History of Homeopathy

Homeopathy is a system of Complementary and Alternative Medicine that strives to treat 'like with like'; its remedies involve treating an illness with an infinitesimally small dose of a substance that, at bigger doses, can cause symptoms like those of the illness. Homeopaths believe that the 'potency' of a remedy can be increased by serial dilution combined with vigorous shaking. The word 'homeopathy' was first used by the German physician Christian Friedrich Samuel Hahnemann (1755-1843). Hahnemann, who was born in Meissen, studied medicine in Leipzig and Vienna, and became eminent as a linguist, as a practical physician and as an enlightened public health reformer before creating his new health system. He believed his new system to be humane and effective , but it was received by the establishment with derision and contempt.

The Theories of Homeopathy

James Tyler Kent and homeoprophylaxis James Tyler Kent (1849-1916) was associated with the spread of homeopathy in the U.S.A., and much modern practice of homeopathy is based on his repertory, published in 1897. Kent denied the germ theory of infectious disease, declaring that "The microbe is not the cause of disease. We should not be carried away by these idle allopathic dreams and vain imaginations but should correct the Élan vital". Instead, he believed that illness had spiritual causes: "You cannot divorce medicine and theology. Man exists all the way down from his innermost spiritual, to his outermost natural." Kent promoted the idea that remedies could prevent diseases: "The great prophylactic is the homeopathic remedy. After working in an epidemic for a few weeks, you will find perhaps that half a dozen remedies are daily indicated and one in these remedies in a larger number of cases than any other. This one remedy seems to be the best suited to the general nature of the sickness. Now you will find that for prophylaxis there is required a less degree of similitude than is necessary for curing. A remedy will not have to be so similar to prevent disease as to cure it, and these remedies in daily use will enable you to prevent a large number of people from becoming sick. We must look to homeopathy for our protection as well as for our cure".

Homeopathy (from the Greek hómoios (similar) and páthos (suffering)) regards diseases as 'morbid derangements of the organism', that involve some disturbance in a 'vital force.' For homeopaths, every case of sickness is a strictly individual phenomenon — "It is the man that is sick and to be restored to health, not his body, not the tissues".

For the early Greek physician Hippocrates of Cos, who lived at about 400 BCE [5], the four 'humours' (blood, black bile, yellow bile and phlegm) were the key to understanding disease. His ideas persisted through the influence of Galen (131-201 AD) until at least 1858, and Rudolf Virchow's theories of cellular pathology. Diseases, it was thought, were the result of some 'imbalance' of the humours, and conventional medicine focused on restoring that balance, either by trying to remove an excess of a humour, or by suppressing the symptoms. "Bloodletting, fever remedies, tepid baths, lowering drinks, weakening diet, blood cleansing and everlasting aperients and clysters (enemas) form the circle in which the ordinary German physician turns round unceasingly", wrote Hahnemann while translating into German the Treatise on Materia Medica (1789) by the Edinburgh physician William Cullen.

After 1783, disillusioned with medicine and the many toxic effects of its cures, Hahnemann began to use smaller and smaller doses of drugs, trying to minimise their toxic effects while retaining their efficacy. He had concluded that diseases are not caused by "...any disease matter, but that they are solely spirit-like derangements of the spirit-like power that animates the human body", and was searching for a way to harness this power for healing. Cullen had written that Cinchona bark (which contains quinine) was effective because it was bitter, and Hahnemann pondered about this; he felt that this explanation was implausible because other substances that were as bitter had no therapeutic value. Accordingly, he took Cinchona bark himself, and saw that its effects were similar to the symptoms of the diseases that it was prescribed for. . For Hahnemann, this was a breakthrough, and it led him to formulate the 'Principle of Similars' on which homeopathy is based, expressed by him as similia similibus curentur or 'let likes cure likes'. Related maxims such as the "principle of similars" are common in anthropological literature, and also are called sympathetic magic.

Provings

Homepathic remedies are found by 'provings', in which volunteers are given substances, the effects of which are recorded as a 'Drug Picture'. Of his first proving, Hahnemann said: "with this first trial broke upon me the dawn that has since brightened into the most brilliant day of the medical art; that it is only in virtue of their power to make the healthy human being ill that medicines can cure morbid states, and indeed, only such morbid states are composed of symptoms which the drug to be selected for them can itself produce in similarity on the healthy."

Today, homeopaths use about 3000 different remedies from animal, plant, mineral, and synthetic substances, including 'Natrum muriaticum' (sodium chloride or table salt)[6], 'Oscillococcinum' (a 200C product made from duck heart and liver that is prescribed for colds and flu-like symptoms) 'Roadrunner' (Geococcyx californianus) [7] and 'Arnica' [8]. Other 'isopathic' remedies involve diluting the agent or product of the disease; for example, Rabies nosode is made from the saliva of a rabid dog. Some homeopaths use more esoteric substances, known as 'imponderables' because they originate from electromagnetic energy 'captured' by alcohol or lactose ('X-ray', 'Sol' (sunlight), 'Positronium', and http://homeoint.org/clarke/e/elect.htm 'Electricitas'](electricity), or with a telescope ('Polaris'). Recent ventures into more esoteric remedies include 'Tempesta' (thunderstorm), and 'Berlin wall'.

