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Objective: To test the hypothesis that homoeopathy is a placebo by examining its effect in patients with allergic rhinitis and so contest the evidence from three previous trials in this series.Design: Randomised, double blind, placebo controlled, parallel group, multicentre study.Setting: Four general practices and a hospital ear, nose, and throat outpatient department.Participants: 51 patients with perennial allergic rhinitis.Intervention: Random assignment to an oral 30c homoeopathic preparation of principal inhalant allergen or to placebo.Main outcome measures: Changes from baseline in nasal inspiratory peak flow and symptom visual analogue scale score over third and fourth weeks after randomisation.Results: Fifty patients completed the study. The homoeopathy group had a significant objective improvement in nasal airflow compared with the placebo group (mean difference 19.8 l/min, 95% confidence interval 10.4 to 29.1, P=0.0001). Both groups reported improvement in symptoms, with patients taking homoeopathy reporting more improvement in all but one of the centres, which had more patients with aggravations. On average no significant difference between the groups was seen on visual analogue scale scores. Initial aggravations of rhinitis symptoms were more common with homoeopathy than placebo (7 (30%) v 2 (7%), P=0.04). Addition of these results to those of three previous trials (n=253) showed a mean symptom reduction on visual analogue scores of 28% (10.9 mm) for homoeopathy compared with 3% (1.1 mm) for placebo (95% confidence interval 4.2 to 15.4, P=0.0007).Conclusion: The objective results reinforce earlier evidence that homoeopathic dilutions differ from placebo. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor on the priority of surgical training among physicians.

Editorial. Discusses various studies in human healing in an effort to focus medical research. Variety of therapeutics; How placebos are used in psychoneuroimmunology, in order to study the way a person reacts to medication; Questions on primary care and biopsychologial perspective; Differences between integrative care and integrated care.

Presents a letter to the editor about the paradoxes in the placebo effect.

Focuses on the health services of the National Health Service in Great Britain. Apprehensions on the absence of waiting list for the recruitment of nurses; Budget deficits for public health services among British countries; Need of surgeons to refrain from dictating the type of surgical services available.

Comments on the management of trust hospitals in Great Britain. Commercial attitude of hospital chief executives; Comparison of health services to crown health enterprises (CHEs) of New Zealand.

Presents letters to the 'British Medical Journal' about a variety of topics. Length of patient consultations with doctors; Drawbacks of telephone consultations; Value of knee imaging by general practitioners; Hormone replacement therapy; Reducing unintended adolescent pregnancy; Others.

Presents letters to the editor concerning medical topics and research. Randomized controlled trials for homeopathy; Evidence based leaflets in maternity care; Sexual behavior and its medicalisation; Domestic violence; Insulin pumps and type-1 diabetes; Advice to tourists travelling to Kilimanjaro.

Presents several letters to the editor for 'The British Medical Journal,' as of January 20, 2001. Thoughts on integrated medicine, where traditional and alternative therapies meet; Use of homoeopathy in perennial allergic rhinitis, as compared to placebos; Protective measures that could help prevent Helicobacter pylori infections; Others.