History

Homoeopathy is a system of therapeutics based upon the "law of similars", introduced by Samuel Hahnemann (1755-1843), a physician and chemist of Meissen, Germany.

Many points of Hahnemann's system were borrowed from Hippocrates who, over 2,300 years ago, wrote,"Through the like, disease is produced and through the application of the like, it is cured", and from Paracelsus (1490-1541), "You there bring together the same anatomy of the illness into one order. This simile gives you understanding of the way in which you shall heal".

Homoeotherapeutics today is a systematic, empirical health practice and attracts a wide "New Age" following.


Theory

The essential tenets of homoeopathy are that the cure of disease is effected by drugs that are capable of producing symptoms similar to those of the disease to be treated in a healthy individual. To ascertain the curative virtues of any drug, it must be "proved" upon healthy persons — that is, taken by individuals of both sexes in a state of good health.

Hahnemann's "Law of Similia" that treated "like with like" is attributed to observations he made after ingesting a dose of cinchona bark (the source of quinine) and experiencing symptoms of fever, which is a symptom of malaria. He reasoned that as the symptoms were similar to the condition it was used to treat, his Law of Similia could be used to evaluate the efficacy of a particular medicine. This process is known as "proving" a medicine.

Hahnemann's theory appears to have been based on a revival of Paracelsus' Doctrine of Signatures, which declared that herbs would cure conditions of the anatomical parts they resembled, such as snakeroot for snakebite. This was much the same as the primitive view of monism, where the ancient practice of eating various organs of animals and humans was believed to endow the consumer with the qualities with which they were associated. A lion's heart for courage, for example.

One may well ask however, what sort of qualities could be associated with some homoeopathic medicines such as powdered starfish (lachryma filia), skunk secretion (mephitis), crushed live bedbugs (cimex lectularius) and uric acid (acidum uricum).


Practice

A homoeopathic consultation consists of taking an elaborate history of the patient which, apart from the usual standard medical questions, includes questions about emotions, moods, food preferences and reactions to the weather. All this is collated, and by referring to the materia medica, a remedy is found. The extent of this personal attention may persuade patients that the practitioner is concerned about their wellbeing.

Another feature of homoeopathy is its theory of dose. Most homoeopaths believe in the action of minute doses of medicine which are prepared as follows: If the medicinal substance is soluble, one part is diluted in 9 or 99 parts water and/or alcohol solution and shaken vigorously. If insoluble, it is ground and mixed in similar proportions with milk sugar. One part of the diluted mixture is diluted and shaken again in proportions ranging from one tenth to one millionth.
 
Most remedies today range from 6x to 30x.

According to the laws of chemistry, there is a limit to the dilution that cant be made without losing the original substance altogether. Hahnemann however, believed that the vigorous shaking with each step of the dilution (Succussion, or Trituration in the case of non-solubles) leaves a spirit-like essence that cures by reviving the body's "vital force". He further believed that dilution increases potency, a remarkable conclusion when one considers things such as pesticides or poisons where it could be claimed that a lesser rather than a greater amount is the more potent. I doubt too, that one is more likely to become intoxicated by drinking a greater rather than lesser quantity of soda water with one's whisky.

As homoeopathic remedies do not have the side effects caused by some modern drugs and because of the current disaffection with and the scepticism of the efficacy of brief and hurried visits to conventional physicians, the popularity of homoeopathic practitioners and homoeopathic medicines has increased dramatically in the past two decades or so.


Assessment

In an attempt to answer the obvious question, "How can a sub-molecular compound possibly have any effect?" Homoeopaths believe that the pounding and vigorous shaking with each step of the dilution imparts a memory which helps revive the body's "vital force". However, although many hypotheses have been put forward to explain "vital force", none have stood up to scientific scrutiny.

A recent attempt to validate homoeopathy came from the French Institute of Health and Medical Research at the South Paris University in 1988, where Dr. Jacques Benveniste put forward experimental results supporting the idea that no matter how small the dilutions of a substance, it would still have an effect. Dr. Benveniste reported that human white blood cells respond to a solution of antibodies, even when the solution is so dilute that it no longer contains a single molecule of the antibody.

Dr. Benveniste and his colleagues estimated that less than one molecule of antibody remains present when the solution is diluted to 1 x 1014 yet in this instance, the dilution procedure was taken to 1 x 10120 and there was still a perceived effect. This claim was taken as supportive of homoeopathy and its "law of infinitesimals". The scientific community was agog and incredulous, for if the results were confirmed, it would question the entire basis upon which molecular scientists work. However, an investigation instigated by Nature in conjunction with sceptical investigator James Randi, Walter Stew art of the U.S. National Institute of Health, and John Maddox, editor of Nature, found that the results of the experiments were due to wishful thinking and were a "delusion". Consumer Reports concluded in its January 1987 issue:

 
The last warning is not to be taken lightly. In 1954, a four year old Long Island boy, Jerald Winston, died of leukemia. For 16 months he had been treated only with a homoeopathic remedy by his mother, the daughter of a homoeopathic doctor. The parents were charged with manslaughter. Among the latest whose death can be blamed on alternative therapies is that of a fourteen year old Canadian resident Rachel Brarsky, who died of asthma in January 1989, after being treated by "chemicals and various therapies from a chiropractor".

