Homeopathic proving symptoms: result of a local, non-local, or placebo process? A blinded, placebo-controlled pilot study

Paradigm-Specific Risk Conceptions, Patient Safety, and the Regulation of Traditional and Complementary Medicine Practitioners: The Case of Homeopathy in Ontario, Canada

While the principle of risk reduction increasingly underpins health professional regulatory models across the globe, concepts of risk are neither static nor epistemically neutral. Conventional biomedicine's risk conceptions are substantially rooted in principles of scientific materialism, while many traditional and complementary medicine systems have vitalistic epistemic underpinnings that give rise to distinctive safety considerations. The statutory regulation of traditional and complementary medicine providers has been identified by the World Health Organization as a strategy for enhancing public safety. However, complex risk-related questions arise at the intersection of medical epistemologies whose concepts are at best overlapping, and at worst incommensurable. Elaborating a theoretical concept of "paradigm-specific risk conceptions," this work employs Bacchi's poststructural mode of policy analysis ("What's the Problem Represented to Be?") to critically analyze risk discourse in government documents pertaining to the 2015 statutory regulation of homeopathic practitioners in Ontario, Canada. The Ontario government's pre-regulatory risk assessments of the homeopathic occupation discursively emphasized cultural safety principles alongside homeopathy-specific risk conceptions. These paradigm-specific concepts, rooted in homeopathy's epistemic vitalism, extend beyond materialist constructions of adverse events and clinical omission to address potential harms from homeopathic "proving symptoms", "aggravation," and "disruption," all considered implausible from a biomedical standpoint. Although the province's new homeopathy regulator subsequently articulated safety competencies addressing such vitalistic concepts, the tangible risk management strategies ultimately mandated for practitioners exclusively addressed risks consistent with the scientific materialist paradigm. This policy approach substantially echoes the implicit biomedical underpinnings evident in Ontario's broader legislative context, but leaves a significant policy gap regarding the primary safety considerations originally articulated as substantiation for homeopathy's statutory regulation. To optimally preserve patient safety and full informed consent, regulators of traditional and complementary medicine professionals should favor a pragmatic, epistemically-inclusive approach that actively negotiates paradigm-specific risk conceptions from both biomedicine and the occupation under governance.

Scientific proving of ultra high dilutions on humans

BACKGROUND

Homeopathic drug provings or pathogenetic trials (HPTs) are the pillar of homeopathy. This review summarizes the authors' findings and interpretations derived from a series of homeopathic drug proving between 1994 and 2015. It gives an overview over a series of attempts to use modern scientific experimental methodology to answer the question, whether such HPTs produce symptoms in healthy volunteers that can be distinguished from placebo symptoms.

METHODS

Various experimental models were used: repeated crossover trials with categorical data collection, and a single-case, randomised study. Final models use diligent qualitative data-collection in experienced volunteers. In those, raters decide whether symptoms are typical for a remedy delivered or not. The design is triple-blind and placebo-controlled.

RESULT

While previous attempts were inconclusive, this new model allowed to separate placebo symptoms from verum symptoms repeatedly in a series of two definitive studies following promising pilot studies. Results were statistically significant. Also, some signs of the purported non-local signature of homeopathic effects were visible, and the consequences for future methodology is discussed.

CONCLUSION

Provided some cautionary notes are taken into account, HPTs can be used to separate out true specific symptoms from placebo symptoms. By the same token this is a road to experimental proof that homeopathic remedies are not just placebos. However, this needs to be taken forward by independent groups.

On the observed specific and non-specific effects of complex therapeutic interventions: truly separate or complementary?

Specific and non-specific effects observed in randomised controlled trials (RCTs) are generally treated implicitly as ontologically separate and purely additive. Building on the notions of Heisenberg uncertainty and complementarity from the discourse of quantum theory, and using a simple arithmetic argument, it is demonstrated how this separation enables results of RCTs (particularly of complex interventions) to be treated in a convenient but ultimately incorrect manner. Conclusions drawn from RCTs (that justify--and are justified by--a reductionist approach to therapeutic efficacy) should therefore be open to question.

Do Homeopathic Pathogenetic Trials generate recognisable and reproducible symptom pictures?: Results from a pilot pathogenetic trial of Ozone 30c

BACKGROUND

Homeopathic Pathogenetic Trials (HPTs) are a pillar of homeopathy, a key source of the symptoms characteristic of a particular homeopathic medicine. Homeopaths choose homeopathic medicines by comparing these remedy pictures with the symptoms the patient is presenting. Thus, recognition of these symptom sets underpins the clinical practice of homeopathy.

