====== POST-DEBATE QUESTIONS FROM DR. JOE SCHWARCZ TO DR. ANDRÉ SAINE ======

These questions were posted by Dr. Joe Schwarcz to Dr. André Saine as a follow-up on the [[en:misc:talk-saine-schwarcz|Debate held at McGill University]] on November 27, 2012.

===== QUESTION 1 =====
**Homeopaths claim that even after a substance is dissolved in water or alcohol and diluted to such an extent that there is not a single molecule of the original solute left, the solution still retains some memory of the solute. But this solution is then impregnated into a sugar pill and the water is evaporated. What then is left behind? And how does whatever is left behind have anything to do with healing?**

Homeopaths are actually not making such a claim, but have instead been reporting a series of very important experimental observations that are, first, sick people are sensitive to remedies that can produce a similar state as their sickness[(Hahnemann reported this phenomenon in great detail and with many observations in 1796 in his //Essay on a New Principle for Ascertaining the Curative Powers of Drugs//. (In The Lesser Writings of Samuel Hahnemann. Collected and translated by R. E. Dudgeon. New York: William Radde, 1852: 249-303.) He confirmed this phenomenon during the 1799 scarlet fever epidemic in an article entitled On the //Power of Small Doses of Medicine in General and of Belladonna in Particular//. (In The Lesser Writings of Samuel Hahnemann. Collected and translated by R. E. Dudgeon. New York: William Radde, 1852: 385-389.))]; second, patients usually experience an initial aggravation when remedies are precisely prescribed to them according to this principle of similarity[(In a five month study in a large clinic, it was estimated that approximately 75% of patients with chronic diseases experienced an initial aggravation after taking the simillimum homeopathic remedy. (Paterakis S, Bachas I, Vithoulkas G. Statistical data on aggravation after the simillimum. //Journal of the American Institute of Homeopathy// 1977; 70: 267-269.)]; third, to avoid this initial aggravation, Hahnemann did what any logical physician would do, he diminished the dose.

At first, he used simple dilutions[(Already in 1786, four years before his experimentation with Peruvian bark, he was prescribing very small doses of mercury in his treatment of syphilitic patients compared to the much larger doses commonly prescribed by his contemporaries.)], and only many years later he began using serial succussed dilutions[(Even though Hahnemann made the experiment with Peruvian bark in 1790 and published the results of the first six years of his experiments by announcing a new therapeutic principle in 1796, he began using serial succussed dilutions (usually of the second or third attenuations) only in 1799 during the epidemic of scarlet fever. He would then mix one part of pulverized Opium with twenty parts of weak alcohol, would let this mixture stand in a cool place for a week and would shake it occasionally to "promote the solution." A drop of this tincture was mixed "intimately" with five hundred drops of diluted alcohol, and the whole was well shaken; and of this last diluted tincture, one drop was added to another five hundred drops of alcohol. Of this diluted tincture, one drop sufficed for a child of four years of age (particularly during stupefaction marked with convulsions), and two drops for one of ten years. For still younger children, one drop of this dilution was mixed with ten teaspoonfuls of water, and one, two, or more spoonfuls given. He wrote, "It is unnecessary to repeat these doses oftener than every four or eight hours, in some case more than every twenty-four hours, and sometime a couple of times during the whole fever, for which the more frequent or more rare occurrence these symptoms must be our guide." (Hahnemann S. Cure and Prevention of Scarlet Ferer. In //The Lesser Writings of Samuel Hahnemann//. Collected and translated by R. E. Dudgeon. New York: William Radde, 1852: 375.))], a process he had previously used in chemistry[(After abandoning the practice of medicine because of its uncertainty, Hahnemann occupied himself mostly with chemistry and translation. He was soon recognized as an expert chemist. (To appreciate Hahnemann's work as a chemist see: Bradford TL. //Life and Letters of Dr. Samuel Hahnemann//. Philadelphia: Boericke & Tafel, 1895: 29-42, and Kleiner) It was said that his accomplishments in chemistry "must be termed remarkable… and [that he can be] added to the list of versatile scientists side by side with Lavoisier, Benjamin Franklin and Pasteur." (Kleiner IS. Hahnemann as a chemist. Scientific Monthly 1938; 46: 450-454.) In his investigation on the fermentation of wine when put in contact with different gases, Hahnemann would fill vials with different gases and hermetically seal them under water. He would then succuss each vial up and down 30 times on a leather-bound book three times a day for a period of two months in order to increase the contact of the gases with the wine. (Hahnemann S. Ueber den Einfluss einiger Luftarten auf die Gährung des Weins. //Chemische Annalen für die Freunde der Naturlehre, Arzneygelahrtheit, Haushaltungskunst und Manufakturen// 1788; 1: 141-142.))] and which had been known at least since Paracelsus[(The following extracts are from the Scholiast’s (believed to be Paracelsus) commentaries to the third section of The Golden Treatise of Hermes, "The dead elements (which a spirit inhabits) are revived; the composed bodies tinge and alter, or are altered; and by a wonderful process they are made permanent. … The bodies of the metals are domiciles of their spirits . . . when their terrestrial substance is by degrees made thin, extended, and purified, the life and fire hitherto lying dormant is excited and made to appear. For the life which dwells in the metals is laid, as it were, asleep (in sense); nor can it exert its powers or show itself unless the bodies (that is, the sensible and vegetable media of life) be first dissolved and turned into their radical source. …This is the property of our medicine, into which the previous bodies of the spirit are reduced; that, at first, one part thereof shall tinge ten parts of an imperfect body, then one hundred, then a thousand, and so infinitely on by which the efficacy of the Creative Word is wonderfully evidenced; and by how much oftener the medicine is dissolved, by so much the more it increases in virtue; which otherwise, and without any more solution, would remain in its single or simple state of perfection. Here, then, is a celestial and divine fountain set open which no man is able to draw dry." (Cameron FT. Antiquity of the doctrine of dynamization of medicines by dilution. //Organon// 1878; 1: 280-281.) This accumulation in UMPs of the applied mechanical force is called "potentization" in homeopathy. )]; fourth, Hahnemann noticed that patients responded better and longer the higher the potency was, a fact that is confirmed daily by every practicing homeopath; and fifth, Hahnemann slowly pursued this upward process of serial dilution and succussion over the next forty years as he never stopped observing increasing benefit in the sick[(It is irrefutable from many authentic historical sources why Hahnemann first diminished the doses, and second how he proceeded very slowly through careful experimentation over many decades from prescribing simple dilutions to a progressive rise in serial trituration/succussion and dilutions, which has nothing to do at all with the skeptics' belief that Hahnemann "came to the conclusion, somehow nobody can explain how, //that less is more//.")]. To illustrate how slow this process of progressive rise in serial trituration/succussion and dilutions was, Hahnemann recommended prescribing Aurum metallicum in the first and second attenuations in 1820, the 12th in 1825, the 30th in 1835 and by 1840 he was consistently using the 200 centesimal potency[(In 1798, two years after Hahnemann published the results of his experiments on a new therapeutic principle, he was still prescribing crude doses of medicine, such as a half-dram dose of Peruvian bark tincture (Some Periodical and Hebdomadal Diseases. In //The Lesser Writings of Samuel Hahnemann//. Collected and translated by R. E. Dudgeon. New York: William Radde, 1852: 341-344.), drop doses of tincture of Opium (Antidotes to Some Heroic Vegetable Substances. In //The Lesser Writings of Samuel Hahnemann//. Collected and translated by R. E. Dudgeon. New York: William Radde, 1852: 322-329.), and grain doses of Arnica Montana and Ignatia amara. (Some Kinds of Continued and Remittent Fevers. In //The Lesser Writings of Samuel Hahnemann//. Collected and translated by R. E. Dudgeon. New York: William Radde, 1852: 329-341.) By 1840, Hahnemann knew that a limit would unlikely ever be found to the efficacy of the higher potencies, as he kept increasing the potency of his remedies while observing increased remedial responses in the sick. Already in 1827, he suspected the unlimited potential of higher potencies when he wrote, "Medicinal substances are not dead masses in the ordinary sense of the term, on the contrary, their true essential nature is only dynamically spiritual—is pure force, which may be increased in potency by that most wonderful process of trituration (and succussion) according to the homeopathic method, //almost to an infinite degree//." (Hahnemann S. How Can Small Doses of Such Very Attenuated Medicine as Homoeopathy Employs Still Possess Great Power? In //The Lesser Writings of Samuel Hahnemann//. Collected and translated by R. E. Dudgeon. New York: William Radde, 1852: 733.))].

In view of these //experimental facts//, Hahnemann logically assumed that //durable//, physical changes were occurring in the vehicles due to this process of serial trituration/succussion and dilutions, a phenomenon that can absolutely not be explained with the theory of Avogadro's limit[(Hahnemann referred to the doctrine of the divisibility of matter in 1810 (Hahnemann S. Organon of Medicine. Translated by Robert E. Dudgeon. Fifth American Edition. Philadelphia: Boericke & Tafel, 1912, 301.), and said in 1829 that "there must be an end to the thing [divisibility of matter], it cannot go on to infinity." (Hahnemann S. Hahnemann's correspondence. //British Journal of Homoeopathy// 1847; 5: 398.) It is very unlikley that Hahnemann, who was an expert chemist, a great scholar and an accomplished scientisit, was not aware of Dalton's ideas on the atomic theory, which he presented between 1804 and 1810, and of the theory of Avogrado's limit, even though it would be determined much later. In 1811, Amadeo Avogadro proposed that the volume of a gas (at a given pressure and temperature) is proportional to the number of atoms or molecules regardless of the nature the gas. However, accurate determinations of Avogadro's number only became possible for the first time in 1910 after American physicist Robert Millikan measured the charge of an electron. The previous year, in 1909, French physicist Jean Perrin proposed the name of Avogadro to identify this fixed number of constituent particles in one mole of any given substance.)]. In 1825, he wrote, "By the //succussion// and //trituration// employed, a //change is effected in the mixture//, which is so incredibly great and so inconceivably curative, that this development of the spiritual power of medicines to such a height by means of the multiplied and continued //trituration// and //succussion// of a small portion of medicinal substance with ever more and more dry or fluid unmedicinal substances, deserves incontestably to be reckoned among the //greatest discoveries// of this age[(Hahnemann S. How Can Small Doses of Such Very Attenuated Medicine as Homoeopathy Employs Still Possess Great Power? In //The Lesser Writings of Samuel Hahnemann//. Collected and translated by R. E. Dudgeon. New York: William Radde, 1852: 729-730.)]."

In the same article, Hahnemann responded to the skeptic's arguments about the implausibility of the higher attenuations as followed, "But there are various reasons why the skeptic ridicules these homeopathic attenuations. //First//, because he is ignorant that by means of such triturations the internal medicinal power is wonderfully developed, and is as it were liberated from its material bonds, so as to enable it to operate more penetratingly and more freely upon the human organism; //secondly//, because his purely arithmetical mind believes that it sees here only an instance of enormous subdivision, //a mere material division and diminution//, wherein every part must be less than the whole—as every child knows; but he does not observe, that in these spiritualizations of the internal medicinal power, the material receptacle of these natural forces, the palpable ponderable matter, is not to be taken into consideration at all; //thirdly//, because the skeptic has no experience relative to the action of preparations of such exalted medicinal power. If, then, he who pretends to be a seeker after truth will not search for it where it is to be found, namely, in //experience//, he will certainly fail to discover it; he will never find it by arithmetical calculations[(Ibid., 734.)]."

