s m leThe Faculty of Homeopathy Newsletter July 2011

The Faculty, British Homeopathic Associat -ion and Society of Homeopaths, alongwith our lawyer and a representativefrom our communications firm met withthe Advertising Standards Authority (ASA)in late June to discuss their advertisingguidelines for homeopathy which werecirculated in late March.

While the homeopathic community is pleased to have opened a dialoguewith the ASA, it must be reported theASA are not going to be easily movedfrom their positions.

There are still many items still indispute and a letter highlighting thoseareas has been sent to the ASA forresponse by the 14 July. However,discussions did produce some positivedevelopments.

The ASA agreed to consider ourproposal for a proper evaluation of theevidence in homeopathy. It was alsoagreed that a meeting should bearranged between the homeopathicorganisations and the Committee ofAdvertising Practice (CAP) to discussadvertising language.

Evidence impasseWe have made emphatically clear our viewthat the ASA’s position on the evidencewhich relies solely on the conclusions ofthe flawed House of Commons Scienceand Technology Committee Report is notacceptable. They use this to defend theirposition “there is no evidence to substant -iate the efficacy for homeopathy”. Using anon-scientific document as an authoritativeand definitive evaluation of the evidencein homeopathy cannot be defended onany grounds.

The ASA agreed to consider anotherprocess for reviewing the evidencesubmitted by us. We proposed that theASA secure a statistician with expertisein systematic review to assess individualRCTs together with a knowledgeableresearcher in homeopathy such as DrRobert Mathie.

Disclaimer dismissedIn an effort to resolve the issues aroundevidence it was suggested to the ASAthat an agreed disclaimer could be includedon websites noting the current contentionaround evidence. Unfortunately, the ASAflatly rejected this idea because, in theirview, a disclaimer would not change thefact that other statements within the web -sites are not “compliant”. A somewhatsurprising stance considering we havefound evidence disclaimers are used byothers in the Health and Beauty sector in which homeopathy is grouped.

This points to a disparity in theapplication of the Advertising Code andhighlights another issue which we fullyintend to follow up with the utmost vigour;that the ASA has adopted a more stringentapproach to issuing guidelines in relationto homeopathy than it does for conven -tional medicines. Further evidence of thiswas presented in the form of an earliercorrespondence from the ASA where theyclearly state “...the bar is set particularlyhigh for homeopathy because of theimplausibility of the mode of action”. Yet the ASA insists their guidelines forhomeo pathy are not different from therest of the sector.

Inconsistent adviceWe, along with the other organisations,also highlighted the lack of consistencyin the advice given by CAP which makesadvising members and supporting themin meeting the ASA’s requirementsimpossible. The ASA explained that CAPoperates as a different department andtherefore they could not discuss thismatter in detail. But agreement wasreached that representatives from thehomeopathic organisations should meetand work with the CAP team to developa vocabulary for use on websites that isappropriate and useful for our professionsand meets the Advertising Code.

As a professional body the Faculty ofHomeopathy wishes to comply with the

ASA and CAP guidance on advertisingso it is “legal, decent, honest andtruthful”. Nevertheless, we are verydetermined to defend wording that isappropriately referenced to a verifiableevidence base.

Valid complaints?The ASA did say they have been swampedby complaints about homeopathy web -sites and recognised that the vast majorityof these complaints have been instigatedby anti-homeopathy campaign groupsand not concerned members of the public.

The Faculty’s position is that the ASAshould first address the core problem,which is not the marketing of homeo -pathy; it is a complaints system whichallows the ASA to be controlled by asmall but well organised group pursu -ing a particular agenda. Respond ing tocomplaints generated by this type ofcampaign is not in the public interest.

Next stepsFollow-up correspondence has beenissued by the ASA to members who havereceived complaints between March andJune, which requires signed complianceto any items they still find in breach ofthe code by 18 July. This pro-forma isoutrageous! We are therefore advisingall members to respond that they areunable to sign it due to the fact that theASA is engaged in constructive dialoguewith their professional registering bodyregarding those very areas addressed inthe letter of compliance.

Our strategy with the ASA is stillone of engagement, to elicit change and demonstrate to them that we are a responsible profession. We thereforeawait their response to our letter,particularly in relation to the letters ofcompliance. If the ASA shows nointerest in constructive engagement we will be adopting a far moreconfrontational stance to defendhomeopathy and our members.

ASA dialogue begins

IN THIS ISSUE: News 1 • Research update 5 • Case study 6 • International focus 11Feature 13 • Comment 16 • Book review 17 • What’s on 19

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•• editorial

…and usually the best one can hope for is a compromise. However, at leasta dialogue is in progress.

In this edition we reproduce a verycomprehensive article on evidence-basedmedicine written by doctors Bayliss andTournier (see pages 13-15). The authorspoint out a number of limitations inapplying EBM, for example patients withrare disorders or multiple pathologieswho are excluded from RCTs. There are also difficulties with patients beingtreated with several different medicinesadministered concurrently. Hereprescribers are relying on the evidencebase for individual interventions withinthe portfolio, there being no evidencebase for the portfolio as a whole. And then – how many experiencedpractition ers restrict their interventionsto EBM alone? Most doctors do nothave the time to apply evidence-basedmedicine to all their clinical decisions(there are over 10,000 publishedmedical journals worldwide). How manyof us use interventions based on whatwe know can be successful in given

circumstances, despite there being nopublished evidence base of which weare aware? Or perhaps we have a “gutfeeling” that this or that will work? Wemay even discuss a case with a colleagueat a CPD event? Indeed, research showsthat UK physicians prefer to usecolleagues to assist in their clinicaldecision making rather than electronicresources or textbooks.1 Isn’t that whatindividualised treatment is all about?

Dr Helen Beaumont presents a veryinteresting long case “Burdened byAmbition” (see pages 6-10) thatdescribes a familiar scenario in thesemodern frantic times. The style of writingmakes it easy to read and hopefully willencourage you to submit examples ofpractice in your own discipline. Short orlong – both are most welcome!The vetsheld their annual conference entitled“Animal Energy 12 – All in the Mind” in conjunction with the InternationalAssociation for Veterinary Homeopathy(IAVH) in the Peak District at thebeginning of July. There werecontributors from the UK, USA andGermany. With the number ofattendees rather lower than usual,mutterings in the bar seemed to be of the opinion that to encourage morepeople, perhaps future conferencesshould include items in the programmefor less committed colleagues or forthose who were just starting out ontheir homeopathic journey, as well asfor the more experienced practitioners.The Faculty might consider somethingsimilar for the Congress in Bristol nextyear. A very satisfying development hasonce again shown the VeterinaryMedicine Directorate’s commitment tosafeguarding the future of homeopathicveterinary medicines. The classificationhas been upgraded from registrationsto licences and remedies are nowconsidered to be veterinary medicinalproducts with full marketingauthorisations. This follows many years’ patient negotiation and is to beapplauded. Certainly there are only a fewlicensed veterinary products at present,for the licensing process is long,tortuous and expensive – but theprocedures are now firmly in place.

Last year, senior members from ThePrince of Wales’s former complementaryhealth charity, the Foundation forIntegrated Health, set up the College of

I have every sympathy with the Faculty and Society representatives who are attempting to negotiate with the Advertising Standards Authority overhomeopathic website content (see page 1). It is not easy to shift suchorganisations from their chosen direction of travel…

Medicine to promote holistic medicinein the NHS. The College aims to raisethe acceptance of an integratedapproach to health among statutorilyregistered healthcare providers, CAMpractitioners, politicians and the public,by running courses and publishingbooks, journals and films. I attendedone of these courses at The RoyalBotanic Gardens at Kew recently andlistened to a fascinating array ofexcellent lectures on both scientific andclinical aspects of CAM practice. Onthis occasion they were mainly, but notexclusively, associated with herbalmedicine. Given the shift in emphasisfrom homeopathy to an integratedapproach, reflected in the renaming of RLHH, I found the contextual natureof the College’s activities very useful.For more information on the College ofMedicine go to www.collegeofmedicine.org.uk

Faculty member Dr Hamish Boydhas become Scotland’s oldest graduateafter gaining a second degree 54 yearsafter his first. We offer our warmestcongratulations. He graduated with anOpen University degree in humanitiesat a ceremony in Glasgow on 28th May2011. Now aged 85, Hamish Boydqualified in medicine from GlasgowUniversity in 1947 and worked atGlasgow Homeopathic Hospital for morethan 20 years before he finally retired in1981. I say finally because I wellremember attending at least three ofhis retirement parties over an eighteenmonth period! His book Introduction toHomeopathic Medicine was a standardteaching text for many years.

I have received an enquiry from a colleague about the ceramic bust of Hahnemann that the Facultycommissioned for sale to memberssome years ago. If anybody has onethat they feel would benefit from a newhome – in a collection of Hahnemannmemorabilia – do please let me knowand I will put you in touch.

Steven Kaynesimile@facultyofhomeopathy.org

Reference:1. Davies KS. Physicians and their use ofinformation: a survey comparison betweenthe United States, Canada, and the UnitedKingdom. J Med Libr Assoc. 2011 January;99(1): 88–91.

Editor: Steven KayneAssistant Editor: John Burry

Faculty of HomeopathyHahnemann House29 Park Street WestLuton LU1 3BE

Tel: 01582 408680Fax: 01582 723032Email: simile@facultyofhomeopathy.orgWeb: www.facultyofhomeopathy.org

All the material in this publication iscopyright and may not be reproducedwithout permission. The publishers do not necessarily identify with or holdthemselves responsible for contributors’,correspondents’ or advertisers’ opinions.

