From winter 2002 - Homeopathy - A Therapy Too Far?
Whilst some therapies such as acupuncture, reflexology and aromatherapy can be clearly traced back to ancient Chinese, Egyptian and Greek civilisations, homeopathy only appeared as a specific form of alternative medicine at the beginning of the nineteenth century.
Historical references to a comparable ancient or early therapy are tenuous to say the least. An essential part of the homeopathic principle, 'like cures like', was considered by Hippocrates (c460-370 BC), who suggested that healing could either be by 'contraries' or 'similars'. However, he made no mention of extreme dilution or a process of shaking or potentisation, which are both central to homeopathy.
Paracelsus (1493-1542), a Swiss physician, alchemist and scientist, also raised the possibility of like curing like and he advocated the use of herbs, minerals and chemicals as medicines. However this appears to have been a minor aspect of his work and it was not until the early nineteenth century that Samuel Hahnemann, a disillusioned German doctor and chemist, progressed this as a fundamental principle of a new therapy which he called homeopathy.
Hahnemann (1755-1843) is recognised as the founder of homeopathy. He was born in Meissen, Saxony, and studied medicine and chemistry at the University of Leipzig. He qualified in 1779 but quickly became disillusioned by the medical treatments of his day, which included bloodletting, purging and the use of dangerous drugs such as mercury and arsenic. After a few years he gave up his medical practice to concentrate on research and translation. During the translation of a treatise on Materia Medica by Dr William Cullen, a doctor working in Edinburgh, he became interested in the properties of the Peruvian cinchona bark and its use for treating malaria.
He tested this on himself and was fascinated to discover that small doses of the substance apparently produced symptoms similar to malaria. This finding, essential to the early development of homeopathy, is now in some doubt and is thought to have most likely been due to an allergic reaction or a contaminant in the preparation. However, these observations prompted him to devise the theory that small doses of a substance apparently producing symptoms similar to those of a disease could be used to treat these same illnesses. He called the testing of these substances 'provings' and he formulated the first law of homeopathy, similar similibus curentur - 'let like be cured by like'.
After studying these provings for six years, he returned to medicine with renewed vigour and proceeded to put his new ideas into practice. He only employed one remedy at a time but used an increasingly wide range of substances, herbal, mineral and chemical, which he dissolved or ground up in water and alcohol, to produce a 'mother tincture'. In order to minimise side effects called 'aggravations' that he noticed in a substantial number of patients, he decided to dilute the tincture progressively before giving it to patients.
This process of 'dilution', the second principle of homeopathy, involved placing one drop of original tincture in nine or 99 drops of solvent (water and alcohol), making a dilution of one in ten (1x) or one in 100 (1c) respectively. He repeated this up to 15 or 30 times and labelled the solutions according to their degree of dilution, eg 6c, 12c or 30c.
Observing that smaller doses were less effective in the relief of symptoms, he decided to shake the preparations vigorously between each diluting process, in the hope of increasing their effectiveness. He called this process 'succussion' and the resulting remedy he referred to as 'potentised'. He believed that some form of 'vital force' was imparted to the medicine by the process of succussion. This is the third principle of homeopathy.
In 1810 Hahnemann's book, Organon of Rationale Medicine, was published. It was later renamed The Organon of the Healing Art and ran to six editions. He also produced a six-volume Materia Medica of his own.
Hahnemann's practice thrived; he lectured at Leipzig University and opened the Leipzig Homeopathic Hospital in 1833. However, due to local opposition this had to close in 1842. Despite this, he attracted a number of followers and homeopathy began to spread quite widely before he died in Paris in 1843. Hahnemann was born into a Christian family, but became an active Freemason and later a devout follower of Confucius.
Enthusiastic followers of Hahnemann helped to promote the therapy. These included Dr Constantine Hering in South America and the USA, James Tyler Kent in the USA and Dr Frederick H Quin in Britain.
During the 20th century, public interest in homeopathy fluctuated but it gradually spread worldwide, becoming particularly strong in India with 300,000 full time homeopaths and 40 homeopathic medical schools. The practice is also quite popular in Europe and Australasia. In Greece there is an influential homeopathic training school whilst interest is rapidly increasing in the USA.
Dr Quin introduced homeopathy into Britain in 1826, after studying with Hahnemann in Germany and Paris. He believed that he had been healed of cholera by a homeopathic preparation of camphor. He set up a homeopathic practice in London in 1832 and established the British Homeopathic Society in 1844.
In the United Kingdom, homeopathy is the third most popular alternative therapy; its image has no doubt been enhanced by high profile users such as the royal family. Their interest in the practice began with Queen Adelaide (1792-1849), wife of William IV, and has continued right up to today, with Queen Elizabeth and Prince Charles, who is a strong advocate of homeopathy, both for humans and animals.
There are currently homeopathic hospitals in London, Bristol, Liverpool, Glasgow and Tunbridge Wells. The professional organisation, the Society of Homeopaths, was founded in 1974 and organises both a register of practitioners (RSHom) and a fellowship (FSHom). Medically qualified practitioners may also become members of the Faculty of Homeopathy (MFHom) after appropriate training at the Royal London Homeopathic Hospital.
Whilst the presence of specific underlying pathology and accurate medical diagnosis is by no means ignored by homeopathy, there is a much greater emphasis on fitting the diagnosis into a 'symptom picture'. Homeopaths without a medical qualification will make a diagnosis and treatment decision without a full medical examination. The orthodox approach of history, full examination and specific investigations followed by a treatment plan is typically only adhered to by homeopaths with a medical qualification.
In addition to symptoms, many homeopaths also assess appearance, constitution and personality. Particularly when homeopathy is presented in New Age settings such as mind/body/spirit festivals and psychic fairs, diagnosis may include divination, astrology and pendulum swinging as well. This is evidently more common in Continental and Asian countries, but in the UK most medically qualified homeopaths would wish to distance themselves from any such involvement.
