OBJECTIVE: To evaluate the response to homeopathic treatment in a public homeopathic clinic of all patients attending between September 1998 until December 2005, and to analyze homeopathic practice. METHODS AND SETTING: Longitudinal observational study in a homeopathic clinic based in a public hospital in Lucca, Italy. Data relating to patient details, clinical diagnosis, remedy prescribed, potency of dosage, prescription strategy and identification of the case as acute-chronic-recurrent were analyzed. Clinical response was assessed by the Glasgow Homeopathic Hospital Outcome Score. RESULTS: Overall 74% of patients reported at least moderate improvement. Outcomes were better with longer treatment duration and younger age of patients. Respiratory, followed by dermatological and gastrointestinal pathologies responded best, psychological problems relatively poorly. CONCLUSIONS: Homeopathic therapy is associated with improvement in a range of chronic and recurring pathologies. Certain characteristics of patient and pathology influence the outcome.

Homeopathy. 2009 Jul;98(3):142-8. Rossi E, Endrizzi C, Panozzo MA, Bianchi A, Da Frè M. Homeopathic Clinic, ASL 2 Lucca, Tuscany Regional Homeopathic Reference Centre, Italy. omeopatia@usl2.toscana.it

Introduction: Homeopathy uses information gathered from healthy volunteers taking homeopathic substances (pathogenetic trials) for clinical treatment. It is controversial whether such studies produce symptoms different from those produced by placebo. Objective: To test whether homeopathic preparations produce different symptoms than placebo in healthy volunteers. Methods: Three armed, double-blind, placebo controlled randomised experimental pathogenetic study in 25 healthy volunteers who took either one of two homeopathic remedies, Natrum muriaticum and Arsenicum album in 30CH or identical placebo. Main outcome parameter was the number of remedy-specific symptoms per group. Results: On average, 6 symptoms typical for Arsenicum album were experienced by participants taking arsenicum album, 5 symptoms typical for Natrum muriaticum by those taking natrum muriaticum, and 11 non-specific symptoms by those in the placebo group. Differences were significant overall (Kruskall Wallis test, p = 0.0002,) and significantly different from placebo (Mann-Whitney test, p = 0.001). Conclusion: Homeopathic remedies produce different symptoms than placebo. Copyright (c) 2009 S. Karger AG, Basel.

Forsch Komplementmed. 2009 Apr;16(2):105-10. Epub 2009 Apr 9. Möllinger H, Schneider R, Walach H. Department of Human Sciences, University of Osnabrück, Germany.

Full Title: Paediatric homoeopathy in Germany: results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)

PURPOSE: Despite growing pressure against homoeopathy, an unexpected resurgence in the use of homoeopathy has been reported. It is of interest to examine the use of homoeopathy and user profiles among children in Germany. METHODS: Last-week homoeopathy use was recorded among 17,450 children aged 0-17 years who participated in the 2003-2006 German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The complex sample method was used to estimate the prevalence of, and factors associated with, homoeopathy use. RESULTS: Nine hundred and fifty-one homoeopathic preparations were used by 718 children (weighted prevalence 4.6%). Nearly half of the homoeopathic preparations were obtained by prescriptions from medical doctors or Heilpraktiker (non-medical practitioners) and used most often to treat certain self-limiting conditions. About 60% of homoeopathy users concomitantly received conventional medicines. Homoeopathy use was closely related to socioeconomic factors, with a significantly higher prevalence rate found in the 0-6 year age group [prevalence 6.2%, odds ratio 2.2, 95% confidence intervals (CIs) 1.7-2.9], among children residing in the former West Germany [5.1%, 2.2(1.5-3.2)] or the south of Germany [6.6%, 1.7(1.3-2.4)], among children with a poor health status [6.8%, 3.0(2.2-4.2)], with no immigration background [5.3%, 3.7(2.2-6.1)], who received breast-feeding >6 months [7.6%, 2.1(1.6-2.9)], were from upper social-class families [7.4%, 1.8(1.1-2.8)] and whose children's mothers were college educated [7.2%, 1.6(1.2-2.2)]. CONCLUSIONS: Paediatric homoeopathy is quite popular in Germany, particularly among children from families with a higher socioeconomic status. The high level of paediatric homoeopathy use in Germany warrants a critical review to determine whether it is evidence based and cost-effective.

