Research Database –
International Updates

Homeopathy

Issue 93

JACOBS and colleagues, Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, WA, USA, jjacobs@igc.org, have analyzed the results from three randomized controlled trials of homeopathy for childhood diarrhoea.
Background: Studies have suggested a beneficial effect of homeopathy on childhood diarrhoea, but were conducted with small sample sizes so that the effects were just on the limit of significance. As all three of these studies were of similar design, the results have been combined so as to improve the statistical significance.
Methods: Three double-blinded clinical trials of homeopathy for acute diarrhoea in a total of 242 children aged 6 months to 5 years were analyzed as one group. Children were randomized to receive either an individualized homeopathic medicine or a placebo to be taken in a single dose after each unformed stool for 5 days. A meta-analysis of the effect-size difference of the three studies was also performed.
Results: Combined analysis shows a duration of diarrhoea of 3.3 days in the homeopathy group as compared to 4.1 days in the placebo group (p = 0.008). The meta-analysis shows a consistent effect-size difference of approximately 0.66 day.
Conclusions: The results from these studies confirm that individualized homeopathic treatment reduces the duration of acute childhood
diarrhoea. The work suggests that larger sample sizes be used in homeopathic research in order to ensure adequate statistical power. Homeopathy should be considered as an adjunct to oral rehydration in childhood diarrhoea.
Jacobs J, Jonas WB, Jimenez-Perez M, Crothers D. Homeopathy for childhood diarrhoea: combined results and meta-analysis from three randomized, controlled clinical trials. The Pediatric Infectious Disease Journal 22 (3): 229-234, Mar 2003.

KOCZIAN and KOELNEI present a history of homeopathy in Hungary between 1820 and 1990.
Abstract: After Hahnemann’s discovery of homeopathy, the theory found enthusiastic followers in Hungary. A first generation of practitioners including Pal Almasi Balogh, Jozsef Bakody, and Gyoergy Forgo established successful practices although the doctrine had been banned by the Habsburg Empire in 1819. The so-called second generation which included Ferenc Hausmann and Istvan Vezekenyi Horner had Hahnemann’s main work translated into Hungarian, and the first homeopathic hospitals were founded in 1833 and 1838. In 1837, the order banning homeopathy was rescinded, and in 1844 the Hungarian parliamanet decided to establish a homeopathic department at the University of Pest. In 1847, Doeme Argenti published his extraordinarily successful book ‘Homeopathic Treatment of Varius Illnesses’. In the 1860s, a new generation of homeopathic physicians including Tihamer Almasi Balogh, Lorant Hausmann, Abraham Szontagh and others, published the first homeopathic periodicals and founded the Society of Hungarian Homeopathic Physicians. In 1870 the homeopathic hospital, the Elisabethinum, opened, and at the University of Pest two different homeopathic departments began to operate. At the end of the 19th century, homeopathy entered into a period of decline due to the resistance of conventional physicians and the success of conventional medicine. Between the two World Wars, Gusztav Schimert and his circle sustained the theory and practice in Hungary. After the Second World War, Schimert emigrated, and homeopathy was informally banned in Hungary although the practice survived in secret. It was not until 1991 that the Society of Hungarian Homeopathic Physicians was re-established.
Koczian M, Koelnei L. History of Homeopathy in Hungary 1820 – 1991. Orvastoerteneti Koezlemenyek 47 (1-4): 75-110, 2002.