OBJECTIVE

To test whether HPTs generate consistent and recognisable sets of symptoms in consecutive trials.

DESIGN

Practising homeopaths, blinded to the homeopathic medicine under investigation, were given the set of symptoms generated during an unpublished HPT and asked to identify the homeopathic medicine used.

HOMEOPATHIC TRIAL SUBSTANCE

Ozone, prepared by homeopathic method to the ultramolecular dilution of 30c (10(-60) dilution), was chosen at random from twenty potential medicines.

RESULTS

Seven practising homeopaths were asked to make three guesses as to the identity of the remedy. Initially from the full list of possible remedies (N = 2372). Two of the seven homeopaths guessed the identity of the remedy correctly (p < 0.0001). Subsequently, when their choice of possible medicines was restricted to a list of 20, the same two homeopaths selected the correct medicine, however none of the other practising homeopaths did so (p = 0.2).

DISCUSSION

The selection of the correct homeopathic medicine from the unrestricted list (N = 2372 medicines) by two homeopaths is noteworthy given that the homeopathic medicine used during the HPT was diluted well beyond Avogadro's number and would not be expected to produce any detectable or recognisable symptomatology. Possible reasons why the remaining five homeopaths did not guess correctly are discussed.

CONCLUSION

The results show that practising homeopaths may be able to correctly identify a homeopathic medicine from the set of symptoms generated during an HPT. This suggests that such symptom pictures generated by taking an ultramolecular homeopathic medicine are recognisable and specific to the substance taken. Since identification of the remedy was based on past HPT information held in the materia medica, this demonstrates that HPT-generated symptom pictures are reproducible, thus validating the HPT methodology. These promising preliminary findings warrant replication; possible improvements to the trial design to be incorporated in future studies were identified.

An exploration of the relationship between placebo and homeopathy and the implications for clinical trial design

Placebo appears to be a real neurobiological phenomenon that has evolved through the selection pressure to be able to heal ourselves. The complex language and social structures of humans means that we can attribute meaning to therapeutic encounters with culturally sanctioned authority figures and we can use our attachment to such figures to generate hope for recovery. Different mechanisms may be involved in the neurobiological aspect of placebo including anxiety, learning, conditioning as well as individual genetic variation. Examination of the published work shows that while some trials do seem to indicate a specific mode of action for homeopathic remedies other trials do not and this is an issue that needs to be addressed at the trial design stage. A clinical trial that includes both a placebo group and a non-participating control arm is the most powerful design for separating the non-specific and polymorphic placebo effect from the specific effects of trial medication. The control variables in a trial of homeopathic medication should also include the process of consultation as this may assume a meaning for the individual that can also be associated with a placebo effect.

Homeopathic drug proving of Okoubaka aubrevillei: a randomised placebo-controlled trial

BACKGROUND

Homeopathic drug proving is a basic concept in homeopathy. This study aimed to record symptoms produced by a homeopathic drug compared with placebo.

METHODS

This multicentre, randomised, double-blind, placebo-controlled phase 1 trial consisted of a 7-day run-in period, a 5-day intervention period and a 16-day post-intervention observation period. Subjects, investigators and statisticians were blinded for intervention groups and identity of the homeopathic drug. Subjects in the intervention group received Okoubaka aubrevillei (potency C12) and subjects in the placebo group received the optically identical sucrose globules. Dosage in both groups was five globules taken five times per day over a maximum period of 5 days. Subjects documented the symptoms they experienced in a semistructured online diary. The primary outcome parameter was the number of characteristic proving symptoms compared with placebo after a period of 3 weeks. Characteristic symptoms were categorised using content analysis. Secondary outcome parameters were the qualitative differences in profiles of characteristic and proving symptoms and the total number of all proving symptoms. The number of symptoms was quantitatively analysed on an intention-to-treat basis using analyses of covariance with the subject's expectation and baseline values as covariates.

RESULTS

Thirty-one subjects were included (19 Okoubaka and 12 placebo). Data for 29 participants could be analysed. No significant differences in number of characteristic symptoms in both groups were observed between Okoubaka (mean±standard deviation 5.4±6.0) and placebo (4.9±5.6). The odds ratio for observation of a characteristic symptom was 1.11 (95% confidence interval 0.4 to 3.05, P=0.843). Females and subjects expecting a higher number of symptoms at baseline or feeling more sensitive to homeopathic drugs experienced more characteristic symptoms regardless of allocation. The qualitative analysis showed an inter-coder reliability of 0.69 (95% confidence interval 0.62 to 0.76). The qualitative comparison of symptom profiles was inconclusive.