Pharmacoepidemiol Drug Saf. 2009 May;18(5):370-9. Du Y, Knopf H. Department of Epidemiology and Health Reporting, Division of Non-Communicable Disease Epidemiology, Robert Koch Institute, Berlin, Germany. DuY@rki.de

OBJECTIVE: Patients are increasingly attracted to homeopathy despite the unproven effectiveness of homeopathic remedies. Clinical benefit of homeopathy may be due to communication. This review aims to identify and assess effective communication patterns in homeopathy. METHODS: Narrative review and synthesis of published communication patterns, patient narratives and the author's professional experience as a homeopathic practitioner. RESULTS: In the biomedical model, where the focus is on disease, communication is physician-centered with early redirection of patients' concerns, and associated with reduced compliance, increasing risk of malpractice claims and low professional fulfillment. The biopsychosocial and the developing integrative medicine models are based on biomedicine but aim to include the whole person. Patient-centeredness is a behavior that elicits, respects and incorporates patients' wishes, allows active patient participation and is related to improved outcomes. The homeopathic model is based on holism and comprehension of the totality of the patient and uses patient-centered communication with a high degree of physician co-operation, empathy, hopefulness, enablement and narrative competence, all of which can improve outcomes. CONCLUSION: Both biopsychosocial and homeopathic models rely on patient-centered communication. Regardless of conceptual differences, they overlap in their common respect for the totality and individuality of the patient. The study of the homeopathic model shows that respect for the whole person is a basic requirement to entrench patient-centeredness more firmly in medicine. PRACTICE IMPLICATIONS: Medical education should include values such as individual coping strategies, the benefits of a sound and healthy life-style and the necessity of hope and enablement. Health care should be redesigned to honor physicians who practice these values.

Patient Educ Couns. 2009 Apr 14. Hartog CS. Department of Anaesthesiology and Intensive Care Medicine, Friedrich Schiller University, Erlanger Allee 101, D-07747 Jena, Germany.

Introduction: Homeopathy uses information gathered from healthy volunteers taking homeopathic substances (pathogenetic trials) for clinical treatment. It is controversial whether such studies produce symptoms different from those produced by placebo. Objective: To test whether homeopathic preparations produce different symptoms than placebo in healthy volunteers. Methods: Three armed, double-blind, placebo controlled randomised experimental pathogenetic study in 25 healthy volunteers who took either one of two homeopathic remedies, Natrum muriaticum and Arsenicum album in 30CH or identical placebo. Main outcome parameter was the number of remedy-specific symptoms per group. Results: On average, 6 symptoms typical for Arsenicum album were experienced by participants taking arsenicum album, 5 symptoms typical for Natrum muriaticum by those taking natrum muriaticum, and 11 non-specific symptoms by those in the placebo group. Differences were significant overall (Kruskall Wallis test, p = 0.0002,) and significantly different from placebo (Mann-Whitney test, p = 0.001). Conclusion: Homeopathic remedies produce different symptoms than placebo. Copyright (c) 2009 S. Karger AG, Basel.

Forsch Komplementmed. 2009 Apr;16(2):105-10. Epub 2009 Apr 9. Möllinger H, Schneider R, Walach H. Department of Human Sciences, University of Osnabrück, Germany.

UK medical students spend 25% of their curricular time on elective "Student Selected Components" (SSCs). We report one in homeopathic medicine run jointly by the University of Bristol and the Bristol Homeopathic Hospital. The SSC was an intensive four week course using a variety of learning methods, grounded in the Faculty of Homeopathy's Primary Health Care Examination (PHCE) Certificate syllabus. Students were exposed to specialist clinics and the prescribing methods used in them. They received tuition from a veterinarian, a psychiatrist, a medical historian, a professional homeopath and an expert in the evidence base of complementary medicine. Educational methods included interactive lectures, out-patient clinics, recorded video cases, live cases via video link, a "dream proving" and a reflective diary. At the end of the course students sat and passed the Faculty's PHC examination. Assessment also included an in-depth case report in which most students revealed understanding of the course. Though students were uncertain about the nature of the healing stimulus, many were affected by the healing responses they witnessed and the intellectual challenge of remedy selection. Some professed interest in further training and all wished to see the Bristol Homeopathic Hospital (BHH) develop as a centre for holistic care. For some the experience was "transformative learning". We conclude that this approach to a foundation training in homeopathy is feasible and effective.

Homeopathy. 2009 Apr;98(2):107-13. Thompson TD, Thompson EA. Academic Unit of Primary Health Care, University of Bristol, Cotham House, Cotham Hill, Bristol BS66JL, UK. trevor.thompson@bris.ac.uk

