Authors' Reply

AUTHORS' REPLY: We thank Kim et al. for their response, which allows us to clarify our 3 main points. We maintain that Fleisher's ¹ criticism of Lewith et al.'s ² study is pertinent here. Fleisher does not discuss the use of single versus combination products, but instead addresses 2 points. The first is that isopathy uses “the exact substance that causes an illness as a therapeutic tool for that same illness,” whereas homeopathy uses a substance that produces certain symptoms in healthy people to treat “individuals experiencing a similar set of symptoms in an innate disease process.” ¹ In other words, using the cause of a disease (eg, the allergen) to treat the same disease underlies isopathy and vaccination, but not homeopathy. That criticism applies to both Lewith et al.'s and Kim et al.'s ³ study.

Fleisher's second point is that in-depth analysis of a patient's individual symptoms is “fundamental” to homeopathy and “critical to the selection of the clinically appropriate homeopathic medicine.” ¹ This criticism applies equally to Kim et al.'s study, which Fleisher accepts.

The second central concern in our editorial ⁴ relates to the doses used by Kim et al. and has not been addressed. We raise the issue of homeopathic dilutions to point out that Kim et al.'s dose fell within the conventional immunotherapeutic range as opposed to the usual homeopathic range. We do not mean to imply that homeopathic products are effective only at ultramolecular potencies, but to point out that the studies cited by Kim et al. as precedent for their study all used ultramolecular potencies. We then state that the “switch from a 1 × 10⁻⁶⁰ mg/mL dilution to a 1 × 10⁻⁶ mg/mL dilution represents a dramatic change and should have been justified.” ⁴

Our third concern about the statistical analysis has been accepted.

For these reasons, we stand by our original conclusion that the results of Kim et al.'s study are of questionable relevance to homeopathy.