“Bach Flower Remedies” (also sometimes called “Flower Essences” or “Flower Remedies”) were invented about 80 years ago by the British physician and microbiologist Dr Edward Bach (1886–1936). Dr Bach became convinced that most human illnesses are caused by negative states of mind (e.g., fear, jealousy, despair). He identified 38 remedies – each based on one native flower which, according to his conviction, would alleviate such negative feelings and thus restore health . Further flower remedies have since been added by Bach’s followers. Dr Bach claimed to treat the whole person in an individualised fashion; two patients afflicted by the same mainstream diagnosis might therefore be treated with two different remedies.
Flower remedies are produced by dropping fresh flowers into water; this yields the “mother tincture” to which brandy is subsequently added as a preservative. Thus they do not contain pharmacologically relevant amounts of constituents of the flowers they originate from. Flower remedies thus have similarities to homeopathic medicines, yet there are clear distinctions between the two systems . According to proponents of flower remedies, their mode of action does not depend on molecular or pharmacological mechanisms but on the subtle “energy” that is transmitted from the flowers to this remedy . This “energy” has so far defied quantification, and critics therefore argue that flower remedies are pure placebos .
Flower remedies have become a thriving business. They are readily available from a wide range of outlets and many consumers strongly believe in their effectiveness. A previously published systematic review of flower remedies by the current author  is now outdated. A more recent review was focussed specifically on pain and psychological problems and included only four controlled trials . Another review also only included four randomised clinical trials (RCTs) . It is therefore timely and relevant to conduct an update.
Review article | Published 24 August 2010, doi:10.4414/smw.2010.13079 Cite this as: Swiss Med Wkly. 2010;140:w13079
Bach flower remedies: a systematic review of randomised clinical trials
Edzard Ernst Universities of Exeter & Plymouth, Exeter, Devon, United Kingdom
Bach flower remedies continue to be popular and its proponents make a range of medicinal claims for them. The aim of this systematic review was to critically evaluate the evidence for these claims. Five electronic databases were searched without restrictions on time or language. All randomised clinical trials of flower remedies were included. Seven such studies were located. All but one were placebo-controlled. All placebo-controlled trials failed to demonstrate efficacy. It is concluded that the most reliable clinical trials do not show any differences between flower remedies and placebos.
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