Homeopathy

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Chapter 39 Homeopathy

Andrew Lange, ND, Susan A. Gaylord, PhD

Chapter Contents

Introduction

History

Philosophy

Provings, 
Like Treating Like, 
The Organon of Medicine, 
Vitalism, 

The Clinical Application of Homeopathic Principles

The Homeopathic Interview, 
Follow-Up and Case Evaluation, 
Prescription, 
Homeopathic Pharmacy and Potency Selection, 
Mechanism of Action, 
Determination of Potency, 
The Study of the Materia Medica, 

Research in Homeopathy

Evidence from a Modern Proving Study, 
Human Clinical Trials, 
Meta-Analyses and Systematic Reviews of Human Clinical Trials, 
Human Effectiveness Studies, 
Animal Studies: Field and Laboratory Research, 
Basic Research, 

Summary

image Introduction

Homeopathy is a highly systematized method of medical therapeutics and clinical evaluation. The term “homeopathy” is derived from the Greek words “homeos,” meaning “similar,” and “pathos,” meaning “suffering.” The medicines used in this system of therapeutics are chosen according to the Law of Similars (the concept of like curing like), a fundamental homeopathic principle based on the observed relationship between a medicine’s ability to produce a specific constellation of signs and symptoms in a healthy individual and the same medicine’s ability to cure a sick patient with similar signs and symptoms. This principle was first recognized by Hippocrates, who noticed that herbs given in low doses tended to cure the same symptoms they produced when given in toxic doses.

Homeopathic medicines are derived from a wide variety of plant, mineral, and chemical substances. They are prepared according to standards of the U.S. Homeopathic Pharmacopoeia, a revised version of which has been approved by the U.S. Food and Drug Administration and U.S. Congress.

image History

The homeopathic school of medicine was founded by a German physician, Samuel Hahnemann. He had already gained a reputation in chemistry and medicine, having formulated a soluble form of mercury and developed a safer method for its use, and having written a number of works on pharmacology, hygiene and public health, industrial toxicology, and psychiatry. His treatise on arsenic poisoning (1786) is still considered authoritative. A prolific writer, Hahnemann collected, compiled, revised, and edited the existing pharmacologic knowledge. The work was well received by the medical profession of the time. Hahnemann was one of the most learned men of his generation in medicine, chemistry, and pharmacology, making his later criticisms of medicine all the more significant.1

Disillusioned with the theories and practice of eighteenth century medicine, Hahnemann retired from practice in 1782 and spent the next 14 years earning a meager living doing chemical research; writing; and translating English, French, Italian, and Latin works. He wrote of his time of practice:

It was painful for me to grope in the dark, guided only by books in the treatment of the sick. To prescribe according to this or that (fanciful) view of the nature of diseases, substances that only owed to mere opinion their place in the materia medica; I had conscientious scruples about treating unknown morbid states in my suffering fellow creatures with these unknown medicines which, being powerful substances, may, if they were not exactly suitable (and how could the physician know whether they were suitable or not, seeing that their peculiar special actions were not yet elucidated) easily change life into death, or produce new affections and chronic ailments, which are often more difficult to remove than the original disease.

In his struggle to determine a reliable basis for therapeutics, he was distressed by his inability to provide medical care for the acute illnesses of even his own growing family. In 1790, during his translation of William Cullen’s (a Scottish physician) Materia Medica, he added a footnote disagreeing with Cullen’s conclusions that the basis of cinchona bark’s effectiveness was its bitter and astringent qualities. Cinchona officinalis (peruvian bark), from which the drug quinine is derived, was known to be clinically effective in malaria and intermittent fevers (then called ague). He argued that there were several drugs in common usage that, in smaller doses, had greater bitter and astringent qualities yet had no specific action on fevers. As an experiment, Hahnemann took four drachms of cinchona twice daily and soon developed the paroxysmal symptoms characteristic of intermittent fevers.

This duplication of symptoms was a revelation to him and ultimately resulted in his formulation of the concept of determining the properties of a medicine by studying its effects on healthy humans.

Although homeopathy offers a profoundly deep and unified evaluation in the treatment of chronic diseases (see the section on “Follow-Up and Case Evaluation”), it had gained most of its early reputation in the treatment of acute and epidemic diseases. An uproar was caused in Cincinnati in 1849, when two immigrant German homeopaths, treating cholera with camphor and other homeopathically prescribed remedies, published statistics in newspapers indicating that only 35 of their 1116 treated cases had died. During the nineteenth century, 33% to 50% of patients with cholera who were given standard medical care died. In the 1879 epidemic of yellow fever, New Orleans homeopaths treated 1945 cases with a mortality rate of 5.6%, whereas standard medical doctors were losing 16% of patients. These and similar statistics had a profound effect on Congress and public opinion.2

Over time, homeopaths established their own network of treatment facilities. By 1892, in the United States, they controlled 110 hospitals, 145 dispensaries, 62 orphan asylums and retirement homes, more than 30 nursing homes and sanatoria, and 16 insane asylums.

Constantine Hering established the first homeopathic medical school in the United States in 1835. It later moved from its original site in Allentown, Pennsylvania, to Philadelphia, where it remains today as an orthodox medical school: the Hahnemann Medical College and Hospital. Hering’s promotion of homeopathy and development of the materia medica was equaled only by Hahnemann himself. His 10-volume work, The Guiding Symptoms of Our Materia Medica, remains a definitive work on the clinical verifications of the homeopathic approach. Unfortunately, of the many medicines introduced by Hering, only nitroglycerine remains in orthodox medical practice as a tribute to his medical genius.

Throughout the world, homeopathy has maintained a consistent tradition. Frederick Harvey Foster Quinn introduced it to England in the 1840s. It has since become a postgraduate medical specialty, recognized by the Department of Health by virtue of an Act of Parliament. Homeopathic hospitals and outpatient clinics are part of England’s national health system. Homeopaths have been engaged as personal physicians to the Royal family for the past four generations.

Homeopathy is widely practiced in Europe, India, Argentina, and Mexico, and is experiencing a renaissance in the United States.

image Philosophy

Provings

Hahnemann defined his method of testing medicines on healthy people as “provings.” He expanded his investigations to include a wide range of substances, using his family, friends, and associates as experimental subjects.

Historically, Hahnemann was not the first to use this methodology. In 1760, Anton Stoerck reported testing stramonium (datura) by rubbing it on the skin, inhaling the vapors of the freshly crushed leaves, and, finally, ingesting the fresh extract. He theorized that if stramonium disturbs the senses and produces mental derangements in healthy people, it might be administered to maniacs for the purpose of restoring the senses by effecting a change of ideas.