Issue 92

BELL and colleagues, Program ion Integrative Medicine, University of Arizona, Tucson, AZ 85724-5153, USA, ibell@u.arizona.edu, have studied homeopathic practitioner views of changes in patients using constitutional treatment for chronic disease.
Background: The aim of the study was to identify areas that classical homeopaths would want to see evaluated in patient self-report questionnaires sensitive to change during constitutional treatment.
Methods: At two classical homeopathy meetings held in the USA, homeopathic practitioners completed an open-ended, written questionnaire. This was analyzed using inductive content analysis.
Results: The categories that 38 homeopaths identified as relevant for the evaluation of changes in patients’ wellbeing included emotions; mental states; specific physical functions; general physical changes; perception of self; relationships; spirituality; lifestyle; energy; dream content and tone; wellbeing; perceptions by others; life relationships; a sense of freedom or feeling less stuck; sleep; coping; ability to adapt; creativity; and recall of past experiences.
Conclusions: The findings are consistent with the systemic orientation of classical homeopathic philosophy to evaluate and treat the patient as a whole person. They support the need for development of new, multidimensional outcome measures for clinical research in homeopathy that go beyond the disease-specific and health-related quality of life scales available in conventional medical research.
Bell IR, Koithan M, Gorman MM, Baldwin CM. Homeopathic practitioner views of changes in patients undergoing constitutional treatment for chronic disease. The Journal of Alternative and Complementary Medicine 9 (1): 39-50, Feb 2003.

OBERBAUM and co-workers, Institute of Research on Complementary Medicine and The Center of Integrated Complementary Medicine, Shaare Zadek Medical Center, Jerusalem, Israel, oberbaum@netvision.net.il, have reviewed (27 references) clinical trials of classical homeopathy and reflected on appropriate research designs.
Abstract: The difficulties encountered in attempting to study complementary medicine using methods developed for conventional medicine are the result of the different paradigms underlying the two different branches of medicine, and the differences in the healing processes. This paper suggests two possibilities of studying homeopathy using conventional research methodology. One is the randomization into placebo and treatment group after an individual remedy has been chosen for each patient. This method requires an experienced homeopath and is reproducible only by the same homeopath in the same population. However the success rate can be expected to be high. Another method is the prescription according to keynotes, a set of symptoms known to respond to a particular remedy. This method is more suitable to a conventional design of clinical studies and can be reproduced by anyone. The expected success rate is however much lower. Some general considerations that may have particular relevance to homeopathy are discussed including the need for sufficiently high powered trials to detect relatively small effects, strategies to manage patient preference, and embracing the use of ‘active control’ pragmatic trial designs.
Oberbaum M, Vithoulkas G, Van Haselen R. Clinical trials of classical homeopathy: reflections on appropriate research designs. The Journal of Alternative and Complementary Medicine 9 (1): 105-111, Feb 2003.
Comment: Papers like this, which attempt to find intelligent solutions for the methodological difficulties in researching complementary treatments, are highly welcome.

Issue 91

OBERBAUM and colleagues, The Center of Integrated Complementary Medicine Shaare Zedek Medical Center, Jerusalem, Israel, oberbaum@szmc.org.il, present a case series on homeopathic treatment in emergency medicine.
Background: Following a multiple-casualty construction disaster, members of the Center of Integrated Complementary Medicine administered homeopathic medicine to injured patients to supplement conventional orthopaedic treatment. The objective of this report is to summarize the rationale, procedures and outcome of the intervention, the first of its kind.
Methods: A case series report.
Results: 15 patients were treated in the first 24 hours post trauma. All received Arnica montana 200CH in a single dose. Anxiety was treated with Aconite 200CH in 9 patients, Opium 200CH in 3 patients, Ignatia 200CH in 2 patients, and Arsenicum album 200CH in one patient, depending on the type of anxiety. After 24 hours, most patients reported less pain, 58% felt improvement, 89% had reduced anxiety, and 61% felt that the homeopathic treatment was helpful. At 48 hours post trauma, specific complaints were addressed with classical homeopathy. At discharge patients rated the homeopathic treatment as successful in 67% of the specific complaints.
Oberbaum M, Schreiber R, Rosenthal C, Itzchaki M. Homeopathic treatment in emergency medicine: a case series. Homeopathy 92 (1): 44-47, Jan 2003.