BACKGROUND: Homeopathic medicines are used by patients with cancer, often alongside conventional treatment. Cancer treatments can cause considerable morbidity and one of the reasons patients use homeopathic medicines is to help with adverse effects. OBJECTIVES: Evaluate effectiveness and safety of homeopathic medicines used to prevent or treat adverse effects of cancer treatments. SEARCH STRATEGY: The following were searched up to November 2008: Cochrane PaPaS Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; CINAHL; BNI; CancerLIT; AMED; CISCOM; Hom-Inform; SIGLE; National Research Register; Zetoc; www.controlled-trials.com; http://clinicaltrials.gov; Liga Medicorum Homeopathica Internationalis (LMHI, Liga) conference proceedings; reference lists of relevant studies were checked; and homeopathic manufacturers, leading researchers and practitioners were contacted. SELECTION CRITERIA: Randomised controlled trials (RCTs) of homeopathic medicines in participants with a clinical or histological diagnosis of cancer where the intervention was aimed at preventing or treating symptoms associated with cancer treatments. All age groups, and all stages of disease were included. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for inclusion and two review authors extracted data. Three review authors independently assessed trial quality using the Delphi List and the Cochrane Collaboration's tool for assessing risk of bias. Disagreements were resolved by consensus. Where available, data were extracted for analysis. MAIN RESULTS: Eight controlled trials (seven placebo controlled and one trial against an active treatment) with a total of 664 participants met the inclusion criteria. Three studied adverse effects of radiotherapy, three studied adverse effects of chemotherapy and two studied menopausal symptoms associated with breast cancer treatment.Two studies with low risk of bias demonstrated benefit: one with 254 participants demonstrated superiority of topical calendula over trolamine (a topical agent not containing corticosteroids) for prevention of radiotherapy-induced dermatitis, and another with 32 participants demonstrated superiority of Traumeel S (a proprietary complex homeopathic medicine) over placebo as a mouthwash for chemotherapy-induced stomatitis. Two other studies reported positive results, although the risk of bias was unclear, and four further studies reported negative results.No serious adverse effects or interactions were reported attributable to the homeopathic medicines used. AUTHORS' CONCLUSIONS: This review found preliminary data in support of the efficacy of topical calendula for prophylaxis of acute dermatitis during radiotherapy and Traumeel S mouthwash in the treatment of chemotherapy-induced stomatitis. These trials need replicating. There is no convincing evidence for the efficacy of homeopathic medicines for other adverse effects of cancer treatments. Further research is required.

Cochrane Database Syst Rev. 2009 Apr 15;(2):CD004845. Kassab S, Cummings M, Berkovitz S, van Haselen R, Fisher P. Royal London Homoeopathic Hospital, 60 Great Ormond Street, London, UK, WC1N 3HR. sosie.kassab@uclh.nhs.uk

Full Title: Healthcare provided by a homeopath as an adjunct to usual care for Fibromyalgia (FMS): results of a pilot Randomised Controlled Trial

OBJECTIVES: To assess the feasibility of a Randomised Controlled Trial (RCT) design of usual care compared with usual care plus adjunctive care by a homeopath for patients with Fibromyalgia syndrome (FMS). METHODS: In a pragmatic parallel group RCT design, adults with a diagnosis of FMS (ACR criteria) were randomly allocated to usual care or usual care plus adjunctive care by a homeopath. Adjunctive care consisted of five in depth interviews and individualised homeopathic medicines. The primary outcome measure was the difference in Fibromyalgia Impact Questionnaire (FIQ) total score at 22 weeks. RESULTS: 47 patients were recruited. Drop out rate in the usual care group was higher than the homeopath care group (8/24 vs 3/23). Adjusted for baseline, there was a significantly greater mean reduction in the FIQ total score (function) in the homeopath care group than the usual care group (-7.62 vs 3.63). There were significantly greater reductions in the homeopath care group in the McGill pain score, FIQ fatigue and tiredness upon waking scores. We found a small effect on pain score (0.21, 95% CI -1.42 to 1.84); but a large effect on function (0.81, 95% CI -8.17 to 9.79). There were no reported adverse events. CONCLUSIONS: Given the acceptability of the treatment and the clinically relevant effect on function, there is a need for a definitive study to assess the clinical and cost effectiveness of adjunctive healthcare by a homeopath for patients with FMS.

Homeopathy. 2009 Apr;98(2):77-82. Relton C, Smith C, Raw J, Walters C, Adebajo AO, Thomas KJ, Young TA. School of Health and Related Research, University of Sheffield, Sheffield, UK; School of Healthcare, University of Leeds, Leeds, UK. c.relton@sheffield.ac.uk

Full Title: Homeopathic practitioner's experiences of the homeopathic consultation: a protocol of a grounded theory study

BACKGROUND: The apparent success of homeopathy is often attributed to a collaborative, holistic, and empathic consultation and to the practitioner-patient relationship. Despite the practitioner's consultative style being shown to affect patient's health outcomes in conventional medicine, most research into the homeopathic consultation has focused on patients' experiences. However, the practitioner is a crucial component of the therapeutic context and may therefore have an important part to play in optimizing health outcomes in homeopathy. Additionally, the mechanisms underlying therapist effects are still poorly understood in clinical medicine generally and particularly so in homeopathy. AIM: The aim of this research is to gain an in-depth understanding of homeopathic practitioners' perceptions and experiences of the consultation, and the process of engaging with the patient and prescribing the remedy. We propose to generate a theoretical model to explain the processes that underpin the homeopathic consultation. DESIGN: This is a qualitative study using grounded theory methodology. Two (2) phases of data collection will be involved. Phase 1 will involve face-to-face in-depth interviews with homeopaths. From these interviews, a theoretical model of the homeopathic consultation will be developed. Phase 2 of data collection will involve observations of homeopathic consultations and the use of practitioner diaries in order to test the emerging theoretical model from phase 1. Homeopaths will be sampled from the Faculty of Homeopathy and the Society of Homeopaths. RESULTS: Results will be available in summer 2009. CONCLUSIONS: The findings from this study will lead to the development of a theoretical model of how homeopaths view and enact the consultation process. Revealing this process may influence the training of new practitioners and improve the practice of experienced practitioners and will therefore be of benefit to patients. In addition, the findings may be of potential benefit to practitioners of other therapeutic consultations.