We could indeed speculate that beyond the twelfth centesimal dilution there isn't any molecule left from the original substance. However, no one can in fact prove the absence of any molecules of the original medicinal substances in ultra-molecular preparations (UMPs[(Ultra-molecular preparations or UMPs are solids or solutions that went through the process of serial trituration/succussion and dilutions particular to homeopathy (or are solids, usually sugars, that have been impregnated with one of these solutions), and which usually exceed in theory Avogadro's limit.)]), unless they are able to investigate them with methods capable of detecting the presence of the smallest concentrations of molecules. It was not until the 1950's and 1960's that scientists conducted experiments with radioisotopes, which permitted the detection of molecules of the original substances in UMPs of up to the 10<sup>-2,000</sup> (Korsakoff)[(Plazy M. //Recherche expérimentale moderne en homéopathie//. Angoulème: Éditions Coquemard, 1967, 13-15. )]. The presence of the original medicinal substances have since been detected by more refined spectrometric measurements and most recently by scientists at the Indian Institute of Technology, who have detected asymptotic amounts of nanoparticles and nanobubbles in UMPs of up to the 10<sup>-400</sup> [(Chikramane PS, Kalita D, Suresh AK, Kane SG, Bellare JR. Why extreme dilutions reach non-zero asymptotes: a nanoparticulate hypothesis based on froth flotation. //Langmuir// 2012; 28: 15864-15875. )].

Also, measurable changes in the physico-chemical properties of UMPs began to appear in the 1940's with wavelength changes of the light passing through them[(Wurmser L, Loch P. Travail de recherche expérimentale sur les dilutions homéopathiques. //Congrès National de la Société Homéopathique de France// 1948: 37-48. )]. Different teams of scientists corroborated other measurable physico-chemical changes of UMPs in the early 1950's[(Stephenson J. A review of investigations into the action of substances in dilutions greater than 1 X 10<sup>-24</sup>. //Journal of the American Institute of Homeopathy// 1955; 48: 327-335. )]. During the 1960's, it was found by high-resolution nuclear magnetic resonance spectroscopy that differences existed in the alcohol phase spectrographs of UMPs[(Boericke GW, Smith RB. Modern aspects of homeopathic research. //Journal of the American Institute of Homeopathy// 1965; 58: 158-167; 1966; 59: 263-272. )]. The advent of more refined spectroscopic equipment is now permitting scientists to push investigation further and discover many new, greatly unexpected physico-chemical properties of UMPs.[(Rey L. Thermoluminescence of ultra-high dilutions of lithium chloride and sodium chloride. //Physica A// 2003; 323: 67–74. )] [(Elia V, Niccoli M. New physico-chemical properties of extremely diluted aqueous solutions. //Journal of Thermal Analysis and Calorimetry// 2004; 75: 815–836. )] [(Elia V, Napoli E, Niccoli M, Tiezzi E. New physico-chemical properties of extremely dilute solutions. A conductivity study at 25°C in relation to ageing. //Journal of Solution Chemistry// 2008; 37: 85–96. )]

In 1984, Scofield reviewed much of the pre-Benveniste research on the physico-chemical properties of UMPs[(Scofield AM. Experimental research in homeopathy—a critical review. //British Homoeopathic Journal// 1984; 73: 161-180, 211-226.)]. We find that already in the 1960's, Barnard had developed the idea of the "memory of water," or in other words, something of the original substances is ingrained in the vehicles, which had in fact been considered by homeopaths since Hahnemann[(Barnard GP. Microdose paradox—a new concept. //Journal of the American Institute of Homeopathy// 1965; 58; 205-212.)].

Why, we can ask, is the outcome of this research on the physico-chemical properties of UMPs so unwelcomed by skeptics but, at the same time, so welcomed by homeopaths? First, skeptics tend to approach homeopathy from a purely theoretical point of view, as it had been done for twenty-five centuries previous to the advent of experimental medicine. They have thus not been at all able to appreciate the facts presented by homeopaths, as they don't even bother examining them. Their whole argumentation lies on the theory of Avogadro's limit, and on the placebo response. They have never yet argued against the principle of similia, which is the fundamental basis of homeopathy. They believe so strongly in their theoretical argument that they don't even take the trouble to enquire into what homeopathy really is, or to examine the enumerable, wonderful facts reported in the vast homeopathic literature, which they perfunctorily reject with dismissive arrogance. Their theoretical scheme takes precedence over any fact, thus sacrificing truth at the altar of prejudice. Unfortunately, things have not changed much since 1828 when Jean Paul Ritcher said that homeopathy was more "detested than examined[(The full quote of Richter is as follows in German, "//Hahnemann, dieser seltene Doppelkopf von Philosophie und Gelehrsamkeit//—dessen system am Ende den Ruin der gemeinen Receptier-köpfe nach sich ziehen muss, aber noch wenig von den Practikern angenommen und mehr verabscheut als untersucht ist." (Zerstreute Blätter, 2 Bd. S. 292.), and in its English translation, "Hahnemann, this rare combination of philosophy and learning, whose system must ultimately drag to destruction the vulgar receipt-crammed heads, but a system as yet little adopted by practitioners, and more detested than examined." (//Defence of Hahnemann and His Doctrines.// Second edition. London: H. Ballière, 1844: 67.))]."

On the other hand, homeopaths approach medicine as a natural science, which has as its basis the study of phenomena through observation. Observations reported by Hahnemann who was known to be an extremely meticulous and conscientious scientist have since been corroborated by hundreds of thousands of physicians and can be found throughout the vast homeopathic literature of more than 25,000 volumes.

The hypothesis of the memory of water is consistent with the series of experimental observations reported above. However, homeopaths are not claiming that there are no molecules left in UMPs, as insinuated by this question. We just couldn't have a clue until the 1950's when scientists began tracing radioisotopes in UMPs, which revealed the presence of the original substances in potencies up to the 1,000 centesimal Korsakoff. Scientists have so far detected //at least two very important phenomena in UMPs//, first, asymptotic amounts of nanoparticles and nanobubbles and, second, durable, physico-chemical changes of their vehicles.

In science, when a large body of evidence contradicts a theory it is time to change or adapt the theory, as Claude Bernard said so well in his //Introduction to the Study of Experimental Medicine//, "In these researches, I followed the principle of the experimental method that we have established, i.e., that, in the presence, of a well-noted new fact which contradicts a [prevailing] theory, instead of keeping the theory and abandoning the fact, I should keep and study the fact, and I hastened to give up the theory, … even when the theory [Avogadro's limit] is supported by great names and generally accepted[(Bernard C. //Introduction à l'Étude de la Médecine Expériementale//. Paris: J. B. Baillières et Fils, 1865: 287-288. (This passage can be found in Claude Bernard's //An Introduction to the Study of Experimental Medicine//. Translated by Henry Copley Green. New York: Dover Publications, 1957, 164.) )]." Hahnemann preceded Claude Bernard in introducing the experimental method in medicine by more than a half of a century[(Hahnemann had clearly described the experimental method in //The Medicine of Experience// published in 1805 (Hahnemann S. Heilkunde der Erfahrung. //Journal der practischen Heilkunde// 1805; 22 (3); 5-99, or its English translation, in //The Lesser Writings of Samuel Hahnemann//. Collected and translated by R. E. Dudgeon. New York: William Radde, 1852: 435-476.))] and pointed out in 1819 something very pertinent to our current discussion with skeptics, "How insignificant and ridiculous is mere theoretical skepticism in opposition to this unerring, infallible experimental proof[(Hahnemann S. //Organon der Heilkunst//. Zweite vermehrte Auflage. Dresden: Arnoldischen Buchlandlung, 1819: 363.)]!"

A very important factor that skeptics tend to not address in their calculation based on the theory of Avogadro's limit is the potential effects of the force of trituration and succussion applied in the preparation of UMPs. Rustum Roy and colleagues at the Materials Research Institute of Penn State University estimated that pressure shock waves generated by the process of trituration and succussion used in the preparation of UMPs can caused localized pressure inside the water, alcohol and sugar molecules to reach over 10,000-15,000 atmospheres (150,000-225,000 pounds per square inch), which is powerful enough to trigger fundamental changes in the properties of these vehicles[(Matthews R. The quantum elixir: water. It's the foundation of life on Earth. But what is it about H<sub>2</sub>O that gives it this amazing ability. //New Scientist// 2006; 190: 32-37. )], [(Roy R, Slawecki T, Rao ML. Water, water everywhere; and so little understood. Lecture June 19, 2009. 
» http://www.youtube.com/watch?v=c8ajf_a9MRw.)].

Regarding the last part of this question, namely, "But this solution is then impregnated into a sugar pill and the water is evaporated. What then is left behind? And how does whatever is left behind have anything to do with healing?" When British astronomer Sir Patrick Moore wanted to emphasize that our comprehension of the universe is often quite incomplete, he would simply say, "We just don't know!" And this is exactly what the situation is at this point in time regarding this question, as the fundamental research on UMPs has so far been conducted //with solutions only//. To my knowledge, UMPs in solid forms have not yet been studied.

It is important here to point out here that fundamental research in homeopathy progress very slowly, as there are very few researchers studying this quite intriguing but extremely promising field of investigation, and also it is supported by minimal research grants. The worldwide budget for all the research in homeopathy is likely to be less than two million dollars per year. Funding usually comes from private foundations and homeopathic laboratories, and typical grants are of the order of $10,000 to $30,000. In comparison, funding for biomedical research in 2007 was over $100 billion for the US alone, which is about half of the total worldwide funding[(Dorsey ER, Roulet JD, Thompson JP, Reminick JI, Thai A, White-Stellato Z, Beck CA, George BP, Moses H. Financial anatomy of biomedical research, 2003–2008. JAMA 2010; 303: 137–143.)]. How ironic and sad it is that homeopathy, without any doubt the most important of all medical disciplines, receives less than 1/100,000 of all the moneys allocated in the world for bio-medical research!

===== QUESTION 2 =====
**If a patient is diagnosed with bacterial pneumonia would you recommend a homeopathic regimen or antibiotics?**

If patients diagnosed with pneumonia of any sort consult me, it is very likely that they are making an informed choice to be treated with homeopathy. After all, doesn't the ultimate choice of treatment belong to patients?

However, aside from the question of freedom of choice, it is an extremely pertinent question, because, first, pneumonia represents a public health problem of substantial magnitude, carries a significant mortality and has been associated in recent decades with an increasing morbidity; second, data clearly shows that homeopathy is the treatment of choice for patients with pneumonia of //all// types, and that innumerable numbers of lives would be saved daily if genuine homeopathy was used as the first line of treatment; and third, by using homeopathy, all the undesirable side-effects of antimicrobial therapy would be completely avoided.

