21. Homeopathy

This section will examine homeopathy, looking at the history and philosophy of homeopathy along with homeopathic remedies and how they are made, mechanism of action, evidence about effectiveness, safety, and regulation of homeopaths. It contains the following sections:

If you wish to go directly to any section, click on the title in blue.

History of Homeopathy

The concept of homeopathy is said to have originated with Hippocrates who thought of treating “like with like”. It lay dormant until around 1790 when a German physician called Samuel Hahnemann developed it further. He experimented on himself with quinine that was used to treat ague, the old term for malaria and he found that he could reproduce the symptoms of the disease by increasing the dose. He concluded that it was the ability of quinine to mimic the symptoms of malaria that enabled it to cure the disease. However, if it is used in homeopathic doses, it does not cure the disease.

Samuel Hahnemann founded homeopathy around 1790.

He began to test other substances on patients. He called the practice homeopathy from the Greek homoios (the same) and pathos (suffering). He used poisons such as arsenic and belladonna in smaller and smaller amounts and concluded that they seemed to have a more specific effect on his patients. His ideas spread throughout Europe and North America in the 19th century. At the time, other forms of treatment included heavy metals such as mercury and arsenic along with purgation and blood-letting. It may have been no more effective than the competition but at least it was less toxic. Unlike many other treatments it conformed to the adage of primum non nocere; first do no harm.

You may also come across the term allopathy. Allo is Greek for different. Although it may sound akin to homeopathy, it means treating with drugs, or conventional medicine.

As the scientific medicine of the 20th century advanced, homeopathy fell from favour although a number of homeopathic hospitals were incorporated into the NHS in 1948. This was an accident of history and not because it was thought to have scientific merit. Homeopathy is known to be favoured by the Royal Family.

In the early part of the 20th century, there was a strong lay movement of “natural health” in Germany, which is where modern homeopathy started. Even in the 1930s, medicine had not advanced very far compared with today. It is estimated that in 1933, when the Nazis took power, there were as many lay practitioners as physicians. The Nazis created the Neue Deutsche Heilkunde (new German medicine). There was forced integration of health care into a single body under strict political control.

Homeopathic Medicines

There are a wide variety of homeopathic preparations, including ones made from belladonna (deadly nightshade), arnica, chamomile, mercury and sulphur, snake venom and compounds extracted from bodily fluids.

Homeopathic medicines are prepared by serial dilution in steps of 1:10 or 1:100, denoted by the Latin numbers X and C respectively. At each step there is “succussion” which is vigorous shaking. The dilution most frequently sold in pharmacies is 6C, which is a 10-12 dilution of the original “mother tincture”. In other words the number of times it has been diluted is 1 with 12 zeros after it. This is a million millions or a trillion fold dilution. Hence it is likely that a 6C dilution will contain only a few molecules of the initial substance but much higher dilutions, such as the 30C (10-60) will probably not contain a single molecule of the original substance.

A great many different
homeopathic medicines have been described.

A large number of homeopathic medicines have been described but about 200 are in regular use. Around 60% are of plant origin, the remainder mostly of animal origin, minerals and chemical salts and disease products. Before prescribing such treatment, the homeopath will enquire not just about the symptoms and signs of the disease, but also about “constitutional factors” peculiar to the patient, rather than the disease. These include the psychological state, environmental reactions and body habitus. Body habitus describes the physical characteristics of an individual such as physique, general bearing, and body build. Historically, attempts have been made to classify people into discrete somatotypes or body types such as mesomorphic which is muscular and athletic, endomorphic which is rounded and stout and ectomorphic which is tall and thin. They have traditionally been related to propensity to disease but these terms are not used in clinical practice today.

A pharmacy in London, by appointment to the Queen and Prince Charles, has started selling homeopathic pills based on ground up fragments of the Berlin Wall. The Berlin Wall remedy is reputed to aid feelings of separation and boost relationships. It charges £18.60 for a 50g bottle of pills, and £108.00 for 100ml in medicating potency of 96% alcohol.1Berlin Wall Remedy Illustrates ‘Ridiculous’ Homeopathy This shows the utter absurdity of homeopathy.