Medical literature contains examples of inadvertent provings: in 1983 a study in the New England Journal of Medicine reported that pyridoxine (vitamin B6), which is used in the treatment of some types of peripheral neuropathy, was also capable of producing neuropathies when given in large doses.3 In 1796, Hahnemann published, in Hufeland’s Journal, the fruit of his investigations in an article, “Essay on a New Principle for Ascertaining the Curative Power of Drugs, with a Few Glances at Those Hitherto Employed.”

Like Treating Like

Hahnemann also recognized the tendency of a natural disease to have a “homeopathic effect” (i.e., a preventive or therapeutic effect) on other diseases with similar symptomatology. Although he ascribed this to the stimulation of the organism to eradicate the disease, he felt the deliberate induction of a disease to be difficult, uncertain, and dangerous.4 This concept has many parallels in modern medical science. Descriptions of viral interference under natural conditions were described in 1937 by G. Findlely and F. MacCallum, who found that monkeys infected with the Raft Valley fever virus were protected from the more fatal yellow fever virus. They adopted the term “virus interference” and believed that when one virus infects a group of cells, a second virus is somehow excluded.5 This eventually led to the discovery of interferon in 1957 by Alick Isaacs and Jean Lindenmann. These methods of inducing self-regulation are critical in enhancing the ability for the body to recognize and resolve illness.

In 1799, Hahnemann gained increased professional acceptance of his ideas by the successful application of atropa belladonna (deadly nightshade) in the prevention and treatment of scarlet fever (which had at that time reached epidemic proportions). In 1860, it was recommended as the treatment of choice in the National Dispensatory, which stated: “As long as persons are under the influence of belladonna the liability to contract scarlatina is very much diminished.”6

The Organon of Medicine

In 1810, Hahnemann published his Organon of Medicine, a book that, through six editions, formed the foundation and definition of the homeopathic practice of medicine. It contains the philosophy, observations, and clinical applications of homeopathy, as well as citations from the historical and current literature of the time. Hahnemann challenged the reductionistic and mechanistic practices of his time, stating that the nature of disease is dynamic and could not be defined by isolating processes, grasping for an explanation. He further asserted that the cause of disease could not be known and that the categorization of disease states and attempts to manipulate physiology were insufficient, because they did not address the integrity and complexity of organization of the organism as a whole.

He described this organization as dynamic, meaning in accordance with the animating principle of life, which is the underlying energetic pattern to which matter conforms.

Disease is therefore addressed descriptively in the context of the whole patient, with the patient’s unique symptoms being indicative of that individual’s vital response to the condition. For any given disease there may be a long list of remedies that have been clinically effective, but it is the individualization and differentiation among medicines, based on the patient’s unique indications, that leads to a successful homeopathic prescription.

Vitalism

Disease, in the homeopathic model, is thought to arise from inherent or developed weaknesses in the patient’s defense mechanisms, creating a susceptibility to “morbific influences” (e.g., toxic factors in the environment, bacteria, psychological stresses). This viewpoint is considered “vitalistic” (see Chapter 3, Hierarchy of Healing, and Chapter 5, Philosophy of Naturopathic Medicine, for further discussion) and, although it does not deny a corporeal reality, considers pathology to be but a singular focus in a complex net of interactions.

William Boyd, in A Textbook of Pathology, discussed the limitations of the causal approach to disease currently in vogue in medicine when he stated7:

We must admit, however unwillingly, that we seldom or never really know the cause of anything. Many a beautiful idea has been slain by ugly fact. We merely note a constant association with one thing always following another. We say that the tubercle bacillus is the cause of tuberculosis. That is merely another way of saying that the bacillus is associated with a constant type of lesion; it is no explanation of how the lesions are produced by the bacillus. Nor does it explain why some persons and animals are susceptible to the infection while others are immune.

Vitalism can be better understood in the context of Hahnemann’s time, when theories of the causation of disease and its treatment abounded, such as Galen’s doctrine that the secondary quality of a medicine (i.e., its action on the disease) could be determined from its primary qualities, such as its taste or smell; the evaluation of medicines by the study of their interactions when mixed with human blood in a jar; iatrochemistry, which had been reduced from the Paracelsian application of spagyric tinctures or oils of metals to dangerous toxic doses; the classification of drugs according to the Dioscoridian approach, which was based on the physiologic action (e.g., diuresis, diaphoresis) and chemical composition; and the “doctrine of signatures,” which held that the outer form and color of a plant revealed its inner archetypal action.8,9

Although some studies of the effects of medicinal agents were done with animals, Hahnemann observed that they had different effects on humans; pigs could safely eat nux vomica in quantities that would immediately kill humans. Dogs could eat aconitum napellus, a deadly poison to humans, without injury. He also rejected the method of testing drugs by studying their effects on the sick as haphazard and unreliable, particularly because the results being sought were often only symptomatic relief rather than eradication of the disease state.

Hahnemann defined the application of medicines whose purpose was to alter physiology or act as an antagonist to disease as the practice of “allopathy” (“allo,” meaning “contrary” in Greek). The current dominant medical system is heavily influenced by the causalistic and allopathic paradigms. This results in the diagnosis being the focal point of practice, without which appropriate therapy cannot be instituted. The pharmacologic approach is limited to the end results of disease rather than the origins of pathogenesis. Subsequent problems are classified as unwanted side effects, because only the primary action of the pharmaceutic agent is used for treating a specific disease state. By focusing on only the primary effects of a drug, a diverse remaining range of physiologic, as well as psychological effects, are ignored.

In the homeopathic model, the side effects are an important part of the agent’s action and the body’s response to them, and by ignoring them, a drug’s range of usefulness is greatly limited, whereas its toxicity is increased. Hahnemann’s empiric investigations not only led to new applications of medicines but provided a method for integrating the physical, mental, and emotional effects of a drug. This allowed the treatment of the totality of a patient’s symptoms as a dynamic pattern of interaction.

Vitalists stress the teleologic behavior of organisms (i.e., the goal directedness and design in biological phenomena). Disease is therefore regarded as a positive expression of the organism’s self-regulatory process in response to environmental or other stresses. Disease is not accidental but is rather the effort of the organism to ward off deeper or more internal disorganization. It is the natural wisdom of the body, the vis medicatrix naturae, or, using current scientific terminology, the tendency of the body to maintain homeostasis. Medical intervention often acts in conflict with these vital intracellular and extracellular regulatory functions.

