An introduction to
homeopathy
Why learn about homeopathy?
 Your patients are using it
 Your colleagues are using it
 There is a clinical need for it
 It’s rewarding
Patient demand
 OTC sales of homeopathic remedies: £38 million in 2007 and
predicted to reach £46 million by 2012
 Pharmacies and supermarkets selling homeopathic medicines:
Tesco, Sainsbury’s, Boots and many others
 British Homeopathic Association website receives around
80,000 visits from the general public a year
Patient demand
ROYAL LONDON HOMEOPATHIC HOSPITAL
- in the year 2004 :
 3,300 new out-patients
 25,000 follow-up appointments
Patient demand
GLASGOW HOMEOPATHIC HOSPITAL
- in the year 2004 :
 1,528 new out-patient consultations
 7,400 follow-up appointments
 515 new in-patients
 Threat to close the in-patient service a few years ago
withdrawn due to intense public lobbying
Patient demand
BRISTOL HOMEOPATHIC HOSPITAL - 2004
 1,100 new out-patient consultations
 3,500 follow-up appointments
LIVERPOOL HOMEOPATHIC HOSPITAL - 2004
 684 new out-patient consultations
 6,468 follow-up appointments
Patient demand
 15% of the UK population trust homeopathy (TGI Global
barometer, January 2008)
 A poll of 3,373 people found that 79% would like to be able to
access complementary medicine alongside conventional
treatment in the NHS (One Poll, January 2009)
Why learn about homeopathy?
 Your patients are using it
 Your colleagues are using it
 There is a clinical need for it
 It’s rewarding
Professional demand
 Professional demand for training
 20-25% of Scottish GPs have had some homeopathic training
 There are 54,000 homeopathic medical doctors and other
healthcare professionals in Europe. Between 25% and 40% of
European healthcare practitioners prescribe homeopathy
occasionally, 7% on a regular basis
Lothian GP Survey
 305 of 540 Lothian GPs replied
 90% of respondents had recommended or referred patients for
a complementary therapy
 109 GPs said they wished training in a complementary therapy
 most of these stated homeopathy as the therapy of choice
 95% said they were willing to refer patients for homeopathic
treatment
 64% wanted such a provision in a hospital out-patient setting
B.M.A. “Complementary Medicine,
New Approaches ....”
 “One of the main reasons for the current upsurge of ‘official’
interest in non-conventional medicine is the rapidly increasing
number of patients who are seeking help from such
practitioners. This has prompted the Council of Europe to
state : ‘It is not possible to consider this phenomenon as a
medical side-issue. It must reflect a genuine public need which
is in urgent need of definition and analysis.’ ”
Why learn about homeopathy?
 Your patients are using it
 Your colleagues are using it
 There is a clinical need for it
 It’s rewarding
The clinical place of homeopathy
 Where there is no effective conventional alternative
 Where conventional medicine is unsafe
 Where conventional medicine has unacceptable side-
effects
 To minimize the use of conventional medicine
No effective conventional treatment
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Allergies
Anal fissures
Anger
Bruises
Chilblains
Colic
Fear/phobias
Glandular fever
Grief
Impotence
No effective conventional treatment
 Intermittent claudication
 Mastalgia
 M.E. / CFS / PVS
 Nightmares / night terrors
 Premenstrual Syndrome
 Teething
 Urethral syndrome
Unsafe situation for
conventional medicine
 Pregnant women
 Young children
 The elderly
 Anticipatory anxiety
Unacceptable side-effect profile
 Anxiety
 Depression
 Cramps
 Osteoarthritis
Reduction in long-term
conventional treatment
 Asthma
 Constipation
 Convulsions
 Dysmenorrhoea
 Eczema
 Migraine
 Neuralgias
 Otitis media ( recurrent )
 Psoriasis
Why learn about homeopathy?
 Your patients are using it
 Your colleagues are using it
 There is a clinical need for it
 It’s rewarding
The rewards of homeopathy
 Making a difference
 Patient satisfaction
 Effects on consultation technique
 Intellectual achievement
 The joy of detective work
 Making sense of patterns of disease
 Making sense of progress of disease
 Understanding aetiology
What is homeopathy?
 Like cures like
 Minimum effective dose
How are remedies prepared?
 Original sources
 Plant
 Mineral
 Animal
 Disease
 Serial dilutions
 Succussion
Is there a phenomenon here?
 Clinical research
 Clinical experience
 Consistency of theory
Professional attitudes
 British Journal of Pharmacology, 2006 – a study by University of
Aberdeen of Scottish general practices found that 49% had
prescribed homeopathy (323 practices in total)
 The doctor’s mag Pulse reported on a survey of 200 GPs in 2007 -
56% had either provided or recommended complementary
medicine to patients
RCTs - the meta-analyses
 Kleijnen J, Knipschild P, Ter Riet G. Clinical trials of
homeopathy. British Medical Journal 1991; 302: 316-323
 Linde K, Clausius N, Ramirez G, et al. Are the clinical effects of
homeopathy placebo effects? A meta-analysis of placebocontrolled trials. Lancet 1997; 350: 834-843
Linde’s conclusion
 Linde's conclusion is: "The results of our meta-analysis are not
compatible with the hypothesis that the clinical effects of
homeopathy are completely due to placebo”
 A reading of the study shows a clearly positive result for
homeopathy
 49% of the trials were clearly positive and a further 35%
showed a positive trend
Kleijnen’s conclusions
 They found that of 105 trials with interpretable results, 81
were positive
 They then looked at a sub-group of the most rigorous trials and
discovered that 15 out of 22 found homeopathy to be superior
to placebo
 One of Kleijnen's conclusions was that the evidence found:
'would probably be sufficient for establishing homeopathy as a
regular treatment for certain conditions'
The Lancet – August 2005
 110 homeopathy trials were compared with 110 allopathy
trials
 Overall positive treatment effect found in both groups
 Final analysis limited to “best” 8 homeopathy and 6 allopathy
trials – significant effect of homeopathy disappeared
 Conclusion: “The clinical effects of homeopathy are those of
placebo”
 Lancet editorial: “The end of homeopathy”!