Design: Wildcat Designwildcat1@ntlworld.comPrinting: Burlington Press, Cambridge

s m leThe Faculty of Homeopathy

Newsletter

•• news

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A plan to blacklist homeopathicmedicines in Nottingham shireis being challenged by localFaculty member Dr VictoriaKarney supported by theFaculty of Homeopathy.

Nottinghamshire CountyPCT has informed GPs it willno longer support theprescription of homeopathicmedicines on the NHS. Thisdecision follows a review ofthe evidence in relation tohomeopathy carried out by theNottinghamshire Area Prescrib -ing Committee (APC) whichconcluded “the medicinesare not to be recommendedon the NHS due to limitedinformation on clinical and/orcost effectiveness”.

As part of the reviewprocess the APC says it madefull reference to the House ofCommons Science andTechnology Committee reportincluding five large meta-analyses of homeopathic trials.However, the APC seems tohave overlooked that four ofthese trials produced broadlypositive results.

The APC’s plan has beenmet with anger and disbelieffrom homeopathic physiciansin the area.

Dr Victoria Karney, asenior partner at a practice inNottingham, says: “I’ve beenprescribing homeopathicmedicines for thirty years. Myhomeopathic prescribing forlast year probably amountedto £3,000, as many patientsfind it cheaper to buy themrather than pay prescriptioncharges. Compared to thePCT’s £1.5 million drugsbudget this expenditure is onlya very small percentage.”

A wider implication alsoarises, that of a doctor’s rightto treat patients appropriatelyas their medical skill andexperience dictates.

“Homeopathic medicinesare part of the formulary andlicensed by the MHRA,” saysCristal Sumner, chiefexecutive of the Faculty.“GPs are allowed to prescribeon an FP10 and it is not the

PCT’s role to restrictmedicines for prescription ifcost effective and on theformulary. It seems the PCTis overstepping their boundsto the detriment of patientsand GPs.”

This view is supported by health minister AndrewLansley, who in replying to a letter from Mark Spencer,MP for the Nottinghamconstituency of Sherwood,said that if a patient anddoctor think a particularcourse of treatment isappropriate, then it is OK.

Concerns have also been raised about the lack of professional and publicconsultation prior to thedecision being made. Only

last year, 150 of Dr Karney’spatients signed a petition totheir local MP calling for theprovision of homeopathy tobe continued as a treatmentoption on the NHS; but itappears no patient groupswere consulted by the APCor by Nottingham PCT.

As well as writing toNottinghamshire APCoutlining its concerns, theFaculty has supplied detailedevidence supporting the

efficacy of homeopathy.Furthermore, the Faculty isproposing it trains a group of GPs, practice nurses andpharmacists free of chargeup to the level required forthem to take the PrimaryHealthcare Examination and,if successful, obtain thequalification of Licentiate ofThe Faculty of Homeopathy(LFHom). This would allowthem to use the medicinesthey have learned about totreat a range of simple acuteconditions. The Faculty wouldthen commit to helping eachof the participants toestablish a local audit of theoutcomes and prescribingcosts of homeopathicmanagement.

While Nottingham PCThas yet to respond to thisproposal, Dr Karney and MsSumner have been invited toattend the next meeting ofNottinghamshire APC on14th July to discuss thematter further.

Plan to blacklist homeopathy challenged

Wirral Primary Care Trust (PCT)has set aside an earlierdecision not to commission a homeopathy service from2011-12 following fierce andcontinuing opposition frompatients and the North WestFriends of Homeopathy(NWFH).

The PCT Board hadprevious ly accepted theirProfessional ExecutiveCommittee’s (PEC) recomm -endation to stop providinghomeopathy on the NHS to people in this part of thecountry on 12th April this year.

Believing there had beengross flaws in the PEC’sconsultation and decision-

making process, a patientinstigated Judicial Reviewproceedings and this hasresulted in the PCT’s climbdown.

The PCT maintains thatalthough its decision todecommission homeopathyservices was “fair andproportionate, and based on robust and meaningfulconsultation, there appears to be a lack of confidence in the PCT’s decision-making process, which is regrettable”.

The PCT has confirmedthat Wirral residents will have access to homeopathyservices “on an equivalent

basis as existed prior to thedecision of 12th April 2011”;however, there may befurther attempts to withdrawthe service because the PCT’sDirector of Communicationsand Engagement has nowwritten to patients saying it has “suspended” itsdecision not to commissionhomeopathy.

The North West Friendsof Homeopathy is a registeredcharity that campaignsfor thecontinuation of homeopathywithin the NHS.

Anyone wishing to offersupport should contact:enquiries@nwfriends.org.uk

Wirral homeopathy service secure for 2011-12

Follow us on TwitterTwitter is a simple and practical way of staying in touch withup-to-the-minute developments relating to homeopathy,sharing views and keeping in touch with colleagues,students and supporters. Keep up to date with the latestnews by logging on to http://twitter. com/fohhomeopathy

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•• news

There have been calls formore EU research fundinginto homeopathy andanthroposophic medicinefollowing a meeting at the EU Parliament.

MEPs, scientists andstakeholders in comple -mentary medicine cametogether to discuss future EU research funding intohomeopathy and anthropo -sophic medicine (a holisticform of medicine thatcombines conventional and complementaryapproaches to healthcare and healing).

The meeting was held under the banner“Homeopathy andAnthroposophic Medicine –what is the evidence?”

Among those attending wasthe British HomeopathicAssociation’s researchdevelopment adviser, DrRobert Mathie, who outlinedthe positive results fromscientific studies intohomeopathy. He stressed the need for more research,calling for more replication of the existing evidence, thesetting up of new and well-designed randomised controltrials and the establishmentof multi-centre researchcollaborations.

Addressing the meeting,Irish MEP Marian Harkin,spoke passionately of theneeds of the millions ofpeople who use these formsof medicine across Europe,and how research into

complementary medicineincluding homeopathy andanthroposophic medicineneeded to be a greaterpriority in future EU research programmes.

“The fast growingdemand for homeopathy andanthroposophic medicinestems from many years ofsuccessful practicalexperience, coupled with the excellent overall safetyprofile of these therapeuticapproaches and theirmedicinal products,” shesaid. “The EU should act now in support of theselong-established Europeantherapies to the benefit ofmore than 100 millionEuropean patients andusers.”

CAM meeting at EU Parliament New Deanappointed

A new Dean of Faculty hasbeen appointed. Dr RussellMalcolm from North Queens -ferry, Scotland began histenure in office on 1st July,replacing Dr Raymond Sevarwho was Dean for seven years.

The new Dean hasextensive experience in medicaltraining and teaching. He iscurrently a senior lecturer atthe Academic Unit of theRoyal London Hospital ofIntegrative Medicine (RLHIM),and director of the Centre ofIntegrative Medical Training. A former director of educationat the RLHIM, Dr Malcolmbecame a member of theFaculty of Homeopathy in 1987and was awarded a Fellowshipin 2001. During his career hehas travelled widely, teachingin Prague, Bucharest, Utrecht,Lisbon New York, Moscowand Washington DC.

He served as a memberof the Faculty’s AcademicBoard until 2000. Over thepast year he has been heavilyinvolved in substantiallyrewriting the first year homeo -pathic course material to PHCElevel to incorporate new multi-ple choice questions (MCQs),single answer questions(SAQs), learning activitiesand illustrative material.

Away from medicine DrMalcolm is a talented operasinger and has performed aslead male soloist with both theFife and Tayside operatic groups.

PS: Please inform usif your practice,

home or email address or your telephone numbers change – call Tracey Rignall on 01582408681 or email trignall@facultyofhomeopathy.org

A reception was held atNelson’s HomeopathicPharmacy in London topresent prizes to the winnersof the joint photographycompetition run by the

Faculty, the BHA and theSociety of Homeopaths, whichNelson’s kindly sponsored.

Prizes were awarded forthe best photograph in each ofthe three categories: patientsand practitioners; originalremedy sources; and theremedy making process.Faculty member Dr MarysiaKratimenos (leftwith Mr Fayab)won the original remedysources category with her

close-up shot of a foxglove(Digitalis purpurea) in bloom.

The overall winner wasSarah Davies RSHom from theSociety of Homeopaths witha picture depicting the remedymaking process. Anthony Youngwon the award in the patientsand practitioners category.

Mr Najib Fayab, ChiefOperating Officer at Nelsons,presented the winners withtheir prizes.

Photography competition winners

The British HomeopathicAssociation (BHA) hasmade it even easier foryou to make donationsby registering withVodafone’s “Just TextGiving” scheme. If youwant to help the BHApromote the use ofhomeopathy just send atext to 70070 and includethe BHA’s identity codeBHAD01 and the amountyou want to give in themessage. It is thatsimple! So why notmake a donation today.

Liverpool PCT committed tohomeopathy service Liverpool Primary Care Trusthave for some years beencommissioning medicalhomeopathy throughLiverpool Community Health.These provision arrange -ments ceased on 30th June 2011 but the PCT hasconfirmed its commitment to the service for Liverpoolresidents as part of anintegrated approach tohealthcare.

