I am pleased that Dr Malthouse took interest in my letter on homeopathic medicine. The safety of homeopathic medicines should be expected because of their extreme dilutions. In regard to aconite tincture, hom­eopathic tincture is the undiluted form of homeopathic medicine, and is not an ultradilution. 

One of the principles of the practice of homeopathy is that the more diluted the homeopathic pre­paration, the more potent it is. Dr Malthouse may consider the undiluted aconite tincture (which is still a hom­eopathic medicine) being too weak in potency. 

The case report described “A 40-year-old male patient, homeopathic pharmacist by profession, presented to the emergency room with heaviness in the chest following self-medication by consuming 8 drops of the ‘tincture of aconite’ (homeopathic medicine) for indigestion…”[1] The aconite tincture was considered by the homeopathic pharmacist patient and the au­thors to be a homeopathic medicine. 

Besides the report of cardiac complication from a homeopathic medicine, there is a case report on thallium intoxication caused by a homeopathic preparation.[2] Several reports were quoted regarding the use of homeopathic Acon­i­tum and Arsenicum including one on management of acute anxiety. 

In a comparative study of placebo-controlled trials of homeopathy and allopathy, the authors conclude the finding is compatible with the notion that the clinical effects of homeopathy are placebo effects.[3] In addition, there were three case reports on arsenic toxicity from homeopathic treatment.[4] 

There is a sad report at Dna Tube, a scientific video site, entitled “What’s the Harm: Gloria Thomas Sam,” on the death of a 9-month-old girl with eczema receiving treatment with hom­eopathic medicine from her homeopath father. The parents were charg­ed and jailed.[5] This is an example of the grave consequence of failure (or delay) in the use of conventional medicine in a relatively common and reasonably manageable disease. 

As for leptospirosis, I wonder if our local infectious disease specialists would advocate the use of homeopathic medicine in the management of infectious diseases. Dr Malthouse rested his case on several meta-analyses supporting the effectiveness of homeopathy. In his reference 10, Linde and coauthors found insufficient evidence from these studies that homeopathy is clearly efficacious for any single clinical condition.[6] 

“A systematic review of systematic reviews of homeopathy”[7] was published by Dr Edzard Ernst, the world’s first professor of complementary medicine, at the University of Exeter, England, with his medical career be­ginning at a homeopathic hospital in Mu­nich. He concluded the evidence from systematic reviews does not support the hypothesis that any given homeopathic remedy leads to clinical effects that are relevantly different from placebo or superior to other control interventions for any medical condition. 

I would like to return to one of the homeopathic medicines in my previous letter, Aconite 30C (Figure 1 [9]). It is an example of Dr Malthouse’s homeopathic ultradilution. The 30C dilution was advocated by Samuel Hahnemann, the father of homeopathy, for most purposes It is 10^-60 dilution. Patient would need to consume 10⁴¹ pills (a billion times the mass of the earth) or 10³⁴ gallons of liquid remedy (10 billion times the volume of the earth) to consume a single molecule of the original substance.[8] 

Moreover, since even in a 15C solution there would very likely be no molecule of the original substance left, the 30C solution would probably contain no molecules of water that had come into contact with the original substance. Figure 2 [10] shows “A homeopathic medical product without approved therapeutic indications.” Certainly this statement is not inserted voluntarily by the manufacturing company. It is imposed by government health authority, with thorough research in homeopathy and its efficacy. 
—H.C. George Wong, MD Vancouver