015, the
Homeopathics at a homeopathic FDA held a hearing on homeopathic product regulation.[259] Representatives from the Center for Inquiry (CFI) and the
pharmacy in Varanasi, India. Committee for Skeptical Inquiry (CSI) gave a testimonial which summarized the harm that is done to the general public
from homeopathics and proposed regulatory actions:[260] 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 hold efficacy and safety claims for OTC homeopathic drugs to the same standard as other products making similar claims.[261] 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."[262] In 2019 the FDA removed an enforcement policy that permitted
unapproved homeopathics to be sold.[263] Currently no homeopathic products are approved by the FDA.[264]

In Canada, Ontario became the first province in the country to regulate the practice of homeopathy, a move that caused widespread criticism.[265] 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".[266] In 2015 the Canadian Broadcasting Corporation tested the system be applying for and then receiving a government approved licence for a
made-up drug aimed at kids.[267]

In Australia, the sale of homeopathic products is regulated by the Therapeutic Goods Administration.[268] 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,[269] while noted the
concerns the government did not adopt the recommendation.[270] In New Zealand there are no regulations specific to homeopathy[271] and the New Zealand
Medical Association does not oppose the use of homeopathy,[272] a stance that has been called unethical by some doctors.[273]

Prevalence

n the UK about 1000 UK doctors practice 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.[274] 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.[243] A 2009
survey found that only 17 percent of respondents knew how homeopathic medicine was made.[243]
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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.[275] Major retailers like Walmart, CVS, and Walgreens sell
homeopathic products that resemble conventional medicines.[243] The homeopathic market is worth about the $3 billion-a-year.[276]

In Africa there is a high reliance on traditional medicines, partially due to the cost of modern medicines and the relative prevalence of practitioners. Many
African countries do not have any official training facilities.[237]

Homeopathy arrived a lot later in China than many other countries, partly due to the restriction on foreigners that persisted until late in the nineteenth
century.[277]

Veterinary use
The idea of using homeopathy as a treatment for other animals termed "veterinary homeopathy", dates back to the
inception of homeopathy; Hahnemann himself wrote and spoke of the use of homeopathy in animals other than
humans.[278] The FDA has not approved homeopathic products as veterinary medicine in the U.S. In the UK, veterinary
surgeons who use homeopathy may belong to the Faculty of Homeopathy and/or to the British Association of
Homeopathic Veterinary Surgeons. Animals may be treated only by qualified veterinary surgeons in the UK and some
other countries. Internationally, the body that supports and represents homeopathic veterinarians is the International
Association for Veterinary Homeopathy.

Little existing research on the subject is not of a high enough scientific standard to provide reliable data on
efficacy.[279][280][281] Given that homeopathy's effects in humans appear to be mainly due to the placebo effect and the Homeopathic cures for small
counseling aspects of the consultation, it is likely that homeopathic treatments would be even less effective in animals Isle of Man 2007
animals.[282]

Other 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.[279] The British Veterinary Association's position statement on alternative medicines says that it "cannot endorse" homeopathy,[283] and
the Australian Veterinary Association includes it on its list of "ineffective therapies".[284] A 2016 review of peer-reviewed articles from 1981 to 2014 by
scientists from the University of Kassel, Germany, concluded that there was insufficient evidence to support the use of homeopathy in livestock as a way to
prevent or treat infectious diseases.[285]

The UK's Department for Environment, Food and Rural Affairs (Defra) has adopted a robust position against use of "alternative" pet preparations including
homeopathy.[286]

Public opposition
In the April 1997 edition of FDA Consumer, William T. Jarvis, the President of the National Council Against Health Fraud, said "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 [chief sponsor of the 1938 Food,
Drug, and Cosmetic Act]."[287]

Mock "overdosing" on homeopathic preparations by individuals or groups in "mass suicides" have become more popular since James Randi began taking
entire bottles of homeopathic sleeping pills before giving lectures.[288][289][290][291] In 2010 The Merseyside Skeptics Society from the United Kingdom
launched the 10:23 campaign, encouraging groups to publicly overdose as groups. In 2011 the 10:23 campaign expanded and saw sixty-nine groups
participate; fifty-four submitted videos.[292] In April 2012, at the Berkeley SkeptiCal conference, over 100 people participated in a mass overdose, taking
coffea cruda, which is supposed to treat sleeplessness.[293][294]

In 2011, the non-profit educational organizations Center for Inquiry (CFI) and the associated Committee for Skeptical Inquiry (CSI) have petitioned the U.S.
Food and Drug Administration (FDA) to initiate "rulemaking that would require all over-the-counter homeopathic drugs to meet the same standards of
effectiveness as non-homeopathic drugs" and "to place warning labels on homeopathic drugs until such time as they are shown to be effective". In a separate
petition, CFI and CSI request FDA to issue warning letters to Boiron, maker of Oscillococcinum, regarding their marketing tactic and criticize Boiron for
misleading labelling and advertising of Oscillococcinum.[295] In 2015, CFI filed comments urging the Federal Trade Commission to end the false advertising
practice of homeopathy.[296] On November 15, 2016, FTC declared that homeopathic products cannot include claims of effectiveness without "competent and
reliable scientific evidence". If no such evidence exists, they must state this fact clearly on their labeling, and state that the product's claims are based only on
18th-century theories that have been discarded by modern science. Failure to do so will be considered a violation of the FTC Act.[297] CFI in Canada is calling
for persons that feel they were harmed by homeopathic products to contact them.[298]