Under the NHS’s newAny Willing Provider schemethe PCT is proposing tocontinue to commission a service and interested

parties have to submit theirbids by 24th July.

John Cook, Chairman of the North West Friends of Homeopathy, said: “I’mpleased that Liverpool PCThas recognised thecontinuing value Liverpoolresidents place on medicalhomeopathy which continuesto be an effective andexcellent value for moneytreatment for patients of allage groups including children.“

He is particularlyconcerned to ensure that this full range of coveragecontinues in the future.

Just text and give…

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Pro-inflammatory cytokinesand their chronic effect – low-grade inflammation – havebeen associated with diversechronic conditions. Non-steroidal anti-inflammatorydrugs (NSAIDs) were recentlyproposed as a treatmentstrategy. Samuel Hahnemann,the founder of homeopathy,had already hypothesised asystemic and progressivedisorder as the cause ofmany chronic diseases – thePsora theory. He also advisedof the consequences ofpalliative use for chronic

diseases, since an effectcontrary to the “life-preserving principle” couldworsen the course of thosediseases. The hypothesespresented here are that themain aspects ofHahnemann’s Psora theoryare supported by current dataon the role of pro-inflammatory cytokines andthat the use of NSAIDs totreat chronic low-gradeinflammation can produce acontrary, rebound effect, asanticipated by Hahnemann.By diverting from the

“palliative action-reboundeffect” course, not onlyhomeopathy but integrativemedicine could providedifferent approaches to thetreatment of low-gradechronic inflammation. Studiesassessing inflammatorymarkers in chronic integrativetreatments are recommended.

Reference:Adler UC. Low-gradeinflammation in chronic diseases:An integrative pathophysiologyanticipated by homeopathy? Med Hypotheses 2011; 76: 622–626. Epub 1 Feb 2011.

Hahnemann’s Psora theory supported by modernconcepts of pro-inflammatory cytokines

Progress continues to bemade in the preparation oftwo series of major reviewsof randomised controlledtrials (RCTs) in homeopathy:one group of papers isfocused on RCTs in humans,the other on RCTs inveterinary medicine. Eachreview aims to appraise the quality of the originalresearch in terms of: (a) the homeopathy providedto the patients; and (b) thecharacteristics of the trialdesign used.

Systematic reviewsof clinical trials inhomeopathy

•• research update

•• news

Research into the homeopathic consultation haslargely focused on patients’ experiences; however, thepractitioner is a crucial component of the therapeuticcontext and may have an important part in optimisinghealth outcomes. The aim of this qualitative researchwas to gain an in-depth understanding of homeopathicpractitioners’ perceptions and experiences of theconsultation. Medical and non-medical homeopathswere sampled from the registers of the Faculty ofHomeopathy and the Society of Homeopaths. Two phases of data collection were employed: Phase1 used in depth face-to-face interviews enabling thedevelopment of an initial model of the homeopathicconsultation; Phase 2 involved observations ofhomeopathic consultations and practitioner reflectivediaries in order to confirm, refute or enlarge the model.Five main categories emerged: exploring the journey;finding the level; responding therapeutically;understanding self; and connecting with a modelentitled “a theoretical model of a UK classicalhomeopathic consultation”, which describes howhomeopaths view and enact the consultation process.The authors conclude that the process of identifyingand prescribing the remedy is embedded in theconsultation and its interconnectedness, especiallythose aspects that are unique and specific tohomeopathy.

Reference:Eyles C, Leydon GM, Lewith GT, Brien S. A grounded theorystudy of homeopathic practitioners’ perceptions andexperiences of the homeopathic consultation. Evid BasedComplement Alternat Med 2011: 957506. Epub 30 Sep 2010.

Homeopathic practitioners’ andexperiences of the consultation

Ecchymosis is commonly encountered after uppereyelid blepharoplasty. The use of homeopathicpreparations of Arnica montana has been advocated by physicians, patients, and manufacturers forreduction of post-surgical ecchymosis. A prospectiveplacebo-controlled, double-blind study was thereforeperformed in which patients were randomly assigned

to the administration of Arnica or placeboconcurrent with unilateralupper eyelid blepharoplasty,followed by contralateraltreatment at least onemonth later. The resultsshowed no statisticallysignificant difference in severity or in area of

observable ecchymosis at days 3 and 7 after treatmentwith Arnica versus placebo. Also, there was nodifference in ease of recovery per patient report, andthere was no difference in the rate of ecchymosisresolution. The authors thus found no evidence thathomeopathic Arnica, as used in this study, is beneficialin the reduction or the resolution of ecchymosis afterupper eyelid blepharoplasty.

Reference:Kotlus BS, Heringer DM, Dryden RM. Evaluation ofhomeopathic Arnica montana for ecchymosis after upperblepharoplasty: a placebo-controlled, randomized, double-blind study. Ophthal Plast Reconstr Surg 2010; 26: 395–397.

Arnica not effective in treatingecchymosis after upper eyelidblepharoplasty

Arnica montana

It all started 14 months ago. Mygeneral health was good. I was as fitas a fiddle; I was indestructible. LastAugust I started to have a stomachproblem – I would wake feeling sick. I would sit up and then it would fadeaway. I saw the GP, but acidsuppressants were no good.

■ Tell me more about the sensation?It’s a non-descript feeling across theupper body, a sort of numbness in thefingers, an unpleasant feeling (hepoints to the area over his sternum). It is an unpleasant feeling. I have hadan endoscopy, a biopsy and a scan andall were clear, but I do not feel well.(Big sigh!)

It has all taken such a long time,

there was no helicobacter and I feltdespondent. I am used to being welland it wears you down, this vaguefeeling of un-wellness.

I tried to exclude wheat and dairyand for one month and I felt muchbetter – a big improvement but not100%. But this last week things havedrifted back. I know I’m not well, I’mnot right, not 100%. I’m cheesed-offalways feeling ill, it’s not life threatening – so far. I was convinced itwas something I was eating but I eatfresh fruit, organic stuff – could it beyeast? Some people say it’s stress.

■ Tell me a bit more? There wasstress last August. I run my ownbusiness. I am responsible for 40

people and these have been difficultchallenging times. I am the managingdirector, it’s my company. Six monthsbefore this all started things werereally tough, I was having sleeplessnights. I had to lose two people, whichwas very difficult as I do “people”things, but we had to get back toprofitability. Before this illness I wasgregarious, I had vision and passion,now it would be good if someoneoffered to buy the business. I’ve foundI’m not indestructible. I’m in shock – I am human. I could sell up. I know I could do more. I would be bored if I retired, but I’ve not got one mortgage– I’ve got 40! I am a very peopleperson, I work in IT services. Familylife is challenging at times, it is easier

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•• case studies

Burdenedby ambition

Dr Helen Beaumont shares a fascinating case history where thepatient’s drive and ambition becomes an obstacle to success.Simon is 39 years old and the managing director of his own company.

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•• case studies•• news•• case studies

as the kids get older, no serious issuesI don’t think. (He sighs and shrugs hisshoulders.)

■ Tell me a bit more? My shouldersfeel tight, this all started after a holidayand I had a cold I could not shake off – it is my body saying you are notindestructible. I am getting that feelingnow.

■ Explain the sensation? It isnumbness in the fingers, an energyflow, an unpleasant numbness, afeeling across the chest and abdomen,not a sick feeling; well, a mild sickfeeling. I have to take a deep breath tomake it easier (he sighs deeply). I haveto sit up straight. Up here and all theway down here (he moves his had upand down his sternum and takesanother deep breath).

■ Just imagine that sensation a littlemore? Are there any images,colours, sensations that come intoyour mind? Just shut your eyes andfocus on that sensation. It is likeseeing someone in torment. It’s apicture of a person trying to get out of something, in a plastic bag. Lookingat someone in the bag, punching to get out, a feeling of panic, neverending, not getting anywhere. (He takes a deep breath.)

This is bringing on the feeling.There is tingling in the legs. Whoosh!Push something away; I’ve got torelease something. I just want to getrid of it. I have work to do, I have a lifeto lead, I have more to achieve.

■ Tell me more about thenumbness? It’s an irritable feeling, an inner frustration. I thought I wasindestructible but I am not. It’s not a proper illness, it’s not me. I amsensitive to noise and walking is achallenge. Will I fall over if I don’t sitdown? Sighing helps. I never havefallen over but what if I did. Irritabilitywith noise, I shudder, “Oh that’s loud!”

■ Do you have any fears or phobias?Claustrophobia – it’s not acute, smallspaces.

■ Tell me more? It would be anightmare to be buried alive. I would betrapped, if you had an itch you couldn’tscratch it, you couldn’t move in acoffin. Helplessness – dying slowly andpainfully – unable to get out. You are ina dream panic state – you could loseyour mind – I could not cope with it.

I had an early experience of beingtrapped, feeling panicked. I was playingon a farm and a bale fell on me.

■ Tell me more about being trapped?Business-wise I am frustrated. I set up15 years ago – a one man band. I’mfrustrated it’s not grown as I hoped,there is an inadequate feeling inmyself; I have not turned it intosomething supersonic. I need people to tell me I’m alright that I have done well. I can’t say I’ve done well but I can say when things have gone wrong.

■ Tell me more? There is an elementof restriction. I can’t do what I like, I have 40 mortgages. How people thinkof me is very important, I wanteveryone to love and like me. I can’t

go off golfing, I feel guilty unless I aminfluencing people while I play. Peoplejudge and look to me to set anexample.