Karl Menninger, in 1948, commented on this medical dilemma10:

I believe that clinicians have come to think more and more in terms of a disturbance in the total economics of the personality, a temporary overwhelming of the efforts of the organism to maintain a continuous internal and external adaptation to continuously changing relationships, threats, pressures, instinctive needs and reality demands … It is the imbalance, the organismic disequilibrium, which is the real pathology, and when that imbalance reaches a degree or duration that threatens the comfort or survival of the individual, it may correctly be denoted disease.

Homeopathy is a method of specific induction of nonspecific resistance that stimulates the body’s inherent defense and self-regulatory mechanisms, rather than by taking over a function of the body, initiating dependency on the medicine itself.

image The Clinical Application of Homeopathic Principles

The homeopathic clinical and therapeutic process consists of three interrelated processes: case taking, evaluation, and prescribing. The process is comprehensive and engages the observations of the patient, as well as those of the doctor. Hahnemann described the process in paragraphs 84 to 103 of the Organon and stressed the importance of distinguishing between chronic and acute, or self-limiting, disease.

The Homeopathic Interview

The initial history of complaints is elicited from the patient with as little interruption as possible (as long as the patient does not digress unduly), so that the patient’s train of thought is not disrupted or directed along lines imposed by the physician’s biases. According to Hahnemann:

The physician elicits further particulars about each of the patient’s statements without ever putting words in his mouth, or asking a question that can be answered only by yes or no, which induces the patient to affirm something untrue or half true or else deny something really there to avoid discomfort or out of desire to please, thereby giving a wrong picture of the disease, which would lead to the wrong treatment.

An entire review of symptoms is recorded in descriptive detail, taking into consideration all modalities that affect a symptom. Hahnemann emphasized the general symptoms (i.e., those affecting the entire organism), as the leading indications for the remedy. These key symptoms include mental and emotional affects, the metabolism and its reactions to environmental stimuli, sleep positions, food cravings and aversions, thirst, body type, and all manifestations of unconscious and autonomic regulation.

Unique characteristic symptoms, particularly those regarded as “strange, rare, and peculiar,” are important considerations in the selection of the remedy. These might be the expression of a paradoxic or unusual relationship, such as pain ameliorated by pressure or the sensation of the legs being made of wood or glass. The association of the start of a disease or symptom complex with an environmental or emotional event can be key and emphasizes the importance of an accurate and extensive interview.

Hahnemann emphasized the importance of taking a comprehensive case, particularly in chronic disease11:

In chronic diseases in women one should pay particular attention to such things as pregnancy, infertility, sexual desire, confinement, miscarriages, nursing, vaginal discharges, and the condition of the monthly flow, especially noting whether it recurs at intervals that are too short or too long, how many days it lasts, whether or not it is interrupted, the quantity, how dark with color, any leukorrhea before or after the flow. If there is leukorrhea, what it is like, what symptoms accompany it, what is its quantity, under what conditions does it appear, what brings it on?

Because the patient’s symptoms are the expressions of the body’s attempts to heal itself, symptomatic treatment (i.e., many allopathic therapies) can impair the physician’s ability to obtain vital information and complicate the taking of the case. This problem has also been recognized by some medical authors, such as Boyd, who stated: “We recognize that the pattern of disease has changed out of recognition during the last 30 to 40 years owing to modern drugs, particularly the antibiotics.”7

Follow-Up and Case Evaluation

Considering the vitalistic and holistic perspective of the homeopathic approach, a clear definition of cure is necessary to establish the treatment goal. Mere palliation or suppression of symptoms at the cost of the overall vitality and function of the individual is considered negligent by the homeopathic practitioner. For example, if a patient’s skin disease is treated and appears to resolve but is followed by asthma, fatigue, and confusion, the treatment is evaluated as having been suppressive. If, upon proper treatment, the more serious lung and systemic disruptions are alleviated and the previous skin lesions return, the patient is considered as progressing toward a cure. When further appropriate therapy results in final alleviation of the skin disease, without any undue stress to the patient, it is then considered a true cure.

This evaluative procedure is part of Hering’s Law of Cure, an observation of the principles of curative responses that can be applied to any healing process, regardless of the school of thought. In true healing, according to this set of observations, symptoms follow these patterns:

• From above, down the body to the extremities

• From within to without (often in the form of discharges and other eliminative processes)

• From the most important organs (e.g., the central nervous system) to the least important organs (typically, the skin)

• In reverse order of their appearance (i.e., the chronologically most recent being replaced by those of the earlier stages of the disease, and, in some instances, earlier in the patient’s life)

Homeopathy holds that the disease first affects the vital force and is manifested first by a change in the patient’s well-being, long before any objective changes can be observed. Illness is usually first recognized when the patient becomes aware of the early manifestations of the disease.

Disease and cure must also be considered in the context of the belief system and culture of the patient. Much of what we call disease arises from the individual’s inability to find meaning and purpose. Many forms of healing are capable of enabling the person to integrate into the fabric of daily life and of providing ways to help the person address personal needs for fulfillment.

In his study of disease, Hahnemann noted that there were inherited predispositions to disease, which he related to the improper treatment, and therefore suppression, of skin eruptions and venereal disease. He called these predispositions miasmas and, in 1828, published his findings in Chronic Diseases: Their Nature and Homeopathic Cure. He observed that many people, despite apparently healthy lifestyles, develop degenerative diseases. These often become established in childhood and continue to plague the person throughout life, despite medical treatment. He described three miasmas: psora, which represents a fundamental flaw in human ability to eradicate disease related to the suppression of skin disease; syphilis; and sycosis, which is caused by the suppression of the figwort, or what is now known as human papilloma virus. Hahnemann described the chronic effects of bacterial and viral diseases in his explanation of miasmas. In his discussion of viral diseases such as smallpox and other epidemic diseases, Hahnemann’s descriptions of the nature of viruses and their treatment predate their discovery by 50 years. He was a contemporary of Edward Jenner and supported his use of smallpox vaccination.