J Altern Complement Med. 2009 Apr;15(4):347-52. Eyles C, Walker J, Brien S. Department of Primary Care, Complementary Medicine Research Unit, The University of Southampton, Southampton, UK. C.G.Eyles@soton.ac.uk

Full Title: European Union directives and their effect on the registration and authorisation of anthroposophic and homeopathic medicines

This paper discusses the question of whether anthroposophic medicinal products can be treated in the European Union as regards registration and marketing authorization, in the same way as homeopathic medicinal products. European Union legislation, European official pharmacopoeias, and bibliography in this regard have been revised. European Directives make a single reference in one of its whereas clauses to anthroposophic medicinal products "described in an official pharmacopoeia and prepared by a homeopathic method". It is referring to those which comply with these two conditions, but it happens that there is no anthroposophic medicinal product "described" in any European official pharmacopoeia. Legislators have known this and continue to be aware of it and have not agreed to extend (since 1992), the reference to anthroposophic products neither do they accept the inclusion of that peculiarity on the label of homeopathic medicinal products. Anthroposophy presents notable variations from homeopathy and it introduces philosophical and "spiritual" variables that are difficult to assess objectively. It is necessary for these products to show, using a scientific methodology, that they are truly bringing patients the therapeutic benefits they claim. In any case, their authorization and registration should not be at the expense of homeopathy, already a highly complex field in its own right.

Med Law. 2009 Mar;28(2):269-82. Laso LR, Alfonso-Galán MT. Spanish Agency of Medicines and Healthcare Products.

This article presents partial findings from a study on trends towards greater or lesser proximity between homeopathic and allopathic physicians, from the perspective of the latter. Forty-eight health professionals were interviewed (faculty, managers, and physicians working in the public health system). This specific article focused only on the interviews with health system managers. The following concepts were used as references: social and scientific field (Bourdieu); medical rationalities (Madel Luz); technological arrangements in health work (Mendes-Gonçalves); and physician's professional identity (Donnangelo & Schraiber). According to the findings, support by managers for the presence of Homeopathy in the Unified National Health System is related to their perception of social demand, defense of patients' right to choose, and the observation that it is a medical practice that reclaims the humanist dimension of medicine, thus contributing to user satisfaction. The difficulties and resistances identified by managers highlight that the lack of information on homeopathic procedures limits the possibilities for use of Homeopathy because it leads to insecurity towards this area of medicine.

Cad Saude Publica. 2009 Jan;25(1):195-202. Salles SA, Schraiber LB. Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil. sandrachaim@terra.com.br

Botulinum toxin (Botox) injection is the only conventional medical treatment available for patients with spasmodic dysphonia (SD). Some patients are reluctant to receive Botox treatment due to concerns about unknown long-term side effects, expense, and dependence on repeated injections. The purpose of the study was to report the perceptual and physiological changes in the vocal functions of an SD patient treated with classical homeopathy. The results were similar to a previous case report: classical homeopathy seems to be capable of amelioratiny SD symptoms beyond the short-term effects of Botox injections. Although the physiological mechanism of homeopathic healing is not fully accounted for by the current bio-medical models, it may be an effective therapeutic alternative for some SD patients.

Homeopathy. 2009 Jan;98(1):56-9. Xue SA, de Schepper L, Hao GJ. Speech Science Lab, Division of Speech and Hearing Sciences, 5th Floor, Prince Philips Dental Hospital, 34 Hospital Road, The University of Hong Kong, Hong Kong. axue@hku.hk

Homeopathic medicine is a type of therapy that appeared in Europe at the end of the eighteenth century. At the present time, it is widely accepted in developed countries as a form of alternative medicine. In Chile, health regulation includes homeopathy as pharmaceutical products and homeopathy is also considered a form of complementary medicine, that is well accepted by the public. The scientific rationale of homeopathy is based on an empiric type of thought that goes from the general to the particular. The symptoms that are valued are those that are particular to each sick individual. It uses diluted solutions of plants, minerals, animals and even venoms. There are basically two hypotheses to explain its mechanisms of action: The "immunological memory" and the "memory of water" or the transmission of electromagnetic information of the water. There still is needed to perform new studies to scientifically assess homeopathy and its usefulness, as an accepted alternative therapy.

Rev Med Chil. 2009 Jan;137(1):115-20. Epub 2009 Apr 23. Avello L M, Avendaño O C, Mennickent C S. Departamento de Farmacia, Facultad de Farmacia, Universidad de Concepcíon. maavello@udec.cl

OBJECTIVE: The objectives of this study were to clinically determine the efficacy of individualised homeopathy in the treatment of minor recurrent aphthous ulceration (MiRAU). DESIGN & INTERVENTION: A randomized, single blind, placebo-controlled clinical trial of individualised homeopathy. One hundred patients with minor aphthous ulcer were treated with individualised homeopathic medicines or placebo and followed up for 6 days. Patients received two doses of individualised homeopathic medicines in the 6C potency as oral liquid at baseline and 12 h later. Pain intensity and ulcer size were recorded at baseline during and at the end of the trial (mornings of days 4 and 6). RESULT: All 100 patients completed treatment. Between group differences for pain intensity and ulcer size were statistically significant at day 4 and at day 6 (P<0.05). No adverse effects were reported. CONCLUSION: The results suggest that homeopathic treatment is an effective and safe method in the treatment of MiRAU.