There is a trapped feeling in myhome life, I feel very selfish saying that,there’s no time for Simon, just time forDad and husband – it is a challenge.The trapped feeling is no time for me.Why do I not deserve a life, I workhard, I earn money, I have things toachieve. I wish home was morefulfilling. I didn’t get the baby thing –they didn’t do a lot except keep meawake. I never get to do what I want.

■ Any more thoughts about beingtrapped? Trapped in a coffin – it’s abiological thing: the little man in theplastic bag. I see the person in the ballthing, in a ball with red liquid; liquid

Photo: shutterstock/Pincasso

“I’ve found I’m not indestructible.

I’m in shock – I am human.

I could sell up. I know I could do more.

I would be bored if I retired, but I’ve not

got one mortgage – I’ve got 40!”

When he went they gave him astainless steel tray. It was a heinouscrime – he was so insulted. I rememberhis anger. I had been working in oneplace for 11 years and I thought youhave to try something for yourself; you can do something so much biggerand better you just have to go for it. I need to run a business, I have apassion for what I do: I can makethings grow.

■ Where do you see yourself in 20years? I will still be alive. I will havesold the business, made millions andbe wildly successful. I’ll be retired but do circuit talks. I’ll get a big kickwatching and helping other businessesgrow. I will be a non-executive directorbut I do not want everyone’s mortgageresponsibilities. To grow and sell wasthe goal. People say I’m ambitious but I have not done the ultimate yet.

Case analysisI found this case fascinating. From very early on in taking the case I felt he was a mineral case. All his issueswere surrounding his business, hisresponsibilities and his performance.Never before has anyone said they felt such a responsibility that they had40 mortgages (i.e. the mortgages of his employees). Even when talkingabout being trapped the conversationreturned to business – this was noanimal case! This I felt pointed towardsa metal. It is important however toguard against making snap decisionsearly in a case and the whole theme of the case needed to be teased out of him and developed.

So I felt it was a metal, but whichmetal and where did he lie on thePeriodic Table? Performance andresponsibility seemed very prominentso I considered the gold series, series6. Having decided the row, which stageor column? Because he felt as if he had not quite reached the top yet andhad more to do, I felt he was left ofcentre (around columns 7 to 9) and so I was looking at Rhenium, Osmiumor Iridium.

However, using this tool solely for case analysis can be ratherdangerous especially if you are not a homeopathic guru, so I then did arepertory search. Following JeremySherr’s advice of taking a rubric that is indisputable and not open to anyinterpretation, I decided to look at“Mind Sighing” and “RespirationSighing” in Radar, and there wasIridium metallicum.

let’s see how good you really are. Oh God, my team put together thepresentation. I had to do my 20minutes. I rehearsed and rehearsed the first seven words, as I knew if I could get those out I would be OK. I pictured them cheering, I could see the applause. I got TOP marks, 500people and I was the best! Bring it on! The next year I was joint highestscorer. The last year I went to anentrepreneurs do – 50 to 60 people – I felt more challenged. There was a 21year-old who ran several of his owncompanies who was such a whiz kid, I almost felt intimidated. The scorecame back and I was average. Thatwas awful. I had been riding a crest of a wave. My scores were three tofour, not five. The 21 year-old got Fives.Bugger! I wasn’t the best; I wasn’t thetop – that is where I need to be. I ammuch better than average.

What am I doing? It would be trueto say the business has not flourishedas I would have hoped. I am too darncritical, I can find fault in everything. If they judge the business they judgeme. I have sacked people, it’s notpleasant but I don’t shy away fromresponsibility, there is no rewind. I don’t have a boss, I have 40 bossesand I have to do my best for them.They all look to me to do the best for them. I am not tough enough.

■ Not tough enough? I let people getaway with things. I’m into performancemanagement. I need to be the boss,show leadership and strength.

■ Have any films had a big impacton you? I’m not a movie watcher butone made me cry. The Field of Dreamswith Kevin Costner, about baseball.

■ Tell me more? There is a guy, afarmer from the Midwest, who goesinto a field and hears a voice “If youbuild it he will come” and he looks upand sees a baseball field with all thelights etc. So he builds a baseball fieldand everyone thinks he is mad but hiswife says if you have to do it – it’ll befine. He had a problem with his dad. He ran out when he was 17 and neverspoke to him again, and then his daddied. His dad arrives as a ghost, playsbaseball with him, plays catch withhim. It made me cry. I don’t know why – I have no issues with my Mum and Dad.

■ Tell me more? My dad worked forthe same company for over 40 years.

with red streaks as if there’s blood in it. He is trying to get out, the ball ispliable, he can push the ball out but he can’t escape. The material is verytough but see-through. He is not me at the moment, I can’t connect withhim. There is a lot of energy goingnowhere. (Another deep sigh) Thesensation is returning: shudder,shudder. I don’t want to be here.

■ What is the opposite? Free – runningup the beach with no one on it but me.On top of a hill or by water.

■ Tell me a bit more about free?Sitting in a street-side café drinkingsomething cold, with people I want to be with, chatting, putting the world to rights, no worries, no “got to go”, no guilt, no feeling I have to besomewhere else, no one judging me,expecting me to do things for them.

■ Judged? (A big sigh again.) It’s self-esteem: I need other people to say I am good. I use a businessexcellence model – I am very good atit, every small business should use it.I’m asked to do talks about it. It givesme a personal high, I really like it. Why should they want to listen to me,these big companies? I did a regionalconference. I thought there would be20-60 people but there were 500.Blimey! 500 people what a challenge.Did it scare me? No, it was a challenge;

•• case studies

8

“The trapped

feeling is no time

for me. Why do

I not deserve a life,

I work hard, I earn

money, I have

things to achieve.

I wish home was

more fulfilling.”

•• case studies•• case studies

Below is a list of quotes from theprovers’ symptoms which I feelcorrelates well with the case.

Mind:• I feel closed in like I couldn’t move. I felt oppressed, there’s no space

• Feeling of pressure on my shouldersand head

• Number 7• Irritated by noise• Feel under water• Feel contained as if in an invisiblecapsule

• I’ve just woken in my own littlecapsule of warmth

• Trapped in a magnetic field• Lots of sighing today, feel as if I need a deep breath

• Blood in dreams

Physical:• Feels like I am vibrating all over• Lots of stomach symptoms –nausea, queasy, anxiety in stomach

• Respiration – spells ofbreathlessness for no reason – hadto gulp lungs full of air

After reading the proving I hadincreased confidence in theprescription. Potency selection wasbased on Sankaran’s hypothesiscorrelating potency to the level thepatient reaches in the case. I felt thispatient was at the level of delusion,especially as the time he felt mostuncomfortable and experienced hissymptoms most was when hedescribed being trapped in the bubble.

The remedy I prescribed wasIridium 1M. Three split single doseevery 12 hours

Follow-upI next saw Simon four weeks later whosaid: “I had a very different feelingtaking the remedy: a clammy feeling, a horrible warmth. I felt awful. It lastedthree to four days after taking theremedy and since then I have startedto feel better. I could live like this butwould still like to improve. Thenumbness is there but less, the sickfeeling has gone and I don’t have totake so many deep breaths.”

Simon then asked what the remedywas. On explaining it was Iridium hewent very pale and shaky. It turned outhe had bought out a company a fewyears ago that had caused all sorts ofgrief in business terms and hadburdened him with forty mortgages.The company name had been Iridium. I was pleased I had not had that

So, all looking good! But I then wantedto study the proving to see whatcorrelation there was between thework of Jan Scholten, Jeremy Sherrand the case in front of me. Ofparticular interest in the proving werethe qualities of the metal itself, for it isa hard brittle metal that is very resistantto corrosion. It is impervious, resistant,and has hardness at a point andtherefore used in the manufacture offountain pens. Simon used the word“indestructible” several times duringthe consultation.

Seven is not insignificant forIridium: the Atomic weight is 77, it is the 77th rarest metal on earth andasteroid number 7 is named after Iris.Simon when talking about giving apresentation said he concentrated on getting the first seven words out.Initially I had not attached anysignificance to this, but the numbers 7and 77 also came up in the proving.

Simon also mentioned he was notyet “supersonic”. Much of the world’sIridium is thought to have come toearth by meteorite and this is onetheory for the extinction of thedinosaurs.

I was not familiar with this remedyalthough I was aware Jeremy Sherr had done a proving with Dynamis in thepast. First, I looked at Iridium in JanScholten’s book Minerals and Elements.

Iridium metallicum is the “EternalCrown Prince”. It will have theconcepts from Stage 9 and the Goldseries. Scholten then describes indetail how these are combined.However, one paragraph particularlycaught my eye which I felt summed up the patient.

“Extending their responsibility”They feel very responsible for theirminors and for society as a whole.Their aims are high and they work hard to achieve them. They can be real workaholics. They always feel they have to extend their business, to go into it in more depth, to do more. They haven’t nearly finishedwhat they set out to do and they dotheir best to get the business to thevery top. Their potential hasn’t beenfully exploited yet. And that whichremains outside their reach is seen as a sign that they have failed to be a super power.

9

Photo: shutterstock/Tom

asz Trojanowski

10

•• case studies

information before as I would have feltit was too much of a coincidence.

