Homeopathy

Homeopathy regards named diseases as misleading human constructs and instead treats each case of sickness as a strictly individual phenomenon. The term "homeopathy" was coined by the Saxon physician Christian Friedrich Samuel Hahnemann (1755–1843) and first appeared in print in 1807.[5], although he had previously outlined his axiom of medical similars in a series of articles and monographs commencing in 1796.[6] This article in English translation can be read here Essay on a New Principle, 1796

However, homeopathy is controversial for four reasons. Firstly, medical studies of its efficacy have not been clearly positive, and often are negative.[7] Secondly, homeopathy is inconsistent with the known laws of chemistry since it states that dilution makes drugs more powerful by enhancing their undefined spirit-like medicinal powers,[8] even at dilutions so high not even a molecule of the original ingredient is present. Thirdly, many homeopathic practitioners do not accept conventional diagnoses, preferring instead to view ill-health as when "the flow of energy is impeded"[9] as a result of either the patient's lifestyle or shocks, mental traumas in their past and bad weather.[10][11] Fourthly, cases have been reported in the medical literature of serious illness resulting from people attempting to prevent or treat serious conditions like malaria solely with homeopathic remedies.[12][13]

Medical Similars

Homeopathy is based on the 'Principle of Similars', first expressed by Hahnemann in the exhortation similia similibus curentur or 'let likes cure likes'. This is the exact opposite of 'contraries' upon which the Galenic medicine of his day was based, which Hahnemann initially practised and in which he had been trained.

The 'law of similars' is an ancient medical maxim [14] [15], but its modern form is based on Hahnemann's conclusion that a constellation of symptoms induced by a given homeopathic remedy in a group of healthy individuals will cure a similar set of symptoms in the sick. Symptom patterns associated with various remedies are determined by 'provings', in which healthy volunteers are given remedies, often in molecular doses, and the resulting physical, mental and spiritual symptoms are compiled by observers into a 'Drug Picture'.

Homeopathic practitioners rely on two types of reference in prescribing. The Homeopathic Materia Medicae comprise alphabetical indexes of Drug Pictures organized by remedy and describe the symptom patterns associated with individual remedies. The Homeopathic repertory consists of an index of sickness symptoms, listing all remedies associated with specific symptoms. The first such Homeopathic Repertory was George Jahr's Repertory, published in 1835. [16]

Homeopathic remedies are prepared either by serial trituration [grinding] with lactose [usually 1 part in 10 or 1 part in 100] for insoluble substances, such as Quartz and Oyster shell, or by dilution of a substance with succussion (shaking between dilutions) for soluble substances. The original serial dilutions by Hahnemann were performed using a 1 part in 100 or centesimal scale, or 1 part in 50,000 or Quintamillesimal [LM or Q potencies]. Some practitioners then developed a decimal scale of 1 part in 10, which were extremely popular in 19th century Europe, but were replaced with even higher dilutions, especially in the U.S. and Britain, in the 20th century.

At first, Hahnemann tested in homeopathic provings, substances commonly used as medicines in his time [such as Antimony and Rhubarb] and also poisons like Arsenic, Mercury and Belladonna. Perhaps in this he was mindful of Paracelsus: “poison is in everything, and no thing is without poison. The dosage makes it either a poison or a remedy.” [17] This subtle connection between poison and medicine, or 'what can kill can cure' was also observed by Shakespeare: "In the infant rind of this small flower, poison hath residence and medicine power:..." [18]

Hahnemann recorded his first provings in the Fragmenta de viribus in 1805 [27 drugs] and later in his Materia Medica Pura, which contained 65 proven drugs. He was most heavily engaged in proving in the 1790s and early 1800s, but he never abandoned these experiments. Another phase of proving commenced with his Miasm theory and The Chronic Diseases [19], published in 1828, and containing 48 freshly 'proven' drugs.