This is such a vital subject that it obliges elaboration. The 2003 Pneumonia Fact Sheet of the American Lung Association reported, "In 1996 (latest data available), there were an estimated 4.8 million cases of pneumonia resulting in 54.6 million restricted-activity days and 31.5 million bed days [in the US alone][(Pneumonia Fact Sheet. //American Lung Association//. October 2003. )]." In 2005, pneumonia and influenza together represented a cost to the US economy of $40.2 billion[(Centers for Disease Control. MMWR //Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices// (ACIP), 2007; 56 (July): 1-54. )]. The //age-adjusted// mortality rate for pneumonia/influenza has steadily been rising over the last few decades, while pneumonia consistently accounts for the overwhelming majority of deaths between the two. It was 11.2 in 1979, 13.2 in 1998 and 15.7 per 100,000 persons per year in 2011[(Murphy Sl. Deaths: Final data for 1998. //National Vital Statistics Reports// 2000; 48 (11): 25. )], [(Hoyert DL, Xu J. Deaths: preliminary data for 2011. //National Vital Statistics Reports// 2012; 61 (6): 28.)]. In the past two decades, individuals older than 65 years of age have experienced a 20% increase in pneumonia-related hospitalizations with a concurrent increase in mortality[(Curns AT, Holman RC, Sejvar JJ, Owings MF, Schonberrger LB. Infectious disease hospitalizations among older adults in the United States from 1990 through 2002. //Archives of Internal Medicine// 2005; 165: 2514–20. )], [(Fry AM, Shay DK, Holman RC, Curns AT, Anderson LJ. Trends in hospitalizations for pneumonia among persons aged 65 years or older in the United States, 1988–2002. //JAMA// 2005; 294: 2712–9. )]. Microbes associated with pneumonia have become more resistant to antibiotics, making treatment much more difficult for allopathy, and multi-drug resistant bacteria are commonly endemic in ICU[(Safdar N, Crnich CJ, Maki DG. The pathogenesis of ventilator-associated pneumonia: its relevance to developing effective strategies for prevention. //Respiratory Care// 2005; 50: 725-741. )]. It is also important to point out that there is no generally effective treatment in conventional medicine for most types of viral pneumonia[(Pneumonia Fact Sheet. //American Lung Association//. December 2012 
» http://www.lung.org/lung-disease/influenza/in-depth-resources/pneumonia-fact-sheet.htm)].

Pneumonia is one of the ten leading causes of death and the number one cause of death due to an infectious disease in the US. Untreated "lobar pneumonia has a mortality of about 30 percent," and "with antibiotics, fatalities are reduced to a varying extent, depending on the underlying condition of the patient, but in persons over 12 years the mortality is at least 18 percent and in immunocompromised persons it is much higher[(Kiple KF (ed.). //The Cambridge World History of Human Disease//. Cambridge: Cambridge University Press, 1993: 938-939. )]." Community-acquired pneumonia (CAP) remains a major cause of mortality at 14%[(Fine MJ, Smith MA, Carson CA, Mutha SS, Sankey SS, Weissfeld, LA; Kapoor WN. Meta-analysis of community-acquired pneumonia. //JAMA// 1996; 275: 134-141. )]. Mortality rate for older patients with CAP is around 30%. 72% of patients with CAP will require hospitalization[(Kothe H, Bauer T, Marre R, Suttorp N, Welte T, Dalhoff K, Comprehensive Network for Commnunity-Acquired Pneumonia study group. Outcome of community-acquired pneumonia: influence of age, residence status and antimicrobial treatment. //European Respiratory Journal// 2008; 32: 139–46. )], making pneumonia the second leading cause of hospitalization (after childbirth) in the US, with 1.2 million hospitalizations in 2006[(Ramirez JA, Anzueto AR. Changing needs of community-acquired pneumonia. //Journal of Antimicrobial Chemotherapy// 2011; 66 Suppl 3: iii3–iii9. )]. For nursing-home acquired pneumonia, mortality rates reach 57%[(Janssens JP, Krause KH. Pneumonia in the very old. Lancet //Infectious Diseases// 2004; 4: 112–24. )]. If pneumonia develops in patients already hospitalized for other conditions, the mortality rates range between 30 to 70%[(McEachern R, Campbell GD. Hospital-acquired pneumonia: epidemiology, etiology, and treatment. //Infectious Disease Clinics of North America// 1998; 12: 761-779. )].

Pneumonia is the leading cause of death in children worldwide. An estimated 1.2 million children under the age of five years die every year from pneumonia—more than AIDS, malaria and tuberculosis combined[(World Health Organization. Pneumonia. //Fact sheet N°331//: November 2012. )]. An estimated 1 in 3 children die in developing countries from or associated with acute respiratory tract infections[(Gareene M, Ronsmans C, Campbell H. The magnitude of mortality from acute respiratory infections in children under 5 years in developing countries. //World Health Statistics Quarterly// 1992; 45 (2-3): 180-191.)].

Throughout the nineteen and the first half of the twentieth centuries, which was before the advent of antibiotics, the average mortality for pneumonia for //hospitalized// patients was uniformly at about 30%. In 1912, Dr. William Osler wrote, "Pneumonia is one of the most fatal of all acute diseases, killing more than diphtheria, and outranking even consumption as a cause of death. The statistics at my clinic at the John Hopkins Hospital from 1889 to 1905 have been analyzed by Chatard. There were 658 cases with 200 deaths, a mortality of 30.4 percent. … Greenwood and Candy in a study of the pneumonia statistics at the London Hospital from 1854-1903, a total of 5,097 cases, conclude that the fatality of the disease has not appreciably changed during this period. In comparing the collected figures of these authors with those from other institutions, there is an extraordinary uniformity in the mortality rate[(Osler W. //The Principles and Practice of Medicine//. Eighth ed. New York and London: D. Appleton and Company, 1912: 96. )]." This uniformity of mortality during that period remained the same as well in //non-hospitalized// patients. In England and Wales, the annual death rates per million of pneumonia for children younger than 9 years old remained the same between 1848 and 1905[(Mercer AJ. Relative trends in mortality from related respiratory and airborne infectious diseases. //Population Studies// 1986; 40: 129-145. )]. During WWI, the great majority of the casualties of the US army were due to pneumonia. Major J. Harold Austin of the US medical corps reported, "About 65 percent of the deaths in the army in this country in 1917 were due to pneumonia[(Austin JH. A few observations upon pneumonia in the army in the United States during the winter of 1917-1918. //Transactions of the College of Physicians// 1918; 40: 192-197.)]."

For how long will our society tolerate such horrible statistics, while the best available method of treatment for patients with pneumonia is being repressed in many parts of world, as it is currently in Canada? How long will Canadian medical students tolerate the bias that they are fed in medical schools, instead of being taught the best that science has to offer, as it will now be illustrated? I conducted a literature search on the results obtained by homeopathy in patients with pneumonia. The final results have not yet been fully tabulated, but the data is overwhelmingly clear regarding the benefits societies would obtain by institutionalizing homeopathy. To provide an idea of this review and its conclusion, I will begin by listing here the first four chronological entries:

In 1829, Dr. J. F. Herrmann took over an Infantry Hospital in St. Petersburg where he homeopathically treated 71 patients with pneumonia without a single loss and without bloodletting[(Attomyr J. Musterung der homöopathischen Spitäler. //Archiv für die Homöopathischen Heilkunst// 1843; 20 (1): 137-138. )].

In 1843, Dr. Carl Heinrich Rosenberg reported collections of cases of pneumonia treated in allopathic and homeopathic hospitals in major cities in Europe. Allopaths treated 760 cases of pneumonia with 286 deaths, a mortality of 37.63 percent. Homeopaths treated 390 cases with 14 deaths, a mortality of 3.59 percent, or //more than a ten times// lower mortality[(Rosenberg CR. //Fortschritte und Leistungen der Homöopathie in und ausser Ungarn nebst einer Darstellung ihrer Grundsätze von ihrem gegenwärtigen wissenschaftlichen Standpunkte und Hinweisung auf die Vortheile, die daraus für Staat und Staatsbürger resultieren//. Leipzig: Verlag von Ludwig Schumann, 1843: 233-236. )]!

In 1846, Dr. Bosch wrote, "Out of one hundred cases of pneumonia, I have lost three; a man of fifty-eight who had long had a vomica [an abscess cavity] in the left lung, to which during the last year dropsical symptoms were added; a child of nine months afflicted with rickets, and a man of sixty-eight years[( Bosch. My experience in the treatment of pneumonia. //Homoeopathic Examiner// 1846; 1 (ns): 330-333. )]."

Between 1843 and 1848, Dr. Reiss reported having treated at the Sisters of Mercy Hospital in Linz, Austria 88 cases with pneumonia with one death, a mortality of 1.14 percent[(Reiss. Verzeichniss. //Oesterreichische Zeitschrift für Homöopathie// 1844; 1: 204-207. Verzeichniss. 1845; 2: 172-175. Ausweis. 1846; 2: 615-618. Ausweis. 1847; 3: 639-642. Ausweis. 1848; 4: 460-463. Ausweis. 1849; 4: 653-655. )].

I will now jump forward to 1928 and bypass close to one hundred years of accumulated data. We find here a survey conducted among homeopathic physicians in the US, which reported a death rate of 2.8 percent among 11,526 patients with pneumonia who were treated with homeopathy[(Fiske RE. A survey of the statistics of the homeopathic treatment of lobar pneumonia. //Journal of the American Institute of Homeopathy// 1928; 21: 886-993.)].

The same year, in 1928, Drs. Alfred and Dayton Pulford of Toledo, Ohio wrote in their monograph on pneumonia:

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It has been stated, and we have every reason to believe truly, that fully 80 percent of all pneumonia cases would get well without any medical interference whatever, under proper nursing, so that any system or method of medical healing that cannot lower the death-rate to less than 20 percent would seem rather a menace than a blessing to pneumonia patients.

After treating 242 cases of pneumonia, of //all// types and degrees of severity, some coming directly from and others having been confirmed in the diagnosis by allopaths, with but 3 deaths, a rate of but 1.4 percent, we can hardly understand a fixed minimum death-rate of 25 percent, much less a maximum rate of 95 percent, in a disease as readily amenable to the proper remedy as is pneumonia. The death rate under the homeopathic //simillimum// should at no time exceed 5 percent, a higher rate would rather reflect on our ability[(Pulford A, Pulford D. //Homoeopathic Leaders in Pneumonia//. Published by the authors: Dayton, Ohio, 1928: 5. )].
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As the results obtained by homeopathy greatly depend of the ability of the physician to apply its principles to practice, the venerable Dr. P. P. Wells of Brooklyn, New York commented in 1885 that a death rate of even 2 or 3 percent is still too high under "right" homeopathy and gave the example of Dr. Reiss, who in his practice between 1843 to 1848 in the hospital of Linz, Austria, had a 1 percent mortality rate. He continues, "We believe this because we have the proof of this in our own experience. In a practice of this system which reaches forty-three and two-thirds years, which most of the time has been very large, and of a general character as to the diseases treated, of which, no doubt, pneumonia has made an average part, I have not lost one case[(Wells PP. Addresses, etc. //Homoeopathic Physician// 1885; 5: 414. )]." Pneumonia was quite common in the days of Dr. Wells, for the simple fact that many acute infectious diseases, common to his time and place, such as influenza, diphtheria, measles, rubella, whooping cough, typhus and typhoid fever, would end up in pneumonia. If we assume that he saw at the very minimum one patient a month with pneumonia during his career, he would have had no deaths in well over 500 cases.