Lancet 2005 – the flaws
 Standard assessment criteria are insufficient to gauge “high
quality” in homeopathy trials
 Authors did not state which 8+6 trials were analysed in details
so their relevance or value was unknown
 8 trials of homeopathy cannot fairly represent the entire
research literature!
 Authors ignore homeopathy’s significant effects in RTIs
 Some key papers are omitted, others wrongly included
 The rigour and validity of the paper’s conclusions were
rebutted in later articles (Rutten and others, 2008)
Categories of research evidence
 The medical conditions for which the published literature
substantiates the clinical value of homeopathic treatment can
be ranked in 3 categories:
1. Systematic reviews with positive conclusions in specific clinical
areas
2. More than one published clinical trial favouring homeopathy
3. One positive published clinical trial only…
1. Systematic reviews with focus on
specific clinical areas
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Allergies and upper respiratory tract infections
Childhood diarrhoea
Influenza
Post-operative ileus
Rheumatic diseases
Seasonal allergic rhinitis
Upper respiratory tract diseases, including otitis media
Vertigo
2. Replicated trials with a majority of
positive findings
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Childhood diarrhoea
Fibromyalgia
Influenza
Osteoarthritis
Seasonal allergic rhinitis
Sinusitis
Vertigo
3. Singleton trials with positive
evidence
 Includes…
 Chronic fatigue syndrome
 Premenstrual syndrome
 Post-partum bleeding
 Sepsis
 Stomatitis
Outcome studies:
Bristol Homeopathic Hospital
 Observational study of 6,544 consecutive follow-up patients
over 6 year period in an NHS hospital outpatient unit
 Outcomes were based on scores on a 7-point Likert-type scale
 70.7% reported positive health changes, with 50.7% recording
their improvement as better (+2) or much better (+3)
Outcome studies:
Royal London Homeopathic Hospital
 Outcome study of 500 asthma patients
 Of 262 who had been taking conventional medicines, 29%
were able to stop conventional treatment and 32% reduced
their conventional treatment.
BMJ, Nov 2007:
 “A principle of evidence based practice is that the evidence
should be only one influence on clinical decision making,
alongside the expertise and perspectives of both patients
and clinicians. However uncomfortable for health system
planners, an evidence based service should reflect expressed
patient preference.” David Tovey, Editor of BMJ Knowledge
Taking a homeopathic history
 Presenting complaints
 Systems review
 PMH
 FH
 SH
 Allergies
 Generals
 Mentals
Analysing the data
 Significant symptoms
 Materia Medica patterns
 Repertorising
Basic homeopathic principles
 Single remedy, Single dose
 Potency
 Direction of cure
Basic homeopathic principles
 Single remedy, single dose
 Potency
 Direction of cure
Potency
 Series of Dilutions and Succussions
 Two common Scales in UK
 x or Decimal scale - serial 1:9 dilutions
 c or Centesimal scale - serial 1:99 dilutions
 Each Potency written as number, then scale symbol:
 2x, 3x, 6x, 12x, etc.
 6c, 12c, 30c, 200c, M, 10M, CM, MM
Basic homeopathic principles
 Single remedy, single dose
 Potency
 Direction of cure
Direction of cure
 Most important organs to least important
 Inwards to outwards
 Top to bottom
 Reverse order of appearance of symptoms
Prescribing a Remedy
 NHS or private
 Pharmaceutical supply
 Local chemist
 Specialist homeopathic pharmacies such as Ainsworths,
Freemans, Helios, Nelsons or Weleda
 Stock order
 Cost
Obtaining homeopathic treatment
NHS
 GP
 Homeopathic hospital (Bristol, Glasgow, Liverpool, London)
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In-patient (Glasgow only)
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Out-patient
 Homeopathic clinics around the country
Private practitioners
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Medically qualified
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Non-medically qualified
First prescriptions
 Infant Colic
 Colocynthis
 Night Cramps
 Cuprum metallicum
What is complementary medicine?
 Definitions  a) “additional to western medicine” or “not taught in medical
schools” ( GP survey )
 b) “all forms of health care which usually lie outside the official
health sector” ( WHO )
 c) “those forms of treatment which are not widely used by
orthodox health-care professions, and the skills of which are
not taught as part of the undergraduate curriculum of
orthodox medical and paramedical health-care courses” (BMA)
What is complementary medicine?
 Acupuncture
 Alexander technique
 Aromatherapy
 Bach Flower Remedies
 Chiropractic
 Crystal therapy
 Healing
 Herbalism
 Homeopathy
What is complementary medicine?
 Hypnotherapy
 Iridology
 Kinesiology
 Massage
 Osteopathy
 Radionics
 Reflexology
 Shiatsu
Hospital-based complementary
medicine
 Outpatient care
 Inpatient care
 Teaching
Faculty of Homeopathy
 The only body in the UK that promotes the education and
training of healthcare professionals in homeopathy
 1400 members worldwide in a range of different professions
including doctors, nurses, dentists, vets, midwives,
pharmacists, podiatrists and osteopaths
 Accredited training available in the UK and overseas
www.facultyofhomeopathy.org