STEINBEKK and FOENNEBOE, Department of Community Medicine and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norwaym aslak.steinsbekk@medisin.ntnu.no, have surveyed users of homeopathy in Norway in 1998 and compared them to previous users and GP patients.
Background: Homeopathy is the form of complementary medicine most frequently used in Norway. This study describes complaints and characteristics of users in 1998, comparing them with those who visited homeopaths in 1985 and GP patients.
Methods: A survey was conducted of 1097 patients visiting 80 Norwegian homeopaths in 1998. For comparison, a similar survey conducted in 1985 was used, and also a similar survey of GP patients conducted in 1989.
Results: One in four patients who visited homeopaths in 1998 were
children aged less than 10, compared to one in ten in 1985 and in
general practice. Almost half of the patients in 1998 had previously used prescription drugs for the same complaint. In 1998 patients sought homeopathic treatment most often for respiratory and skin complaints. In 1985 the most common reasons were musculoskeletal and digestive problems. Four of the five most common reasons for seeking treatment in 1998 were also found in the top five reasons for GP consultations.
Conclusions: Patients currently visiting homeopaths differ in age and to some extent in complaints compared to previous users and GP patients.
Steinsbekk A, Foenneboe V. Users of homeopaths in Norway in 1998, compared to previous users and GP patients. Homeopathy 92 (1): 3-10, Jan 2003.

WHITMARSH, Glasgow Homeopathic Hospital, 1053 Great Western Road, Glasgow G12 9UY, Scotland, UK, tom.whitmarsh@virgin.net has reviewed (9 references) homeopathy in multiple sclerosis.
Abstract: Multiple Sclerosis (MS) is a disease of the Central Nervous System. No definitive treatment exists to halt the almost inevitable decline in function and accumulation of disability over the years in sufferers. Management is largely of symptoms which arise variably in the course of the illness. Problems such as urinary incontinence, sexual dysfunction, cramps and spasms, tremor and trigeminal neuralgia can often be helped to some extent by conventional therapies. There are some commonly reported symptoms such as fatigue or emotional lability for which there are no generally accepted conventional treatments. Complementary and Alternative Medicine (CAM) is often used by MS sufferers, and some studies in this area are summarized. It is interesting to reflect on what this CAM use says about what MS sufferers really need from their carers. Glasgow Homeopathic Hospital has about 100 admissions a year of MS sufferers and aims at an integrated response to their distress. A homeopathic approach is of particular benefit in MS. By its nature, it is a whole-person approach and takes account of the minutiae of the sufferer’s life. This is discussed, and some examples of treatment for commonly encountered symptoms are given.
Whitmarsh TE. Homeopathy in multiple sclerosis. Complementary Therapies in Nursing and Midwifery 9 (1): 5-9, Feb 2003.
Comment: It is interesting to note that homeopathy is the most commonly used form of complementary medicine in Norway. It is also fascinating to read about research regarding the application of homeopathy both the emergency medicine treatment in Israel and to Multiple Sclerosis in Scotland.

Issue 79

SMITH and colleagues, Loma Lux Laboratories, Tulsa, OK, USA, ssmith@lomalux.com, evaluated the effects of a homeopathic mineral therapy in patients with seborrhoeic dermatitis and/or chronic dandruff.
Background: Sufferers of seborrhoeic dermatitis and/or chronic dandruff can purchase over-the-counter remedies to help relieve the signs and symptoms of their condition(s). There is some evidence to indicate that low doses of nickel and bromide, taken orally, can help to improve and eventually eliminate the problem(s).
Methods: In this randomized, double-blind, placebo-controlled clinical trial, 41 patients with seborrhoeic dermatitis and/or chronic dandruff were treated with either a homeopathic medicine (combining Potassium bromide 1X, Sodium bromide 2X, Nickel sulfate 3X and Sodium chloride 6X) or an oral placebo (vehicle) for 10 weeks. At the end of 10 weeks, all patients were placed on ‘active’ (the homeopathic) medicine (under a different label/visual form) for a further 10 weeks on an open-label (i.e. unblinded) basis.
Results: 29 patients completed the double-blind 10 weeks of the study. Patients receiving the oral homeopathic medicine improved significantly in comparison with the placebo-treated patients during the first 10 weeks of the study. At the end of the second 10 weeks of the study, during which time all patients crossed over to the active treatment, the placebo-treated group also showed significant improvement .
Conclusion: The low-dose oral homeopathic preparation (combining Potassium bromide 1X, Sodium bromide 2X, Nickel sulfate 3X and Sodium chloride 6X) used in this study was able to significantly improve signs and symptoms of seborrhoeic dermatitis and chronic dandruff after 10 weeks of treatment.
Smith SA et al. Effective treatment of seborrheic dermatitis using a low dose, oral homeopathic medication consisting of potassium bromide, sodium bromide, nickel sulfate, and sodium chloride in a double-blind, placebo-controlled study. Alternative Medicine Review 7 (1): 59-67. Feb 2002.

