|The focus of my editorial is to examine the concept of ‘Evidence based homeopathy’ and I shall take as my starting point the definition of ‘evidence’, viz “indication, sign, proof that can be seen and clearness” (Chamber’s Dictionary).|
Starting from this premise, I should like to review the historical and current debate on the subject and move towards a resolution of the issue with suggestions as to how homeopathic practitioners and researchers can further develop and refine their methods of homeopathic treatment and evaluation.
|There has been much controversy concerning the efficacy of homeopathic treatment since the publication of Hahnemann’s . Perhaps the most important distinction, Hahnemann made in the Organon is that between ‘wissen’ – intellectual knowledge – and ‘kennen’- the knowledge of experience. In a literal sense, the Organon represents a unique, systematic and integrated methodology of observation, principled diagnosis and treatment of patients, and thus represents the medicine of experience underpinned by a profound and lasting discovery, viz, similia simililum curentur (‘like cures like’). Furthermore, Hahnemann’s Organon was the result of years of painstaking empirical research on the dynamic power of potentised substances on himself, his family, friends and patients by the means of systematic ‘provings’. The empirical foundation of Hahnemann’s methodology of diagnosis and treatment is clearly stated in Paragraph 6 of his Organon: ‘The unprejudiced observer…perceives nothing in each case of disease other than the alterations in the condition of the body and soul, disease signs, befallments, symptoms which are outwardly discernible through the senses (Ibid). Perhaps the most classical and reliable means of evaluating homeopathic treatment has been Hering’s  ‘Laws of Cure’ and elaborated on by Kent  and, more recently, Vithoulkas . According to Hering’s Laws of Cure, symptoms should reflect the following patterns of cure: from the head down; from the inside out; from the most vital organs to the less vital and in the reverse order of symptoms that they first appeared.|
|With the development of more sophisticated research methodologies, such as the Random Controlled Trial (RCT), there have been widespread and sustained efforts to evaluate the effectiveness of homeopathic treatment of a wide range of symptoms and conditions. For example, there are a range of electronic databases which have collated all the RCTs of homeopathic clinical effectiveness, such as AMED, PubMed, CISCOM, Cochrane Reviews and Hom-inform, among others. More recently, Brien et al.  have endeavoured to develop a simple assessment tool, the Hering’s Law Assessment Tool (HELAT) to identify and differentiate patient responses to homeopathic treatment as corresponding to Hering’s Law from other symptomatic responses. In their paper, the authors have described the development of the tool and assessed its face, content and predictive validity hypothesizing that that the HELAT total score would predict changes in a clinical response in 32 patients with rheumatoid arthritis receiving homeopathic intervention over 24 weeks as part of a clinical trial. The final version of the HELAT assessment tool was employed for phase two as a predictor outcome with the result that the HELAT score predicted patients’ clinical response (ACR20) which was independent of practitioner assessing the patients’ clinical response. Further work is now needed to formally assess its reliability and validity for potential use in clinical practice and trials.|
|To conclude, a recent comprehensive and authoritative research study by Swiss scientists has offered an unambiguous endorsement of the evidence base for homeopathy as a clinically effective system of medicine. The Swiss Health Technology Assessment concluded that there was sufficient supporting evidence for the pre-clinical (experimental) effects of homeopathy, and that, when compared to conventional therapies, it offers a safe and cost-effective treatment (Cf ). Thus, this latest study, combined with the accumulated evidence of a number of electronic databases indicates that there is considerable evidence of the effectiveness of homeopathic medicine, i.e. that it is ‘evidence based’. Finally, in the words of Hahnemann : the certain cure of human diseases is only possible through the homeopathic use of medicines.|
Written by: Harrison H. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Photo: Public Domain.