Definition
Homeopathy (also spelt homoeopathy and homœopathy) – Etymology: from the Greek homoios, ‘similar’ and pathos, ‘suffering’.
Homeopathy is a form of complementary and alternative medicine (CAM), based on the idea of ‘treating like with like’ (Similia similibus curentur), aiming to stimulate self-healing processes. Treatment is often individualized. Homeopathic medicines are of botanical, chemical, mineral, zoological, or human origin, and prepared by a process of successive dilution and agitation (succussion), known as potentization.
Related therapies/approaches: Anthroposophical medicine, homotoxicology, isopathy.
Some terms used in homeopathy
Aggravation: A temporary increase in severity or worsening of symptoms or of the illness being treated, followed by improvement. Considered a favourable prognostic sign.
Classical homeopathy: In classical homeopathy, typically a single homeopathic medicine is selected on the basis of the total symptom picture of a patient, including mental, general and constitutional features. Also known as individualised prescribing.
Clinical homeopathy: In clinical homeopathy, one or more homeopathic medicines are administered for standard clinical situations or conventional diagnoses.
Complex homeopathy: In complex homeopathy, several medicines are combined in a standard mixture to treat a particular illness or syndrome.
Constitution: The permanent characteristics of an individual including personality, general physical features (for instance sensitivity to cold) and body morphology.
Constitutional prescribing: The homeopathic medicine is selected on the basis of the constitution of a patient (see above) as opposed to the symptoms of the disease. Sometimes summarised as treating people, not diseases.
Genus epidemicus: In the treatment of epidemics, homeopaths identified one, or a small number, of medicines that seemed effective in most cases, referred to as the ‘genus epidemicus’.
Homeopathic Pathogenetic Trials (HPTs): A method to test a substance at a non-toxic level on healthy volunteers to determine the symptoms it provokes and which, according to the Similarity Principle, it may be used to treat. Synonymous with proving.
Homeopathic medicine: Medicine produced according to an homeopathic pharmacopoeia. Synonyms: homeopathic medicinal product, homeopathic remedy. Homeopathic medicine is the preferred term.
Isopathy: The use of homeopathic dilutions of allergens or causative infectious or toxic agents in the treatment ailments stimulated by the same. For instance dilutions of grass pollen to treat hayfever.
Materia medica: A book, program or other information source on prescribing indications for medicines.
Potency: Homeopathic dilution.
Potentisation: The process of serial dilution and succussion (vigorous shaking) by which homeopathic medicines are produced.
Proving: see Homeopathic Pathogenetic Trial.
Remedy: see Homeopathic medicine.
Repertory: Book or computer program systematically listing symptoms (usually by body system) and the homeopathic medicines whose prescription they may indicate.
Similarity (or Similia) Principle: The basic concept of homeopathy ‘Similia similibus curentur’ (‘Let like be cured by like’), stated by the German physician Samuel Hahnemann (1755-1843) in 1796. This implies that substances capable of causing disorder in healthy subjects are used as medicines to treat similar patterns of disorder experienced by ill people.
Simillimum: The homeopathic medicine which most closely matches a patient’s symptoms.
Succussion: Vigorous shaking carried out at each stage of the dilution in the preparation of a homeopathic medicine.
Trituration: Dilution by grinding with lactose, used in the first stages of dilution of homeopathic medicines prepared from insoluble source material.
Ultramolecular dilution: A dilution beyond Avogadro’s number in which there is unlikely to be any material trace of the original substance.
Definitions adapted from International Dictionary of Homeopathy (2000). Swayne J. (Ed), London: Churchill Livingstone. |
Introduction
Homeopathy is a system of medicine developed by Samuel Hahnemann, a German physician in the late 18th century. It is based on three key principles: similarity, individualization and minimum dose.
The fundamental idea of homeopathy is the Similarity (or Similia) Principle: ‘‘Let like be cured by like’ (often quoted in Latin ‘Similia similibus curentur’) . This means the selection as a medicine, of a substance which, if given to a healthy person, would cause symptoms similar to those from which the patient is suffering. This is believed to stimulate intrinsic healing systems. For instance the homeopathic medicine Apis mellifica, made from bees is used to treat conditions characterised by acute onset, swelling, stinging pain, made worse by pressure and relieved by cold, like a beesting. This may include skin and rheumatic conditions.