Comment: This is an encouraging result, particularly due to the frequent intransigence of skin conditions to conventional medical treatments.

Issue 70

OBERBAUM and colleagues, The Institute of Research on Complementary Medicine, The Center of Integrated Complementary Medicine, Shaare Zedek Medical Center, P. O. Box 3235, Jerusalem 91031, Israel, oberbaum@netvision.net.il, assessed the efficacy of a homeopathic remedy, TRAUMEEL S(R), in the management of chemotherapy-induced stomatitis (inflammation of the mouth) in children and young adults undergoing bone marrow transplantation.
Background: Stomatitis is a common consequence of chemotherapy and a condition for which there is little effective treatment. The incidence of stomatitis is increasing because of more intensive treatment and is often a dose-limiting factor in chemotherapy.
Methods: 32 patients aged 3-25 years who had all undergone allogeneic (n=16) or autologous (n=16) stem cell transplantation entered a randomized, placebo-controlled, double-blind clinical trial and were assigned to either placebo or TRAUMEEL S as a mouth rinse administered five times daily from 2 days after transplantation for a minimum of 14 days or until at least 2 days after all signs of stomatitis were absent. Stomatitis scores were evaluated according to the World Health Organization grading system for mucositis.
Results: 30 patients were evaluable (15 on placebo and 15 on TRAUMEEL S). 5 patients (33%) in the TRAUMEEL S group did not develop stomatitis compared with only 1 patient (7%) in the placebo group. Stomatitis worsened in only 7 patients (47%) in the TRAUMEEL S group compared with 14 patients (93%) in the placebo group. The mean area-under-the-curve (AUC) stomatitis scores were 10.4 in the TRAUMEEL S compared with 24.3 in the placebo group (p<0.01).
Conclusion: TRAUMEEL S may significantly reduce the severity and duration of chemotherapy-induced stomatitis in [patients] undergoing bone marrow transplantation.
Oberbaum M et al. A randomized, controlled clinical trial of the homeopathic medication TRAUMEEL S in the treatment of chemotherapy-induced stomatitis in children undergoing stem cell transplantation. Cancer 92 (3): 684-90. Aug 2001.

BERREBI and colleagues, Federation of Gynecologie-Obstetrique, Service de Pharmacie, CHU La Grave, 31052 Toulouse Cedex, France, investigated the efficacy of a homeopathic treatment in inhibiting lactation in new mothers unable or not wanting to breast feed.
Background: Dopaminergic agents such as Parlodel (R) are widely used to inhibit lactation. However, some countries, such as the USA, no longer use these drugs in this indication because of sometimes serious side effects.
Methods: In a double-blind, placebo-controlled study, 71 parturients received basic treatment comprising naproxen and fluid restriction and in addition received either a homeopathic combination (APIS MELLIFICA 9 CH and BRYONIA 9 CH) or placebo.
Results: Patients treated with homeopathy showed a significant improvement in lactation pain (the main criterion of the study) on Day 2 (p<0.02) and Day 4 (p<0.01), and significant improvement in breast tension and [inhibition of] spontaneous milk flow on Day 4 (p<0.05). No significant differences were seen for other criteria measured.
Conclusion: The homeopathic combination was effective in relieving pain of lactation and should be integrated into the therapeutic armamentarium.
Berrebi A et al. (Treatment of pain due to unwanted lactation with a homeopathic preparation given in the immediate post-partum period). Journal de Gynecologie, Obstetrique et Biologie de la Reproduction (Paris) 30 (4): 353-7. Jun 2001.