On further discussion he said hefelt he was on the road to recovery, the impact on his work had been quitedramatic and he felt he finally was ableto turn things round. Sleep and othergeneral factors had improved. Myimpression was that there had beensome improvement but there was stillsome way to go. The dilemma is when to repeat the remedy. I decidedthat it was too early and that theremedy was still acting. I initially wasgoing to give him a remedy to hold, butin view of his general impatience to“get well quick” I felt he might take it prematurely and wanted to avoid this as he’d already had an aggravation. I arranged a follow-up appointment forsix weeks but told him to contact mesooner if he needed to.

Second follow-up appointmentSimon reported he had been doing verywell up until the last week or so, whenhe felt things were slipping slightly. Hecommented on an improvement in hisability to inspire people and motivatethem. His edge in selling had returned.He talked about meeting up with a 21year-old entrepreneur who was a realinspiration and they were workingtogether towards something supersonic.This was the same 21 year-old who had beaten him at the presentation lastyear and caused him so much irritation,but he had forgotten all about that.

He felt he had more inspiration,there were so many amazingpossibilities out there and “he was not dead yet”.

He didn’t mention any of hisprevious physical symptoms, so I felt it was important to try and assess howthings were progressing. Up until theprevious week the queasy feeling in hisstomach had not been there at all andthere had been no odd sensations inhis limbs. But over the last week hefelt his energy had been dipping, he’dhad a few disturbed nights and a slightsensation in his stomach, but nowherenear as bad as previously.

In view of the slight deterioration insymptoms I felt it was time to repeatthe remedy in the same potency andfrequency and arranged another follow-up in eight weeks. But Simon cancelledthe appointment. He said he felt fineand didn’t have time to attend becausehe had a golf tournament to go to.

SummaryThough this case was not complicatedin terms of management I have learnt a huge amount from it. There was a certain elegance seeing synergybetween the Scholten method, theSherr proving and a simplerepertorisation. It would have beeneasy to have given him a more wellknown remedy but I doubt it would

Contribute to simile

simile is your newsletter and we are always pleased to receive articles,

case studies and news items from members. Please email John Burry

at jburry@facultyofhomeopathy.org or call 01582 408682.The next copy deadline is 31 August 2011

have had such lasting benefit.Sometimes we need to have courageto discover more about the newerremedies and have faith in prescribingthem. This case was made easierbecause a proving had been done. An unproven remedy can be moredifficult to prescribe. However, bysharing our information with the rest of the homeopathic community ourknowledge of new remedies can beexpanded. With the patient’s consent I have sent this case to Jeremy Sherr,who is keen to have records of curedcases of remedies he has proved. I’ve also found it to be an invaluableteaching case when discussing theelements and the Periodic Table.

The rather spooky coincidence of the name of the remedy being thesame as the name of the troublesomecompany that he’d acquired is one ofthose odd situations that seem to cropup so many times in homeopathy. Andwhile I’m pleased I had no knowledgeof this before prescribing, it wasamazing to hear afterwards.

Dr Helen BeaumontMBChB MRCGP DRCOG MFHom*

Photo: shutterstock/concept W

“The rather spookycoincidence of thename of the remedybeing the same as thename of the trouble -some company thathe’d acquired is oneof those odd situationsthat seem to crop upso many times inhomeopathy.”

•• news

11

It all started in April 2010 when 13Iranian medical doctors and oneIndonesian physiotherapist enrolled on the first LFHom course to take placein Iran. I’m pleased to announce thatnearly all of the students passed thePHCE and achieved their LFHomcertificate.

Teaching the course, however, didpresent a few challenges. Although the course was taught in Farsi, all thehandouts were in English so I had tochoose the students whose Englishwas good enough to comprehend ahomeopathic text.

Most of the students had alreadyhad some homeopathic training and so were aware of homeopathy andhomeopathic terms. But their previoustraining had given them some ideasabout homeopathy that were not in linewith Faculty training. Some of theseideas were so fixed in their minds

I found myself having to explain certain points continuously. Eventually I discovered the best way to rid themof their preconceived notions was tosay “this is what the Faculty says andyou have to pass the Faculty exam”.

When the students came to takethe exam the language barrier onceagain presented a problem as the paper was set in English andunfortunately I didn’t have enough time to translate it. To overcome thisobstacle I allowed students to ask me the meaning of words they didn’tunderstand. There were somequestions about language or structureof the sentence that were common to most students and I found myselfhaving to quietly explain the samequestion to each student. This resultedin me having to run around the exam -ination room repeating the same thingover and over again. Then I decided

to write the common questions on thewhite board and refer the students tothe board. In future I will adopt a moreorganised approach and to try to predictquestions that are most likely to be askedand write them on the board in advance.Although the students were faced withthese challenges they did very well, andI would like to offer my congratulations to those who gained their LFHom.

Dr Amir Azizi, Dr Mehdi Tanhaee, Dr Maedeh Hajiaghaee, Mehdi Tanhaee,Maedeh Hajiaghaee, Dr JavadHoseinpoor, Dr Nazila Khaliliazad, Dr Reza Khajehyousefi, Dr Roya Rategh,Dr Marzieh Shenavar, Dr NasrollahSolatnia, Dr Majidreza Tabibzadeh, Dr Naser Kanani, Dr Labib Noorani,Dr Ghobad Nikravesh and Indri Mouludyafrom Indonesia.

Publishing researchFaculty courses have been designed to

•• international focus:

•• IRAN

The first LFHom course in Iran– a personal experience

The Faculty is now providing courses for students in Iran. Dr Kasra Chehrazydescribes some of the difficulties he faced delivering the course and its success.

Photo: shutterstock/fckncg

12

•• news

deliver a high standard of education andtrain ing. Using homeopathy ethicallyand within the bounds of an individual’smedical profession is part of thecurriculum for both the PHCE andMFHom courses. However there isnothing in the curriculum in relation tocarrying out research to an acceptablestandard. Many medical professionalsin this region have no idea about theinternational standards governing thepublication of scientific or medicalresearch. For countries where researchis not so widely undertaken and wherethere are no guidelines covering thisimportant area, would it not be a goodidea for this subject to be covered inthe curriculum?

In my view, the Faculty curriculumshould include an introduction on howto produce good research papers thatmeet international standards. It wouldhelp to improve the research culture inthis country and make students awareof what is acceptable for publication,which in turn would encourage more

professionals to get involved in qualityresearch programmes looking intohomeopathy and its therapeutic use.

A culture of titlesTeaching in foreign countries to peopleof different cultures will inevitably high -light the need for a flexible approach tohow the courses are delivered.

In countries where free speech islimited or even prohibited, the concept ofpower has assumed an important role. Itseems to be common throughout mostMiddle Eastern countries that people arebrought up to respect the most powerful;it can be seen in many aspects ofsociety – and teaching is no exception.

In the academic world power equateswith knowledge and what indicatesknowledge is a title. The person withthe most impressive title is deemed tobe the most powerful and thus the bestperson to impart knowledge. This aspectof Middle Eastern culture is quitedifferent from western culture wheretitles are used to indicate academic

rank and seniority. In my view, a courseprovider with a title that shows a clearrelationship with the Faculty of Homeo -pathy would be in a far better positionto attract students away from otherteaching centres. It will identify thecourse provider as being accreditedwith the Faculty and thus a provider of a high standard of training.

The emphasis I place on theimportance of titles may seem some -what strange to those of you living inWestern Europe, but titles and the rolethey play in the Middle East should notbe underestimated. Therefore I wouldlike to suggest the Faculty work withmembers from this part of the world to create a suitable title for courseproviders, which I’m sure would resultin the Faculty being viewed with fargreater respect as a teaching body and increase the number of medicalprofessionals enrolling on its courses.

Dr Kasra ChehrazyMD MFHom

•• international focus:

•• IRAN contd.

CPD seminarin LiverpoolNovember 5, 2011

from 9:30-16:30

Dr Elizabeth Thompsonwill be talking about homeopathy inan integrative cancer care setting.

Whether you work in private practice orthe National Health Service come alongand feel more confident to prescribe in thisincreasingly relevant clinical area.

Contact: Nanci FawcettTel:01582 408679

Email: nfawcett@facultyofhomeopathy.org

Homeopathy in supportive cancercare – an integrative approach

•• feature

13

Evidence-based medicine– highway to excellence in healthcare?

The term evidence-based medicine(EBM) is commonly used andmisused. In this article, first publishedin the Homeopathy ResearchInstitute’s newsletter in 2009, DoctorsAlex Tournier and Patricia Baylissexplore the meaning of EBM and itsapplication to homeopathy.

In the pursuit of better healthcare,health authorities increasingly requireclinical decisions to be based on soundclinical evidence. The development ofevidence-based health servicecommissioning has further reinforcedthis trend. In the wake of this drive forexcellence in healthcare, homeopathyhas been criticised for its lack ofsupporting evidence, leading to areduction or withdrawal of funding bymany primary care trusts (PCTs).

EBM – definitionThe widely accepted definition of EBMis “the conscientious, explicit andjudicious use of current best medicinein making decisions about the care of individual patients” (Sackett et alBMJ 1996). This laudable initiative seeksto integrate individual clinical expertisewith the best available external clinicalevidence from systematic research andthe opinions and values of patients,families and carers (Guyatt JAMA 2000).

