"(As stated below, this review focuses on the pages and references dedicated to homeopathy. As these represent a small part of the book, the review should not be taken as a reflection of the book as a whole - CAMRN administrator) Desktop guide to complementary and alternative medicine: an evidence-based approach By Edzard Ernst, Max Pittler, Barbara Wider Mosby, London 2006 444 pages & CD Here is a book of 444 pages which manages to devote just 2 pages to homeopathy plus one page of references. In accepting the authors' definition of homeopathy, my first issue is with the heading `related techniques'. Autoisopathy, biochemic medicine, homotoxicology, isopathy, tautopathy are listed. I suspect that they are included because they imply the use of diluted medicines, but this is misleading. `Homotoxicology' is the creation of a Dr Reckeweg and is related to homeopathy only in the mind of this doctor, it does not rely on the principles of Hahnemann. Biochemic medicine is the creation of a Dr Heinrich Schüssler, and uses low potencies of just 12 remedies after the cellular pathology theory of a late 19th century scientist, Rudolf Virchow. It could be called a schismatic system. Autoisopathy I think uses secretions of the patient, isopathy uses identical substances, and tautopathy allopathic medicinal substances to make potentised remedies. None of these could be called comprehensive medical systems or paradigms so to cite them here for comparison in the second paragraph is very misleading, especially if this textbook is intended for beginners. Homeopathy, like any school of thought, is littered with more or less valuable experimental thoughts or experiments which may become part of the mainstream or become schisms. Then the authors claim that homeopathy is built on two key principles, similars and the minimum dose. They omit the third key which is the use of a single remedy, just one medicine at a time. They then deny the existence of the rule of similars as a natural law, and deny that there is any rationale for understanding the clinical effects of a minimum dose. There is available a huge body of evidence, clinical observation, laboratory experiments from medicine and physics to better understand homeopathy. The problem to my mind is that the authors do not accept it. The claim that homeopaths to not use conventional disease categories is a canard. Such classification is useful as diagnosis, as prognosis, as a help in understanding if homeopathy may be if value. It may or may not be helpful in arriving at a choice of homeopathic remedy which is a different issue. The authors imply that homeopaths treat benign chronic conditions only. We do not insist on several long consultations. That may or may not be needed and is in any even the patients' choice. It is our experience that patients with acute, life threatening, or malignant conditions also respond well to homeopathy. I have a library of over 7000 volumes of books on homeopathy since the 1830s and I invite the authors to come and read and learn. Here is the clinical evidence which they deny. Using the word 'headache' as an example of a condition to demonstrate the principle of similars is misleading as headache is a concept without much reality until it is described and located. A homeopath would do this so it could be used as an example if the whole process was described including the different specific headache symptoms, concomitants, sensation, location, modality, and aetiology, as described in the proving and by the patient during a consultation. The homeopath would have medical science training so as to be able to professionally judge if there could be a hidden cause e.g. meningitis or brain tumour so that in the end a patient is much safer with this treatment than simply taking a 'pain-killer!' which may mask a serious condition and can never treat the cause. Where is the authors' evidence that provings yield negative results? I have shelves, (and computer files) full of new provings, or homeopathic pathogenetic trials, as they would like to name them, full of useful results. We do not name higher potencies as `stronger', rather as more powerful. And we look at primary and secondary action of medicines. Homeopathy is so safe in pregnancy that one recent audit of homeopathy in an NHS primary care team showed that the largest single category of successful referrals was from the midwife for patients in pregnancy. Many could not, for example, continue their allopathic medication for pre-existing conditions, which were successfully and safely dealt with by homeopathy. These two pages oversimplify and caricature the practice of homeopathy. There is quite a change from the first edition of this work, especially in the references. In the first edition there was a reference to a research claim made by the Nazi regime, that homeopathy was bunk. Firstly to use medical research by that discredited regime is ethically suspect. Secondly there is evidence that the Nazis used and abused homeopathy for foul experiments in concentration camps, about which I have read the Nuremberg transcript from a physician who did this; and they certainly subsidised the homeopathic hospital in Stuttgart. So this reference has gone to be replaced by 24 others. Number 6, Shang et al has been discredited as linked to an attempt to change the access to public funds for the payment of fees for homeopathy by the Swiss government. Another, number 22 involved the use of deceitful email messages purporting to come from anxious parents asking for vaccination advice. The recipients of the messages were not only registered homeopaths, but a haphazard set of names from a publicity website. The replies were used like the inertia selling of insurance, without ensuring permission. This sort of research being unreliable and of doubtful ethics makes me suspect the rest of the book. There are some other references to homeopathy in other sections but the authors having devoted so much negative energy to negative references in this section no doubt have not asked the right questions in relation to clinical experience in the various conditions discussed. Having myself spent this time and space on the unexpectedly brief homeopathy chapter I am not inclined to continue. There will not be space on my desktop for this book. -- Francis Treuherz MA RSHom FSHom Registered Homeopath "