RILEY and colleagues, University of New Mexico Medical School, Albuquerque, USA, dsriley@integrativemed.org, compared the effectiveness of homeopathy in primary care with conventional medicine in primary care for three commonly encountered clinical conditions.
Background: Recent meta-analyses of randomized controlled trials in homeopathy have suggested that the effects of homeopathy are more than a placebo response.
Methods: This international, multicentre, prospective, observational study in a real-world medical setting involved 30 clinical investigators with medical licences at six clinical sites in four countries, and enrolled 500 consecutive patients with at least one of the following three complaints: 1) upper respiratory tract complaints including allergies; 2) lower respiratory tract complaints including allergies; or 3) ear complaints; and compared the effectiveness of homeopathic treatment with conventional medicine. The primary outcomes criterion was the response to treatment, defined as ‘cured or major improvement’ after 14 days of treatment. Secondary outcomes criteria were: 1) rate of recovery; 2) occurrence of adverse events; 3) patient satisfaction; and 4) length of consultation.
Results: 456 patient visits were compared: 281 received homeopathy and 175 received conventional medical treatment. 82.6% in the homeopathy group showed a positive response to treatment, compared with 68% in the conventional treatment group. Improvement in less than 1 day and in 1 to 3 days was recorded in 67.3% in the homeopathy group and in 56.6% in the conventional treatment group. Adverse events were reported in 7.8% of those in the homeopathy group compared with 22.3% in the conventional treatment group. 79.0% of patients in the homeopathy group were ‘very satisfied’ with treatment, compared with 65.1% in the conventional treatment group. In both treatment groups, 60% of patients had consultations lasting between 5 and 15 minutes.
Conclusion: Homeopathy appeared at least at effective as conventional medical treatment in the three commonly encountered conditions studied. In addition, the incidence of reported adverse events was lower in patients treated with homeopathy.
Riley D et al. Homeopathy and conventional medicine: an outcomes study comparing effectiveness in a primary care setting. The Journal of Alternative and Complementary Medicine 7 (2): 149-59. Apr 2001.
Comment: The above research studies indicate that homeopathic treatments impart a real, significant clinical effect in a wide range of conditions, including chemotherapy-induced stomatitis, lactation pain, upper and lower respiratory complaints including allergies and ear complaints.

Issue 67

MILGROM and colleagues, Department of Chemistry, Imperial College of Science, Technology and Medicine, London, UK attempted to reproduce the differences in low resolution nuclear magnetic resonance (NMR) T2 spin-spin relaxation times between homeopathically potentized and unpotentized nitric acid solutions previously reported by Conté et al.
Methods: The investigators used similar instrumentation and experimental protocols as Conté et al.
Results and conclusions: The investigators claim to have shown that Conte’s original results were attributable to experimental artifact originating in the glassware used for the manufacture of the NMR tubes.
Milgrom LR et al. On the investigation of homeopathic potencies using low resolution NMR T2 relaxation times: an experimental and critical survey of the work of Roland Conté et al. The British Homoeopathic Journal 90 (1): 5-13. Jan 2001.

AABEL and colleagues, Institute of General Practice and Community Medicine, Department of General Practice, University of Oslo, Norway attempted to reproduce the previously reported positive results of a nuclear magnetic resonance (NMR) analysis of homeopathic solutions.
Background: The efficacy of homeopathy is controversial. NMR has been used to study homeopathic solutions, producing provocative results.
Methods: 1H NMR spectra were recorded for Sulphur D4, diluted and succussed up to D30 (called potentization) at two different frequencies (300 and 500 MHz). The Sulphur solution had been potentiated according to homeopathic principles with deionized water and alcohol. Water proton T1 relaxation measurements were also performed at 20 MHz for the different potentiated Sulphur solutions. Similarly, the homeopathic remedy Betula alba 30c (birch pollen extract) and appropriate control solutions (deionized water, unsuccussed solutions, and placebo globules) were measured, both with frequencies giving spectra and T1 relaxometry.
Results: The Sulphur remedies showed identical one-dimensional proton spectra (1H NMR) at 300 and 500 MHz, regardless of dilution/succussion stage, from D4 to D30. Betula 30c as a potentiated solution and its controls showed identical spectra. There were no statistically significant differences in longitudinal (T1) relaxation times between deionized water and Sulphur D10 to D30 preparations. The Sulphur D4 preparation showed a shorter T1, which could be ascribed to the higher microviscosity within the sample matrix caused by the high concentration of dissolved material. T1 values of Betula alba 30c preparation (in globular form) and control placebo globules were identical.
Conclusions: The investigators were unable to reproduce previously published results from NMR research indicating differences between homeopathic solutions and control samples.
Aabel S et al. Nuclear magnetic resonance (NMR) studies of homeopathic solutions. The British Homoeopathic Journal 90 (1): 14-20. Jan 2001.