Wells' success is corroborated by my own experience. In over 30 years of private practice that include over 180 cases with pneumonia, some of which were treated on their death bed[(About 10% of the patients I have treated with pneumonia were in a critical state.)], many having failed under allopathy, there has not been a single death under homeopathic treatment. It is in fact hard to imagine a person dying of pneumonia with a physician experienced in genuine homeopathy at the bedside, even in the worst and most hopeless circumstances, whether it is in an infant in the last stage of viral pneumonia in an ICU, a centenarian in a very weakened state when all hopes are given up, a wasted and incapacitated middle-age man with a four-year refractory Aspergillus pneumonia, a patient with advanced lung cancer, or a comatose patient in the last stage of AIDS. However, a great number of people will continue to unnecessarily die of pneumonia until the most efficacious treatment in existence is requested by the tired victims of the politics of medicine. Such sterling results obtained with genuine homeopathy in patients with pneumonia point out the invaluableness of this system of medicine, in which statistics become basically useless, as Sir Ernest Rutherford remarked, "If your experiment needs statistics, you ought to have done a better experiment."

It is important to point out that skeptics like Oliver Wendell Holmes[(Holmes OW. Homoeopathy, and Its Kindred Delusions. In //Currents and Counter-Currents in Medical Science: With Other Addresses and Essays.// Boston: Ticknor and Fields, 1861.)] have been very influential in their campaign to denigrate homeopathy and have greatly slowed down the progress of science and limited its potential benefits to reach suffering humanity. Contrary to general expectations, skeptics approach homeopathy with unwavering conviction instead of the completely unbiased mind required in science. The good news however is that facts are more stubborn than prejudices; at the end, truth shall prevail; and as Lincoln said so well, "You can fool all the people some of the time and some of the people all the time, but you cannot fool all the people all the time." Utter ignorance[(A clear example of the utter ignorance displayed by skeptics is seen in the 2005 Shang et al. meta-analysis published in the Lancet and its accompanying article calling for the end of homeopathy. The most fundamental flaw of this meta-analysis is that six of the eight studies retained for the final analysis comparing homeopathy to allopathy were not about homeopathy, as I explained in the debate. It is extremely doubtful whetehr Shang et al. and the editors of Lancet were at all aware that "without the most minute individualization, homeopathy is not conceivable." (Hahnemann S. //Organon of Medicine.// Translated by William Boericke. Philadelphia: Boericke & Tafel, 1922: 34.) )], lack of scholarship, contradictions[(A blattant example of contradictions commonly found in the arguments of skeptics was seen during the debate when Joe Schwarcz said, "Well, this, I think, does not stand up to the rigor of what we call science-based medicine, which has four basic pillars. Of course we rely on peer-review. We do rely on plausibility because we have a large fountain of scientific knowledge upon which we can stand and gaze out at the world and judge to see what makes sense and what doesn't. And, of course, experience plays a role, as does critical thinking. But, really, the cornerstones are peer review and plausibility." Yet, he stated, "I'm not going to get into the battle of papers, because there are 6,500 peer reviewed journals in the world. Every minute of every day there are four new peer reviewed publications that come out. They can be put on a bell curve, like everything else in the world is. Some are excellent, some are terrible; most are mediocre. So, it is possible to take a look and cherry pick and show anything you want with the literature. That's why we don't get into the paper vs. paper." When you insist on twisting the truth around you have to be quite adroit throughout your logic and arguments. You can't learn what genuine homeopathy is not (great medicine or mere placebo) from the gobbledygook of the skeptics, where everything is turned upside down. Confusion is what you are generally left with. However, when you turn to the authentic sources about the development and clinical outcome of homeopathy, it is like night and day. The discourse here is logic, consistent and scientific throughout, and the results are most admirable.)], misinformation[(How can skeptics bring light to this scientific question that is homeopathy when they don't approach it with a purely scientific mind? Or when they have not even read the basic works of homeopathy? There has been a number of honest scientists, like Constantine Hering, Benjamin Joslin or David Reilly, who approached homeopathy in order to discredit it from a scientific point of view. However, they first informed themselves about the fundamental principles of homeopathy and its basic experimental facts. When they tried to reproduce the experiments "carefully and accurately," as Hahnemann clearly requested in his //Nota Bene for my Reviewers//, they found out, despite their utter disbelief, that Hahnemann had been right at every step of the way. However, this has never been the case with skeptics who characteristically base their arguments, not on accurate experiments and pertinent facts, but on mere assumptions. Once carefully analyzed, how can arguments brought forward by skeptics have any credibility before an unbiased scientific community? This debate has always came down to facts versus assumptions, as pointed out by Hahnemann in 1825 in his //Information for the Truth Seeker//, "If the supposed seeker after truth is not willing to seek truth where it is to be found, //namely in experience//, then he may leave it undiscovered; he cannot find it in the multiplication tables." (Hahnemann S. Belehrung für den Wahrheitssucher in Nr. 165 d. Bl. //Allgemeiner Anzeiger der Deutschen// 1825; 2 (194): 2387-2392.) )], gross distortions of historical facts[(Recent examples of gross distortions of historical facts that were displayed during the debate at McGill University are how Hahnemann "kept taking bigger and bigger doses [of Peruvian bark tincture] to see what would happen. And he took these doses and, eventually, he developed a fever," or how Hahnemann discovered the process of succussion, "Well, one day he made a house call. And he answered this house call in a horse-drawn carriage…", or how Hahnemann "gave arsenic in increasing doses to friends, family members et cetera and cause symptoms, for example, in this case, gastric pain, vomiting, and diarrhea," and "lost some friends and relatives along the way." 
» http://www.youtube.com/watch?v=T2uBBU4XT7Y&feature=youtu.be 
or for the unabridged transcription of the debate see: » http://www.legatum.sk/en:misc:talk-saine-schwarcz)], sophistries[(Rejection of the extraordinary facts presented by homeopathy with a theoretical argument is a good example of the most blattant sophistry used by skeptics.)] and far-fetched analogies[(As a recent example of far-fetched analogies, Dr. Amir Raz said during the recent debate held at McGill University, "For someone who knows the literature, it's like science fiction versus reality." It would be really interesting to know how much of the homeopathic literature he has actually read. Skeptics typically respond to facts presented to them by pointing out their impossibility without presenting any precise, concrete, sustanable facts or accurate experimentation as counter arguments, as if skeptics are saying, "take my word for it, as I am after all a well-known professor at a famous university.")] displayed by skeptics about homeopathy will in due time be fully uncovered, and, unleashed, medical science will finally be able to continue its march forward without the skeptics' spokes in its wheels. During the time of Hahnemann literally hundreds of books and pamphlets and even a journal[(Three volumes of //Antihomöopathisches Archiv// were published in Hamburg between 1834-1838. )] and an anti-Organon[(Heinroth, JCA. //Anti-Organon oder Das irrige der Hahnemannischen Lehre im Organon der Heilkunst//. Leipzig: C. H. F. Hartmann, 1 8 2 5.)] were published by skeptics. Despite these intensive campaigns of denigration, homeopathy has continued its march forward, slowly but surely. What is true and good will remain true and good, despite what well-known communicators and supposedly men of science write against it. It is interesting to note how unwavering is the skeptics' stance despite mounts of evidence. This phenomenon seems to not be so uncommon in science as Max Planck once remarked, "A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it." Hahnemann in its turn remarked that it is impossible without virtue to be a true man of science.

Reports similar to Wells' experience described above are commonplaces in the homeopathic literature. However, in the face of such spectacular statistics, one wonders whether any allopath of high reputation has had the courage to openly try homeopathy in a public institution and publicly report in details the results of his experiments in the treatment of patients with pneumonia. Well, at least one allopath did it. Between 1847 and 1849, Dr. Jean-Paul Tessier, "one of the distinguished practitioners of medicine in Paris," conducted at the St. Marguerite Hospital experiments to investigate homeopathy in the treatment of patients with cholera and pneumonia[(Hempel CJ. Preface. In //Clinical Remarks Concerning the Homoeopathic Treatment of Pneumonia: Preceded by a Retrospective View of the Alleopathic Material Medica, and an Explanation of the Homoeopathic Law of Cure//. By Jean-Paul Tessier, M. D., //Physician to the Hospital Sainte-Marguerite in Paris//. Translated by Charles J. Hempel, M. D. New York: William Radde, 1855: iii. )]. He wrote that he presented himself "neither as a partisan or opponent of homeopathy but as a scientist guarding himself against the misguiding bias of blind passion," and he will "endeavor to strictly adhere to the legitimate demands of a scientific inquiry[(Tessier JP. //Clinical Remarks Concerning the Homoeopathic Treatment of Pneumonia: Preceded by a Retrospective View of the Alleopathic Material Medica, and an Explanation of the Homoeopathic Law of Cure//. Translated by Charles J. Hempel, M. D. New York: William Radde, 1855: vi. )]."

He choose pneumonia to conduct his first trial, as he said, "Pneumonia is a disease of frequent occurrence, acute, serious, with well-defined characteristic symptoms; it is on this account that I have selected it as the first example of an application of Hahnemann's method to the treatment of disease. No physician will dispute either the frequency or the acute nature of pneumonia; … the signs by which this disease is recognized, are generally very striking, and easily distinguished; and if I admit that we might be mistaken on a first examination I make all the concessions that can be legitimately claimed. No physician can possibly mistake a case of pneumonia when he sees his patient every morning and evening, auscultates him carefully, and watches all the evolutions of the disease with the intention of determining its true character[(Ibid, 20.)]."

However, instead of applying the principles of homeopathy as they were clearly spelled out by Hahnemann, he applied his own version by prescribing for localized pathologies with alternation of remedies in very low potencies. Despite these three major departures from the practical rules of homeopathy, he was still able to observe a significant positive outcome in both patients with pneumonia and cholera compared to all other methods of treatment used in the hospital and more particularly to the ones used during the cholera epidemics of 1832 and 1849.

Regarding the results obtained in patients with pneumonia in particular, he reported 40 detailed cases with 37 recoveries and 3 deaths, a mortality rate of 7.5%. This means, by simply switching halfway between allopathy to homeopathy, //he was able to save 23 more lives out of 100 patients// compared to the constancy of 30% of his previous allopathic practice. It is a strange fact about human behavior that this incredible, well-publicized reduction in mortality was not followed, at the very least, by more trials or even, until proven otherwise, by institutionalization of homeopathy in the St. Marguerite Hospital or in every other hospital worldwide. Instead, when Tessier presented his results before the Academy in Paris he aroused a storm of protest. It again confirms how prejudice tends to be such a stubborn thing. Luckily for humanity, facts are even more stubborn.

Regarding antimicrobial therapy, homeopathic physicians have traditionally never been against their use but have been opposed to their undesirable side-effects, which include the permanent disruption of the flora of the body, increased susceptibility to opportunistic infections, development of more resistant strains of microbes, and pollution of our streams and waterways and poisoning of the body of life therein. It is also noteworthy to mention two extra advantages of being treated with homeopathy for patients with pneumonia above and beyond antimicrobial therapy, which are that with homeopathy we witness an improvement of the health of the person on all levels, and a decreased susceptibility to develop pneumonia in particular and of being sick in general.

===== QUESTION 3 =====
**Can you provide a peer reviewed, randomized, blinded trial that has been duplicated at least once and appears in a mainstream journal of any specific homeopathic remedy that has been shown to be beneficial in any specific disease?**

As homeopathy is based on individualized medicine your request for "specific homeopathic remedy" "in any specific disease" is an oxymoron. However, there are some studies that did in fact examine the use of one remedy in one potency for patients presenting with one similar complaint. In 1989, Fisher et al. published in the //British Medical Journal// the results of a //non-individualized//, double-blind, randomized, placebo-controlled, crossover trial on the use of Rhus toxicodendron 6 C in patients with primary fibromyalgia. Despite important departures from genuine homeopathy, some of the findings of this research were, "The patients did better in all variables when they took active treatments rather than placebo. The number of tender points was reduced by about a quarter (p < 0.05). … If the null hypothesis were correct the direction of change after placebo and active treatment would be randomly distributed. Analysis showed a significant difference in favour of the homoeopathic medicine[(Fisher P, Greenwood A, Huskisson EC, Turner P, Belon P. Effect of homoeopathic treatment on fibrositis (primary fibromyalgia). //British Medical Journal// 1989; 299: 365–6. )]."