EBM requires four sequentialprocesses, not always adhered to in practice; these are:

1. Translating information needsinto an answerable question

2. Finding the best evidence withwhich to answer the questions

3. Critically appraising theevidence

4. Applying the results into clinical practice

EBM – historyOver the last 50 years, the search for new and effective therapeuticinterventions has engendered muchprivately and publicly funded medicalresearch. Over that period, researchprotocols have been refined so as tobest answer specific questions aboutthe effectiveness or efficacy ofhealthcare options.

EBM evolved as a tool to helppractitioners deliver best clinicalpractice, the term “evidence-basedmedicine” first appearing in medicalliterature in 1991 (Guyatt ACP J Club).It was subsequently used by healthpolicy makers to provide reliableevidence on which to base their fund -ing priorities for public healthcare.

Thereafter, key developments inEBM have included advances in easeof accessing and understanding clinicalinformation, and greater availability of pre-processed evidence-basedinformation. Improvements ininformation technology and thedevelopment of clinical databases, e.g. MEDLINE, have facilitated theperusal of original articles.

More recently, decision supportsystems, incorporating best availableclinical evidence at the point of care,are also evolving.

EBM – the frameworkIn the UK, the EBM framework categor -

ises clinical evidence according to thestrength of its freedom from bias intocategories A, B, C and D. The strongestevidence for therapeutic interventionsis considered to be provided bysystematic reviews of randomised,double-blind, placebo-controlled trials(RCTs), involving a homogeneouspatient population and medicalcondition (A). In contrast, patienttestimonials, case reports and even“expert” opinion, represent only weakevidence, due to placebo effect, biasinherent in observation and reporting of cases, and because of difficulties of defining the term “expert”(D).

Organisations such as the CochraneCollaboration integrate sources of high quality clinical evidence anddisseminate systematic reviews of primary studies. The CochraneDatabase of Systematic Reviews(CDSR) is one of several databases in the Cochrane Library, an electronicresource that regularly updates the collected work of the CochraneCollaboration, and now contains morethan 3,000 systematic reviews.

To conclude the process, theNational Institute for Health andClinical Excellence (NICE) carries outassessments of the most appropriatetreatment regimes for different clinical conditions.

EBM – the drawbacksIn its current form, EBM fails to achieveits aims in a number of areas.

As the “gold standard” forevaluating clinical interventions, theRCT is the most rigorous scientific

Above photo: iStock.com

14

•• feature

homeopaths unskilled in modernresearch methods. Currently the trendis towards trial designs better suited to complementary and alternativemedicine (CAM), resolving thelimitations of traditional RCTs. Anexample of this is the novel RCT trialdesign by C. Relton, which dispensedwith the constraints placebo controlwhile retaining high statistical validity(Relton et al Homeopathy 2009).

CAM-related Cochrane reviews andprotocols are available in The CochraneLibrary. Five Cochrane reviews ofhomeopathic treatment have beencompiled. These examine thehomeopathic treatment of attentiondeficit hyperactivity disorder, chronicasthma, prevention and treatment ofinfluenza and influenza-like syndromesand the induction of labour. None of these recommend the use ofhomeopathy. The ScottishIntercollegiate Guidelines Network(SIGN) guidelines, which investigatedthe management of cancer pain, lung cancer, and headache usinghomeopathy, also concluded that there is currently insufficient evidenceto recommend homeopathy.

However, as Mathie and Fisher pointout in their paper published in the British

method for the evaluation of efficacy of clinical interventions. However, itrequires skill to evaluate and criticallyappraise the quality of evidencedelivered by individual RCTs, whereflawed trial design and managementmay produce bias. Studies have shownthat researchers not uncommonlyemploy inappropriate techniques,misinterpret results, cite literatureselectively, or draw unjustifiedconclusions (Groves BMJ 2008).

Systematic trials on which evidenceis based do not necessarily representthe population at large. RCTs often useselected groups of patients, excludingthose with co-morbidities, which wouldconfound the trial design. So how canwe be certain that the evidence fromRCTs is applicable to the patient foundin daily practice? (Hunink BMJ 2004)

The EBM hierarchy of evidencemay be unjustified and misleading. For example, a systematic review ofseveral small, poorly conducted RCTs is clearly not better than one large,well-executed, double blind trial.Systematic reviews may also misleadon account of absent or weakinformation about adverse effects.

With the increase in evidence-basedpolicy making, there is the ever-presentdanger that healthcare managers,equating lack of evidence with lack ofeffectiveness, will use the former as a rationale for reducing services.

Although British generalpractitioners often use evidence-basedguidelines or protocols generated byothers, very few routinely apply theprinciples of EBM to individual patientsin clinical practice. Indeed only aminority of medical interventions issupported by solid scientific evidence(Smith BMJ 1991).

The necessity of an evidence basein homeopathy is clear, as public healthpolicies need to make best use ofavailable resources as well as protectthe public from malpractice andpotential fraud.

There exists presently little clinicalevidence in homeopathy; relatively few trials have been performed incomparison with conventional medicine.This state of affairs has come about ashomeopaths have generally tended tostrive towards best practice by seekingthe opinion of leaders in the field,whereas conventional medicine has embraced the RCT as the key to best practice.

Historically, many trials have beenperformed by scientists with limitedunderstanding of homeopathy, or by

Journal of Clinical Pharmacology in2007, half of all homeopathic trialspublished have significant and positiveresults. They cite the positive researchfindings in several reviews, along withthe positive evidence of costeffectiveness and safety. Morespecifically, systematic reviews of trialsperformed on children have shownpositive results for the treatment ofattention deficit hyperactivity disorder,diarrhoea, otitis media, stomatitis, andupper respiratory tract infections (seereview by Mathie & Fisher BJCP 2007).

Also of significance is the fact thatof the five meta-analyses of homeo -pathy trials published to date, fourconclude in favour of the existence of a homeopathic effect. The lateststudy by Shang (Shang et al, Lancet2005) reports negatively; however its methodology has been heavilycriticised and its conclusions deemedunreliable (Lutdke & Rutten J ClinEpidemio 2008, Rutten & StolperHomeopathy 2008).

EBM – the challenges forhomeopathyA pivotal difficulty in applying RCTdesigns to homeopathy is the lowvalidity of the RCT in relation to thepractice of homeopathy in the realworld (Walach JACM 2001, ThompsonBMC Medical Research Methodology2004). Moreover, the introduction of placebo has an effect on thepractitioner’s interpretation of theremedy response. There is also the issue of the complexity of thehomeopathic “package of care”, as the homeopathic approach involves a potentially therapeutic, in-depth consultation (Thompson BMC Med Res Meth 2004).

Recognising the special place ofcomplex interventions, the MedicalResearch Council (MRC) hasacknowledged the need to revise itsguidelines on designing, conductingand evaluating complex interventions in healthcare (Craig et al BMJ 2008).

The development of EBM hascoincided with an increase in for-profitfunding of research, and in thereporting of industry-funded researchresults designed to promote its products(Druss BMJ 2005). Yet in the UK only0.0085% of the medical researchbudget is spent on CAM (UKCRC2006), a significant factor in the relativelack of peer reviewed homeopathicclinical trial research, compared withthat in orthodox medicine (Mathie andFisher BJCP 2007).

“The necessity ofan evidence-basein homeopathy

is clear”

Photo: iStock.com

15

•• feature

In the context of homeopathy, thebest possible outcome of the currentEBM process would be the generationof proof of the effectiveness ofhomeopathy. However, in its presentform, EBM does not create useabletemplates to foster best practice inhomeopathy.

A challenge facing current homeo -pathic practitioners is to use andexpand current EBM methods to strengthen the evidence ofeffectiveness of homeopathy, whileconcurrently generating innovativeresearch able to meaningfully comparethe different trends of homeopathicpractice, thus becoming a driving force

for best practice in homeopathy.Currently, the greatest obstacle to thisgoal is a relative scarcity of funds forCAM-related research as compared to conventional medical research.

Dr P Bayliss and Dr A Tournier

The Homeopathy Research Institute(HRI) facilitates research in homeopathywith the aim of providing reliable,objective information. In April, the HRIlaunched an appeal to raise funds sothat vital scientific research in this field of medicine can continue.

“A challenge facing current homeopathic practitioners is to

use and expand current EBM methods to strengthen the evidence of theeffectiveness of homeopathy”

EBM – conclusionEBM is used increasingly to informhealth policy decision-making andindividual health choices; however, forthe unwary there remain pitfalls in itsuse. The term “evidence-based” isapplied to many recommendations and guidelines that do not incorporatesystematic and critical appraisal ofclinical evidence. There is perhaps adanger that unsophisticated users ofmedical literature will place on thesemore reliance than is appropriate.

Ideally, clinical evidence shouldremain complementary to clinicaljudgement, including a consideration of patients’ individual predicaments,values and preferences, in makingtreatment decisions; even excellentevidence may be inapplicable orinappropriate for an individual patient.

EBM does not provide guidance for rare disorders, nor for patients with multiple pathologies, who areexcluded from RCTs. In these casesthere is evidence that the individualisedapproach of homeopathy can beeffective (Linde et al Lancet 1997,Spence et al JACM 2005).

We invite members to submit abstracts for presentation.

The theme for the 2012 Congress is Homeopathy: Empowering the Individual

Bristol 4-7 October 2012

The focus is on providing sustainable self-care toempower patients in these challenging times.

Abstracts on the empowerment of patients, theirfamilies and fellow practitioners are welcome.

The deadline for submissions is 13 January 2012 (250 words maximum)

Abstracts will be selected by the Organising Committee.

