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msJAMA
March 4, 1998

Homeopathy: Another Tool in the Bag

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JAMA. 1998;279(9):707. doi:10.1001/jama.279.9.707-JMS0304-3-1

One popular form of alternative medicine is homeopathy, a system of medicine that attempts to stimulate the body to heal itself. Homeopathy is based on two main principles.1 The first is that "like cures like": one should administer therapies that will produce symptoms similar to those the patient is already experiencing.2 According to this principle, symptoms are seen as the body's attempt to restore itself to health. Enhancing these symptoms would then aid the body's normal healing process. For example, one homeopathic remedy for a patient with a runny nose is the red onion extract, called allium, that enhances the runny nose by stimulating the tear glands and mucous membranes of the upper respiratory tract.1 In contrast, allopathic medications such as antihistamines would suppress the runniness.

The second principle of homeopathy is that of "minimum dilution": one should use the lowest concentration of a substance that still provokes a response.2 This principle is essential to homeopathy's viability, since some compounds used in homeopathy can be toxic at high concentrations.1 Homeopathic medications have beneficial effects only at lower dilutions, although how this occurs is unclear. Published guidelines state the prescribed concentration for homeopaths to follow when creating remedies.2

Many factors contribute to the popularity of homeopathy, among which may be allopathic medicine's ineffectiveness in treating the chronic health complaints of many patients. This may be especially true for more systemic conditions such as backaches, the "blues," and general malaise. In these cases, homeopathic remedies may be useful, since they do not require a specific diagnosis but are based on the symptoms presented by the patient. Rather than sorting out conditions that may not match a specific diagnosis, homeopaths seek to enhance all symptoms through their therapies. In this sense, part of homeopathy's popularity may be due to this patient-centered view of illness, where the key to resolving health issues lies in understanding and treating all symptoms, not just those that fit the textbook description of a specific disease.

Despite homeopathy's popularity, several barriers exist to its broad acceptance in the United States. The uncertain legal and clinical limits that govern the practice of homeopathy are the most serious problems facing homeopaths. Only three states, Arizona, Connecticut, and Nevada, have homeopathic licensing laws that apply specifically to those with medical (MD) or osteopathic (DO) degrees.3 Within these laws no clear directives exist that distinguish between circumstances in which homeopathy could be applied and situations in which it would not be beneficial. In practice though, most homeopathic treatments are aimed at chronic illnesses; homeopathy is not generally considered useful for acute, life-threatening situations. However, the lack of legal and medical guidelines hinders homeopathy's widespread use.

A second difficulty is the inconsistency in homeopathic training. While many programs are offered in the United States, no state licenses the practice of homeopathy without a medical degree.

A third barrier is that most insurance companies do not reimburse for alternative medical practices, because they lack sufficient scientific proof of efficacy. Nonetheless, homeopathic remedies are easily purchased over-the-counter and are also relatively affordable.

Despite these obstacles, homeopathic and alternative medicines present a "significant public health challenge as well as an opportunity."4 If homeopathy is, in part, a reaction to the shortcomings of modern medicine, it is also a force that cannot be ignored. For many patients suffering from chronic problems that lack a specific diagnosis, homeopathy may be an important and useful treatment option. If used within its limits, homeopathy could complement modern medicine as, "another tool in the bag."2 Perhaps, together with allopathic medicine, a more complete therapy can be employed to benefit patients' health.

References
1.
Jonas  WJacobs  J Healing with Homeopathy.  New York, NY Warner Books1996;
2.
Cant  SSharma  U Demarcation and transformation within homeopathic knowledge: a strategy of professionalization. Soc Sci Med. 1996;42579- 588Article
3.
Lebensorger  M Legalities of homeopathic practice and the NCH Directory of Practitioners. Homeopathy Today. 1997;172- 10
4.
Marwick  C Complementary medicine congress draws a crowd. JAMA. 1995;274106- 107
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