Kent's Lectures on Homoeopathic Materia Medica (1905) lists 217 remedies, and new substances are continually added to contemporary versions. Homeopathy uses many animal, plant, mineral, and synthetic substances. Examples include Natrum muriaticum (sodium chloride or table salt), Lachesis muta (the venom of the bushmaster snake), Opium, and Thyroidinum (thyroid hormone). Other homeopathic remedies, ('isopathic' remedies') involve dilution of the agent or product of the disease. Rabies nosode, for example, is made by dilution the saliva of a rabid dog. Some modern homeopaths are exploring the use of more esoteric substances, known as "imponderables" because they do not originate from a material but from electromagnetic energy presumed to have been somehow "captured" by alcohol or lactose (X-ray, Sol (sunlight), Positronium, and Electricitas (electricity) or through the use of a telescope (Polaris). Recent ventures by homeopaths into even more esoteric substances include Tempesta (thunderstorm), and Berlin wall.

Today, about 3000 remedies are used in homeopathy; about 300 are based on comprehensive Materia Medica information, about 1500 on relatively fragmentary knowledge and the rest are used experimentally in difficult cases based on the law of similars, either without knowledge of their homeopathic properties or through speculative knowledge independent of the law of similars. Examples include: the use of an isopathic (disease associated) agent as a first prescription in a 'stuck' case, when the beginning of disease coincides with a specific event such as vaccination; the use of a chemically-related substance when a remedy that was well-indicated fails. A good example of this is found in the Bowel Nosodes [20] which were introduced by the British homeopaths, Edward Bach (1886-1936), John Paterson (1890-1954) and Charles Edwin Wheeler (1868-1946) in the 1920s. Their use is based on the variable bowel bacterial flora thought to be associated with persons of different homeopathic constitutional types. Though receiving more attention today, the Bowel Nosodes are rarely used outside British homeopathy.

More recently, homeopathy has embraced the use of substances based on their elemental classification (the periodic table or biological taxonomy). [21] [22] This approach may well create neat systems for grouping remedies and classifying the ever-burgeoning Materia Medica, but its usefulness is questioned by some purists on the basis that inherently it involves speculation about remedy action without provings.[23]

There are many methods for determining the most-similar remedy (the simillimum), and homeopaths sometimes disagree about the required remedy. This is partly due to the complexity of the 'totality of symptoms' concept; homeopaths do not use 'all' symptoms, but decide which are the most characteristic; this subjective evaluation of case analysis rests crucially on knowledge and experience. Finally, the Drug Picture in the Materia Medica is always more comprehensive than the symptomatology exhibited by any individual. These factors mean that a homeopathic prescription can remain presumptive until it is verified by testing the effect of the remedy on the patient.

The law of similars is more of a guiding principle than a 'scientific' law. It is not built on a hypothesis that can be falsified; a failure to cure homeopathically can always be attributed to incorrect selection of a remedy: I have often heard physicians tell me that it was due to suggestion that my medicines acted so well; but my answer to this is, that I suggest just as strongly with my wrong remedy as with the right one, and my patients improve only when they have received the similar or correct remedy. [24]

The Minimum Dose

The most characteristic—and controversial—principle of homeopathy is that the potency of a remedy can be enhanced (and the side-effects diminished) by dilution, in a procedure known as dynamization or potentization. Liquids are progressively diluted (with water, or alcohol) and shaken by ten hard strikes against an elastic body (succussion). For this purpose, Hahnemann had a saddlemaker construct a special wooden striking board covered in leather on one side and stuffed with horsehair. It can be viewed at the Hahnemann Museum in Stuttgart.[25] Insoluble solids are diluted by grinding them with lactose (trituration). Higher 'potencies' are considered to be stronger 'deep-acting' remedies.