Philosophy and Mechanism of Action

The underlying philosophy is that the remedy will cause minimal symptoms of the disease and this will stimulate the body to begin the healing process. The basic ingredient that is used is one that would normally cause the symptoms of the disease. For example, the homeopathic remedy Allium cepa is made from an extract of onions but highly diluted. If a person chops onions, the eyes sting and water and the nose runs. The homeopathic philosophy of “like for like” states that a disorder with these symptoms would be cured by a small dose of onion. Hence Allium cepa may be used to treat hay fever with it symptoms of a running nose and watery eyes. At the very high dilutions used with only a few molecules of the original substance remaining it is very difficult to give a reasonable explanation for how the treatment may work.

Increasing potency with increasing dilution is a concept that if found nowhere else

In 1988 a French immunologist called Jacques Benveniste published a paper in Nature claiming to have detected the effects of an antibody at ultramolecular dilution, using the human basophil degranulation test.2Human basophil degranulation triggered by very dilute antiserum against IgE Basophils are a type of white blood cell. Others have failed to reproduce his results3Human basophil degranulation is not triggered by very dilute antiserum against human IgE and it has become known as “the Benveniste Affair” with an inference of scientific malpractice if not fraud.

In 1999 a multi-centre experiment using a related method showed positive results.4Flow-cytometric analysis of basophil activation: inhibition by histamine at conventional and homeopathic concentrations (no abstract) This produced the “information medicine” hypothesis. This states that “water is capable of storing information relating to substances with which it has previously been in contact, and subsequently transmitting this information to pre-sensitized bio systems”. The process is thought to be mediated by structural modifications of water, analogous to the storage of information by magnetic media as with computer memory storage. This concept is incompatible with our ideas about molecular structure and function and most people regard it as fanciful. Homeopathic remedies are made up with tap water, not distilled water and it seems most convenient that the water “remembers” the good things but not the bad.

Because there is no rational explanation for how something works does not mean that it does not work. However, the concept of a medicine that is so dilute that it may or may not contain just a few molecules of the original substance does tax the bounds of credibility.

The report of the Royal College of Physicians says that “Despite its apparent implausibility, homeopathy is among the most popular forms of CAM, with an estimated 470,000 regular users in the UK, and sales growing by around 12% annually.”5Complementary medicine: evidence base, competence to practice and regulation.

The remedy for a hangover, called “the hair of the dog” is about treating like with like. The full term is “the hair of the dog that bit you” and it involves drinking more alcohol the morning after a heavy night. It does not prevent a hangover but merely delays the inevitable.

Evidence

In the past practitioners of homeopathy would argue that because their techniques are tailored to the needs of the individual patient, they are not amenable to assessment by Randomised Controlled Trials. This is untrue. The practitioner can go through the very detailed and meticulous history and at the end he writes his prescription in the usual way. A dispenser makes up the prescription and opens a sealed envelope to decide if he gives that or a similarly labelled bottle of unadulterated water from the tap. Neither the patient nor the practitioner who will assess the patient knows which the patient received and so the requirements for “double blind” are fulfilled.

Of the various forms of CAM, homeopathy has been one of the better ones in terms of quality and quantity of research. There have been many publications about homeopathy over the years. In 1997 a review from Germany found 185 trials of which 119 met their inclusion criteria and 89 had adequate data for meta-analysis. The conclusion that was published in The Lancet was that homeopathy is more effective than placebo although they included papers looking at different clinical conditions and they were unable to state that it was more effective than placebo for any specific condition.6A meta-analysis of placebo-controlled trials

These findings were not readily accepted as proof of the efficacy of homeopathy and a review from Bandolier was highly critical.7Dilute information and little knowledge They praised the attempt to find and account for publication bias but they noted that:

  • The median number of patients studied in each trial was 60. (This is rather small)
  • There were 24 clinical categories. (It does not compare like with like)
    There were four types of homeopathy.
  • There were 50 classes of homeopathic remedy.

They noted that 42% of the trials found in favour of homeopathy but they observed that in trials of conventional medicine, no one would bundle together such a disparate group of clinical conditions. Just 42% had a significant benefit from homeopathy. Therefore 58% found no significant difference as none found that homeopathy did worse than placebo. To find such a small majority in favour and none against suggests considerable publication bias.