Homeopathy. 2009 Jul;98(3):137-41. Mousavi F, Mojaver YN, Asadzadeh M, Mirzazadeh M. Department of Oral Medicine, Tehran University of Medical Sciences, Dental School, Tehran, Iran.

OBJECTIVE: The use of complementary and alternative medicine (CAM) may influence surgical care by inducing coagulopathies and interacting with other medication. We investigated the prevalence and pattern of CAM use in patients admitted to our department for elective otolaryngologic surgery. DESIGN: Cross-sectional survey. SETTING: Tertiary care referral centre in northeast Scotland. METHOD AND PATIENTS: All adult patients admitted for elective surgery, over a 14-week period from October 2005 to January 2006, were requested to complete an anonymous questionnaire. Data were analyzed with descriptive statistics using SPSS version 12 (SPSS Inc, Chicago, IL). MAIN OUTCOME MEASURES: To establish the prevalence of CAM use in patients admitted for surgery in our unit. Secondary measures included the type of CAM used, indications for use, perceived benefit, and communication with the family physician. RESULTS: Sixty-three percent (177 of 285) of the patient group had used CAM-36% in the preceding year. Popular remedies were cod liver oil, garlic, aloe vera, cranberry, echinacea, primrose oil, herbal vitamin supplement, and St. John's wort. Nonherbal therapies included massage, acupuncture, chiropractic, aromatherapy, reflexology, yoga, homeopathy, and osteopathy. Nine percent used CAM for their admission illness. Only 8% (15 of 177) found CAM ineffective. Only 76 of 177 (43%) had discussed their CAM use with their family doctor. CONCLUSION: Despite concerns over its safety, efficacy, and cost-effectiveness, the use of CAM is common among patients undergoing otolaryngologic and head and neck surgery. This has implications for all health care workers involved in their care, in particular the anesthetist and the surgeon. A detailed history of CAM use by patients should be taken and documented during the preoperative clerking.

J Otolaryngol Head Neck Surg. 2009 Jun;38(3):355-61. Shakeel M, Newton JR, Ah-See KW. Department of Otolaryngology, University of Aberdeen, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB252ZN, UK. drshakeel@doctors.org.uk

by Avghi Constantinides D.hom HMC MA

Homeopathy is a holistic therapeutic medical science based upon the teachings of Hahnemann. The primary precept, "The Law of Similars", is used to treat children, adults and animals, using minute doses of potentize substances from the plant, mineral and animal kingdoms. Dr. Samuel Hahnemann of Germany, is the founder of Homeopathic Medicine, born in 1755 and died at the age of 89 in 1843.

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Homeopathy is a system of therapeutics placed outside the boundaries of orthodox medicine and regarded as a complementary and alternative medicine. Homeopathy has been used to alleviate menopausal symptoms both in the climacteric and in breast cancer survivors. Individualized treatment by a homeopath, regarded as the gold standard of homeopathic care, is a complex intervention where the homeopathic medicine is matched to the individual using holistic principles. This review article describes and interprets the existing evidence from observational studies and clinical trials and makes recommendations for trial design in the future.

Menopause Int. 2009 Mar;15(1):31-4. Thompson EA, Relton C. Bristol Homeopathic Hospital, Cotham Hill, Bristol, UK. Elizabeth.Thompson@UHBristol.nhs.uk

The question of whether homeopathy is a science is currently discussed almost exclusively against the background of the modern concept of natural science. This approach, however, fails to notice that homeopathy-in terms of history of science-rests on different roots that can essentially be traced back to two most influential traditions of science: on the one hand, principles and notions of Aristotelism which determined 2,000 years of Western history of science and, on the other hand, the modern concept of natural science that has been dominating the history of medicine for less than 200 years. While Aristotle's "science of the living" still included ontologic and teleologic dimensions for the sake of comprehending nature in a uniform way, the interest of modern natural science was reduced to functional and causal explanations of all phenomena for the purpose of commanding nature. In order to prevent further ecological catastrophes as well as to regain lost dimensions of our lives, the one-sidedness and theory-loadedness of our modern natural-scientific view of life should henceforth be counterbalanced by lifeworld-practical Aristotelic categories. In this way, the ground would be ready to conceive the scientific character of homeopathy-in a broader, Aristotelian sense.

J Med Humanit. 2009 Jan 16. Schmidt JM. Institut für Geschichte der Medizin, Ludwig-Maximilians-Universität München, Lessingstr. 2, 80336, Munich, Germany, j.m.schmidt@lrz.uni-muenchen.de.