A second principle is individualization of treatment for the patient, although this is not universal. The characteristics of the chosen medicine should be as similar as possible to the characteristics of the illness in the patient. This closest match is called the ‘similimum’. Similarity may be at the ‘whole person’ level, taking into account the symptoms and signs of the disease, the patient’s physical build, personality, temperament and genetic predispositions. This high level of individualization is not always required: ‘similarity’ may be at a simpler, local level and is not usually necessary in treating simple or acute conditions.
The third principle is the use of the minimum dose. The doses used in homeopathy range from those similar to some conventional medicines to very high dilutions containing no material trace of the starting substance. There is no currently understood way that homeopathic medicines in such ‘ultra-molecular’ dilution could exert specific physiological effects. Until there is greater certainty about a mechanism or mechanisms of action, claims of the effectiveness of homeopathy will continue to encounter resistance on the grounds of implausibility. There are a number of theories concerning the possible mode of action of ultramolecular dilutions, most of which involve storage of information in aqueous media.
Homeopathic medicines, also called homeopathic medicinal products or remedies, are of botanical, chemical, mineral, zoological or human origin. They are prepared by a process, sometimes known as potentization, involving successive dilutions and vigorous shaking (succussion) for liquid preparations and successive grinding (trituration) followed by suspension in a liquid medium for insoluble substances. Homeopathic potencies are designated by a number and a letter:
- The number refers to the number of successive serial dilutions to which the starting material has been subjected in order to prepare that medicine.
- The letter refers to the scale on which the dilution has been carried out. There are several different scales, of which the decimal (1:10) and centesimal scales (1:100) are the most widely used. The letter D or X denotes the decimal method in which 1 part is added to 9 parts of diluent. The letter C indicates the centesimal method (i.e., 1 part to 99 parts of diluent). Other scales are also used.
Homeopathic medicines are used both in low dilutions, where the original substance is materially present, and in high dilutions, in which it is unlikely that any trace of the original substance remains. In homeopathic dilutions above 12C / 24D (10-24 M), beyond Avogadro’s number, there are, in theory, no material traces of the original substance. Such dilutions are known as ‘ultramolecular’. The most frequently used potencies in the UK are 6c and 30c, the latter is ultramolecular.
Homeopathic medicines exist in two main forms: ‘single’ and ‘complex’. Single homeopathic medicines are made from an individual starting substance. Complex homeopathic medicines are fixed combinations of homeopathic medicines, generally used for a specific clinical indication.
The final pharmaceutical form is usually lactose or lactose and sucrose pillules, but other forms including liquid oral and injectable preparations are available. The starting materials and homeopathic manufacturing procedures, including quality specification and control measures, are governed by standards documented in pharmacopoeias, and Good Manufacturing Practices (GMP). National and international authorities (such as the European Commission) have issued regulatory guidelines on factors related to safety, including dilutions, contra-indications, interactions and use during pregnancy or lactation and in children.
Clinical uses
The conditions most commonly treated by homeopathy in the NHS include: allergic rhinitis, atopy, arthritis and rheumatism, asthma, bowel disease - inflammatory and functional, cancer-related symptoms, chronic fatigue syndrome, depression, eczema, menopausal and menstrual symptoms, migraine, psoriasis and recurrent upper respiratory tract infections. Historically homeopathy was used with apparent success in epidemics, notably of cholera in the 19th century and of influenza in the pandemic of 1918-19.
Systematic reviews
Selected systematic reviews from the CAM SL can be viewed at: http://www.library.nhs.uk/cam/SearchResults.aspx?catID=9652.
Safety
The literature on the safety of homeopathy suggests that homeopathic medicines may provoke adverse effects but these are relatively rare, mild and transient, although there is probably under-reporting.1,2 A recent systematic review3 of homeopathic observations did not identify clear evidence of the existence of homeopathic aggravations contrary to the findings of the earlier systematic review and to those of audits in practice4.