In 2001 an education paper in the BMJ used the article in The Lancet as an example of the problems of meta-analysis.8Systematic reviews in health care They used funnel plotting and cut and fill. The concept is that if there are a number of trials, the bigger trials should have more consistent results and less scatter around the mean for all the trials whilst the results of smaller trials should be evenly spread above and below the mean. Hence a plot of outcome versus size of trial should produce a shape like an inverted funnel. Failure to produce such a shape suggests publication bias and cut and fill can be used to “discover the trials that have not been published.” Using this technique they concluded that homeopathy is not an effective therapy. There had been substantial publication bias. There is more about meta-analysis along with funnel plotting and cut and fill in the chapter Randomised Controlled Trials.

In 2009, Cancer Research UK published advice headed, “’No convincing evidence for benefits of homeopathy in cancer treatment”.9“No convincing evidence” for benefits of homeopathy in cancer treatment Their main message was that whilst some may choose to use homeopathy to treat the side-effects of treatment, it should not be used as a treatment for the cancer.

There have been a number of Cochrane and other systematic reviews relating to homeopathy over the years.

The advocates of homeopathy argue that it is effective in animals and there can be no placebo response there. I have found a database of clinical trials of homeopathy in animals.19The databases of the Karl and Veronica Carstens Foundation It is a German website but an English translation can be obtained. However, when I searched for double blind placebo controlled trials it gave only five results. Remember that for a double blind trial not only the patient (or animal) has to be unaware of his treatment group but also the therapist and assessor. Presumably the animals were unaware of the trial but what about the humans? One paper was in German, two in English and two in French and they were for four different conditions. Therefore, there is inadequate data to produce a meta-analysis with funnel plotting.

The quality of evidence is very poor

Looking at the papers in English, the one for bovine endometritis included 929 subjects and did not find any benefit. That is a good number of subjects. The one for itching from atopic eczema in dogs did find benefit but there were only five subjects. That is a ridiculously small number. There seems to be a marked shortage of good quality trials of homeopathy in veterinary practice. There is likely to be serious publication bias as with human trials and the evidence to date is grossly inadequate to support its use. Most of the publications on homeopathy are in journals such as “Homeopathy” or “Evidence Based Complementary Alternative Medicine” rather than more general journals, especially the positive results. Despite the name of the latter journal, I suspect that they are less rigorous about scientific method than more general medical or veterinary journals. The consensus in mainstream journals is very much that evidence is inadequate to support the use of homeopathy in humans or in animals.

In 2015, the biggest survey of studies of homeopathy was published when Australia’s National Health and Medical Research Council examined 57 systematic reviews that assessed the effectiveness of homeopathy compared to placebo or other treatment, for 68 different health conditions.20Australian Government National Health and Medical Research Council. Homeopathy working committee The systematic reviews included 176 individual studies. It concluded: “Based on all the evidence considered, there were no health conditions for which there was reliable evidence that homeopathy was effective. No good-quality, well-designed studies with enough participants for a meaningful result reported either that homeopathy caused greater health improvements than placebo or caused health improvements equal to those of another treatment.”

Since then, this enormous review has been cited by organisations and health services seeking to withdraw funding for homeopathy. In the UK, the Specialist Pharmacy Service updated the NHMRC review by searching for systematic reviews published since the original search date. It concluded: “the quality of the trials included within most of the reviews are variable thus this new data does not change the conclusion of the NHMRC review conducted in 2015”.21NHS Specialist Pharmacy Service. Clinical evidence for homeopathy

Safety

It would seem reasonable to believe that even arsenic, diluted to the level of just a few molecules, is unlikely to be toxic and the evidence relating to homeopathy does seem to suggest that it is as safe as may be expected. It is still possible to get adverse reactions from the placebo, or more correctly, the nocebo response.

Adverse outcomes occur if an ineffective treatment is used for a serious and treatable condition. This concept is very important. Using an ineffective treatment can lead to unnecessary suffering and even unnecessary mortality.

Homeopathic immunisations are available and some parents opt for these for their children as they believe that they are safer than the conventional vaccines. However, they do not produce any antibody response and so, presumably, the children remain at risk of those serious diseases. Homeopathic immunisations will be discussed below.