More recently, George Vithoulkas, a contemporary homeopathic author and teacher, defined health on three levels: mental, emotional, and physical. The mind should be capable of functioning with clarity, rationality, coherence, and logical sequence. It should be capable of engaging in creative service for the good of others, as well as for the good of oneself, demonstrating a freedom from selfishness and possessiveness. On the emotional level, there should be a state of serenity free from excessive passion, a state that should not be confused with lack of emotional response generated as a protection against emotional vulnerability. Finally, on the physical level, there should be freedom from pain. The healing person should experience a subjective sense of well-being and a progressive increase in vitality.12

Prescription

Because homeopathy is oriented toward the administration of a single medicine at a time, careful prescribing is important. It is through the application of single medicines that homeopathic physicians have been able to record clinical verification of the provings and amass an impressive body of literature.

Combination homeopathic medicines have been introduced as specific remedies for diseases and therefore have not represented homeopathic methods, although many studies support their efficacy.

The process of selecting the correct remedy involves both careful study of the patient’s symptomatology and medical history and matching these with the appropriate remedy. This requires a sound understanding of the homeopathic materia medica (see section on “The Study of the Materia Medica”).

The symptoms of the homeopathic materia medica are indexed in repertories that have evolved both in reference books and computer analysis programs.

Homeopathic Pharmacy and Potency Selection

This leads to a discussion of what has remained the greatest mystery of homeopathic medicine (and the source of considerable ridicule and misunderstanding): the use of “potentized” substances.

As Hahnemann began his research, he found that when treating patients according to the Law of Similars there was an initial aggravation of the symptoms, the “healing crisis,” when using the high dosages typical of that era. He empirically tried using progressive dilutions of the medicines, beginning with tinctures from plants and titurations with milk sugar for metals and salts. He made the dilutions serially by mixing 1 drop of the tincture to 100 drops of alcohol, which were then “succussed” (shaken by pounding against a resilient surface) vigorously. He found that, with increasing dilution, the severity of the aggravation lessened while the patient continued to improve, often with deeper and more enduring results. He called these diluted remedies “potentized.” As an analytic chemist, he was aware of Avogadro’s theories (they were contemporaries), but he persisted in evaluating dilutions beyond the point where chemical activity could be detected.

This challenge to the present understanding of therapeutic mechanism has been addressed by recent workers, who have suggested that the therapeutic properties of the remedy lie in the energetic impression they make on the diluting vehicle (typically alcohol and water or lactose). Various techniques have been used to determine if there is a physical difference between the potentized dilution and the unmodified vehicle. These studies have used ultraviolet spectroscopy, conductivity measurements, infrared spectroscopy, surface tension measurements, Ranian-Laser spectroscopy, nuclear magnetic resonance, and other methods. Much of this work has shown regular peaks and troughs in activity with progressive dilutions, and Heintz claimed that the peaks corresponded to the maximum effects found in the biological studies he reported (see section on “Basic Research”).13

Mechanism of Action

To date there is no conclusive understanding of the mechanism of action of the potentizing process. However, this has not inhibited the use of potencies, which have been diluted by a factor of 100 up to 100,000 times (10200,000). At this time, most explanations for the mechanism of homeopathic high potencies are provisional (such as the postulate that the remedies act in resonance with the magnetic fields of the body, or that the physiochemical properties of water can be modified by a solute and remain so even in the absence of the solute).14

This has not affected clinical practice or demonstration of efficacy in clinical trials any more than the use of aspirin did, despite the fact that the discovery of its mechanism of action through modulation of prostaglandins did not occur until the 1980s. There are many forces whose nature can only be recognized by their results (e.g., gravity). These observations of relationships, confirmations of experience, are the basis of an empiric system. Medicine remains an art in the field of science.

Interestingly, a group operating in the Hematology Department of the School of Pharmacy in Bordeaux, France, tested both the effect of common aspirin and homeopathic preparations on the vascular walls of rats. Aspirin at high concentrations (100 mg/kg) induced a decrease in platelet aggregation (amplitude and speed), as well as a decrease in the area of the thrombi (arterial and venous) and the number of emboli (arterials and venous).

Aspirin at ultra-low doses (9, 15, 30 CH) induced an increase in platelet aggregation (amplitude and speed), as well as an increase in the area of thrombi (arterial and venous) and the number of emboli (arterial and venous). The antiaggregation and antithrombotic action of aspirin at high concentrations (100 mg/kg) was inhibited by the concomitant injection of aspirin 15 CH.15

This confirmed Hahnemann’s observations of the primary and secondary effects of medicines mentioned in the Organon.16 Bellavite described these effects as “biologically active compounds (which) may cause inverse or paradoxical effects on a complex homeostatic system when either the doses of the compound, or the methods of preparation and of administering, or the sensitivity of the target system are changed.”17,18

Research into both the pharmacologic effects of homeopathic preparations and the paradoxic effects of orthodox drugs that confirm the Law of Similars’ underlying homeopathic prescribing are a growing body of literature. Certain pharmacologic substances when tested in high dilutions act on the same biological systems.19–25

The reaction to the high dilutions can also be the opposite to a drug at low dilutions (e.g., proinflammatory agents can be anti-inflammatory at high dilutions).26–29

Paradoxic effects of medicines are the basis of the Arndt-Schulz Law in pharmacology and hormesis. The Arndt-Schulz law states that weak stimuli slightly accelerate vital activity, medium strong stimuli raise it, strong ones suppress it, and strong ones arrest it.30

Southam and Erlich31 reported the stimulatory effect of an antifungal agent when used at low doses and proposed the term “hormesis.” Hormesis is defined as “the stimulatory effect of subinhibitory concentrations of any toxic substance on any organism.”32 Hormesis is considered a nonspecific phenomenon that increases the resistance and growth of the treated organism. It exists in all living organisms. This “action–reaction” model shows the efficacy of the “vital activity” in fighting the poison in a nonspecific way, although specific defense molecules are also synthetized.33–38 A modern and important pathologic model showed that a single dose of an antitumoral immunosuppressive substance (cisplatin) induced increased lymphokine-activated killer activity.39 Wagner and colleagues demonstrated that low doses of cytostatic agents stimulated human granulocyte and lymphocyte growth.40

The goals and methods of homeopathic pharmacy have their roots in earlier Paracelsian and spagyric medical systems. The challenge remains to define homeopathic empiric science in the context of a modern science. It may be that homeopathy presents a challenge to science itself that will bring forth new models for pharmacology. The more central challenge is for homeopathy to discover how it can apply its own critical methods to develop a more effective health care service.

The assumption that we can find substances in nature that can alter disease underlies the history of medicine and pharmacology, yet healing remains a mystery. Further studies are necessary to confirm and develop the understanding of the mechanisms and validity of homeopathic medicines.