In 2004, Bell et al. published in Rheumatology their results of the //individualized// double-blind, randomized, parallel-group, placebo-controlled treatment of patients with fibromyalgia in a study that was supported by grants from the National Institutes of Health (NIH) and the National Center for Complementary and Alternative Medicine (NCCAM). Their main finding and conclusion were, "Participants on active treatment showed significantly greater improvements in tender point count and tender point pain, quality of life, global health and a trend toward less depression compared with those on placebo. This study replicates and extends a previous one-month placebo-controlled crossover study in fibromyalgia that pre-screened for only one homeopathic remedy. Using a broad selection of remedies and the flexible LM dose (1/50 000 dilution factor) series, the present study demonstrated that individualized homeopathy is significantly better than placebo in lessening tender point pain and improving the quality of life and global health of persons with fibromyalgia[(Bell IR, Lewis DA, Brooks AJ, Schwartz GE, Lewis SE, Walsh BT, Baldwin M. Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo //Rheumatology// 2004; 43: 577–582.)]."

In 1993, Jacobs et al. published in //Pediatrics// the outcome of a RCT on the homeopathic (individualized) treatment of children with diarrhea in Nicaragua. The treatment group had a statistically significant decrease in duration of diarrhea (p < 0.05) and in the number of stools per day between the two groups after 72 hours of treatment (p < 0.05)[(Jacobs J, Jiménez LM, Gloyd S, Gale J, Crothers D. Treatment of acute childhood diarrhea with homeopathic medicine: a randomized clinical trial in Nicaragua. //Pediatrics// 1994; 93: 719–25. )].

In 2000, another RCT was published in the //Journal of Alternative and Complementary Medicine// on the treatment of children with diarrhea, but in Nepal this time. The outcome of this study was consistent with the previous mentioned RCT[(Jacobs J, Jiménez LM, Malthouse S, Chapman E, Crothers D, Masuk M, Jonas WB. Homeopathic treatment of acute childhood diarrhea: results from a clinical trial in Nepal. //Journal of Alternative and Complementary Medicine// 2000; 6: 131-139.)].

In 2003, the combined results and meta-analysis from three RCTs on the homeopathic (individualized) treatment of children with diarrhea were published in the //Pediatric Infectious Disease Journal//. The main findings of this meta-analysis showed a duration of diarrhea of 3.3 days in the homeopathy group compared with 4.1 in the placebo group (P = 0.008), and consistent effect-size difference of 0.66 day (P = 0.008). It was concluded that the results from these studies confirmed that individualized homeopathic treatment decreases the duration of acute childhood diarrhea, and that homeopathy should be considered for use as an adjunct to oral rehydration for this illness[(Jacobs J, Jonas W, Jiménez-Pérez M, Crothers D. Homeopathy for childhood diarrhea: combined results and metaanalysis from three randomized, controlled clinical trials. //Pediatric Infectious Disease Journal// 2003; 22: 229–34. )].

If we look at RCTs evaluating //non-individualized// use of UMPs, we find that in 2000 Taylor et al. published in the British Medical Journal a meta-analysis of four randomized, double-blind, placebo-controlled trials conducted in patients with hay fever. Their findings were, "Addition of these results to those of three previous trials (n = 253) showed a mean symptom reduction on visual analogue scores of 28% (10.9 mm) for homoeopathy compared with 3% (1.1 mm) for placebo (95% confidence interval 4.2 to 15.4, P = 0.0007). Objective results reinforce earlier evidence that homoeopathic dilutions differ from placebo." To the question whether the evidence for homeopathy was reproducible? Reilly et al. answered, "Either answer suggested by the evidence to date—homoeopathy works, or the clinical trial does not—is equally challenging to current medical science[(Taylor MA, Reilly D, Llewellyn-Jones RH, McSharry C, Aitchson TC. Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series. //British Medical Journal// 2000; 321: 471-476.)]." Two of the previous three RCTs had been published in the Lancet in 1986 and 1994[(Reilly DT, Taylor MA, McSharry C, Aitchison T. Is homoeopathy a placebo response? Controlled trial of homoeopathic potency, with pollen in hayfever as model. //Lancet// 1986; ii; 881-886. )], [(Reilly D, Taylor MA, Beattie NGM, Campbell JH, McSharry C, Aitchison TC, Carter R. Is evidence for homoeopathy reproducible? //Lancet// 1994; 344: 1601-1606.)].

===== QUESTION 4 =====

**Given a vial of sugar pills provided by a homeopathic supplier, can you in any way determine whether or not the pills have been "activated" by being impregnated with a homeopathically prepared solution?**

There is a number of ways that could be used to differentiate a verum homeopathic remedy from a placebo, and even one potency from another of the same remedy. First, it is quite easy for an experienced clinician to differentiate the omnipresent placebo response in any doctor-patient encounter versus the patient's response to a simillimum verum homeopathic remedy. Their respective response curves are completely different. The placebo response is characterized by an immediate improvement that tends to be minimal, rarely substantial and of a short duration, particularly in patients suffering from serious diseases. The response to a simillimum verum homeopathic remedy is completely different and is characterized by an immediate, short-lasting and of minimal intensity aggravation, which is followed by a prolonged, durable and progressive state of improvement.

In the placebo response, subjective symptoms especially the ones patients are consulting for tend to be most affected, and most other collateral symptoms remain typically unchanged. Contrarily, in the response to the simillimum verum homeopathic remedy, we observed an improvement of the whole person, which include most of the chief complaints of the patient, as well as moods, disposition, social behavior, sensitivities, energy level, sleep, appetite, food cravings, menses, etc.

Second, well-conducted provings of verum homeopathic remedies should show the difference between one remedy from another, and remedies versus placebo. It was found out that in a three armed, double-blind, placebo controlled randomized experimental pathogenetic study homeopathic remedies produce more specific symptoms as compared to the non-specific symptoms common to the placebo response[(Möllinger H, Schneider R, Walach H. Homeopathic pathogenetic trials produce specific symptoms different from placebo. //Forschende Komplementrärmedizin// 2009; 16: 105–110. )].

Third, many in vitro, plant, animal and human models could be used to differentiate one remedy from another and one potency from another. For instance in one study, a well-known model of restrained-induced catalepsy (RIC) was used in white rats, in which the duration of the effects of different UMPs in the 30 C and 200 C potencies was measured. The higher potencies (200 C or 10<sup>-400</sup>) showed significant longer RICs. The authors concluded, "The technique of RIC could, therefore, be employed to differentiate between the four homoeopathic drugs tested and also between the two potencies of each drugs[(Sukul NC, Bala SK, Bhattacharyya B. Prolonged cataleptogenic effects of potentized homoeopathic drugs. //Psychopharmacology// 1986; 89; 338-339. )]."

Fourth, with refined spectroscopic analysis such as thermoluminescence, UV–visible spectroscopy and Raman spectroscopy, scientists are reporting that it is possible to observe clear differences between two different remedies and different potencies of UMPs[(Rey L. Thermoluminescence of ultra-high dilutions of lithium chloride and sodium chloride. //Physica A// 2003; 323: 67-74.)], [(Rao ML, Roy R, Bell IR. Characterization of the structure of ultra dilute sols with remarkable biological properties. //Materials Letters// 2008; 62: 1487-1490.)].

Fifth, the presence of nanoparticles will be obviously detected in verum UMPs versus placebos with refined spectroscopic analysis[(Chikramane PS, Suresh AK, Bellare JR, Kalita D, Kane SG. Extreme homeopathic dilutions retain starting materials: A nanoparticulate perspective. //Homeopathy// 2010; 99: 231-242.)].

===== QUESTION 5 =====

**Given that the water used to prepare homeopathic solutions has been in contact with all sorts of substances as it cruised through lakes, rivers and sewage systems, why does it remember only what homeopaths would like it to remember?**

At least, two factors must be considered in the fabrication of homeopathic remedies to answer your question. First, pure substances are used in the preparation of homeopathic remedies, which must be in accordance with the official pharmacopeia of the country in which they are made. Canada doesn't have its own pharmacopeia but recognizes official pharmacopeias of other countries, such as the United States Pharmacopeia (USP) and Homeopathic Pharmacopeia of the United States (HPUS)[(For instance, Health Canada recognizes the Homeopathic Pharmacopeia of the United States, the Homöopathisches ArzneiBuch (Germany), the Pharmacopée française, the European Pharmacopoeia, and the Encyclopedia of Homeopathic Pharmacopoeia (India). )]. The HPUS has been in continuous publication since 1897, and since the creation of the FDA by the US Congress in 1938, it has been recognized along the USP as one of the two official drug manuals. //Aqua distillata, alcohol fortior, alcohol officinale// and //glycerin// are the four liquid vehicles permitted by the HPUS and they must all meet the tests for identity and purity described in the USP.

Purity of the vehicles and medicinal substances is important for the production and longevity of homeopathic remedies, which must afterward be stored and handled properly, as a number of factors could destroy them after fabrication, such as too high or too low temperatures[(UMPs //in solutions// lose their properties after being heated at 55°C for 30 minutes and also when any of the various mixtures of water/alcohol solutions solidifies at lower temperatures. However, UMPs in solid forms can be heated at 100°C for one hour and will keep their medicinal properties. (Baranger P, Filer MK. Contribution à l'étude des facteurs physiques pouvant influer sur l'efficacité thérapeuthique des hautes dilutions de Geraniol. //Annales Homéopathiques Françaises// 1975; 17: 357-69.))], microbial contamination, and various forms of ionizing radiation[(Weber S, Endler PC, Welles SU, Suanjak-Traidl E, Scherer-Pongratz W, Frass M, Spranger H, Peithner G, Lothaller H. The effect of homeopathically prepared thyroxine on highland frogs: influence of electromagnetic fields. //Homeopathy// 2008; 97: 3-9.)].

Second, it is important to remember that great force is used in the process of trituration and succussion during the preparation of homeopathic remedies. Rustum Roy, one of the fathers of materials science, estimated that 10,000 to 15,000 atmospheres are applied during this process. According to Roy, it shouldn't be surprising that these exceptional great forces can produce durable changes in the properties of the vehicles used and even permit metal to become colloids. This is the reason why it has been asserted that Hahnemann is the actual founder of colloid chemistry[(Kleiner IS. Hahnemann as a chemist. //Scientific Monthly// 1938; 46: 450-454.)].

Obviously, as no water in our waterways is pure or is submitted to a process of serial dilution and succussion particular to homeopathy, the question of a prior memory of water has never ever been considered.

===== QUESTION 6 =====

**What possible rationale is there for potency to increase with decreasing concentration? And if this is a case, why does toxicity not increase in a parallel fashion?**

This question illustrates well the central point of dichotomy between skeptics and homeopaths, which comes down to ask, of theory or facts, which one should rule? By only focusing on the dilution aspect of UMPs, it is clear, even to a child, as Hahnemann pointed out, that the more you dilute the less concentrated and the weaker a solution becomes. However, if the most undeniable experience teaches the more a solution goes through the serial process of succussion and dilution particular to UMPs the greater is the healing response, should we forgo of this phenomenon because it is counterintuitive, or as true scientists shall we be intrigued by it, and pursue the experiment until no doubt left is possible? This is the crossroad where skeptics prefer to follow their ideas and theories, while homeopaths, like Hahnemann and Claude Bernard, forgo of ideas and rely instead on the result of pure observation.