RICHARDSON-BOEDLER, reviewed (29 references) data and literature on the source of the homeopathic remedy Tarentulal hispanica and found evidence to indicate that the ‘official medicinal source’ is incorrect.
Background: The European wolf spider Lycosa tarentula is said to have caused the historical phenomenon of ‘tarantism’ and is the official medicinal source of the homeopathic remedy Tarentula hispanica. However, scientific evidence links the spider’s venomous effects with mild necrotic and minor systemic effects, which contrast with the proving symptoms of Tarentula hispanica, which display a cerebral and neural component.
Results and conclusions: A comparative investigation using toxicological and clinical findings, supported by modern and antique biological texts as well as the Homeopathic Materia Medica, traced the source of the remedy Tarentula hispanica to the Mediterranean widow spider Latrodectus tredecimguttatus, warranting a reevaluation of pharmacological preparation.
Richardson-Boedler C. The widow spider Latrodectus tredecimguttatus: source of the remedy Tarentula hispanica? The British Homoeopathic Journal 90 (1): 44-9. Jan 2001.

Issue 66

LONG and ERNST, Department of Complementary Medicine, School of Postgraduate Medicine and Health Studies, University of Exeter, UK, L.Long@exeter.ac.uk reviewed (45 references) the clinical evidence for and against the effectiveness of homeopathic medicines in the treatment of osteoarthritis.
Background: Osteoarthritis is common, and limitations of conventional medical management indicate a real need for safe and effective treatment.
Methods: The authors conducted a systematic review of all randomized, controlled clinical trials of homeopathic treatment of osteoarthritis. Four trials emerged from a comprehensive search of the literature and are discussed in detail.
Results and conclusions: The small number of randomized clinical trials conducted to date, although favouring homeopathic treatment on the whole, do not allow a firm conclusion to be drawn regarding the effectiveness of homeopathic remedies in the treatment of osteoarthritis. The clinical evidence appears promising and warrants further research in this area.
Long L, Ernst E. Homeopathic remedies for the treatment of osteoarthritis: a systematic review. The British Homoeopathic Journal 90 (1): 37-43. Jan 2001.

STAM and colleagues, Regulatory Affairs Department, VSM Geneesmiddelen bv, Alkmaar, The Netherlands compared the efficacy and tolerability of the homeopathic gel Spiroflor SRL gel (SRL) with that of Cremor Capsici Compositus FNA (CCC) in treating low-back pain.
Background: Acute low-back pain is very common in Western industrialized countries. Usually analgesics or topical medications are prescribed at the first visit to the GP.
Methods: This multicentre, randomized, double-blind, controlled trial was carried out in the practices of 19 GPs in Bristol and Manchester, UK. 161 subjects with acute low-back pain were treated for 1 week with either SRL or CCC. Pain was scored on a 100-mm visual analogue scale (VAS) and VAS score reduction was compared between treatments. Safety was evaluated from the number of subjects who experienced adverse events (AEs), withdrawals from the study due to an AE, and adverse drug
reactions (ADRs).
Results: After adjusting for VAS score at baseline and age, the VAS reduction differed between the SRL group and the CCC group by –0.6 mm. Fewer subjects in the SRL group experienced an AE (11% versus 26%) or an ADR (4% versus 24%), and fewer subjects withdrew due to an AE (0% versus 11%) compared with the CCC group.
Conclusions: SRL and CCC were equally effective in the treatment of low-back pain; however SRL had a better safety profile. The authors’ conclusion was that SRL is preferable to capsicum-based products for the topical treatment of low-back pain because of the lower risk of adverse effects.
Stam C et al. The efficacy and safety of a homeopathic gel in the treatment of acute low back pain: a multi-centre, randomised, double-blind comparative clinical trial. The British Homoeopathic Journal 90 (1): 21-8. Jan 2001.