Regulation

The House of Lords Select Committee was very keen on the regulation of all forms of CAM. There is a Faculty of Homeopathy but practitioners have no compulsion for membership and it has no statutory power. In 2014 an official system of registration for homeopaths was announced.22Outcry as register of homeopaths gets official backing Some argue that regulation would give undue credibility to a system for which the evidence of effectiveness is poor to non-existent. On the other hand, it may ascertain that non-medical practitioners are properly trained and they do not persist with useless treatments for serious and treatable conditions. In 2009 the WHO responded to pressure from the scientific community about the promotion of homeopathy for serious illnesses in developing countries. It stated that it does not recommend its use for HIV, tuberculosis, malaria, influenza and infant diarrhoea.23Homeopathy not a cure, says WHO In all parts of the world people need to be warned about accepting useless remedies for serious but treatable disease.

The BMJ reported on a German organisation called Homoeopathen ohne Grenzen which translates as Homeopathy without Borders.24Homeopaths Without Borders practice exploitation not humanitarianism It is obviously a take on the French charity Médecins Sans Frontières which does sterling work as a medical charity in very difficult international situations. They have managed to gain a foothold in Bosnia-Herzegovina and Macedonia. They claim that in Kenya traditional midwives learned to save lives by using homeopathy in difficult deliveries if there is no hospital available. It is years since any responsible homeopath claimed that homeopathy could save lives and there is certainly no evidence to support it in complicated deliveries. After the earthquake hit Haiti in 2010, the American wing of this organization sent homeopaths to the area to offer treatment and to teach others. We may be tolerant of the “worried well” who seek homeopathy for self-limiting conditions but homeopathy has no place in a disaster zone. The article finishes by saying, “Homeopathy is neither helpful nor humanitarian, and to claim otherwise to the victims of disasters amounts to exploitation of those in need of genuine aid.”

Homeopathy Without Borders does not aid but exploits the vulnerable in need

In February 2020, there was an outcry when the Professional Standards Authority for Health and Social Care (PSA) renewed its accreditation despite a plea from the NHS that it be revoked.25Society of Homeopaths rebuked over bogus autism remedies It imposed several conditions, including that members of the society stop offering “Cease” therapy, a supposed cure for autism that relies on the idea that it is caused by vaccinations. Stephen Powis, national medical director for NHS England, said: “It’s absolutely right that homeopaths should be banned from advertising quack remedies for autism, but frankly this is not enough and they should not be issuing medical advice, full stop. “Taking homeopathic remedies, instead of evidence-based, effective and scientific advice, particularly on lifesaving interventions like measles vaccines, risks sending well-meaning parents down a path that puts them and their children at great risk.” In October 2019 Sir Simon Stevens, chief executive of NHS England, wrote to the PSA to demand that the homeopath society’s accreditation be revoked. He said that accrediting homeopaths increased the risk of “chancers being able to con more people” and said that some homeopaths “spread misinformation about vaccines”.

There was particular concern about a treatment called Cease which is an acronym of Complete Elimination of Autistic Spectrum Expression. It is aimed often at children and involves extremely high doses of vitamin C and dietary restrictions. To keep its accreditation the society must now provide quarterly reports of its monitoring of its members. They will not be able to advertise Cease therapy or give advice on vaccinations. Reaccreditation was offered under the conditions that they must not:

  • Offer CEASE (Complete Elimination of Autistic Spectrum Expression) autism therapy
  • Claim to cure or treat named conditions
  • Discourage conventional vaccination

Homeopathic Vaccines

This section is a copy of the section in Fake News and Vaccine Scares

Homeopathic vaccines exist but are so dilute that they do not elicit an antibody response.26antibody responses to homeopathic and conventional vaccines The British Homeopathic Association must be commended for taking the responsible line in that it recommends that children should have conventional vaccines.27Vaccinations statement

An online search shows that many homeopathic practitioners follow that line but not all. Some claim that their vaccines are safe, no doubt meaning a low incidence of side-effects but if they do not confer any immunity, that is not safe at all.