Determination of Potency

In terms of clinical practice, general guidelines have evolved for the determination of potency. In the sixth edition of the Organon, Hahnemann recommended ascending the scale of potencies gradually. In paragraph 248, he suggested that the medicinal solution be “succussed anew with use.” In chronic cases, the patient is directed to take one teaspoonful daily or every other day, and in acute diseases, as frequently as needed. If the solution is used up before the problem alleviates, the next higher dilution is used (if still indicated by the symptom pattern).41

The higher potencies, whose use largely developed in the United States, are repeated much less frequently and are generally reserved for the experienced practitioner. The more potentized the remedy, the closer it must meet the Law of Similars (i.e., the accuracy of the prescription must be high for a curative effect). Lower potencies are often repeated daily, depending on the condition being treated.

Several ranges of potencies include the decimal scale, which uses a 1:10 dilution; the centesimal scale, which is diluted 1:100; and the LM potencies introduced in the sixth edition of the Organon, using daily doses of 1:50,000 dilutions.

It is important to note that the sixth edition was unavailable until 1924, 76 years after Hahnemann’s death. The predominant clinical application of homeopathic potencies had developed using an ascending scale. A single dose was used until its action had ceased, when the same potency would be repeated. When that potency seemed to no longer demonstrate an enduring effect, a higher potency was used. There have been regular arguments between low- and high-potency prescribers as to the most effective method.

The Study of the Materia Medica

Constantine Hering once stated the following:

A mere acquaintance with the principal symptoms cannot be called studying the materia medica, although we make it the basis of our study. The study of materia medica must be regarded and dealt with in exactly the same manner as that of other natural sciences.

To give a perspective on the way in which homeopathic physicians organize the proving symptoms into clinical pictures, we draw from an essay on Sepia by E.B. Nash42:

This is another of our wonderful remedies of which the dominant school knows nothing, except what they have learned from us. Its chief sphere of action seems to be in the abdomen and pelvis, especially in women. No remedy produces stronger symptoms here. We quote from different but equally good observers.

Sensation of bearing down in the pelvic region, with dragging pains from the sacrum; or feeling of bearing down of all pelvic organs. (Hahnemann)

Labor-like pains accompanied with the feeling as though she must cross her legs and “sit close” to keep something from coming out through the vagina. (Guernsey)

Pain in uterus, bearing down, comes from back to abdomen, causing oppression of breathing; crosses limbs to prevent protrusion of parts. (Hering)

Prolapse of the uterus, of the vagina, with pressure as if everything would protrude. (Lippe)

Experience has shown its value in cases of ulceration and congestion of the os and cervix uteri. Its use supersedes all local applications. (Dunham)

No higher authority than the united testimony of these five of our best observers could be brought to show the action of Sepia upon the pelvic organs.

Now when we come to examine the provings in Allen’s Encyclopedia, we find that these symptoms were mainly produced by Hahnemann and his provers, and Hahnemann advocated proving remedies in the 30th, and some of them were produced by the 200th, especially those most strongly verified by black-faced type.

We confess that we cannot understand how so many question the value of potencies for proving or curing Sepia, like Sulphur, affects the general circulation in a very marked manner. Flashes of heat with perspiration and faintness is almost as characteristic of this remedy as of Sulphur. But there are, with Sepia, more apt to be associated with them the pelvic symptoms already given, and they are also more apt to occur in conjunction with the climacteric. Indeed, these flashes often seem with Sepia to start in the pelvic organs and from thence to spread over the body.

But this irregularity of circulation extends as far as that of Sulphur. The hands and feet are hot alternately, that is, if the feet are hot, the hands are cold, and vice versa. There is not so much sensation of burning with Sepia as with Sulphur, but there is actual heat, and the venous congestion, which seems to be the real state of the organs where the pressive bearing down et cetera is felt, is also accompanied with much throbbing and beating.

This local congestion to the pelvic organs is not simply sensational. There are actual displacements in consequence of it, and the long continued congestion results in inflammations, ulcerations, leukorrheas and even malignancies or cancerous organizations. Induration with a painful sense of stiffness in the uterine region is characteristic.

This pelvic congestion also affects the rectum in a marked degree. The rectum prolapses, there is a sensation of fullness, or of a foreign substance as of a ball or weight, and oozing of moisture from the rectum. Indeed, the rectal and anal symptoms are almost as strong as the uterine and vaginal. It is impossible to enumerate all the symptoms connected with the circulatory disturbances of Sepia in such a work as this, only a general study of the Materia Medica can do it.

The urinary organs come in for their share of symptoms. The same pressure and fullness consequent upon the portal congestion reaches here. We will now proceed to give what we have found to be particularly valuable symptoms under the various organs in this region. “Pressure on bladder and frequent micturation with tension in lower abdomen.” “Sediment in the urine like clay; as if clay burnt on the bottom of the vessel; urine very offensive (Indium), can’t endure to have it in the room, it is reddish or may be bloody.” This is found mostly in women. With children there is one peculiar symptom which has often been verified. “The child always wets the bed during its first sleep.”

Upon the male organs I have found it particularly useful in chronic infection. There is not much discharge, but a few drops, perhaps, which glue up the orifice of the urethra in the morning; but it is so persistent and the usual remedies will not “dry it up.” In my early practice I used to use a weak injection of Sulphate of Zinc, but it used to annoy me that I could not use it without resorting to local measures. Sepia does it in the majority of cases and Kali iodatum will do it in the rest. I have, where there was a thick discharge of long standing and the smarting and burning on urination continued, several times finished the case with Capsicum.

As a rule, this long continued slight, passive gleety discharge is a result of weakness of the male genitals, as is shown by a flaccidity of the organs and frequent seminal emissions. The emissions are thin and watery. Sepia covers all of this and often sets all to rights in a short time.

The mind symptoms of Sepia are like Pulsatilla, in that she is sad and cries frequently without knowing the reason why. So if in a tearful mind with uterine disturbances Pulsatilla should fail you, the next remedy to be studied is Sepia. But there is another condition of mind not found under Pulsatilla or any other remedy in the same degree, and that is, that, notwithstanding there is no sign of dementia from actual brain lesion, the patient, contrary to her usual habit, becomes indifferent to her occupation, her house work, her family or their comfort, even to those whom she loves the best. This is a very peculiar symptom and a genuine keynote for the exhibition of Sepia…

I once cured a very obstinate case of entero-colitis (so-called cholera infantum), after the complete failure of two eminent allopaths, with Sepia, the leading symptom being, always worse after taking milk. Oozing of moisture from the anus finds its remedy here sometimes, but oftener in Antimonium crudum. The Sepia patient is very weak. A short walk fatigues her very much. She faints easily from extremes of cold and eat, after getting wet, from riding in a carriage, while kneeling at church, and on other trifling occasions. This fainting, or sense of sinking faintness, may be found in pregnancy, child bed, or during lactation; or, again, it may come on after hard work, such as “laundry work;” so it has come to be called the “washer woman’s” remedy.