Understanding how homeopaths make clinical decisions is important in terms of optimising patient care, yet currently little is understood about this process. Most current literature investigating decision-making has focussed on conventional medicine; to date only two studies, both quantitative, have explored this area, with both studies investigating this in homeopathy. The aim of this qualitative study was to explore how homeopaths make prescribing decisions primarily during their first consultation with a patient.

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Homeopathic medications and treatments are becoming increasingly popular in this day of modem medicine. Patients are often unable to tell us if they are taking homeopathic or herbal therapy, or they don't think such treatments are important to mention. The continued growth and use of alternative medications indicates a strong need to ensure that patients include these treatments and medications in their responses during the SAMPLE history assessment. EMS providers must look at the whole scene for clues indicating a response to alternative medication. Being familiar with homeopathic medicine and herbal medications, as well as asking specific questions regarding use of alternative medicine, ensures a complete and comprehensive patient assessment followed by appropriate interventions in the prehospital setting.

EMS Mag. 2008 Oct;37(10):78, 80-5. Scadden J. Sac County Ambulance, USA.

Homeopathy is a highly debated but often used medical treatment. With this cohort we aimed to evaluate health status changes under homeopathic treatment in routine care. Here we extend former results, now presenting data of an 8-year follow-up.

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India ranks third in the world in absolute burden of HIV. While increasing numbers of Government-sponsored clinics are providing free antiretroviral therapy (ART), its utility is limited by lack of affordability and acceptability and the requirement for lifelong administration.

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Despite the widespread use of complementary and alternative medicine (CAM) in the general population for the treatment of chronic diseases, only few data have been published for patients with leukemia. The aim of this survey was to study systematically the use of CAM in patients with chronic lymphocytic leukemia (CLL).

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How do parents of child patients experience and compare consultations with homeopaths and physicians, and how do they describe an ideal consultation.

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There are active public campaigns both for and against homeopathy, and its continuing availability in the NHS is debated in the medical, scientific and popular press. However, there is a lack of clarity in key terms used in the debate, and in how the evidence base of homeopathy is described and interpreted. The term 'homeopathy' is used with several different meanings including: the therapeutic system, homeopathic medicine, treatment by a homeopath, and the principles of 'homeopathy'. Conclusions drawn from one of these aspects are often inappropriately applied to another aspect. In interpreting the homeopathy evidence it is important to understand that the existing clinical experimental (randomised controlled trial) evidence base provides evidence as to the efficacy of homeopathic medicines, but not the effectiveness of treatment by a homeopath. The observational evidence base provides evidence as to the effectiveness of treatment by a homeopath. We make four recommendations to promote clarity in the reporting, design and interpretation of homeopathy research.

Relton C, O'Cathain A, Thomas KJ. University of Sheffield, Medical Care Research Unit, School of Health & Related Research, Regent Court, Regent Street, Sheffield S1 4DA, UK. c.relton@sheffield.ac.uk Homeopathy . 2008 Jul;97(3):152-5.

by Manohar Santwani, M.S., MHM, CCH, RSHom(NA), CCH(US)

In a recent international seminar – Homeopathy: a Hoax or the Medicine for the Twenty-first Century - organized by the Connecticut University, several interesting and new facts about homeopathy were brought out by a couple of Homeopathic scientists which brought out the efficacy and superiority of this holistic system of medicine. The data presented revealed that during the eighteenth and nineteenth century epidemics, Homeopathy had the most effective cures of the diseases without any side effects, had the least mortality rate, and the recovery period was more prompt than the other systems of medicine. It was an eye-opening session that was televised.

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The management of chronic low back pain (CLBP) has proven very challenging in North America, as evidenced by its mounting socioeconomic burden. Choosing amongst available nonsurgical therapies can be overwhelming for many stakeholders, including patients, health providers, policy makers, and third-party payers. Although all parties share a common goal and wish to use limited health-care resources to support interventions most likely to result in clinically meaningful improvements, there is often uncertainty about the most appropriate intervention for a particular patient. To help understand and evaluate the various commonly used nonsurgical approaches to CLBP, the North American Spine Society has sponsored this special focus issue of The Spine Journal, titled Evidence-Informed Management of Chronic Low Back Pain Without Surgery. Articles in this special focus issue were contributed by leading spine practitioners and researchers, who were invited to summarize the best available evidence for a particular intervention and encouraged to make this information accessible to nonexperts. Each of the articles contains five sections (description, theory, evidence of efficacy, harms, and summary) with common subheadings to facilitate comparison across the 24 different interventions profiled in this special focus issue, blending narrative and systematic review methodology as deemed appropriate by the authors. It is hoped that articles in this special focus issue will be informative and aid in decision making for the many stakeholders evaluating nonsurgical interventions for CLBP.