Today, fundamental science is slowly but surely demonstrating that, as remedies are prepared through the process of serial trituration/succussion and dilution, the great amount of force applied to them at each step of the process creates unexpected and durable changes of their physico-chemical properties. The rationale here is clear, the greater and the more often mechanical force is applied the greater are the physico-chemical changes of UMPs. As the chemical toxicity of the original substances decreases in this serial process of dilution, the newer physico-chemical properties augment which corresponds to the greater curative responses observed clinically in patients with the use of the higher potencies.

The increased potency of the higher attenuations of UMPs has been observed in many in vitro, plant and animal studies. For instance, silver nitrate is known to be generally biostatic and will inhibit the growth of wheat seedlings. However, UMPs of silver nitrate beyond 10-24 have been found to stimulate stalk growth. The growth was the greatest with the higher potency[(Pongratz W, Nograsek A, Endler C. Highly Diluted Agitated Silver Nitrate and Wheat Seedling Development. Effect Kinetics of a Process of Successive Agitation Phases. In //Fundamental Research in Ultra High Dilution and Homoeopathy//. Edited by Jurgen Schulte and P. Chrsitain Endler. Dordrecht: Klumer Academic Publishers, 1998: 143-154. )].

In 1825, Hahnemann answered a similar question that had been publicly asked to him by a skeptic. He wrote, "It is only the ignorant vulgar that still look upon matter as a dead mass, for from its interior can be elicited incredible and hitherto unsuspected powers. All new discoveries of this sort are usually met by denial and incredulity from the great mass of mankind, who have neither adequate acquaintance with physical phenomena nor with the causes of these phenomena, nor the capacity to observe for themselves, and to reflect upon what they perceive. They see, for example, that when a piece of steel is strongly and rapidly rubbed against a hard stone (agate, flint), an operation that is termed striking fire, incandescent sparks fly off (and kindle the tinder or punk they fall on): but how few among them have carefully observed and reflected upon what really takes place there. All of them, or at least almost all, go on thoughtlessly lighting their tinder, and almost no one perceives, what a miracle, what a great natural phenomenon thereby takes place.

When sparks are thus struck with sufficient force, and caught on a sheet of white paper, then we may see, either with the naked eye or by means of a lens, usually small pellets of steel lying there, which have been detached in a state of fusion from the surface of the steel by the smart collision with the flint, and have fallen in an incandescent state, like small fire balls, in the form of sparks, upon the paper, where they cooled. How! can the violent friction of the flint and steel (in the operation of striking fire) cause such a degree of heat as to fuse steel into little balls? Does it not require a heat of at least 3000° Fahrenheit in order to melt steel? Whence comes this tremendous heat?

Not out of the air, for this phenomenon takes place just as well in the vacuum of the air-pump! Therefore it must come from the substances that are rubbed together; which is the fact. But does the ordinary individual really believe that the cold steel which he draws thoughtlessly from his pocket to light his tinder, contains hidden within it (in a latent, confined, undeveloped state) an inexhaustible store of caloric, which the blow only develops, and as it were, wakes into activity? No, he does not believe it, he has never reflected, //and never will reflect//, upon the phenomena of nature. And yet it is so. And yet his steel, which when at rest is cold, contains—whether he believe it or no—an inexhaustible store of caloric, which can only be released by //friction//. An inexhaustible store of caloric, I repeat, which is not calculable by the ciphers of any of those arithmeticians who seek to limit nature and render her contemptible, by applying their multiplication table to the phenomena of her illimitable forces[(Hahnemann S. How Can Small Doses of Such Very Attenuated Medicine as Homoeopathy Employs Still Possess Great Power? In //The Lesser Writings of Samuel Hahnemann//. Collected and translated by R. E. Dudgeon. New York: William Radde, 1852: 730.)]."

===== QUESTION 7 =====

**If homeopathy has truly been proven to be effective as stated by homeopaths, why would it not be embraced by physicians? Are they not interested in healing their patients?**

It is an extraordinary fact how skeptics are so poorly informed about the state of homeopathy in the world. Contrary to what they may think, homeopathy was originally developed by Hahnemann who was a physician and scientist of great learning and industry. Hufeland, who was known as the Nestor of Medicine, was one of the most eminent physicians in Germany during the time of Hahnemann, author of numerous works displaying extensive reading and a cultivated critical faculty, and editors for 42 years of the most reputable journal of the practical healing art. He said of Hahnemann in 1826, "Hahnemann, who I have known for more than 30 years, is one of our most distinguished, intelligent and original physicians… and who I have esteemed for a long time for his earlier productions, and for his sterling contributions to the science of medicine[(Hufeland CW. Die Homöopathie. //Journal der practischen Heilkunde// 1826; 62: 7. )]."

In 1829, in a second essay on homeopathy, he wrote, "I consider it wrong and unworthy of science to treat the new doctrine with ridicule and contempt. Persecution and tyranny in scientific matters are especially repugnant to me; here we should meet with only liberality of thought, thorough investigation, rational refutation, mutual respect, and rigid adherence to the subject, but no personalities. … ‘Prove all things; hold fast that which is good,' is and will ever be the first commandment in all science, and in medicine especially. … Liberty of thought, liberty of science—that is and must be ever be our chief palladium, if we desire to advance[(Hufeland CW. Homoeopathy. //British Journal of Homoeopathy// 1858; 16: 179-198. This essay was originally published in 1829 and was reprinted in 1831, see: Hufeland CW. //Die Homöopathie//. Berlin: Reimer, 1831. )]."

Many prominent physicians adopted homeopathy during the time of Hahnemann and a great number of the court physicians were homeopaths throughout Europe. Even today, a great part of the European royalty is treated with homeopathy, and many Popes of the Catholic Church have been treated with homeopathy[(For more information about the Vatican support of homeopathy see: Dana Ullman's //The Homeopathic Revolution//. Berkeley: North Atlantic books, 2007, 304-308.)]. At least seven US Presidents, namely Tyler, Garfield, Arthur, McKinley, Harding, Coolidge and Hoover, have been treated with homeopathy and their physicians were attending their families at the White House.

Homeopathy has continued to be embraced by physicians all over the world, especially where homeopathy is not repressed, unlike it is currently in many parts of Canada and the United States[(For instance, medical doctors in Quebec haven't been able for decades to practice homeopathy without risking being disciplined by the College of Physicians and Surgeons for practicing medicine outside of the standards of practice. In USA and Canada, physicians and scientitists greatly put at risk their academic reputation and career by showing any interest in homeopathy. Many choose medicine as a profession for its social prestige and financial advantages usually associated with it, which they will not risk loosing by exercising their scientific freedom. In fact, few choose medicine and even a smaller number will pursue it as a true vocation.)]. Homeopathy spread in the early 1820's from Germany to the rest of the world. Today in many countries, homeopathy is recognized as official medicine, is part of national health services and its institutions are supported by governments.

For instance, in Germany, the population is so supportive of complimentary medicine that the German government mandated all medical school curricula to include information about complementary medicine. In Germany, the title "Homeopathic Physician" is legally protected. The Medical Chamber bestows this title after a three-year training program. Official courses in homeopathy are offered in the medical faculties of Berlin, Dusseldorf, Hannover, Heidelberg and Freiburg. Approximately 10%, or about 32,000 physicians in Germany, specialize in homeopathy and 75% of Germans regularly use complementary medicine. 98% of the pharmacies dispense homeopathic medicines.

In Switzerland, the Swiss National Medical Association (FMH) recognizes homeopathy as a specialty (Fähigkeitsausweis Homöopathie) for physician who have acquired the recognized postgraduate training. About half of the Swiss physicians consider complementary and alternative medicine (CAM) to be effective. Perhaps most significantly, 85 percent of the Swiss population wants CAM to be a part of their country's health insurance program. It is therefore not surprising that more than 50 percent of the Swiss population surveyed prefer a hospital that provides CAM rather to one that is limited to conventional medical care. As a result of a 2009 national referendum in which more than two-thirds of voters supported the inclusion of homeopathy and selected alternative medicines in Switzerland's national health care insurance program, and complementary and alternative medicine has become a part of this government's constitution.

In Austria, homeopathic training is available for medical students and physicians. Basic training takes 3 years, which leads to a certification that is officially recognized by the Ministry of Health (Oesterreichische Aerztekammer). The Medical University in Vienna, which offers training in homeopathy, has an institute for research in homeopathy and runs an outpatient clinic for cancer patients. The Austrian Association of Homeopathic Physicians (Österreichische Gesellschaft für Homöopathische Medizin) offers specialty training for pharmacists and veterinarians.

In France, homeopathy is the most used CAM, and 70% of the physicians are receptive to it and consider it effective. At least 25,000 physicians prescribe homeopathic medicines to their patients every year. Its use rose from 16% of the population in 1982 to 29% in 1987 and 36% in 1992. In 1998, homeopathy was taught in at least seven medical schools in France: Besancon, Bordeaux, Lille, Limoges, Marseille, Paris-Nord, and Poitiers, and there are many postgraduate programs. Courses in homeopathy were offered in 21 of the 24 French schools of pharmacy, and in dental and veterinary schools. Homeopathic medicines are refunded by the public health system, and almost every French drugstore dispenses them.

In Spain, homeopathy is recognized as a medical specialty, being taught in universities in Seville, Valladolid, Murcia, Barcelona, Bilbao and Malaga.

In the UK, homeopathy is recognized as a medical practice and has always been available on the National Health Service. The General Practitioners' Committee of the British Medical Association issued the following guidance to general practitioners in 1999, "General practitioners are obliged under their terms of service to refer patients for services available under the NHS... Referral to NHS doctors at one of the five homeopathic hospitals or NHS homeopathic clinics, in cases where GPs think such treatment is appropriate, will be part of the terms of service." Today, there are several NHS homeopathic hospitals regulated by the Care Quality Commission[(» http://www.nhs.uk/conditions/Homeopathy/Pages/Introduction.aspx)].

Homeopathy is the most popular postgraduate course among all in Great Britain. The respect towards homeopathy and its practice is even more evident after a research showed that close to 50% of physicians prescribe or refers patients to homeopathic physicians.

In Italy, there were in 1999 about 5,000 homeopathic physicians, 7,000 pharmacies dispensing homeopathic medicines, and 20 different laboratories. 8.2 millions Italians used homeopathy in 2000 and close 90% of them said they were helped.

In Holland, 40% of general practitioners use homeopathy.

In Belgium, 81% of consultations in CAM involve homeopathy. Homeopathy has been officially recognized in 1999, and about 25% of the population makes use of homeopathic medicines.

During the time of the iron curtain, homeopathy was banned in many Eastern block countries, but this medical repressive iron curtain fell down with communism. It is noteworthy to mention that in Canada, a supposedly democratic society, there is no homeopathic association for licensed MDs; it is not taught in any of the medical schools and, in many Canadian provinces; and its practitioners have to be very discrete or risk suspension of their license for practicing homeopathy.