CONCLUSIONS

Combined results of qualitative and quantitative methods did not result in a significant difference of characteristic proving symptoms between O. aubrevillei C12 and placebo. The qualitative comparison of the symptom profiles leaves some open questions. The nocebo effect might be a plausible explanation for most of the phenomena observed in this trial.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT01061229.

Homeopathic drug discovery: theory update and methodological aspect

BACKGROUND

Homeopathy treats patient on the basis of totality of symptoms and is based on the principle of 'like cures like'. It uses ultra-low doses of highly diluted natural substances as remedies that originate from plants, minerals or animals.

OBJECTIVE

The objectives of this review are to discuss concepts, controversies and research related to understanding homeopathy in the light of modern science.

METHODS

Attempts have been made to focus on current views of homeopathy and to delineate its most plausible mechanism(s) of action.

RESULTS

Although some areas of concern remain, research carried out so far both in vitro and in vivo validates the effects of highly diluted homeopathic medicines in a wide variety of organisms.

CONCLUSION

The precise mechanism(s) and pathway(s) of action of highly diluted homeopathic drugs are still unknown.

Toward a topological description of the therapeutic process: part 2. Practitioner and patient perspectives of the "journey to cure"

BACKGROUND

The discourse of quantum theory has been used to describe (1) the homeopathic therapeutic process (in terms of three-way macro-entanglement between patient, practitioner, and remedy, called PPR entanglement), and (2) the homeopathic concept of the vital force.

METHODS

Combining these two approaches leads to a semiotic (i.e., pertaining to the theory of sign systems in language) geometry that illustrates the nature of this entanglement and how it could facilitate the patient's journey to cure. Here, this geometry is extended further to gain insight into both practitioner and patient perspectives of the process.

RESULTS

From the practitioner's perspective, the semiotic geometry predicts PPR entanglement, generating a number of distinguishable therapeutic outcomes that depend on the various patient-, disease-, and remedy-based "contributions" to the overall symptom picture of the remedy arrived at holistically. Furthermore, these outcomes may be seen as different facets of a more generalized PPR entangled state whose semiotic geometrical representation is hyperdimensional. Likewise, the patient's perspective of the journey to cure can also be represented semiotically, this time as a series of cross-sections through a hyperdimensional figure of similar symmetry, entering and leaving the patient's notional "dis-ease" space.

CONCLUSIONS

The semiotic geometries representing practitioner and patient experiences of the therapeutic process ultimately converge. Where they differ is that in elaborating the patient's journey to cure, the practitioner's perspective may be seen as from the outside of a whole process. As it is the patient who ultimately is traveling this journey, the patient's perspective is necessarily from the inside, of stages or cross-sections of the whole process.

Toward a topological description of the therapeutic process

INTRODUCTION

Two (2) quantum theoretically based metaphor/models have been proposed recently to describe the therapeutic process in homeopathy in terms of (1) a representation of the vital force (Vf) as a spinning quantized gyroscope, describable as a wave function; and (2) a form of nonorthodox quantum theoretical entanglement (called PPR entanglement) between the patient, practitioner, and remedy.

METHOD

Combining these two descriptions permits "normalization" of the Vf gyroscopic wave function. In this context, "normalization" refers to the probability of a patient's symptom totality being expressed and observable to the practitioner within a "therapeutic state space" that has mirror-like characteristics.

RESULTS

The Vf gyroscopic wave function contains a constant A related to this symptom totality and its expression. Normalization provides values for A at various stages of the patient's journey to cure, while at the same time suggesting a possible Möbius strip-like "topology" for the practitioner-derived "therapeutic state space."

CONCLUSIONS

Changes in the value of A on normalization indicate how expression of symptom totality varies at different stages of the patient's journey to cure, while suggesting a "topology" for the therapeutic process and how the practitioner could be affected by it.

Protocol for a phase 1 homeopathic drug proving trial

Background

This study protocol adapts the traditional homeopathic drug proving methodology to a modern clinical trial design.