WALACH and colleagues, Department of Environmental Medicine and Hygiene, University Hospital Freiburg, Germany, walach@ukl.uni-freiburg.de followed up patients who had taken part in a double-blind, placebo-controlled trial of classical homeopathy on chronic headaches to determine the long-term effects 1 year later.
Background: Little is known about the long-term effects of homeopathic treatment.
Methods: All 98 patients enrolled in the double-blind study were sent a 6-week headache diary and a follow-up questionnaire. 87 patients returned questionnaires and 81 returned diaries.
Results: There was no additional change from the end of the trial to the 1-year follow-up. The improvement seen at the end of the 12-week trial was maintained at 1 year.
Conclusions: The investigators concluded that approximately 30% of patients in homeopathic treatment will benefit after 1 year of treatment, and there was no indication of a specific or delayed effect of homeopathy.
Walach H et al. The long-term effects of homeopathic treatment of chronic headaches: 1 year follow up. Cephalalgia 20 (9): 835-7. Nov 2000.

Issue 64

ATTENA and colleagues, Istituto di Igiene e Medicina Preventiva, Facolta di Medicina, Seconda Universita degli Studi di Napoli, Italy evaluated homeopathy by investigating its impact in primary health care, i.e. its impact on outpatients to a homeopathy centre.
Background: In recent years, numerous clinical trials have evaluated homeopathy. The authors aimed to evaluate the therapy using a different approach – i.e. investigating its impact in primary health care.
Methods: 609 patients received a telephone call 1 year after their first visit to a homeopathic clinic (between June 1995 and May 1997); they were asked to rate their present general health compared with a year ago.
Results: 73.5% of the patients reported a moderate or marked improvement in their health status. Marked improvement was significantly higher in: subjects who stated they were satisfied with the care they received; females; subjects aged 0-15 years; and those who completed therapy.
Conclusion: For conditions that are not life threatening, homeopathy seems to meet patients’ needs in primary health care.
Attena F et al. Homoeopathy in primary care: self-reported change in health status. Complementary Therapies in Medicine 8 (1): 21-5. Mar 2000.

VICKERS and SMITH, Integrative Medicine, Memorial Sloane-Kettering Cancer Center, 1275 York Avenue, New York, New York 10021, USA, andrewline@earthlink.net evaluated data from placebo-controlled trials of the homeopathic medicine Oscillococcinum or similar medicines investigating its efficacy in the prevention or treatment of influenza and influenza-like symptoms.
Background: Oscillococcinum is a patented, commercially available homeopathic medicine used to treat influenza. It is manufactured from wild duck heart and liver, well-known reservoirs for influenza virus.
Methods: The authors searched the registry of randomized trials for the Cochrane Complementary Medicine Field using the term ‘homeopathy’ with ‘influenza’, ‘respiratory tract’, ‘infection’, ‘cough’, ‘virus’ and ‘fever’. They also contacted the manufacturers of Oscillococcinum for details of other trials. The date of the most recent search was February 1999. The two reviewers extracted the data and assessed quality of methodology independently.
Results: 7 studies were included in the review: 3 prevention trials (2265 patients) and 4 treatment trials (1194 patients). Sufficient information to complete data extraction fully was available from only 2 of the trials. There was no evidence that treatment could prevent influenza-like
syndrome (relative risk 0.64). Oscillococcinum treatment reduced the length of influenza illness by 0.28 days and increased the chance of a patient considering treatment effective (relative risk 1.08).
Conclusion: Current evidence does not support a preventative effect of Oscillococcinum in influenza and influenza-like syndromes. Oscillococcinum probably reduces the duration of illness in patients with influenza symptoms. However, the data are not strong enough to make a general recommendation to use Oscillococcinum as a first-line treatment. Further research is warranted, but large sample sizes will be required.
Vickers AJ, Smith C. Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes. The Cochrane Database of Systematic Reviews (2): CD001957. 2000.