As can be seen by this excerpt, the indications for a remedy are complex, requiring study and understanding.

image Research in Homeopathy

Homeopathy arose from empiric observations and operates from empiric clinical evidence and phenomenologically descriptive fields. Samuel Hahnemann was the first to use the methodology of provings, to gather information about the reactions of healthy subjects to the ingestion of minute amounts of substances. Both clinical trials and laboratory research, although relatively sparse and often inconclusive, do point to efficacy and activity beyond placebo. Homeopathy has faced challenges in the scientific as well as political arena, because its mechanism of action is still unknown. For example, quoting from a recent review, “…according to current pharmacological theory it would appear impossible that homeopathic therapy could have any effect over placebo.” 43 However, as the authors go on to say, “The available hypotheses for a possible mechanism of action, however, do not claim that homeopathic remedies act through pharmacological but through biophysical pathways and all include the idea of some form of information transfer….”43 Despite adversaries who claim that research has determined that homeopathy is nothing more than placebo, homeopathy researchers, utilizing increasingly sophisticated research designs, continue to produce intriguing evidence regarding the effects and efficacy of homeopathic substances. This evidence, which emerged from several types of research, including provings, clinical trials, and laboratory studies, may soon converge to build a promising case for homeopathy’s impact.

Evidence from a Modern Proving Study

Although traditionally provings, also called pathogenetic trials, first involved material doses of substances, Hahnemann himself, as well as later provers, conducted proving studies using potencies beyond Avogadro’s number. One recent proving study provided convincing evidence that ultramolecular doses of homeopathic substances can produce symptoms different from placebo.44 This double-blind, placebo-controlled experimental study randomized 25 medical doctors into three groups who received 30 CH potentized doses of either Natrum muriaticum or Arsenicum album, or an identical placebo. All substances were beyond Avogadro’s number in terms of dilution. The main outcome parameter was number of remedy-specific symptoms per group. The actual remedies themselves were chosen randomly from a list of 20 already proven remedies that are frequently used in homeopathic practice; this list was not known to subjects or the study team, other than the study director and pharmacist; the two selected remedies were not known to anyone on the study team, including the study director. Participants were advised to ingest five remedy globules on day one, then 2 × 5 on day two, or until symptoms appeared, and then write their symptoms in a diary over 4 days. These symptoms were compiled and reviewed by an independent homeopathic expert, blinded to group assignment, who analyzed each symptom via a computer program for its typicality, or not, for one of the two remedies tested. The results showed that symptoms typical for the respective remedy were significantly more likely to occur in both the Natrum muriaticum or Arsenicum album groups, whereas nonspecific symptoms were more frequent in the placebo group (P = 0.001). Typical symptoms reported by subjects ingesting Arsenicum album included “strange restlessness”; “increased desire to swallow”; “lack of desire to urinate”; and “gushing diarrhea.” Typical symptoms reported by subjects ingesting Natrum muriaticum were “difficulty concentrating”; “slight vertigo when seated”; “tearing pain in scalp”; “twitching in right eye”; and “cramping like labor in abdomen.”44 This impressive finding showed that nonmaterial doses of substances produced specific and distinctive effects—characteristic of the remedy—in subjects who were blinded to which remedy they were ingesting.

Human Clinical Trials

Although the above study provides evidence for an effect of ultramolecular homepathic substances on the human organism, what is of primary interest to humans, and particularly clinicians, is whether such effects are therapeutic. In one early classic study, Gibson et al45 published a double-blind clinical trial of homeopathic treatment in rheumatoid arthritis. The 3-month study was elegantly designed in that the prescribing was individualized to the patient’s symptoms and was controlled, on a double-blind basis, by giving half the patients the correct remedy and the rest a placebo. All patients continued to use conventional, nonsteroidal, anti-inflammatory drugs, and the treated group showed significant improvement in subjective pain, articular index, stiffness, and grip strength. Other published studies demonstrated the efficacy of homeopathic treatment for treatment of headache, bruising, cancer-related symptoms, attention-deficit-hyperactivity disorder in children, asthma, upper respiratory tract infections, otitis media, arthritis, allergies, male infertility, influenza, cardiac insufficiency, herpes, osteoarthritis, acquired immunodeficiency syndrome, and chronic fatigue syndrome.46–83

Meta-Analyses and Systematic Reviews of Human Clinical Trials

Hundreds of human clinical trials, of varying quality, with both positive and negative results, have now been carried out. Meta-analyses and systematic reviews have been helpful in identifying promising treatments and areas where more research is needed, thus moving the field forward.

In 1991, a meta-analysis by Kleijnen et al84 was published in the British Medical Journal of a total of 105 controlled trials. The quality of trials was described as poor for two thirds of those reviewed. Positive results for homeopathic treatment were found in 81 trials, leading the authors to state, “The evidence in this review would probably be sufficient for establishing homeopathy as a regular treatment for certain indications.”

In 1997, Linde et al85 published another meta-analysis of 119 trials that met the inclusion criteria; 89 had adequate data for meta-analysis, and 2 sets of trials were used to assess reproducibility. The combined odds ratio for the 89 studies was 2.45 in favor of homeopathy, with an odds ratio of 1.78 for the 26 good quality studies. The authors concluded, “The results of our metaanalysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo.”