Method

Multi-centre, randomised, double-blind, placebo-controlled phase 1 trial with 30 healthy volunteers. The study consists of a seven day run-in period, a five day intervention period and a 16 day post-intervention observation period. Subjects, investigators and the statisticians are blinded from the allocation to the study arm and from the identity of the homeopathic drug. The intervention is a highly diluted homeopathic drug (potency C12 = 10²⁴), Dose: 5 globules taken 5 times per day over a maximum period of 5 days. The placebo consists of an optically identical carrier substance (sucrose globules). Subjects document the symptoms they experience in a semi-structured online diary. The primary outcome parameter is the number of specific symptoms that characterise the intervention compared to the placebo after a period of three weeks. Secondary outcome parameters are qualitative differences in profiles of characteristic and proving symptoms and the total number of all proving symptoms. The number of symptoms will be quantitatively analysed on an intention-to-treat basis using ANCOVA with the subject's expectation and baseline values as covariates. Content analysis according to Mayring is adapted to suit the homeopathic qualitative analysis procedure.

Discussion

Homeopathic drug proving trials using the terminology of clinical trials according GCP and fulfilling current requirements for research under the current drug regulations is feasible. However, within the current regulations, homeopathic drug proving trials are classified as phase 1 trials, although their aim is not to explore the safety and pharmacological dynamics of the drug, but rather to find clinical indications according to the theory of homeopathy. To avoid bias, it is necessary that neither the subjects nor the investigators know the identity of the drug. This requires a modification to the informed consent process and blinded study materials. Because it is impossible to distinguish between adverse events and proving symptoms, both must be documented together.

Trial registration

ClinicalTrials.gov identifier: NCT01061229.

Falling trees, fractals, and sophistry: some philosophical "biohazards" en route to reconciling biomedicine and homeopathy

INTRODUCTION

Reconciling biomedical science and homeopathy might usefully begin by examining their various observational stances. This depends significantly on preconceptions about the nature of reality (e.g., whether it exists externally, independent of observers, or whether it is to some extent correlated nondeterministically with observation).

METHODS

Based on known observables, a rudimentary fractal model of the universe is proposed consisting of a series of self-similar integrated levels of reality, or "wholes" contained one within another like a set of Russian dolls. This model suggests possible contextualization of homeopathy and biomedicine's observational stances.

RESULTS

The fractal model bears compelling similarities to the ancient Hermetic tradition encapsulated in the phrase, "As above; so below." In the context of this model, homeopathy's observational stance includes a multidimensional range of symptoms from across several "levels of wholeness." In contrast, biomedicine's stance corresponds to exclusive observation of separate symptoms, each originating from one physical level of reality.

CONCLUSIONS

Pragmatic reconciliation of these two viewpoints is possible if it is realized that they are not contradictory but complementary; that each has its place in the therapeutic scheme of things, and that it should be possible to move freely between each type of observational stance as the patient's circumstances dictate.

A new geometrical description of entanglement and the curative homeopathic process

INTRODUCTION

The Memory of Water, a "local" explanation of homeopathy's efficacy, has been supplemented recently by complementary "nonlocal" hypotheses. One of these envisages "quantum macro-entanglement" among patient, practitioner, and remedy to form a "PPR" entangled state, from which the possibility of cure may manifest.

METHODS

Semiotic analysis affords a geometrical description of this entangled state as a patient-centered chiral tetrahedron. Its four corners depict three different types of symptoms (of the patient, the dis-ease, and the remedial substance) and the potentized remedy.

RESULTS

Reflecting this state in a practitioner-derived mirror-like "therapeutic state space" generates two notional patient-centered chiral tetrahedra: cure may be thought to arise from their patient-driven combination "through the looking glass" of the therapeutic state space, into one polyhedron called a stella octangula or stellated octahedron; in essence, a 3-dimensional Star of David.

CONCLUSIONS

The practitioner helps in forming these notional semiotic polyhedra, but the patient is at their epicenters (i.e., the practitioner facilitates but ultimately does not control the curative process).

Homeopathic pathogenetic trials produce more specific than non-specific symptoms: results from two double-blind placebo controlled trials

We conducted two parallel, blinded homeopathic pathogenetic trials conducted at two different sites to determine whether symptoms reported by healthy volunteers were significantly different for homeopathic remedies than for placebos. Study 1 used a two-armed design, testing ozone against placebo. Study 2 used a three-armed design, testing ozone and iridium against placebo. We found significantly more remedy-specific symptoms in provers taking ozone or iridium than in provers taking placebo in the three-armed trial and in both trials pooled for ozone and placebo. We, therefore, conclude that homeopathic remedies produce more symptoms typical for a remedy than non-typical symptoms. The results furthermore suggest a somewhat non-classical pattern because symptoms of one remedy appear to be mimicked in the other trial arm. This might be indicative of entanglement in homeopathic systems.