Homeopaths prefer the term “nosodes” to vaccines, saying that they do not work in the same way. They admit that they do not seem to stimulate the immune system. To quote one source that recommends it for horses and riders,28Homeopathic Nosodes “One theory is that nosodes work by creating an artificial disease in the body. Homeopathic medicines may occupy a space, a resonance that the natural disease would occupy should the animal come into contact with the natural disease. If at the time the space is occupied by the nosode, then the disease has no place to settle and reside. If there is no resonance with the patient whatsoever, then it just kind of disappears and nothing much happens. We are putting into the body a very, very dilute substance that really puts a picture into the body, an energetic picture that triggers a healing response. It is sort of like turning a switch with this very dilute energetic substance that says to the body ‘you need to fix this problem.’ With a nosode, what we’re doing is trying to tell the body energetically that it’s capable of dealing with a bug.”

Are you impressed? This is pseudoscience at its worst, pretending to offer an explanation that has no basis in the true scientific world of physics, chemistry or biology. It is just supposed to sound convincing to those who know no better. Some of the evidence of efficacy that is promoted is just anecdotal, which, as we have seen before, is of no value. Others are small, underpowered trials of poor methodology. This is the classical scenario for selective publication.

In 2019, senior NHS leaders called for the UK’s largest group of registered homeopaths to have its accreditation revoked amid concerns that some practitioners are spreading misinformation about vaccines. In a letter to the Professional Standards Authority (PSA) for Health and Social Care, the NHS England chief executive and the national medical director expressed “serious concerns” about the possible re-accreditation of the Society of Homeopaths.29Homeopathy should have professional accreditation revoked, NHS leaders urge

Health Economics

Some people have tried to propose homeopathy on the grounds that it is cheaper than conventional, scientific medicine. This would seem to be part of the gist of the Smallwood report that was discussed in Introduction to Alternative Healthcare, although they appeared to deny it. The cost of homeopathy is irrelevant if it is not effective as whatever it costs is a waste of money. Furthermore, it may be keeping patients away from effective treatment. A report from the York Research Database was highly critical of an article in The European Journal of Health Economics in December 2012, with the title “Patients whose GP knows complementary medicine tend to have lower costs and live longer”.30Bad science in health economics: complementary medicine, costs and mortality The authors from York accuse the writers of the paper of being highly selective in their data and not comparing like with like.

In 2017 The Daily Telegraph reported that the NHS was to ban homeopathy and herbal medicine as a “misuse of resources.”31NHS to ban homeopathy and herbal medicine, as ‘misuse of resources’ In Europe, the tide is turning against homeopathy. For example, France has ended reimbursement of homeopathic medications. Thefe was an outcry in Spain after the deaths of several young adult cancer patients who had refused conventional medical treatment in favour of alternative therapies. The deaths prompted an open letter to the government from 400 healthcare professionals calling for action. The government may have an uphill struggle to wean Spanish patients off homeopathy, after a survey showed more than half believed it worked.32Homeopathy in Europe: Is the Tide Starting to Turn? Even in Germany, there is a move against homeopathy.

Conclusion

The evidence about homeopathy is poor, largely because too many assorted conditions and treatments have been lumped together. This is remarkably poor technique. A study on the effectiveness of penicillin would look at the treatment of one condition only with specific entry criteria for subjects. It would not lump together tonsillitis, meningitis, arthritis, pneumonia and the common cold. For some conditions the evidence is that homeopathy does not work but for most conditions the evidence is of such poor quality that it is impossible to form a conclusion. The treatment involves the practitioner spending about an hour with the patient asking many questions in great detail and this is bound to have a considerable placebo effect. The best evidence is that it does not have any effect beyond the placebo effect.33Homeopathy: what does the “best” evidence tell us? In its favour, at least plain tap water is unlikely to be toxic. The main concern is that serious disease may not be adequately investigated and effective treatment not offered. In addition, useless immunisations may be employed.

The theory is implausible, reasearch has poor methodology and there is no convincing evidence to support homeopathy in any form.

All of the evidence I have found seems negative. Whenever I find something positive, I find that it has been debunked. Since the first part of the 21st century there have been many cries of “Is this the end for homeopathy?” From the evidence-based perspective I would say so but there are very many people who do not understand evidence or who do not want to know. I am shocked at how many registered doctors practice it. Where is their scientific training?