Spine J. 2008 Jan-Feb;8(1):70-9. Gagnier JJ. Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. j.gagnier@utoronto.ca

Could theoretical links exist between homeopathy and conventional medicine? In homeopathy, disturbance of the self-regulating Vital Force (Vf) results in dis-ease as multileveled symptom expression. Treatment aids the Vf as it attempts to restore holistic balance. Conventional medicine (allopathy) deterministically considers external agents (viruses, bacteria, etc.) or internal biochemical imbalances as disease causes. Treatment is geared to eradicating causative factors, sometimes at the expense of the homeostatic immune system. Method: A previous mathematical model described the Vf as a quantized gyroscopic "wave function," equating strength of symptom expression to degree of Vf gyroscopic "precession." Diseases and homeopathic remedies were interpreted respectively as braking and accelerating "torques" on Vf "angular momentum." In this paper, approximations applied to the Vf "wave function" could provide insights into why conventional medicine dismisses the action of highly potentized homeopathic remedies. In addition, a simple geometric force diagram provides another mathematical model for allopathic drug action and immune system reaction. Results: The 2 models converge on the same result, delivering conventional biomedicine's conclusion: potentized homeopathic remedies should exert no clinically observable effects. Conclusions: Following the logic of these models, conventional medicine could be seen as a special case of a broader therapeutic paradigm also containing homeopathy.

J Altern Complement Med. 2007 Sep;13(7):759-70. Milgrom LR. Department of Chemistry, Imperial College London, South Kensington, United Kingdom.

OBJECTIVE: To set a standard of routine goal setting with patients within their package of care at the Bristol Homeopathic Hospital. We hope goal setting will improve communication with our patients and health professional colleagues, focus outcome and improve targeting of problems. We therefore explored motivation for and expectation of hospital attendance from a patient perspective. MATERIALS AND METHODS: Questionnaire based pre-audit survey. The questionnaire was administered to 110 consecutive patients attending outpatients and 20 parents of children attending with asthma and eczema to gain understanding of motivation and expectation and more specific information for two of the commonest conditions. RESULTS: Seventy percent of patients had used some form of complementary and alternative medicine (CAM), 35% had used homeopathy and only 10% had specialist homeopathic care, the majority of use being over the counter. The majority of patients had been encouraged by their General Practitioners, themselves and by word of mouth with family and friends. Few patients cited the media as a major influence. "Pull" factors such as "treating the whole person" were given greater emphasis except for parents of children with asthma and eczema for whom "push" factors such as fear of steroid side effects predominated. In the main patient expectations were reasonable with the majority hoping to see improvements in their conditions. A fifth of patients hoped to reduce conventional medications. CONCLUSIONS: Patients had used CAM in general but not homeopathy in particular. Encouragement from doctors, self motivation and word of mouth most motivated patients to come and might suggest more direct communication with General Practitioners would be worthwhile. Being treated as a whole person was the most significant motivating factor, with a significant number of patients wishing to reduce medication. Goal setting and direct communication with other healthcare professionals is essential for safety, to focus outcome, and to value the role of homeopathy in a patient's healthcare. As a result we have set a standard whereby treatment goals are agreed with patients and communicated to referring health care professionals at each outpatient visit. This could be audited.

Homeopathy. 2007 Oct;96(4):243-6. Thompson E, Dahr J, Susan M, Barron S. Bristol Homeopathic Hospital, Cotham Hill, Bristol, UK.

The HomBRex database indexes basic research on homeopathy (www.carstens-stiftung.de/hombrex). It includes research on effects of homeopathic preparations in bioassays and physico-chemical effects of the homeopathic preparation process (potentization). At the end of 2006 it contained more than 1100 experiments in more than 900 original articles, including 1014 biological studies. The types of organisms used as laboratory "model" organisms in fundamental homeopathic research include animal, human, plant, fungi and microbial organisms. Most animal studies (607) were with rats (209) or mice (171). Most plant studies (171) were with wheat (52). The database catalogues whether the experiment was performed on intact organisms or in organs or cells, isolated and analyzed for changes in structure, function and subcellular composition. The database might be especially useful to facilitate a search for experimental models that have been used in the study of both proving and therapeutic experiments-ultimately in the research on the homeopathic similia principle.

Homeopathy. 2007 Oct;96(4):247-51. Van Wijk R, Albrecht H. Faculty of Biology, Utrecht University, Padualaan 8, 3584CH Utrecht, The Netherlands.

Within the last decade there has been a dramatic increase in the sale and use of herbal supplements and food supplements by Western populations and within the UK. This increased usage has coincided with a resurgence of interest in nutritional therapy and complementary and alternative medicine (CAM) therapies, such as herbal medicine, naturopathy and homeopathy, in which therapists may provide dietary advice and advocate the use of food or herbal supplements. The rise in the use of CAM therapies by the UK population can be attributed to several factors, including: promotion via health programmes and the media; a change in public attitudes; training of more nutritional and CAM therapists as a result of the increased availability of courses; a greater use of CAM and food and herbal supplements, particularly by patients with cancer. The aim of the present paper is to identify the pattern of usage of food and herbal supplements in the UK.

Proc Nutr Soc. 2007 Nov;66(4):479-82. Ritchie MR. The Herbal Medicine Research Unit, School of Life Sciences, Napier University, Edinburgh EH9 2TB, UK.