Journeys in the country of the blind: entanglement theory and the effects of blinding on trials of homeopathy and homeopathic provings

The idea of quantum entanglement is borrowed from physics and developed into an algebraic argument to explain how double-blinding randomized controlled trials could lead to failure to provide unequivocal evidence for the efficacy of homeopathy, and inability to distinguish proving and placebo groups in homeopathic pathogenic trials. By analogy with the famous double-slit experiment of quantum physics, and more modern notions of quantum information processing, these failings are understood as blinding causing information loss resulting from a kind of quantum superposition between the remedy and placebo.

A systematic review of the quality of homeopathic pathogenetic trials published from 1945 to 1995

BACKGROUND

The quality of information gathered from homeopathic pathogenetic trials (HPTs), also known as 'provings', is fundamental to homeopathy. We systematically reviewed HPTs published in six languages (English, German, Spanish, French, Portuguese and Dutch) from 1945 to 1995, to assess their quality in terms of the validity of the information they provide.

METHODS

The literature was comprehensively searched, only published reports of HPTs were included. Information was extracted by two reviewers per trial using a form with 87 items. Information on: medicines, volunteers, ethical aspects, blinding, randomization, use of placebo, adverse effects, assessments, presentation of data and number of claimed findings were recorded. Methodological quality was assessed by an index including indicators of internal and external validity, personal judgement and comments of reviewers for each study.

RESULTS

156 HPTs on 143 medicines, involving 2815 volunteers, produced 20,538 pathogenetic effects (median 6.5 per volunteer). There was wide variation in methods and results. Sample size (median 15, range 1-103) and trial duration (mean 34 days) were very variable. Most studies had design flaws, particularly absence of proper randomization, blinding, placebo control and criteria for analysis of outcomes. Mean methodological score was 5.6 (range 4-16). More symptoms were reported from HPTs of poor quality than from better ones. In 56% of trials volunteers took placebo. Pathogenetic effects were claimed in 98% of publications. On average about 84% of volunteers receiving active treatment developed symptoms. The quality of reports was in general poor, and much important information was not available.

CONCLUSIONS

The HPTs were generally of low methodological quality. There is a high incidence of pathogenetic effects in publications and volunteers but this could be attributable to design flaws. Homeopathic medicines, tested in HPTs, appear safe. The central question of whether homeopathic medicines in high dilutions can provoke effects in healthy volunteers has not yet been definitively answered, because of methodological weaknesses of the reports. Improvement of the method and reporting of results of HPTs are required.

REFERENCES

References to all included RCTs are available on-line at.

Double-blind, placebo-controlled homeopathic pathogenetic trials: Symptom collection and analysis

BACKGROUND

Homeopathic pathogenetic trials (provings) are fundamental to homeopathy. Since most of the data from available provings have not been statistically evaluated, it is unclear how specific reported symptoms are and how they differ from those reported by people taking placebo.

METHOD

We combine and analyse data from two different homeopathic pathogenic trials--including 10 and 11 provers, respectively, and both including 30% placebo-to test the null hypothesis that there is no significant difference between the number of symptoms in placebo and verum groups.

RESULTS

The principal results were: Placebo reported less symptoms than verum groups. Symptom distribution according to predefined classes (common symptoms increased in intensity and/or duration-, cured, old, new and exceptional) was statistically different between placebo and verum group at a high level of significance (P<0.001). Compared to verum, placebo provers reported less new and old but more common (increased in duration or intensity) symptoms. Within repertory categories, other differences were detected. The two groups differ in terms of the duration of each symptom and kinetics of symptoms: most symptoms were more persistent in verum than in placebo groups and verum provers recorded a decreasing number of symptoms with time. Placebo provers did not show such a temporal pattern.

CONCLUSIONS

If confirmed by other studies these results would demonstrate the non-equivalence between homeopathic medicines in high dilution and placebo and contribute to the improvement of proving methodology and evaluation.

Towards a New Model of the Homeopathic Process Based on Quantum Field Theory

BACKGROUND

Quantum theory's notions of non-locality and entanglement have previously informed attempts to model the therapeutic process. Of these, Weak Quantum Theory (WQT) and Patient- Practitioner-Remedy (PPR) entanglement are developing into mathematically- based models of homeopathy.