Guidelines on the preparation of abstracts areavailable from the Congress Organiser,

Nanci Fawcett (nfawcett@facultyofhomeopathy.org)

“Homeopathy: Empoweringthe Individual”Call for papers

British Homeopathic Congress 2012

•• news extra

Lights, camera, action!Short films featuring Facultymembers will soon beappearing on the Faculty’swebsite.

In mid-July, severalFaculty members travelled to Luton to take part in theFaculty’s filming day.Designed to encouragerecruitment each memberwas filmed talking about why they decided to train in homeopathy and thebenefits it brings to theirpractice and patients.

The films will be uploadedon to the home page of theFaculty website in the coming months. Among theFaculty’s “film stars” were Dr Jeremy Swayne, veterinarysurgeon Chris Day, consultantobstetrician Dr Clare Willocksand Dean of Faculty, Dr Russell Malcolm.

The series of short films were shot by award-winning film companyBaracoa Pictures at theirLuton studio.

16

Has your local group ever thought of holding an Introductory Day?

From time to time the WessexHomeopathic Medical Group hasIntroductory Days to promotehomeopathy and encouragerecruitment. Sadly, at the moment,there are very few people taking up places on homeopathic trainingcourses and, as many of us practisinghomeopathy today are getting older,this situation is clearly not good forthe development of homeopathy in the UK. Recruiting new, youngerpractitioners to homeopathy is crucialfor the future of our marvelloushealing art and each and every one of us should be doing everything we can to promote homeopathy to other healthcare professionals. An Introductory Day serves thispurpose very well. It is a way ofwaving our flag and saying, “We’restill here, homeopathy is fantastic and we’re proud of it!”

As well as serving as anintroduction to fellow healthprofessionals with an interest inhomeopathy, it is also a great moralebooster for your local group.Whenever the Wessex Group gets together it’s always a positiveexperience: sharing our enthusiasmfor homeopathy and inspiring andsupporting each other in our efforts to develop as homeopathicpractitioners. An Introductory Day isanother good excuse to get togetheras a group and generate a positivemessage to the wider world.

Here are a few hints and ideas onhow to run a successful IntroductoryDay. We normally hold these eventson a Saturday, starting at 10 in themorning and finishing at 5pm. Sincewe are quite a big group it’s possibleto share out the roles among quite a large number of people. Our lastIntroductory Day was promoted todoctors, dentists and vets and wasattended by a good mix of peoplefrom these professions along with

a number of medical students too. In our group we’re fortunate to havemembers from all three professionswho can give presentations in theirparticular speciality. It was veryinteresting to have a dentalpresentation, and everybody alwaysseems to be interested in theapplication of homeopathy in treatinganimals. Other members of the groupgave short presentations on thehistory of homeopathy, its principlesand philosophy. We also had severalshort video case presentationsshowing dramatic cures.

Following lunch, the afternoonsession was mainly devoted topresenting five remedy pictures ofhomeopathic medicines which arecommonly used in primary care andfirst aid practice – Pulsatilla, Arnica,Belladonna, Chamomilla and RhusToxicodendron, and again we featuredseveral case examples. We had alsoarranged for Tony Pinkus fromAinsworths Pharmacy to come along to give a presentation on theHomeopathic Pharmacy, which wasexcellent. In addition, Ainsworthskindly provided every delegate with a kit of the remedies we covered sothey could take them away and usethem straight away in their practice.

I believe the success of the eventwas down to a number of things.Firstly, the people attending knewbefore the event that they would begiven prescribing guidelines andremedies so they could immediatelygo off and try homeopathy in theirown practices. We also ensured therewas plenty of discussion and includedbrief sessions where those attendingworked on the remedies and cases in small groups. The quality ofpresentations was very high and I think people like seeing video cases if they are reasonably brief and welledited. And remember to always leavetime at the end of the event to answerquestions. Providing a good lunch andkeeping the cost low also helps toboost the attendance. The fee for theday including lunch and refreshmentswas only £25. We subsidised theevent with excess money we had inthe Wessex Group’s account, whichwas collected over several years fromour regular meetings.

So what’s it like organising such an event? Well, to be honest it’s quitehard work, but extremely worthwhileand we’ll definitely be doing it again.The feedback from our most recentevent was very positive withattendees describing it as inspiringand good fun. But most importantly,some of the delegates went on toattend the Faculty’s courses. So whynot get your local group to try anIntroductory Day.

Dr Jonathan HardyMA BM FFHom*

Promote Homeopathy with an Introductory Day

For the latest news of our campaign to defend homeopathy visit our website www.facultyofhomeopathy.org

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•• book review

Recent developments in homeopathicmethodology have led to the use of a greater number of remedies inpractice. Comparing these to related,well-known remedies can offergreater confidence in prescribing. The use of the materia medica basedon more reliable information fromearly provings is also associated with improved outcomes in practice.A new, revised edition of Studies ofHomeopathic Remedies providesconcise and insightful pictures ofthese important remedies.

Dr Douglas Gibson (1888-1977)trained at St Thomas’ Hospital inLondon. He first worked as a surgeon before serving as a medicalmissionary in China until the outbreakof the Second World War. He wasintroduced to homeopathy in 1936and later worked at the LondonHomeopathic Hospital and became aFellow of the Faculty of Homeopathy.Studies of Homeopathic Remediesbegan life as a series of articles hewrote for the British HomeopathicJournal from 1963 to 1977. Thiscollection of writings on remedypictures is available as a materiamedica, making it readily accessible to new and experienced homeopathicpractitioners alike.

The book was first published in1987 and is available this year inhardback with a new front cover. The original series consisted of 96studies of remedies. The editors haverearranged these in alphabetical order,while also providing a list of theremedies in groups as originallypublished. The editors have added the remedy pictures of four nosodes – Medorrhinum, Syphilinum,Tuberculinum, and Carcinsoin – to make it more complete.

Each remedy is described underdifferent headings shown here in italics.The section on Source is often moststriking for the detailed descriptions ofthe origin and nature of the remedy. Theappearance of the remedy in its naturalstate and environment is revealed, often

within a context of tradition, literature,history and mythology.

The Pharmacology of the remedydescribes some of their chemicaleffects in material form and toxicology,often with colourful descriptions ofpoisonings. The section on Provingrefers to early published provings of a remedy. The actual sources of theinformation within the text are onlyoccasionally referred to.

The general physical Appearanceand behaviour of individuals likely to besensitive to the remedy are explained.The section on Psychology of theremedy picture describes mental andemotional symptoms, while Physiologyrefers to general symptoms.

The Symptomatology of the remedyrelates different symptoms to systemsof the body and is divided into –General, Head, Eyes, Ears, Respiratory,Alimentary, Lymphatic and Glandular,Cardiovascular, Urinary, Genital,Nervous, Locomotor systems and Skin.Information on Modalities is followed

by Clinical notes describing dose,treatment and the relationships of a remedy in practice.

Sometimes, comparison is madebetween the physical appearance ofthe remedy in material form and themental and physical symptoms inthe remedy picture. He writes ofLachesis muta: “The snake has noproper ear but is highly equipped with the sense of touch and acutelyaware of any vibration. In theLachesis subject all the senses areintensified and there is a specialsensitivity to noise, the equivalent in the human to the sensitivity tovibration of the snake.”

The author remarks that “theseparallels and correspondences aresufficiently numerous and striking todeserve mention”. The vivid imageryevoked by these comparisons ofstructure and function makes thewriting memorable, while avoidingany interpretation.

Materia medica reflect the time in which they are written, insofar as

some medical words may not be sofamiliar and any essences and themesof remedy pictures less known. Theunexpected effect of this is to giveinsight into the understanding ofhomeopathy at the time.

The well-structured and conciselywritten remedy pictures make this an accessible and practical book; itsnarrative style contrasts with the listingand highlighting of symptoms in othermateria medica.

The engaging and well-informedwriting is what is most outstanding. The strength of this book lies in theauthor’s unique narration andperceptions on the natural history ofremedies. Studies of HomeopathicRemedies is a unique contribution to the learning and understanding ofremedies that remain essential, even in light of changing practice.

Dr Roger SmithMBBS, LFHom(Med), ST in Medicine(ST refers to Specialist Trainee)

Studies of Homeopathic Remediesby Douglas Gibson; Edited by Marianne Harling and Brian Kaplan

Publishers: Narayana Publishers • 543pp • ISBN: 978-0-906584-17-0Price: €29.00 from www.narayana-publishers.com or £21.95 from Amazon

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•• events

•• examinations calendar 2011

Members-only areaValuable new information is now available in the Members’ area of the Faculty website.