The safety of homeopathy appears to be an important motive for patients who choose it and the situation with regard to safety can be summed up as follows:
“Homeopathic medications in high dilutions prescribed by trained professionals are probably safe and unlikely to provoke severe adverse reactions. It is difficult to draw definite conclusions due to the low methodological quality of reports claiming possible adverse effects of homeopathic medicines” 2
1. Dantas F, Rampes H. Do homeopathic medicines provoke adverse effects? The British Homoeopathic Journal. 2000, 89: S35–38. [PubMed abstract]
2. Fisher P, Dantas F, Rampes, H, The safety of homeopathic products. Journal of the Royal Society of Medicine. 2002, 95: 474-5. [PubMed abstract] [Full text]
3. Grabia S, Ernst E. Homeopathic aggravations: a systematic review of randomised, placebo-controlled clinical trials. Homeopathy. 2003, 92(2):92-8. [PubMed abstract]
4. Thompson E, Barron S, Spence D. A preliminary audit investigating remedy reactions including adverse events in routine homeopathic practice. Homeopathy. 2004 93(4):203-9. [PubMed abstract]
Regulation of homeopathy
The Faculty of Homeopathy is incorporated by Act of Parliament, it admits only statutorily registered healthcare professionals, including doctors, nurses, midwives, dentists, veterinarians and pharmacists. It accredits training and awards qualifications through examination at different levels, including LFHom (basic level), MFHom and FFHom (specialist level). Faculty members are primarily regulated by their profession's statutory body.
Homeopathy is not a statutorily regulated profession in the UK, so there is no legal definition of who can call themselves an homeopath. There are however National Occupational Standards for Homeopathy.
There are a number of professional associations that homeopaths who are not members of statutorily registered healthcare professionals can choose to join but they are not required by law to belong to a professional association nor to have completed a specified course of training. However, many do belong to the organisations listed below.
Alliance of Registered Homeopaths
Association of Natural Medicine
British Register of Complementary Practitioners
Embody
Fellowship of Homeopaths
Homeopathic Medical Association
International Register of Consultant Herbalists and Homoeopaths (IRCH)
International Society for Homeopathy
Scottish Association of Professional Homeopaths
Society of Homeopaths
These organisations are working together as the Council of Organisations Registering Homeopaths (CORH) to develop common standards of training and practice and one register of practitioners who all meet a required standard.
Doctors may refer patients for homeopathic treatment to members of the Faculty of Homeopathy but may only delegate patients to homeopaths who are not statutorily regulated.
Professional bodies and organisations
British Homeopathic Association
Faculty of Homeopathy
Society of Homeopaths
Other relevant information
Journals
Homeopathy
Homeopathic Links
Complementary Therapies in Medicine
NHS Homeopathy Centres
There are five NHS homeopathic centres, offering homeopathic treatment (and in most cases also other forms of complementary and alternative medicine), on the usual NHS terms and conditions. Most also offer training courses at various levels for statutorily registered healthcare professionals.
Bristol Homeopathic Hospital
Cotham Hill, Cotham,
Bristol BS6 6JU
Tel.: 0117 973 1231
Academic department: 0117 946 6087
www.ubht.nhs.uk/homeopathy
Glasgow Homoeopathic Hospital
1053 Great Western Road,
Glasgow G12 0XQ
Tel: 0141 211 1616
http://ghh.info/welcome.htm
Academic department: 0141 337 1824
http://www.adhom.com/index.htm
Royal London Homoeopathic Hospital
Great Ormond Street
London WC1N 3HR
Tel: 0845 1555 000
Patient services: 020 7391 8888
Academic department: 020 7391 8823
www.uclh.nhs.uk/rlhh
Tunbridge Wells Homoeopathic Hospital
Church Road,
Tunbridge Wells,
Kent TN1 1JU
Tel: 01892 632801
Department of Homoeopathic Medicine
The Old Swan Health Centre,
St Oswald's Street, Old Swan
Liverpool L13 2BY
Tel: 0151 285 3707