We do not need any more research into homeopathy. What exists is often of poor quality but there is enough that is cogent to form a sound opinion that homeopathy is theoretically implausible and the evidence shows that it does not work. Government funding must cease.

Do not take just my word for it. Here are a dozen quotations from around the world:

  1. The principles of homeopathy contradict known chemical, physical and biological laws and persuasive scientific trials proving its effectiveness are not available.
    Russian Academy of Sciences
  2. Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness.
    National Health and Medical Research Council, Australia
  3. These products are not supported by scientific evidence.
    Health Canada
  4. Homeopathic remedies do not meet the criteria of evidence-based medicine.
    Hungarian Academy of Sciences
  5. The incorporation of anthroposophical and homeopathic products in the Swedish directive on medicinal products would run counter to several of the fundamental principles regarding medicinal products and evidence-based medicine.
    Swedish Academy of Sciences
  6. We recommend parents and caregivers not give homeopathic teething tablets and gels to children and seek advice from their healthcare professional for safe alternatives.
    US Food and Drug Administration
  7. There is little evidence to support homeopathy as an effective treatment for any specific condition.
    National Centre for Complementary and Integrative Health, US
  8. There is no good-quality evidence that homeopathy is effective as a treatment for any health condition.
    National Health Service, UK
  9. Homeopathic remedies perform no better than placebos, and the principles on which homeopathy is based are scientifically implausible.
    House of Commons Science and Technology Committee, UK
  10. Homeopathy has not definitively proven its efficacy in any specific indication or clinical situation.
    Ministry of Health, Spain
  11. There is a constant increase in the quantity of evidence and the conviction of the scientific community in medicine, that homeopathy should be treated as one of the unscientific methods of so-called “alternative medicine”, which proposes worthless products without scientifically proven efficacy.
    National Medical Council, Poland
  12. From a purely clinical perspective, the fact remains that there is no valid empirical proof of the efficacy of homeopathy (evidence-based medicine) beyond the placebo effect.
    Federaal Kenniscentrum voor de Gezondheidszorg, Belgium

Further Resources

The list contains three separate organisations for homeopathy. All have .org on the URL with no uk but all three are British.

  • Faculty of Homeopathy website.
    http://www.facultyofhomeopathy.org/
    It is a British site which says that The Faculty of Homeopathy was founded in 1844. In 1950 it was incorporated by Act of UK Parliament. It accepts membership from doctors, dentists, pharmacists, nurses and midwives, veterinarians, osteopaths, chiropractors, opticians and podiatrists, plus professions regulated by the UK Health and Care Professions Council
  • The British Homeopathic Association.
    https://www.britishhomeopathic.org/ This is a charity that was founded in 1902. It says that The principal objects of the charity are to promote and develop the study and practice of homeopathy and to advance education and research in the theory and practice of homeopathy provided that the useful results of such research shall be published. One of their aims is the development of the evidence base for homeopathy. There is plenty of work to be done there.
  • The Society of Homeopaths.
    https://homeopathy-soh.org/It starts by saying, “Homeopathy is an evidence-based medicine” which is patently untrue but it also says, “The Society of Homeopaths is a professional body whose members are trained to high standards and agree to practise according to a strict code of ethics and practice” which must be welcomed.
  • The Truth about Homeopathy by E. Ernst. British Journal of Pharmacology 2007.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2291211/pdf/bcp0065-0163.pdf
    A brief but devastating appraisal of homeopathy.
  • Advice about homeopathy from the NHS.
    https://www.nhs.uk/conditions/Homeopathy/