■ Guidance for promoting your website■ Peer appraisal forms and information■ Congress presentations for review■ Media toolkit

To access the Members’ area you will need your user name and password to login – for a login reminder email: info@facultyofhomeopathy.org

What’s on the website www.facultyofhomeopathy.org

PRIMARY HEALTH CARE EXAMEXAM EXAM DATE VENUE CLOSING DATE FOR APPLICATIONS

PHCE 2 September 2011 Bristol 1 July 2011

SPECIALIST REGISTRATION – OPEN TO DOCTORS WHO HAVE GAINED THE MFHOM

EXAM EXAM DATE VENUE CLOSING DATE FOR APPLICATIONS

Assessment 10 October 2011 Glasgow 12 August (cases and dissertation)Assessment 17 October 2011 Luton 12 August (cases and dissertation)

VETERINARY LICENCIATE EXAM – OPEN TO VETS WHO HAVE COMPLETED INTRODUCTORY TRAINING

EXAM EXAM DATE VENUE CLOSING DATE FOR APPLICATIONS

LFHom/Vet 2 September 2011 Bristol 1 July 2011

VETERINARY MEMBERSHIP EXAM – OPEN TO VETS WHO HAVE PASSED THE PCVH

EXAM EXAM DATE VENUE CLOSING DATE FOR APPLICATIONS

Vet MFHom TBA Oxon 16 September 2011

MEMBERSHIP EXAM – OPEN TO NURSES & DOCTORS WHO HAVE PASSED THE PHCE

EXAM EXAM DATE VENUE CLOSING DATE FOR APPLICATIONS

MFHom (Dent) 9 September 2011 TBA 8 July 2011MFHom/MFHom (Nurse) 11 November 2011 Glasgow 23 September 2011

•• case studies

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•• events

•• what’s on August – November

Word, Voice & Mind in Medicine –Russell MalcolmEvent Date: 27/08/2011 – 28/08/2011Event Time: 09:15 until 17:00Venue: The Centre for Integrative MedicalTraining, 11-13 North Claremont Street,Glasgow, G3• Speaker: Dr Russell MalcolmContact: +44 (0)1413 310393

Society of Homeopaths Conference –Evolution & IntegrationEvent Date: 17/09/2011 – 18/09/2011Event Time: 09:00 until 16:00Venue: School of Pharmacy, 29-39 BrunswickSquare, London WC1N 1AKeynote speaker: Dr David LilleyFor more information visit the Society ofHomeopaths website:• http://www.homeopathy-soh.org/events/seminars-and-conferences/event-autumn-conference/

BHH Clinical MeetingsAll meetings are FREE and are open tohomeopaths holding full membership of theFaculty of Homeopathy and students toYear 3, 4, and 5 registered at BristolHomeopathic teaching centre.Next meetings: 19/09/2011 with Dr ElizabethThompson and 17/10/2011 with Dr Lee Burton.Event Time: 8:00pm until 9:30pmVenue: Bristol Homeopathic HospitalFor more information please contact:• Renata Sopiarz, Tel: 0117 9466087Email: Renata.Sopiarz@UHBristol.nhs.uk

Wessex Homeopathic Medical GroupEvent Date: 21/09/2011Event Time: 19:30 until 21:30Venue: Postgraduate Centre, the RoyalHampshire County Hospital, Winchester

The Wessex Homeopathic Medical Groupmeets four times a year for a two-hoursession on a Tuesday or Wednesdayevening. Health professionals with any levelof experience and knowledge ofHomeopathy are welcome.For further information contact:• Dr Jonathan Hardy, The Homeopathic andNatural Health Clinic, Havant, PO9 1PWTel: 023 9247 1757. Email: drjonathanhardy@havant-homeopathic.co.uk

GEMS Gradually Evolving andMastering Sensation withDr Liz Thompson and Geoff Johnson.GEMS days are held on Fridays at the PennyBrohn Centre in Pill BS20 0HHNext event: 23/09/2011“Snakes and Spiders”Event time: 9:15am until 4:30pmStudy day investment: £85Open to fully qualified and registeredhomeopaths. Each day will be worth 5 hours45 minutes CPD time.

Introduction to homeopathy andits position in the field of integrativemedicineEvent date: 23/09/2011Event time: 1:30pm until 4:30pmThis FREE event is open to all stateregistered healthcare and veterinaryprofessionals.For more information please contact:• Renata Sopiarz, Tel: 0117 9466087Email: Renata.Sopiarz@UHBristol.nhs.uk

Bristol Homeopathic Master ClassMammal Remedies from thePrimate OrderEvent Date: 24/09/2011Event time: 10:00am until 4:00pm

Presenter: Dr Jonathan HardyAll Master Classes are held at the upliftingPenny Brohn Centre on SaturdaysFor more information please contact:• Renata Sopiarz, Tel: 0117 9466087Email: Renata.Sopiarz@UHBristol.nhs.uk

Cat and Dog Remedies SeminarEvent Date: 05/11/2011Event Time: 09:30 until 16:30Venue: Blackthorn Trust, St Andrew’s Road,Maidstone, ME16 9ANPresenter: Jonathan HardyTopic: Cat and Dog Remedies• Contact: Christine Suppelt atDrSuppelt@HomeopathyKent.co.ukor on 01622 741086.

Faculty CPD eventHomeopathy in supportive cancercare – an integrative approachEvent Date: 05/11/2011Event Time: 09:30 until 16:30Venue: The West Lancashire Golf Club,Hall Road West, Blundellsands, Liverpool,L23 8SZ.Speaker: Dr Elizabeth ThompsonAt this year’s official Faculty of HomeopathyCPD event Liz Thompson will be talkingabout homeopathy in an integrative cancercare setting at the Bristol HomeopathicHospital. We will look at how homeopathycan be useful in different stages ofsomeone’s cancer journey and will look at different prescribing approaches. Dr Thompson always teaches usinginteractive methods with a mixture of videoand paper cases and we will look at someinteresting homeopathic medicines. Whetheryou work in private practice or the NationalHealth Service come along and feel moreconfident to prescribe in this increasinglyrelevant clinical area.For more information or to bookplease contact:• Nanci Fawcett: 01582 408679nfawcett@facultyofhomeopathy.org

Friday Video Clinic with Dr Elizabeth ThompsonEvent Date: 11/11/2011Event Time: 1:30pm until 3:30pmVenue: Bristol Homeopathic HospitalThese events will suit all levels ofexperience. Each video clinic will be worth2 hrs of CPD time. Cost £15.For more information please contact:• Renata Sopiarz, Tel: 0117 9466087Email: Renata.Sopiarz@UHBristol.nhs.uk

Regular meetingsW Surrey & W Sussex Homeopathic GroupEvent Date: 16/08/2011; 20/09/2011; 18/10/2011Event Time: 20:00 until 22:00Members include doctors, vets, dentists and pharmacists. The aim of the group is to actas a forum for ongoing learning and support, covering all aspects of homeopathy andmedical practice.The Punch Bowl, Oakwood Hill, nr Ockley, Surrey RH5 5PU• Charles Forsyth on 01737 226338 (office), 01737 248605 (home), 07802 293006 (mobile)or charles@dr-forsyth.com

Scotland North Area Group MeetingEvent Date: 12/09/2011 – Event Time: 19:30Venue and speaker TBC• For more information or to confirm attendance please contact Catherine Tiphanie atfac.hom.nth.scot@btinternet.com

Leeds Homeopathic GroupRegular meetings in the Ramada Jarvis Hotel, Adel, north Leeds.• Jutta Prekow on 0113 203 7329 or at jutta.prekow@bradford.nhs.uk

London Homeopathic GroupEvent Date: 29/09/2011 – Event Time: 19:15 until 21:30AGM and accounts. Interdisciplinary case discussions led by Dr Ralf Schmalhorst.Venue: 1 Upper Wimpole Street, London, W1.£10.00 to cover refreshments and administration.• Please contact: anita.e.davies@btconnect.com or Rosie Coles on 020 7935 4271.

If you are organisingan event and would like

it to be included infuture listings,please contactJohn Burry at

jburry@facultyofhomeopathy.org

Free listings

● Sara Eames, President:sara.eames@uclh.nhs.uk

● Liz Thompson, Vice-President:Elizabeth.Thompson@ubht.swest.nhs.uk

● Peter Darby, Dental Dean:peterddarby@aol.com

● Christopher Day, Veterinary Dean:cd@alternativevet.org

● Patricia Donnachie, Nursing Dean:patriciadonnachie@blueyonder.co.uk

● Jonathan Hardy, Independent PracticeRepresentative:drjonathanhardy@havant-homeopathic.co.uk

● Graham Jagger, NHS Primary CareRepresentative:graham.jagger@ntlworld.com

● Lee Kayne, Pharmacy Dean:lee.kayne@nhs.net

● Tariq Khan, Podiatry Dean: tariq.khan@uclh.nhs.uk

● Russell Malcolm, Dean:russellmalcolm@hotmail.co.uk

● Tim Robinson, Members’ Committee Convener:email@doctortwrobinson.com

● Helmut Roniger, NHS Secondary CareRepresentative:helmut.roniger@uclh.nhs.uk

● John Saxton, Immediate Past-President: john.saxton@talk21.com

● Nick Thompson, Promotion Committee Convener:nickthompson@holisticvet.co.uk

● Andrea Wiessner, Treasurer:andrea.wiessner@uclh.nhs.uk

● Cristal Sumner – Chief Executive:csumner@facultyofhomeopathy.org01582 408674

● John Burry – Communications Officer:jburry@facultyofhomeopathy.org01582 408682

● Nanci Fawcett – Education Manager:nfawcett@facultyofhomeopathy.org01582 408679

● Robert Mathie – Research Development Adviser:rmathie@facultyofhomeopathy.org01582 408683

● Lisa Peacock – Web and Social Media Officer:lpeacock@facultyofhomeopathy.org01582 408676

● Tracey Rignall – Membership Officer:trignall@facultyofhomeopathy.org01582 408681

● Lilia Russell – Executive Assistant to ChiefExecutive:lrussell@facultyofhomeopathy.org01582 408675

Who to contact at the Faculty

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