In July 2018 the Center for Inquiry filed a lawsuit against CVS for consumer fraud over its sale of homeopathic medicines.[299] According to Nicholas Little,
CFI's Vice President and General Counsel:

Homeopathy is a total sham, and CVS knows it. Yet the company persists in deceiving its customers about the effectiveness of homeopathic
products. Homeopathics are shelved right alongside scientifically-proven medicines, under the same signs for cold and flu, pain relief, sleep aids,
and so on. If you search for "flu treatment" on their website, it even suggests homeopathics to you, CVS is making no distinction between those
products that have been vetted and tested by science, and those that are nothing but snake oil.[299]

The filing in part contends that apart from being a waste of money, choosing homeopathic treatments to the exclusion of evidence-based medicines can result
in worsened or prolonged symptoms, and in some cases, even death.[299] It also claimed that CVS was selling homeopathic products on an easier-to-obtain
basis than standard medication; for example on the CVS website Oscillococcinum could be purchased as a "Flu remedy", whereas the Tylenol brand could
only be purchased by visiting a physical pharmacy.[300] In May, 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".[301][302]

In 2019, CFI also conducted a survey to assess the effects on consumer attitudes of having been informed about the lack of scientific evidence for the efficacy
of the homeopathic remedies sold by Walmart and CVS. The survey found that "Exposure to the truth about the pseudoscience of homeopathy leads a large
percentage of consumers to feel ripped off and deceived by the two largest drug retailers".[303][304]

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In August 2011, a class action lawsuit was filed against Boiron on behalf of "all California residents who purchased Oscillo at any time within the past four
years".[305] The lawsuit charged that it "is nothing more than a sugar pill", "despite falsely advertising that it contains an active ingredient known to treat flu
symptoms".[306] In March 2012, Boiron agreed to spend up to $12 million to settle the claims of falsely advertising the benefits of its homeopathic
preparations.[307]

In July 2012, CBC News reporter Erica Johnson for Marketplace conducted an investigation on the homeopathy industry in Canada; her findings were that it
is "based on flawed science and some loopy thinking". Center for Inquiry (CFI) Vancouver skeptics participated in a mass overdose outside an emergency
room in Vancouver, B.C., taking entire bottles of "medications" that should have made them sleepy, nauseous or dead; after 45 minutes of observation no ill
effects were felt. Johnson asked homeopaths and company representatives about cures for cancer and vaccine claims. All reported positive results but none
could offer any science backing up their statements, only that "it works". Johnson was unable to find any evidence that homeopathic preparations contain
any active ingredient. Analysis performed at the University of Toronto's chemistry department found that the active ingredient is so small "it is equivalent to
5 billion times less than the amount of aspirin ... in a single pellet". Belladonna and ipecac "would be indistinguishable from each other in a blind
test".[308][309]

Homeopathic services offered at Bristol Homeopathic Hospital in the UK ceased in October 2015,[310][311] partly in response to increased public awareness as
a result of the 10:23 Campaign and a campaign led by the Good Thinking Society.[312] University Hospitals Bristol confirmed that it would cease to offer
homeopathic therapies from October 2015, at which point homeopathic therapies would no longer be included in the contract.[311] Homeopathic services in
the Bristol area were relocated to "a new independent social enterprise"[311] at which Bristol Clinical Commissioning Group revealed "there are currently no
(NHS) contracts for homeopathy in place."[311] Following a threat of legal action by the Good Thinking Society campaign group, the British government has
stated that the Department of Health will hold a consultation in 2016 regarding whether homeopathic treatments should be added to the NHS treatments
blacklist (officially, Schedule 1 of the National Health Service (General Medical Services Contracts) (Prescription of Drugs etc.) Regulations 2004), that
specifies a blacklist of medicines not to be prescribed under the NHS.[313][314][315]

In March 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 stated that "Homeopathy has not definitely proved its efficacy under any indication or concrete clinical situation".[316] Shortly afterwards,
in April 2016, the University of Valencia announced the elimination of its Masters in Homeopathy for 2017.[317]

In June 2016, blogger and sceptic Jithin Mohandas launched a petition through Change.org asking the government of Kerala, India, to stop admitting
students to homeopathy medical colleges.[318] Mohandas said that government approval of these colleges makes them appear legitimate, leading thousands
of talented students to join them and end up with invalid degrees. The petition asks that homeopathy colleges be converted to regular medical colleges and
that people with homeopathy degrees be provided with training in scientific medicine.[319]

In Germany, physician and critic of alternative medicine Irmgard Oepen was a relentless critic of homeopathy.[320]

See also
Fringe science
List of topics characterized as pseudoscience

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External links
Homeopathy (http://www.nhs.uk/conditions/homeopathy/pages/introduction.aspx) (NHS Choices, UK)

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This page was last edited on 5 September 2020, at 17:41 (UTC).

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