References

  1. Berlin Wall Remedy Illustrates ‘Ridiculous’ Homeopathy> Medscape 29 August 2019.
    https://www.medscape.com/viewarticle/917426
  2. Davenas E, Beauvais F, Amara J, Oberbaum M et al. Human basophil degranulation triggered by very dilute antiserum against IgE. Nature.
    https://www.ncbi.nlm.nih.gov/pubmed/2455231
  3. Hirst SJ, Hayes NA, Burridge J, Pearce FL et al. Human basophil degranulation is not triggered by very dilute antiserum against human IgE. Nature 1993;366:525–7. https://www.ncbi.nlm.nih.gov/pubmed/8255290
    http://www.nobelprize.org/
  4. Brown V, Ennis M. Flow-cytometric analysis of basophil activation: inhibition by histamine at conventional and homeopathic concentrations. Inflamm Res 2001;50(Suppl 2):S47– [no abstract]
    https://www.ncbi.nlm.nih.gov/pubmed/11411598
  5. Lewith GT, Breen A, Filshie J, et al; Complementary medicine: evidence base, competence to practice and regulation.; Clin Med. 2003 May-Jun;3(3):235-40.[full text]
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4952448/pdf/235.pdf
  6. Linde K, Clausius N, Ramirez G, et al; Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials.; Lancet. 1997 Sep 20;350(9081):834-43.
    http://www.ncbi.nlm.nih.gov/pubmed/9310601
  7. Bandolier; Dilute information and little knowledge; November 1997 45-2.
    http://www.bandolier.org.uk/band45/b45-2.html
  8. Sterne JAC, Egger M, Smith GD.; Systematic reviews in health care: Investigating and dealing with publication and other biases in meta-analysis; BMJ, Jul 2001; 323: 101 – 105. [full text]
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1120714/
  9. Cancer Research UK ‘No convincing evidence’ for benefits of homeopathy in cancer treatment. 15th April 2009.
    https://www.cancerresearchuk.org/about-us/cancer-news/news-report/2009-04-15-no-convincing-evidence-for-benefits-of-homeopathy-in-cancer-treatment?
  10. Ernst E, Pittler MH; Efficacy of homeopathic arnica: a systematic review of placebo-controlled clinical trials.; Arch Surg. 1998 Nov;133(11):1187-90.
    http://www.ncbi.nlm.nih.gov/pubmed/9820349
  11. McCarney RW, Warner J, Fisher P, van Haselen R. No evidence that homeopathy is effective in treating dementia. Cochrane Summaries2003 [full text]
    https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003803/full
  12. Smith CA; Homoeopathy for induction of labour. Cochrane Summaries. 17th March 2010
    https://www.cochrane.org/CD003399/PREG_homoeopathy-for-induction-of-labour
  13. McCarney RW, Linde K, Lasserson TJ; Homeopathy for chronic asthma.; Cochrane Summaries. 8th October 2008.
    https://www.cochrane.org/CD000353/AIRWAYS_homeopathy-for-chronic-asthma
  14. Mathie RT, Frye J, Fisher P. Homeopathic Oscillococcinum for preventing and treating influenza and influenza-like illness. Cochrane Summaries. 2015.
    https://www.cochrane.org/CD001957/ARI_homeopathic-oscillococcinumr-for-preventing-and-treating-influenza-and-influenza-like-illness
  15. Pittler MH, Ernst E; Complementary therapies for reducing body weight: a systematic review.; Int J Obes (Lond). 2005 Sep;29(9):1030-8.
  16. Pilkington K, Kirkwood G, Rampes H, et al; Homeopathy for depression: a systematic review of the research evidence.; Homeopathy. 2005 Jul;94(3):153-63.
    http://www.ncbi.nlm.nih.gov/pubmed/15925954
  17. Shang A, Huwiler-Muntener K, Nartey L, et al; Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy.; Lancet. 2005 Aug 27-Sep 2;366(9487):726-32.
    http://www.ncbi.nlm.nih.gov/pubmed/16125589
  18. Peckham EJ, Nelson E, Greenhalgh J, Cooper K, Roberts E, Agrawal A. Homeopathy for treatment of irritable bowel syndrome. Cochrane Library 13th November 2013.
    https://www.cochrane.org/CD009710/IBD_homeopathy-for-treatment-of-irritable-bowel-syndrome
  19. The databases of the Karl and Veronica Carstens Foundation. In German but an English translation can be obtained.
    https://www.carstens-stiftung.de/die-datenbanken-der-karl-und-veronica-carstens-stiftung.html
  20. Outcry as register of homeopaths gets official backing. The Times 16th September 2014.
    http://www.thetimes.co.uk/tto/health/news/article4207497.ece
  21. Australian Government National Health and Medical Research Council. Homeopathy working committee 2015
    https://www.nhmrc.gov.au/about-us/publications/homeopathy
  22. NHS Specialist Pharmacy Service. Clinical evidence for homeopathy
    https://www.england.nhs.uk/wp-content/uploads/2017/11/sps-homeopathy.pdf
  23. Homeopathy not a cure, says WHO BBC News 20thhttp://news.bbc.co.uk/1/hi/health/8211925.stm
  24. Shaw DM. Homeopaths Without Borders practice exploitation not humanitarianism. BMJ 2013;347:f5448 full text only available for a fee.
    https://www.bmj.com/content/347/bmj.f5448.long
  25. Society of Homeopaths rebuked over bogus autism remedies. The Times 14 February 2020.
    https://www.thetimes.co.uk/edition/news/homeopaths-ordered-to-stop-offering-autism-treatment-bvvh0cmbn
  26. Loeb M , Russell ML, Neupane B, Thanabalan V, Sing P, Newton J, et al. A randomized, blinded, placebo-controlled trial comparing antibody responses to homeopathic and conventional vaccines in university students. Vaccine Volume 36, Issue 48, 19 November 2018, Pages 7423-7429.
    https://www.sciencedirect.com/science/article/pii/S0264410X18312325#!
  27. British Homeopathic Association. Vaccinations Statement 2013.
    https://www.britishhomeopathic.org/media-centre/vaccinations-statement/
  28. Holistic Horse. Interative care for horse and rider. Homeopathic Nosodes: Vaccination Alternative?
    https://holistichorse.com/health-care/homeopathic-nosodes-vaccination-alternative/
  29. Sampson CJ, Whitehurst DGT, Street AD. Bad science in health economics: complementary medicine, costs and mortality. The York Research Database. 5th June 2013.
    https://pure.york.ac.uk/portal/en/publications/bad-science-in-health-economics-complementary-medicine-costs-and-mortality(6252a67e-692e-4051-8613-6a9b1639c6f5).html
  30. Homeopathy should have professional accreditation revoked, NHS leaders urge. BMJ 2019;367:l6248
    https://www.bmj.com/content/367/bmj.l6248
  31. NHS to ban homeopathy and herbal medicine, as ‘misuse of resources’ Daily Telegraph 21st July 2017
    https://www.telegraph.co.uk/news/2017/07/21/nhs-ban-homeopathy-herbal-medicine-misuse-resources/
  32. Homeopathy in Europe: Is the Tide Starting to Turn? Medscape 29 July 2019.
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Site Index