Homeopathy should not be confused with the Bach Flower Remedies and herbal medicine. There are significant differences between these therapies, whose preparations do not involve serial dilution or potentisation.
Hahnemann's essential principles, ie the law of similars, dilution, succussion and potentisation, remain the same today. When the symptom picture is decided, treatment is based on matching it with a 'remedy picture' from a homeopathic Materia Medica. The dosage of individual remedies is believed to be less important than the frequency with which they are administered. If one remedy is unsuccessful after six doses, this may be changed to a different remedy. Alternatively, if a condition does not respond to a certain dilution, eg 6c, homeopaths might well suggest a dilution of 30c, believing that the weaker the solution is, the more powerful its effect! A dilution of 6x is a usual strength for over the counter preparations sold in pharmacies and 6c and 12c would be common starting strengths for trained homeopaths.
As Hahnemann discovered, a significant number of patients experience an exacerbation of their symptoms after beginning treatment. This is still called an aggravation and may be treated with coffee or peppermint as well as withdrawal of the remedy. There are very few contra-indications but patients are advised to take the medication with water and to eat or drink nothing else for 20 minutes before and after treatment.
It is said that the remedies keep for many years if undisturbed, but it is advised that they are kept in a cool, dark place away from strong odours. They should also not be touched by hand during transfer from the container to the patient, for fear of contamination.
It is commonly believed that homeopathic remedies are based on the use of herbs, plants and other natural substances, with the assumption that natural = harmless. In fact many of the substances used to produce mother tinctures are noxious and poisonous, such as anthrax poison from the spleen of an infected sheep, rattlesnake, cobra and viper venom, discharge from a scabies blister, sulphuric acid and tarantula spider. No harm results, however, because of the extreme dilution. Hahnemann started with around 60 remedies but there are now many hundreds in the homeopathic Materia Medica.
There are some very obvious problems with homeopathy, from both a medical and Christian perspective. These concern both the use of homeopathy and the principles upon which it is based.
The idea of like curing like is not generally observed in medical practice. It is much more common for symptoms and diseases to respond to medicines that produce the opposite effect to the medical problem. For example, diarrhoea responds to constipating substances such as codeine, rather than bowel irritatives such as castor oil. This is known as allopathy.
Vaccination is an exception, where an attenuated pathogen may be used to provoke an immune response. There can be no meaningful comparison, however, between homeopathy and vaccination (see 'Evidence' section below).
A basic principle of pharmacology is that, up to a point, the higher the concentration of a drug, the greater the effect. But homeopathy turns this on its head. The extreme dilution that takes place during the preparation of homeopathic remedies, means that from the dilution 12c and beyond not one single molecule of original substance is present in the medicine, whether it is in the form of tablets, powder or liquid. This fact is freely admitted by homeopathic practitioners and teachers but they do suggest that some obscure and as yet undiscovered reaction known as 'imaging' has taken place during the process.
The 'healing power' resident in homeopathic medicines is said to be essentially dependent upon the potentisation that takes place between each dilution process. This is apparently why the dilution process is in stages rather than just applying one drop of the mother tincture to a very much larger amount of solvent. However, this would be somewhat impractical since, for example, 12c roughly represents the equivalent of a pinch of substance in a volume of solvent the size of the Atlantic ocean!
An examination of the term 'vital force' is most significant. There is really little doubt that this equates to the ch'i of Chinese acupuncture and similar therapies, the prana of Hindu ayurvedic medicine and the universal cosmic energy so beloved by New Age advocates. It is an essential feature of the alternative therapies that each of these embrace.
Homeopathy is generally considered to be safe, particularly when used for minor and self-limiting complaints. It clearly should not be relied upon for serious or life-threatening conditions. Use of this therapy without proper medical advice and diagnosis may result in serious delay in orthodox treatment, sometimes with tragic results.
From a logical, scientific and evidence-based approach, there are obviously major difficulties in accepting homeopathy as a valid therapy. Possible theories for an understanding of the homeopathic process have been advanced but these are hardly tenable. In particular:
There have been a significant number of clinical trials and scientific investigations into the potential value of homeopathy in a variety of medical conditions. Of particular interest are those involving allergic processes, such as hayfever and asthma, as well as those of a predominantly painful nature such as migraine. Uncritical examination of the outcomes of this research may suggest some positive results. However groups such as that at the Department of Complementary Medicine at Exeter University have subjected the data to detailed examination, including rigorous clinical, scientific and statistical analysis, and have shown that they do not reveal any conclusive evidence for the efficacy and value of homeopathy.
In the magazine FACT (Focus on Alternative and Complementary Therapies), published by Exeter University there were 44 reports of investigations into homeopathy between December 1996 and June 2002. These were mostly randomised controlled trials but their methodology and results were very variable and not one provided conclusive evidence for the efficacy of the homeopathic remedies investigated. In addition, a paper published in 2000 in the European Journal of Clinical Pharmacology called for more research in this area and the authors concluded: 'there is simply not enough evidence to conclude that homeopathy is clinically effective'.
Particularly when so poorly substantiated, it is quite remarkable that the observations and theories of one man, Samuel Hahnemann, should have led to homeopathy being so widely accepted as an alternative to orthodox, evidence-based medicine. It is essential for Christians to exercise proper integrity in their assessment of alternative therapies. Careful investigation of the theory, practice and unproven value of homeopathy must surely lead to the conclusion that it is inappropriate for Christians to accept or to practise this therapy.
Prove all things; hold fast that which is good. Abstain from all appearance of evil.
Asterisked publications (*) are recommended as further reading.