Accumulating evidence is beginning to make it feasible to carry out systematic reviews to evaluate homeopathy’s use for treatment for specific conditions. For example, in a review of homeopathic treatment of people with human immunodeficiency virus or acquired immune deficiency syndrome, five controlled clinical trials were identified, with evidence for improved CD4 and CD8 counts, and specific physical, immunologic, neurologic, metabolic, and quality-of-life benefits. The author concluded that homeopathy might play a useful role as an adjunctive therapy in this condition.82 Pilkington et al83 examined the use of homeopathy for anxiety and anxiety disorders, concluding that homeopathy might be beneficial. One particularly fruitful and positive research, for which there are several positive trials, is in the use of homeopathy for treatment of respiratory allergies.75

Human Effectiveness Studies

Effectiveness research involves evaluation of a treatment’s usefulness in more natural or real-world settings. For example, during World War II, isopathic preparations were given prophylactically, and homeopathic therapies were used in mustard gas burns. A subsequent statistical analysis found that these treatments yielded significant results compared with placebos. The remedies used were mustard gas, Rhus toxicodendron, and kali bichromium.13

More recently, Witt et al86 evaluated health status changes of chronically ill patients after 8 years of homeopathic treatment. This prospective, multicenter cohort study involved 103 homeopathic primary care practices in Germany and Switzerland; a total of 3709 patients were studied, with the most frequent diagnoses being allergic rhinitis, headache in adults, and atopic dermatitis and multiple recurrent infections in children. Disease severity decreased significantly over this time, with considerable improvement in physical and mental quality of life. Another prospective multicenter observational study of 129 patients treated homeopathically by 48 physicians for low-back pain found sustained physical and quality of life improvements, with decreased use of conventional health care services and pharmacologic therapies.87 A similar prospective multicenter observational study evaluated symptom changes in 212 adult patients with chronic migraines who were treated with individualized homeopathy by 68 physicians. Migraine severity showed marked improvement at 3 and 24 months, with improved quality of life and decreased use of conventional health services.88

Animal Studies: Field and Laboratory Research

In a now classic study, Caulophyllum (in the thirtieth centesimal potency) was given to 10 sows to test its efficacy in the control of stillbirths. The results showed a statistically significant drop in the number of stillbirths and led to a larger, uncontrolled study in a whole herd. After 4 months of therapy, piglet mortality dropped from 20% to 2.6%.89

Cloudhury obtained dramatic results from injecting mice intraperitoneally with kali phosphoricum, calcarea phosphorica, or ferrum phosphorica (in the thirtieth decimal potency) 12 days after implantation of fibrosarcoma. Of the 77 treated mice, 52% were cured and survived more than 1 year, whereas all of the 77 controls died within 10 to 15 days.90

Scofield, in his review article, discussed numerous experiments with humans, animals, and plants using isopathic treatment for poisoning and experimental liver damage and various in vitro studies.13

A number of studies have been conducted to investigate the ability for homeopathic preparations to effect either the elimination or consequences of toxic substances.

There is good evidence that homeopathy may be effective in assisting in the elimination and treatment of heavy metals and other toxins. Studies of arsenic,91,92 bismuth,19,20,93 lead,94 mercury,95,96 carbon tetrachloride,21,26 a-amanitine (from the mushroom Amanita phalloides),27 and carcinogens such as 2-acetylaminofluorene and phenobarbital97 have been published.

The use of homeopathic dilutions of hormones and immunomodulators have shown potential. Immunostimulatory effects of high dilutions of thymic hormones and interferons were demonstrated in mice by Bastide’s group.27,98–101 Other studies demonstrated that extremely small amounts of antigens were specific for immunomodulation.102–106 In one study, half of a group of mice were given preparations of reticuloendothelial tissue from F. tularensis-infected mice in six different serial agitated dilutions (SADs), three of which were beyond Avogadro’s number in terms of molecular content. The other half of the group of mice were given control dilutents. All mice were then challenged with lethal doses of F. tularensis and evaluated for time to death and total number of deaths per group. The SAD preparations resulted in increased mean times to death (18.6 vs 13.7 days) and decreased mortality (53% vs 75%). The protective effect was not related to the level of dilution of substance.106

Magnani et al used a well-designed mouse model to examine the anxiolytic-like activity of several potencies of ultra-diluted Gelsemium sempervirens, compared with the drug buspirone and placebo. Gelsemium-treated mice spent more time in a lighted compartment (a measure of reduced anxiety), similar to the effects of buspirone and significantly greater than the placebo group. The authors concluded that Gelsemium acted on the emotional reactivity of mice, with anxiolytic-like effects even at ultra-high dilutions.107

These and other such dramatic results have tremendous implications in pharmacy, immunology, and clinical health care that demand continued research.

Basic Research

Clinical and experimental data obtained in studies about the effect of homeopathic preparations in inflammatory conditions present a considerable degree of reproducibility.108–112

The inability of Ovelgonne et al113 and Hirst et al114 to replicate their study published in the journal Nature, using the human basophil degranulation test (HBDT) to establish the ability for high dilutions to trigger the degranulation of anti–immunoglobulin-E caused considerable distraction from other more credible research.

Brown and Ennis115 used different methods to demonstrate the efficacy of high dilutions of histamine to inhibit the activation of basophils using HBDT. Instead of measuring degranulation provoked by ultramolecular dilutions of anti–immunoglobulin-E, as Ovelgonne et al and Hirst et al did, they examined the inhibition of activation of basophils by ultramolecular dilutions of histamine.

The experiments used ultramolecular dilutions of histamine (15 to 19 c), prepared with vortexing (instead of succussion). The main experiment, performed by all the laboratories, was based on inhibition of basophil activation as measured by degranulation. Flow cytometry experiments at three laboratories showed compatible results, with inhibition of activation as high as 43%. Nearly all experiments showed statistically significant inhibition of basophil activation.116–119

Experimental study of homeopathy in allergology120 effects have been reported in vivo,121–123 as well as in vitro.124–128

The physical properties of homeopathic preparations are gaining considerable understanding via research. Studies demonstrated that the physicochemical properties of extremely diluted solutions (EDS) are different from those of pure untreated water, notwithstanding the identical chemical composition of the two liquids.129–131 The same conclusions were inferred by Lo.132,133 Rey134 showed that the structure of hydrogen bonds in pure water was different from that of an EDS obtained by an iterative procedure of successive dilutions and succussions, and was not identical as expected. Recent studies on the physicochemical properties of water provided evidence that the most studied liquid by far, water, still exhibits unexpected properties.135–141 Lobyshev et al142 showed that low concentrations and electromagnetic fields can produce large-scale realignments of its structure, which can be either reversible or irreversible. One can deduce from these studies that water and aqueous solutions are complex systems, capable of auto-organization as a consequence of small perturbations of various kinds.