OBJECTIVE

The present study attempted to identify fundamental concepts within quantum field theory (QFT) that could be used to broaden the scope of PPR entanglement models, prior to constructing a more rigorous mathematical treatment.

METHODS

In QFT, particles and forces are considered as fully interacting relativistic quantum matter and force fields, respectively. These interactions are visualized graphically as spacetime Feynman diagrams. Further, these interacting field systems can have ground states with broken symmetry; the so-called Higgs field being responsible for this symmetry breaking. In the new model, patient, practitioner and remedy are imagined as fully interacting quantum-like fields; patients and practitioners in terms of quantum matter-type fields, and remedies and diseases as quantum interaction-type fields.

RESULTS

Disease manifestation by the Vital Force (Vf) could be an event similar to spontaneous symmetry breaking in QFT: the curative remedy acting to restore the broken symmetry of the Vf field. Entanglement between patient, practitioner, and remedy might be representable as Feynman-like diagrams.

CONCLUSION

QFT demonstrates that quantum properties can be physical without being observable. Thus, an underlying similarity in discourse could exist between homeopathy and quantum theory which could be useful for modelling the homeopathic process. This preliminary investigation also suggested that key elements of previous quantum models of the homeopathic process, may become unified within this new QFT-type approach.

Research on homeopathy: state of the art

In this paper, we review research on homeopathy from four perspectives, focusing on reviews and some landmark studies. These perspectives are laboratory studies, clinical trials, observational studies, and theoretical work. In laboratory models, numerous effects and anomalies have been reported. However, no single model has been sufficiently widely replicated. Instead, researchers have focused on ever-new models and experiments, leaving the picture of scattered anomalies without coherence. Basic research, trying to elucidate a purported difference between homeopathic remedies and control solutions has also produced some encouraging results, but again, series of independent replications are missing. While there are nearly 200 reports on clinical trials, few series have been conducted for single conditions. Some of these series document clinically useful effects and differences against placebo and some series do not. Observational research into uncontrolled homeopathic practice documents consistently strong therapeutic effects and sustained satisfaction in patients. We suggest that this scattered picture has to do with the fourth line of research: lack of a good theory. Some of the extant theoretical models are reviewed, including placebo, water structure, silica contamination, energy models, and entanglement models. It emerges that local models, suggesting some change in structure in the solvent, are far from convincing. The nonlocal models proposed would predict that it is impossible to nail down homeopathic effects with direct experimental testing and this places homeopathy in a scientific dilemma. We close with some suggestions for potentially fruitful research.

Entanglement, Knowledge, and Their Possible Effects on the Outcomes of Blinded Trials of Homeopathic Provings

INTRODUCTION

In two recent studies of double-blind placebo-controlled homeopathic provings, entanglement was reported to have occurred between verum and placebo arms of the trials. This contrasts directly with the entanglement-disrupting effects of blinding, recently proposed as the reason for the failure of randomized controlled trials (RCTs) to demonstrate unequivocally the efficacy of homeopathy. It is proposed here that such entanglement between remedy and placebo during these double-blind placebo controlled provings is the direct result of the blinding process.

METHOD

A previously developed theoretical model of entanglement in homeopathy among patient, practitioner, and remedy (called PPR entanglement) was used in this investigation.

RESULTS

In agreement with the results from the proving studies, the model predicts that application of the double-blind RCT methodology to homeopathic provings leads to entanglement between both remedy and placebo arms of the trial.

CONCLUSIONS

These theoretical findings can be understood in terms of the act of blinding leading to loss of information because of quantum-like state superposition of the verum and placebo proving groups. This is compared to conclusions drawn from the well-known double-slit experiment of quantum physics, and quantum information processing. It leads to a suggestion for testing entanglement in homeopathic provings.

Presentiment or entanglement?

A number of authors have recently discussed the possible role entanglement in homeopathy. Walach et al have published a homeopathic proving which they interpreted as demonstrating entanglement between placebo and verum groups in a proving. The lack of a 'run-in' period was a weakness of this trial. We present further results of our proving of Belladonna which show that subjects who reported symptoms during the placebo run-in period ('presentiment provers') were more likely to report symptoms during the treatment period. This data suggests and the observations of Walach et al may be explicable by conventional mechanisms including differential reporting and constitutional type.