Complementary and alternative medicine (CAM) is used by large numbers of the general public and is increasingly becoming integrated into the mainstream. An understanding of why people use CAM in general has been developed in the literature, but relatively little is known specifically about adherence to CAM. We tested hypotheses (derived from a dynamic extended version of Leventhal's common-sense model) that patients' beliefs about treatment, perceptions of illness, and treatment appraisals would predict adherence to CAM.DesignA prospective self-report questionnaire study was carried out with a 3-month follow-up period.MethodsA total of 240 patients from five CAM clinics completed self-report questionnaire measures of treatment beliefs, illness perceptions, and treatment appraisals at baseline. Three months later, they completed self-report measures of adherence to therapists' recommendations concerning attendance, remedy use, and life-style changes.ResultsLogistic regression analyses showed that positive perceptions of one's therapist and belief that mental factors do not cause illness independently predicted adherence to appointments. Positive beliefs in holistic health and finding it difficult to travel to appointments predicted adherence to remedy use. Using homeopathy was the only independent predictor of adherence to life-style changes.ConclusionsTreatment appraisals, treatment beliefs, and illness perceptions explain modest proportions of the variance in adherence to CAM. This study highlights the value of operationalizing the appraisal element of the common-sense model when investigating adherence to treatment.

Br J Health Psychol. 2007 Oct 24 Bishop FL, Yardley L, Lewith GT.

Seventy-five dogs that showed a fear response to fireworks participated in a double-blinded, placebo-controlled clinical trial to assess the efficacy of a homeopathic remedy for the alleviation of their behavioural signs. Dogs were randomly assigned to one of two treatments; the homeopathic treatment or the placebo treatment. At the baseline assessments the owners identified the behavioural signs of fear that their dogs normally displayed in response to fireworks, rated their frequency and intensity, and assessed the global severity of their dog's responses. These measures were repeated at the final assessment and owners also completed weekly diaries for the length of the trial. There were significant improvements in the owners' rating of 14/15 behavioural signs of fear in the placebo treatment group and all 15 behavioural signs in the homeopathic treatment group. Both treatment groups also showed significant improvement in the owners' rating of the global severity of their dog's responses. However, there was no significant difference in the response seen between the two treatment groups.

Vet J. 2007 Jun 13;

Cracknell NR, Mills DS.

Animal Behaviour, Cognition and Welfare Group, Department of Biological Sciences, University of Lincoln, Riseholme Park, Lincoln LN2 2LG, UK.

BACKGROUND: Many individuals who appear to suffer from incurable chronic skin disease use complementary and alternative medicine (CAM). Homeopathy has recently increased in popularity among patients with skin disease. The effects of homeopathic treatment have yet to be fully investigated in patients for whom conventional dermatological treatment is not sufficiently effective. OBJECTIVES: To describe patient-reported and clinically observed effects of individualized homeopathic treatment of chronic skin disease. PATIENTS AND METHODS: The effectiveness of individualized homeopathic treatment was measured using the patients' own assessments of seven elements (overall impression, improvement of skin condition, reduction of itchiness, reduction of sleep disturbance, satisfaction in daily life, fulfillment at work and satisfaction in human relations) using a nine-point scale similar to the Glasgow Homeopathic Hospital Outcome Scale (GHHOS). Sixty patients with chronic skin disease were included in the study: atopic dermatitis (AD) (n=25), eczema other than AD (n=20), severe acne (n=6), chronic urticaria (n=6), psoriasis vulgaris (n=2) and alopecia universalis (n=1). These patients received individualized homeopathic treatments in addition to conventional dermatological treatments for a period of from 3 months to 2 years 7 months. RESULTS: Six patients reported a score of 4 (complete recovery), 23 patients a score of 3 (75% improvement), 24 patients a score of 2 (50% improvement) and 7 patients a score of 1 (25% improvement). A total of 88.3% of patients reported over 50% improvement. Around one-half the patients with AD and eczema reported greater satisfaction in daily life, greater fulfillment at work and greater satisfaction in human relations. CONCLUSIONS: The psychological, physical and psychosomatic symptoms and effects of chronic skin diseases are inextricable. Individualized homeopathic treatment can provoke a good response in patients with chronic skin disease; therefore, the holistic approach used in homeopathy may be a useful strategy alongside conventional treatment.

Itamura R.

Department of Dermatology, Obitsu Sankei Hospital, 1-4 Namikinishi-machi, Kawagoe-city, Saitama-ken 350-0025, Japan.

Homeopathic preparations of blue cohosh (Caulophyllum thalictroides) and black cohosh (Actaea racemosa [formerly Cimicifuga racemosa]) have been used around the world for induction and augmentation of labor. There are few clinical studies examining these preparations, and the evidence for their safety and efficacy is largely anecdotal. More research needs to be done to determine whether homeopathy is a potentially viable alternative to oxytocin and prostaglandins for labor induction.

J Midwifery Womens Health. 2007 May-Jun;52(3):303-7.

Kistin SJ, Newman AD.

sjk2115@columbia.edu