The question of whether water can maintain “memory” of solutes in EDS is best understood by understanding the physical characteristics of water and its ability to form stable clusters and crystals. This aspect of physics is not widely studied but is well documented.129–132,135,140,143

Sukal et al144 pointed out that ethanol molecules, via which potentized homeopathic substances are prepared and stored, are thought to promote or preserve water structures in the potentized substance. These researchers examined the Fourier transform infrared spectra of various ultra-diluted homeopathic substances—Nux vomica 30C, Lycopodium 30C, Santonin, 30C, Cina 30C, Cina 206C, and Cina 1006C—as well as their diluent media, 90% ethanol and ethanol 30C. The potencies differed from each other, and from their diluent media, in the number of oxygen–hydrogen bending vibrational bands, as well as their wave number, shape, and halfwidth of the bands. This study illustrated that medicated sucrose globules used in homeopathic practice can retain specific spectral properties and can be differentiated from each other by Fourier transform infrared spectra with regard to the oxygen–hydrogen bending vibrational band.144

Such meticulously designed and executed studies are bringing us ever closer to understanding the mechanisms by which homeopathy may work.

image Summary

Homeopathy plays an important role in the context of modern naturopathic medicine. Hahnemann emphasized the importance of lifestyle in the treatment of the patient. One of his primary dictums was to first remove the obstacles to cure, as he said:

While taking a case of chronic disease one should examine and weigh the particular conditions of the patient’s day to day activities, living habits, diet, domestic situation, and so on. One should ascertain whether there is anything in them which may cause or sustain the disease and remove it to help the cure.

Unfortunately, homeopathy is also an extremely challenging system to master, requiring both considerable understanding of case taking and materia medica, as well as extensive consultation time with the patient. It has therefore often been discarded, even by those aware of its efficacy. Although attempts have been made to reduce it to simpler systems (e.g., allergy desensitizations, vaccinations, Schuessler’s cell salts, and isopathic preparations from diseased tissues and heavy metals), they are not considered strictly homeopathic unless prescribed according to their effects upon healthy people or the confirmed observations of cured symptoms.

The greatest challenge to homeopathy is not how it fits into the current scientific paradigm, but how it fits into health care. The same biases against homeopathy have been used against other nonpharmacologic approaches to medicine, including psychology and nutritional medicine.

The wide acceptance in the homeopathic community of unaccredited educational programs has favored the spread of nonclinically trained homeopaths. Naturopathic medical schools in the United States have remained one of the few resources for clinical training in homeopathy. Homeopathic medical schools in other countries have maintained homeopathy in the context of medical and clinical training.

There have been many individualized styles of prescribing introduced into homeopathy that have created breaches between different practitioners. In addition, many new medicines are being introduced without adequate clinical verification. Unfortunately, there are few forums for critical discourse within the homeopathic community.

The divisions between different schools of homeopathic practice are attempts to parlay new ideas against an orthodox view that solely seeks to maintain the integrity of principles developed by Hahnemann.

One basic argument by some of these schools has been that because a homeopathic prescription should not be based on a specific disease, extensive training in current medical sciences would not be primary. However, this ignores an essential part of Hahnemann’s instructions. In the third paragraph of the Organon he stated, “The physician should distinctly understand…what is curable in diseases in general, and in each case in particular; that is, the recognition of disease.”

Correct diagnosis is primary in understanding the context and pathogenesis of a disease. So it would not be possible to understand the relation of much of drug proving symptoms, their clinical application, and the evaluation of efficacy or subsequent case management without understanding the nature of disease. Homeopathy is proven in the context of good health care. It is a system of therapeutics, not a replacement for common standards of diagnosis and preventive care.

Homeopathy is representative of a principle found throughout nature and its role in bringing forth concepts of resonance, constitution, and holism are shared throughout fields of science and healing. Homeopathy represents an integrated holistic system of natural therapeutics. Its capacity for addressing psychosomatic disease and acute pathology as a dynamic process is unique. It has remained a coherent system, with extensive clinical verification, for more than 2 centuries. Homeopathy is an economical and effective method that has been established as an integral part of the medical system in many countries. With the resurgence of interest in natural medicine, this discipline will undoubtedly be more widely used.

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Further Reading

The research section of this chapter is deeply indebted to the works of Peter Fisher, editor of the British Homeopathic Journal, Madeleine Bastide, Paolo Bellavite, and Andrea Signorini. The clinical training the first author received from Alan Sutherland and Marion Belle Rood has continued to be the foundation of sound practice and the inspiration to sustain study in the philosophy of nature.

Books

Bastide M. Signals and images. Dordrecht, Netherlands: Kluwer Academic Publishers; 1997.

Bellavite P., Signorini A. Homeopathy, a frontier in medical science. Berkeley, CA: North Atlantic Books; 1995.

Boerke W. Pocket manual of materia medica with repertory, 1936. New Delhi, India: Jain; 1982. Reprint.

Clark J. Dictionary of practical materia medica. Vols. 1-3, 1900. Essex, England: Health Sciences; 1962. Reprint.

Edzard E., Hahn E.G. Homeopathy, a critical appraisal. Oxford, England: Butterworth Heinemann; 1998.

Hahnemann S. Chronic diseases: Their specific nature and homeopathic treatment. New York: Wm Radde; 1845.

Hahnemann S. Organon of medicine. Los Angeles: JP Tharcher; 1982.

Kent J.T. Materia medica. Philadelphia: P Blakiston; 1900.

Lange A. Getting at the root: treating the deepest source of disease. Berkeley: North Atlantic Books; 2002.

Nash E.B. Leaders in homeopathic therapeutics, 1898. New Delhi, India: Jain; 1983. Reprint.

Roberts H.A. The principles and art of cure by homeopathy. Essex, England: Health Sciences. 1942.

Journals

Homeopathy, formerly the British Homeopathic Journal; the official Journal of the Faculty of Homeopathy, London.

Homeopathic Links, International Journal for Classical Homeopathy.

Simillimum, Journal of the Homeopathic Academy of Naturopathic Physicians.

The American Homeopath, Journal of the North American Society of Homeopaths.

The Homeopath, Journal of the Society of Homeopaths (UK).

Web Resources

Ad Hom. the Academic Departments of Homeopathy at Glasgow Homeopathic Hospital. www.adhom.com. Website

British Homeopathic Library is a library and information service dedicated to the research and practice of homeopathy. http://dspace.dial.pipex.com/hom-inform/index.shtml. Website

HOMINT Documentation Information System VSM. Alkmaar (Netherlands)/DHU, Karlsruhe (Germany) containing 35,000 references, major articles, homeopathic journals, literature-search on request. vsm@gn.apc.org. Arjo Bol, information specialist VSM/Susanne Rehm, DHU. E-mail

Homoepathic Educational Resources Database. Compiled by Dr. Russell Malcolm of the Glasgow Homoeopathic Hospital. ghl@gn.apc.org. E-mail

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