The dilution factor at each stage is traditionally 1:10 ('D' or 'X' potencies) or 1:100 ('C' potencies). Hahnemann advocated 30C dilutions for most purposes, i.e. dilution by a factor of 10030 = 1060. As Avogadro's number is only 6.02 × 1023 particles/mole, the chance of any molecule of the original substance being present in a 15C solution is small, and it is extremely unlikely that one molecule of the original solution would be present in a 30C dilution. For a perspective on these numbers, there are in the order of 1032 molecules of water in an Olympic size swimming pool; to expect to get one molecule of a 15C solution, one would need to take 1percent of the volume of such a pool, or roughly 25 metric tons of water. Thus, homeopathic remedies of a high "potency" contain, with overwhelming probability, only water. Practitioners of homeopathy believe that this water retains some 'essential property' of one of the substances that it has contacted in the past. However, water will have been in contact with millions of different substances in its history. According to this molecular paradigm, any glass of water must be regarded as an extreme dilution of almost any agent you care to mention. Thus, critics argue that by drinking water one receives homeopathic treatment for every imaginable condition. Proponents of homeopathy are unable to accept the molecular paradigm as a complete account of life phenomena and therapeutics. They believe that the methodical dilution of a particular substance, beginning with a 10percent solution and working downwards, produces a therapeutically active 'remedy', in contrast to regular water which is therapeutically inert.

High potency remedies were first produced in the 1830s. Though Hahnemann wished to see 30c as standard potency in homeopathy, the majority of his contemporaries preferred tinctures and 3x, while others, like the powerfully-built horse-trainer, Caspar Julius Jenichen [1787-1849], [7] General Korsakoff [1788-1853] and Dr N Schreter [1803-1864], were busy raising potency to heights beyond his wildest dreams.

Jenichen sat or stood stripped naked to the waist, holding the bottle in his fist in an oblique direction from left to right, and shook it in a vertical direction. The fluid, at every stroke, emitted a sound like the ringing of silver coins. He paused after every 25th potency, and the muscles of his naked arm vibrated...he was latterly able to give 8400 strokes in an hour. [8]

Such high potencies could not be made by traditional methods, but required succussion without dilution (Jenichen), higher dilution factors (LM potencies are diluted by a factor of 50,000), or machines which integrate dilution and succussion into a continuous process (Korsakoff). Such a Korsakoff potentising machine can be seen (here) and (here). Some old potentising devices can be seen (here). Such machines are still on sale today and some manufacturers claim it is undefined "vibrations" that produce the healing effect and, when the correct vibration is selected, only water need be added to produce a remedy.[26] Today, radionics potentising devices are used by many homeopaths to prepare remedies, [27]. These are based on the work of the British engineer, Malcom Rae [1913-1979] [28] and the potentising devices he developed in the 1960s.[29]

Yet another bizarre technique used by a few homeopaths involves using "a paper remedy. Write the remedy and potency on a piece of paper and place the paper on the left hand side of the body with the writing towards the body." [9] One homeopath, "finds out what they need, writes the remedy down on a piece of paper, they put it in their pocket and it works." [10] In essence, this comprises an emerging alternative homeopathic tradition, "`paperremedies' i.e., name of remedy just written on a piece of paper." Jörg Wichmann, Defining a different tradition for homeopathy.

The practitioner's choice of what potency is appropriate derives in part from a judgement as to whether the disease is acute and superficial or 'deeper' and more chronic in nature; whether it is primarily physical or more mental/emotional; the patient's general sensitivity and previous reactions to remedies; and the practitioner's preferred posology [dosing regimen], e.g. low potency repeated often, vs. high potency repeated seldom. For example, French and German homeopaths generally prefer to use lower potencies than their American & British counterparts. Most homeopaths assert that the choice of potency is secondary to the choice of remedy: i.e. that a well-chosen remedy will act in a variety of potencies, but an approximately matched remedy might act only in certain potencies, or not at all. Alternative modes of selecting remedies are through medical dowsing[30] or the use of other psychic powers.[31] [32] However, these methods are controversial and not accepted by all homeopathic practitioners.
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