In Hungary, homeopathic literature was banned for 40 years until 1990. Homeopathy has now been accepted and integrated into regular medical education and is taught in two medical schools. The Hungarian Homeopathic Medical Association started with 11 members in 1990, grew to 75 after 18 months, and grew further to 302 members in 1994.

After the fall of communism in Czechoslovakia, a homeopathic organization was established in November 1990, and it was immediately accepted and integrated within the larger conventional medical society. Within a year, the Ministry of Health officially recognized homeopathy as a medical specialty.

In Romania, medical doctors and dentists can legally practice homeopathy, after having passed an examination following a three-year course. Until now, more than 2,300 physicians have completed this training.

In Poland, only medical doctors may practice homeopathy. Homeopathic training is provided at seven universities (Warsaw, Poznan, Krakow, Katowice, Lublin, Gdansk, and Wroclaw).

In Russia, only medical doctors and dentists can practice homeopathy. Homeopathy is considered a medical specialty, and a medical doctor must obtain a license from the Ministry of Health. Homeopathy holds a unique place, where it has been widely accepted. Demand for homeopathic care is so great that Russians prefer to pay for homeopathic care than to receive free conventional medical care. 58% of physicians use or refer for homeopathic treatment.

In India, homeopathy is integrated into the national health care system and has the largest homeopathic infrastructure in the world, with 400,000 registered practicing homeopaths, 180 colleges teaching courses and graduating 13,000 homeopaths yearly, 7,500 government clinics, 307 hospitals and 24 state boards for the registration of qualified practitioners of homeopathy. According to the Indian government around 10% of its population—or more than 100 million people—depend solely on homeopathy for their health care[(Prasad R. Homeopathy booming in India. //Lancet// 2007; 370; 1679-1680.)].

In Pakistan, homeopathy is integrated into the national health system. In 1998, there were about 40,000 homeopathic physicians registered with the National Council for Homeopathy, and seventy-six colleges of homeopathic medicine offered officially recognized programs for the four-year Diploma of Homeopathic Medical Science. Several hospitals, outpatient clinics, and dispensaries are attached to the homeopathic medical colleges.

In Argentina, only qualified medical doctors, who have been trained and have graduated from a recognized medical school, are allowed to practice homeopathy. There are seven homeopathic schools offering regular three-year and more advanced postgraduate programs. Today, there are an estimated 3,000 medical doctors practicing homeopathy as their specialty, and 500 pharmacists who specialized in homeopathic pharmacy.

In Brazil, homeopathy has been recognized a medical specialty by the National Medical Council in 1980, was integrated in the national health care system in 1988 and is not viewed anymore as alternative medicine. Since 1991, physicians, who want to practice homeopathy, must complete 2,300 hours of training in homeopathy prior to being licensed. In1995, the Federal Council of Pharmacy recognized and standardized the title of "Specialist in Homeopathic Pharmacy." There are more than 15,000 physicians specialized in homeopathy, making it the 16th most popular of the 61 medical specialties. There are more than 200 homeopathic veterinarians, 100 homeopathic dentists, 1,300 homeopathic pharmacists, and six homeopathic laboratories. In 2005, a survey conducted among medical students found out that 85% of them were of the opinion that homeopathy should be part of the medical school curriculum (19% think it should be mandatory and 72% optional).

In Chile, homeopathy and the Homeopathic Pharmacopoeia are legally recognized.

In Ecuador, the Government recognized homeopathy as a medical practice in 1983. The Ecuadorian Medical Federation began officially recognizing homeopathy as a medical specialty in 1988.

In Colombia, the Congress of Deputies officially recognized homeopathy as a system of medicine in 1905. In 1914, the Government standardized training requirements for homeopathic doctors and established a system of title protection. Only physicians can practice homeopathy. The Institute of Medicaments and Food regulates the manufacturing of homeopathic remedies. Integration of homeopathy into the Public Health Services is planned.

In Costa Rica, the College of Physicians and Surgeons recognized homeopathy as a medical specialty in 1994.

In Cuba, the Ministry of Health officially recognized homeopathy in 1992. Courses on introductory and advanced homeopathy are given at the medical and pharmaceutical schools. Homeopathic dispensaries are spread all over the country.

In Mexico, homeopathy has been recognized since 1896. In 1985, regulations specifying training requirements for homeopathic doctors were established by a presidential decree. It is currently integrated into the national health care system; there are two schools that grant the MD degree, and five others that offer postgraduate training, and there are two homeopathic hospitals. In 1998, there were about 3,000 homeopathic physicians[(World Health Organization. //Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review//. 2001. 
» http://apps.who.int/medicinedocs/pdf/h2943e/h2943e.pdf )] [(Das E. //History and Status of Homoeopathy Around the World//. New Delhi: Jain Publsihers, 2005. )] [(//Regulation and Prevalence of Homeopathy//.
» http://en.wikipedia.org/wiki/Regulation_and_prevalence_of_homeopathy )] [(A European Council for Classical Homeopathy Report. //The Recognition and Regulation of Homeopathy in Europe//. June 2007. 
» www.homeopathy-ecch.eu)].

===== QUESTION 8 =====

**The National Center for Complementary and Alternative Medicine in the US has spent 1.4 billion dollars in ten years investigating all sorts of alternative treatments, including homeopathy. How is it that it has been unable to find any evidence that homeopathy provides benefits that are superior to those of a placebo?**

This is wrong, as the following EEG and fibromyalgia studies[(Bell IR, Lewis DA, Lewis SE, Schwartz G. EEG alpha sensitization in individualized homeopathic treatment of fibromyalgia. //International Journal of Neuroscience// 2004; 114: 1195-1120. )] [(Bell IR, Lewis DA, Brooks AJ, Schwartz GE, Lewis SE, Walsh BT, Baldwin CM. Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo //Rheumatology// 2004; 43: 577–582.)], were funded by a number of grants from the NIH/NCCAM and researchers found differences from placebo in all of these studies. The fibromyalgia study was the second study on that condition to show that homeopathy is beneficial. Fisher et al. first published their study in British Medical Journal, and Bell et al. published theirs in Rheumatology, as mentioned in the answer to question 3.

Others studies on homeopathy funded by the NIH/NCCAM grants have been published in peer-review journals in recent years include the one in Sleep Medicine on young adults with coffee-related insomnia. Researchers found that polysomnography (PSG) offers a modern methodology for evaluating the objective effects of taking homeopathic remedies that clinicians claim exert effects on sleep quality in susceptible individuals. Animal studies have previously shown changes in non-rapid eye movement sleep with certain homeopathic remedies. Verum remedies significantly increased PSG total sleep time and non-rapid eye movement sleep, as well as awakenings and stage changes. Changes in actigraphic and self-rated scale effects were not significant[(Bell IR, Howerter A, Jackson N, Aickin M, Baldwin CM, Bootzin RR. Effects of homeopathic medicines on polysomnographic sleep of young adults with histories of coffee-related insomnia. //Sleep Medicine// 2011; 12: 505–511.)]. In another study, researchers found out that EEG alpha offers an objective biomarker of remedy effects for future studies and potential method for distinguishing time-dependent effects of specific remedies and remedy potencies from one another[(Brooks AJ, Bell IR, Howerter A, Jackson N, Aickin M. Short-term effects of repeated olfactory administration of homeopathic Sulphur or Pulsatilla on electroencephalographic alpha power in healthy young adults. //Homeopathy// 2011; 100: 203-211.)]. In a third study, it was found that EEG cordance provided a minimally invasive technique for assessing objective nonlinear physiologic effects of two different homeopathic remedies salient to the individuals who received them. These findings open the door for additional neuroimaging research on nonlinear psychophysiologic effects of specific homeopathic remedies[(Bell IR, Howerter A, Jackson N, Brooks AJ, Schwartz GE. Multiweek resting EEG cordance change patterns from repeated olfactory activation with two constitutionally salient homeopathic remedies in healthy young adults. Journal of Alternative and Complementary Medicine 2012; 18: 445-453.)].

Research on homeopathy funded by the NCCAM in its 20 years of existence has been quite limited to most likely less than 1% of its total budget. Today, junior researchers most likely risk their career and of being kicked out of tenure track if they focus on homeopathy. Also as there are very few researchers applying for grants to research homeopathy, there is little funding. Since there is little funding and few homeopathy researchers in the US, there has not been larger scale funding to replicate findings. There are structural problems with "peer review" for larger applications to do larger clinical trials, which means no CAM researchers, let alone homeopaths, are on review committees. The bias against homeopathy creates a self-fulfilling prophecy—no academic advancement for researchers pursuing homeopathic studies and no true CAM peers on the grant reviews if someone does send in studies.

===== QUESTION 9 =====

**Can you make a comparison between the number of years of education a homeopath receives versus that of a medical doctor as well as the residency requirements?**

The training requirements for becoming a homeopath vary from one country to another, as can be seen in the answer to question 7. However, the preparation I have always recommended for a person interested in pursuing a career in homeopathy has been the following: first, to obtain a wide-spread education in liberal arts and science with particular emphases on philosophy, psychology, biology, arts and science. Second, this should be followed by medical training, preferably one that offers homeopathy as parts of its curriculum, as it is given in all the accredited naturopathic medical schools in North America[(See the Association of Acredited Naturopathic Medical Colleges: 
» http://www.aanmc.org/ )].

A specialty can be pursued, such as pediatrics, gynecology, psychiatry, cardiology, etc., but always keeping homeopathy as the main focus. Following this training, a specialty in homeopathy should be pursued in a postgraduate training, like I pursued after graduation from naturopathic medical college in order to obtain my board certification in the Homeopathic Academy of Naturopathic Physicians.

The question seems to insinuate that homeopathic training is subpar with the one received by an allopathic family medicine practitioner. It is likely to be the opposite. Once, while I was the acting secretary of the Council on Homeopathic Education, a US-based organization, we had a meeting on which I was the only non-MD on that board (as I hold a doctorate of naturopathic medicine (ND)). If my memory serves me well, there were a cardiologist, a psychiatrist, a radiologist and a few family practitioners sitting on the council at that time. They unanimously agreed that homeopathy had so far been the most difficult discipline they had had to learn in all their training, and a greater amount of work and experience was required in order to master it than any other discipline they had to learn.

In essence, aside from therapeutics, a first class homeopathic physician must know human beings in health and disease and from genes to psyche, and understand the factors, conditions and influences needed for optimal health and be able to recognize all the possible causes of diseases. In 1862, Carroll Dunham explained in details in a long essay the requirement needed for becoming a homeopathic physician and the importance of being an excellent diagnostician. He wrote, "When first brought into the presence of a concrete case of disease, the business of the physician is to ascertain what branch of medical science he is called upon to exercise. Is the case one which requires hygienic management, or therapeutic, or both, or is the patient beyond the reach of art?

To answer these questions a diagnosis and prognosis must be made, and to make these, a knowledge of the remote and proximate causes and of the course and determination of diseases is required. In a word, a knowledge of physiology and pathology is indispensable on the very threshold of medical practice and before any question of therapeutics has arisen[([[en:ahr:dunham-c-homoeopathy-the-science-of-therapeutics-158-10408|Dunham C. Homoeopathy, the science of therapeutics]]. American Homoeopathic Review 1862-1863; 3: 9-15, 61-71, 103-111, 156-162, 203-210, 263-273, 305-313.)]."