The coroner's jury found that Rachel's condition was reported to be treatable by conventional means and that her health care had been inadequate.

A comment from a reputable Fellow of the Royal Pharmacological Society draws attention to the fact that after brushing one's teeth with fluoride toothpaste and thoroughly rinsing your mouth, you will still ingest a dose of both fluoride and flavouring in quantities of the order of a homoeopathic dose. Also many foods and beverages contain flavours, colouring, preservatives and impurities in small amounts, so that the quantity ingested approximates to a homoeopathic dose. Many of these factors could influence human physiology at least as much as homoeopathic medicines.

There have been many controlled studies of homoeopathic remedies (Kleijen 1981, Schofield 1984) and while the evidence of clinical trials is positive, it is not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias.

In view of the absence of scientific evidence of the efficacy of holistic medicine, why are people flocking to alternative practitioners?

A 160 page report completed by the British Medical Association in May 1986, points to a paradox. Along with the great modern developments in rational therapeutics and the diagnostic techniques that have revolutionised the effective expectations of medical science, there has also been a significant change in patient/doctor relationship — less time to counsel and to support the patient. In bygone days when there was little else to offer, a long personal chat was in many cases a therapy in itself. Alternative practitioners, who, according to a Council of Europe report, spend up to eight times longer over a consultation than an average general practitioner, seem to fulfil the personal attention and support expectations of many patients.

Due to the incredible increase in the number of effective drugs that have become available since the end of World War II, patients expect and demand instant cures. If conventional medicine cannot supply one, then maybe alternative, albeit irrational cures, can. The very efficiency of modern medicine too, turns people away. Those afraid of organic disease, especially of a malignant nature, may prefer to go to an alternative therapist because they are afraid what the orthodox diagnostic process might reveal.

What of the testimonies of those who claim to have been cured by fringe medicines?

First there is the natural variability of all diseases where the pain or symptom has important points of remission. The patient may feel as though the pain is diminishing or getting worse. It doesn't matter whether the patient starts treatment (and the treatment can be anything from a sugar pill, glass of coloured water or a "healing crystal") on a worsening slide or an improving climb, the result will eventually be one of perceived improvement. The important point is the way we perceive illness — we tend to ascribe cause and effect where none exists.

Finally there is the placebo effect. Many of our ill-effects are psychosomatic — a variety of problems, particularly headaches, brought on by muscular tension, anxiety or depression and which, if they arise for psychological reasons would probably go away for the same reasons. Therefore, belief in a therapy, regardless of what it may be, and in the therapist whether genuine or a quack, will lead to an effect on the mind which in turn will produce an effect on the body.

A final observation on radically diluted compounds. Vitamin C is advocated by both science-based medical practitioners and homoeopathists as a proven preventative and cure for scurvy. However, contrary to the "dilution increases potency" theory, homoeopathists do not potentiate vitamin C by dilution.


References

Barrett, Stephen. MD. 1987. Homoeopathy: Is it Medicine? Skeptical Inquirer. 12(1):56-62.

Coulter, H. 1972. Homoeopathic Medicine. Formur International. St Louis.

Danciger, E. 1987. The Emergence of Homoeopathy. Century.

Grossman, R. 1986. The Other Medicines. Pan Books Ltd.

Hahnemann, S. 1980. The Chronic Diseases. Their Peculiar Nature and Their Homoeopathic Cure. Jain Publishing Co. New Delhi.

Kleijnen, K. 1991 British Medical Journal. 302:316-23.

Jones, Lewis. 1987. Alternative Therapies: A report on an inquiry by the British Medical Association. Skeptical Inquirer. 12(1):63-68.

Leeser, O.1943. The Contribution of Homoeopathy to the Development of Medicine. Hippocrates Publishing Co.

Mitchell, G.R. 1975. Homoeopathy: The First Authorative Study of Its Place in Medicine Today. W. H. Allen. London.

Nature. 1989. Human basophil degranulation triggered by very dilute antiserum against IgE. Vol. 333, June 30, p. 816.

Panos, M.B. and Heilich, J. 1980. Homoeopathic Medicine at Home. J. P. Tarcher. Los Angeles. CA.

Schofield. 1984. The British Homeopathic Journal. 73:161-¬226.

Sharma, C.H. 1977. A Manual of Homoeopathy and Natural Medicine. Turnstone Press. Wellingborough. UK.

Stalker, D. and Glymour, C. 1985. Examining Holistic Medicine. Prometheus Books. Buffalo NY.