This website is now completed, although I shall continue to do updates. The following list shows the sections or chapters. Just click on the topic in blue to go to that part of the site.

1 Introduction
2 A Very Brief History of Science And Medicine
Fundamentals of Medical Science
3 Finding Good Medical Advice and Evidence Based Medicine
4 Randomised Controlled Trials
5 Cohort or Longitudinal and Epidemiological Studies
6 Qualitative Research
7 Basic Maths in Medical Research and Decision Making
8 How Good is the Evidence?
9 Ethics in Practice and Research
Public Health Issues
10 Screening Programmes
11 Fake News and Vaccine Scares
12 Electronic Cigarettes (E-Cigarettes)
13 Motor Vehicle Emissions, Air Pollution and Health
14 COVID-19. What You Need to Know
15 What we Must Learn from the COVID-19 Pandemic
Nutrition
16 Basics of Nutrition
17 Exercise, Obesity and Diets for Weight Loss
18 Diets and Nutrition for Health and Fitness
19 Supplements
Complementary and Alternative Medicine
20 Introduction to Alternative Healthcare
21 Homeopathy
22 Acupuncture
23 Manipulation of the Spine
24 Reflexology
25 Herbal Remedies
26 Other Natural Products
27 Chelation Therapy
28 Hypnosis
29 Other Modalities of Complementary and Alternative Medicine
Some Controversial Diseases
30 Fibromyalgia
31 Chronic Fatigue Syndrome (CFS) or Myalgic Encephalitis (ME)
32 Systemic Candidiasis and Leaky Gut Syndrome
33 Mobile Phones, Masts, Wi-Fi and Electro-sensitivity
The Environment
34 Global Warming and Climate Change
35 Alternative Energy
Some Final Thoughts
36 Still Searching for the Age of Reason