===== QUESTION 10 =====
**Given that there are substances that can increase the chance of pregnancy in women, why are there no homeopathic birth control pills?**

Homeopathic remedies are prescribed in order to obtain a healing or remedial response in the sick or for homeoprophylaxis, and not to submit the autocratic living organism to the effects of a drug. With homeopathy, the organism is active in the healing or protective processes, as it is with immunization. However, when it is under the effect of crude drugs, especially if not prescribed homeopathically, the living organism is passive.

//Whole system of allostatic responses of the living organism// to homeopathic remedies should never be confused with the //physiological effects// of drugs. Responses to homeopathic remedies are prolonged, durable and cumulative, and affect the whole person, and are therefore curative. While physiological effects of drugs are short in duration and partial in their effects, therefore palliative. BCP have a physiological effect on the organism, and are completely outside the domain of homeopathy.

===== QUESTION 11 =====
**Given that there are numerous chemicals that can cause cancer, why are there no homeopathic remedies to treat the disease?**

Homeopaths don't treat disease but sick persons. Homeopathic physicians consider the whole person in the context of a dynamic environment in every prescription they make, //i.e.//, every chief complaint, the past medical history, the family history, the personality, the habits, the sensitivities, sleep, appetite, energy, etc., are taken into account. Experienced homeopathic physicians will obtain very favorable results in the treatment of patients with cancer. Many in vitro studies have showed that UMPs can significantly increase apoptosis in cancer cells. For instance, researchers at the University of Texas M.D. Anderson Cancer Center recently found that UMPs exerted preferential cytotoxic effects against two breast cancer cell lines, causing cell cycle delay/arrest and apoptosis[(Frenkel M, Mishra BM, Sen S, Yang P, Pawlus A, Vence L, Leblanc A, Cohen L, Banerji P, Banerji P. Cytotoxic effects of ultra-diluted remedies on breast cancer cells. //International Journal of Oncology// 2012; 36: 395-403.)]. It is a shame that every cancer patient is not treated concurrently with homeopathy.

===== QUESTION 12 =====
**Given that homeopathic medications are claimed to have a physiological effect, why should they not be required to meet the same standard of proof of efficacy as other medications?**

During provings, we could say that homeopathic remedies produce effects on healthy subjects. But as homeopathic remedies are mainly prescribed for therapeutic purpose, we should talk of therapeutic or physiological responses rather than effects. This being understood, I will suggest two good reasons to answer your question. First, homeopathic remedies are devoid of chemical toxicity. Second, because homeopathic remedies are prescribed with the objective of obtaining a whole system allostatic response and not to provoke particular physiological effects, any remedy can be effective in an infinite number of cases. It would then be impossible to demonstrate the efficacy of every single remedy for the infinite number of cases it could potentially be indicated. Demonstration of the efficacy of the principle of similia in the hands of well-trained physicians should be sufficient for authorities to institutionalize homeopathy as an extremely safe system of medicine, without having to focus on each individual remedy, as it is in the allopathic system that uses toxic doses of medicines.

Allopathy's strength is its specialization of addressing symptoms and therefore to palliate. It has thus developed much success for relieving pain and for silencing symptoms. There can be great advantage in such an approach, as in the use of anesthetic during surgery. However, as a whole such an approach is reductionist, doesn't affect the fundamental causes of disease and is never without danger. On the other hand, homeopathy is a science that considers the totality of symptoms in order to deal with the whole person. It will use the signs and symptoms as a guide to curative means without obscuring them. Allopathy seeks to silence the warning signals of the organism that something is wrong, while homeopathy is able to reach the vis medicatrix naturae by mean of its distress signals and annihilate the danger at its source.

===== QUESTION 13 =====
**Is there any homeopathic medication that can in any way cause harm to the patient?**

Sensitive patients can react strongly to homeopathic remedies. This is why it is preferable that homeopathy is practiced by well-trained physicians. Extremely low attenuations, which are almost never prescribed by qualified homeopaths, keep a certain level of chemical toxicity and could potentially cause harm if taken in very large quantities and for a long period of time by an uninstructed public.

===== QUESTION 14 =====
What would be the effect of using D<sub>2</sub>O instead of H<sub>2</sub>O in preparing a homeopathic solution?

In his 2003 paper, Rey studied thermoluminescence of ultra-molecular D2O preparations of lithium chloride 10-30 and sodium chloride 10-30. He found that D2O samples gave a much higher signal than the H2O ones. He wrote, "Much to our surprise, the experimental results do show—without any ambiguity— that for an X-ray dose of 0:4 kGy the thermoluminescence glows of the three systems [LiCl 15 C, NaCl 15 C and D2O 15 C] were substantially different. These findings did prove to be reproducible in the course of many different identical experiments. As a working hypothesis, we believe that this phenomenon results from a marked structural change in the hydrogen bond network initiated at the onset by the presence of the dissolved ions and maintained in the course of the dilution process, probably thanks to the successive vigorous mechanical stirrings[(Rey L. Thermoluminescence of ultra-high dilutions of lithium chloride and sodium chloride. //Physica A// 2003; 323: 67-74.)]."
===== QUESTION 15 =====
**You mentioned that you take your own blood and interpret the results because you are a qualified "physician." But no physician I know of does this. Was William Osler wrong when he said that a physician who treats himself has a fool for a patient?**

Perhaps, it is because you only know allopathic physicians who don't trust their own skills, judgment or recommendations. In homeopathy, we quickly learn to become objective and to understand the individuality of each person. I have known many physicians, especially homeopathic physicians, who interpreted their own lab work, treated themselves very satisfactorily, and practiced medicine successfully into their 90's. My father, for instance, practiced medicine for 61 years, was a very good role model for me, and was one of these physicians who interpreted his own lab work and treated himself with success. It can also happen that homeopathic physicians will consult more experienced colleagues, not only for their patients but also for their own case or members of their family.

===== QUESTION 16 =====
**You referred several times to nanoparticles and made a connection to homeopathy. But homeopathy is based on dissolving a substance and sequentially diluting it. By definition nanoparticles are insoluble, so what do they have to do with homeopathy?**

Aside form the physico-chemical changes of the vehicles, research with refined spectroscopy has revealed that UMPs are actually composed of nanoparticles of the original medical substances in colloidal suspensions. Emil Roduner, professor of physical chemistry at the University of Stuggart and author of a textbook on size-dependent phenomena of nanoparticles, explained some of the extraordinary and unexpected changes in the physico-chemical properties of substances when they are reduced to nanoparticles. For instance, he reports that gold is known as a shiny, yellow noble metal that does not tarnish, has a face centered cubic structure, is non-magnetic and melts at 1336?K. However, a small sample of the same gold is quite different, providing it is tiny enough: 10 nm particles absorb green light and thus appear red. The melting temperature decreases dramatically as the size goes down. Moreover, gold ceases to be noble, and 2–3 nm nanoparticles are excellent catalysts, which also exhibit considerable magnetism. At this size they are still metallic, but smaller ones turn into insulators[(Roduner E. Size matters: why nanomaterials are different. //Chemical Society Reviews// 2006; 35: 583–592. )]."

Chikramane et al. demonstrated the serial process of succussion and dilution producing numerous large air bubbles aided nanoparticle levitation to the liquid surface, forming a monolayer that was preserved in the serial dilutions. They wrote, "Our conclusions arise from our experiments indicating that in the successive dilution process of manufacturing, beyond a certain stage, the dilution is merely apparent and the concentration of the starting material in the diluted product reaches a non-zero asymptotic level no matter how much more the sample is diluted[(Chikramane PS, Kalita D, Suresh AK, Kane SG, Bellare JR. Why extreme dilutions reach non-zero asymptotes: a nanoparticulate hypothesis based on froth flotation. //Langmuir// 2012; 28: 15864-15875.)]."

===== QUESTION 17 =====
**Would you ever recommend homeopathic prophylaxis for malaria?**

Homeopathy has a very long history of using homeopathic remedies for prophylactic purposes. Hahnemann did his first experiment in homeoprophylaxis in 1799 during an epidemic of scarlet fever. In my review of the literature on the results obtained by homeopathy in epidemics, the results obtained with homeoprophylaxis are as consistent and predictable as the therapeutic results of homeopathy.

Regarding malaria in particular, there are many wonderful stories of homeoprophylaxis. I will mention two from my own practice. In the late 1980's, a patient of mine who was an engineer, was mandated by his engineering firm to spend six months in southern Egypt at the construction site of a dam. He knew from colleagues who had preceded him that malaria was endemic and that most developed malaria despite conventional prophylaxis. Instead of the conventional approach, he wanted to only rely on homeoprophylaxis, which he did and was even asked to prolong his stay at the construction site by another three months. As far he could know he was the only who did not develop malaria during his nine-month stay.

In 1998, while I was on an ethnobotany expedition deep in the jungle of Papua New Guinea, we came to a village along a lake that was surrounded by marshes. We noticed that there weren't any children younger than about 6 years old in that particular village. We found out through our interpreter that all the younger ones had died because of malaria that was endemic, and that there was no medicine man in this village, and were therefore more or less powerless during sickness[(One or two days later, we came to another village down river, which had a normal youth population and had as well an old medicine man, who, with great reluctance, showed me the bark of the tree he was using for the treatment of patients affected with malaria.)]. I provided the leader of the village with a remedy to be given monthly to everyone in the tribe of about 50 persons. About one year later, I received a letter written in Pidgin by a young man of this village who had learned from a missionary how to write. In essence, he said, "Thank you greatly for your miraculous medicine, as no one in our village has had fever in the last year."

A recent research showed that mice infected with //Plasmodium bergei// and also received on the same day homeoprophylaxis lived twice as long as the ones that only received a placebo[(Bagai U, Rajan A, Kaur S. Antimalarial potential of Nosode 30 and 200 against Plasmodium berghei infection in BALB/c mice. //Journal of Vertor Borne Diseases// 2012; 49: 72-77.)]. The in vivo research is here consistent with the clinical experience, which is usually the rule in homeopathy.

===== QUESTION 18 =====
**What journals do you subscribe to?**

Probably like most other physicians, I subscribe to a number of periodicals of my specialty, which is homeopathy. I also keep abreast discoveries in medicine in general by subscribing to the Harvard Medical School Health Newsletters, Scientific American Health and Medicine Briefings, Nutritionfacts.org, etc. I read on average 10-20 articles a week from peer-reviewed journals, aside from homeopathy, on subjects such as health promoting factors and influences, nutrition, exercise (mental and physical), psychology, genetics, epigenetics, pathology, disease etiology, infectious diseases, etc.

As we can never know too much about health and how to remedy disease, we constantly have to keep abreast on medical science. About on a monthly basis, I see a patient who presents with a rare condition that requires investigation. A literature search is then launched to better understand the pathology, particularly the common symptoms and course of the disease, the prognosis, and any known remedial approach that could complement homeopathic treatment. For instance in late November, a young man with a rare type of familiar muscular dystrophy (MD) consulted me. As there are dozens of such type of MD, I had to enquire about his particular type to better understand the course of the disease and the prognosis.
===== References =====

~~REFNOTES~~

====== DOCUMENT DESCRIPTOR ======

^ Source: | http://www.homeopathy.ca/debates_2012-11-27_FromDrSchawrtz-to-DrSaine.shtml |
^ Description: | Questions posted by Dr. Joe Schwarcz to Dr. André Saine as a follow-up on the [[en:misc:talk-saine-schwarcz|Debate held at McGill University]] on November 27, 2012.  |
^ Year: | 2013 |
^ Editing: | errors only; interlinks; formatting |
^ Attribution: | http://www.homeopathy.ca |