Preparation of similars

The most characteristic — and controversial — principle of homeopathy is that the efficacy of a remedy can be enhanced and its side-effects reduced by diluting it, in a process known as 'dynamization' or 'potentization'. Liquids are diluted (with water or alcohol) and shaken by ten hard strikes against an elastic body ('succussion'). For this, Hahnemann had a saddlemaker construct a special, wooden, 'striking board', covered in leather on one side and stuffed with horsehair. When insoluble solids are used as the basis of remedies, such as quartz or oyster shell, they are diluted by grinding them with lactose ('trituration'). The original serial dilutions by Hahnemann used a 1 part in 100 or centesimal scale, or 1 part in 50,000 or Quintamillesimal ('LM' or 'Q' potencies). The dilution factor at each stage is 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). The number of molecules in a given weight of a substance can be calculated by Avogadro's number; the chance that there is even one molecule of the original substance in a 15C solution is small, and it is very unlikely that one molecule would be present in a 30C dilution. Thus, homeopathic remedies of a high 'potency' contain just water, but water that, according to homeopaths, retains some essential property of one of the substances that it has contacted in the past.

Hahnemann's explanation for how higher potencies could be more efficacious was that the friction involved in succussion might release some hidden curative power of substances. He wrote in 1825: "The effect of friction is so great, that not only the physical properties, such as caloric, odour, etc., are thereby called into life and developed by it, but also the dynamic medicinal powers of natural substances are thereby developed to an incredible degree".

Alternative methods

Hahnemann wanted to see 30C as the standard potency in homeopathy, but most of his contemporaries preferred tinctures and 3X, while others, including Caspar Julius Jenichen (1787-1849) and the Russian General Count Iseman von Korsakoff (1788-1853) [9] were busy raising potency to extremes:

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.

Such high potencies could not be made by traditional methods, but required succussion without dilution, higher dilution factors (LM potencies are diluted by a factor of 50,000), or 'Korsakoff machines' [10] that continuously combine dilution and succussion. Such machines[11][12] are still sold today; some claim that 'vibrations' produce the healing effect and, that when the correct vibration is selected, only water need be added to produce a remedy. Today, 'radionics' devices are used by many homeopaths to prepare remedies, based on the 'geomagnetic potentiser' invented by Malcolm Rae (1913-1979) [13], an electronic engineer and dowser. Another technique involves a 'paper remedy' - "finds out what they need, writes the remedy down on a piece of paper, they put it in their pocket and it works."

In 1832, Korsakov described the method of 'dry grafting'. A single dry globule of a potentized remedy is put in a bottle half-filled with sugar globules. The bottle is shaken for five minutes, and this way all the globuli should be able to exert the influence of the initial remedy, "as if by contagion". Hahnemann approved of the idea, saying that it "is a sort of infection, bearing a strong resemblance to the infection of healthy persons by a contagion brought near or in contact with them".

Miasms

By 1816, Hahnemann was concerned at the failure of homeopathic remedies to produce lasting cures for chronic diseases: "...the non-venereal chronic diseases, after being time and again removed homoeopathically … always returned in a more or less varied form and with new symptoms." He introduced the theory that three fundamental 'miasms' underlie of all the chronic diseases of mankind: 'Syphilis', 'Sycosis' (suppressed gonorrhoea), and 'Psora'. Miasma, from the Greek for 'stain', was an old medical concept, used for "pestiferous exhalations". In Hahnemann's words: "...a child with small-pox or measles communicates to a near, untouched healthy child in an invisible manner (dynamically) the small-pox or measles, … in the same way as the magnet communicated to the near needle the magnetic property..."

According to Hahnemann, miasmatic infection causes local symptoms, usually in the skin. If these are suppressed by medication, the sickness goes deeper, and emerges later as organ pathologies. In the 'Organon' he asserted that Psora was the cause of such diseases as epilepsy, cyphosis, cancer, jaundice, deafness, and cataract. However, even in his own time, many of his followers, including Hering, made almost no reference to Hahnemann’s concept of chronic diseases. Today, some homeopathic practitioners find Hahnemann’s theory difficult to reconcile with current scientific knowledge, as it seems to ignore the importance of genetic, metabolic, nutritional, and degenerative factors in sickness, and fails to differentiate between the many different infectious diseases. Nevertheless, most homeopaths believe that the fundamental causes of disease are internal and constitutional and that it is contrary to good health to suppress symptoms, and they accept the concept of 'latent Psora', the early signs of an organism’s imbalance which indicate that treatment is needed.

Hahnemann was also a powerful advocate of good hygiene, fresh air, regular exercise, and good nutrition as essential for good health (see his 1792 essay: The Friend of Health). He was also a pioneer of humane treatment of the insane (1796, Description of Klockenbring During his Insanity) a year before William Tuke and Philippe Pinel, and he published tracts describing the cause of cholera as "excessively minute, invisible, living creatures", indicating his acceptance of some of the conventional ideas about infectious disease.

The Spread of Homeopathy

In the UK, homeopathy was established by Dr Frederick Quin (1799-1878) at around 1827 [14]. (Two Italian homeopathic doctors (Drs Romani and Roberta) had been employed two years previously by the Earl of Shrewsbury, but had quickly returned to Naples as they could not tolerate the damp English climate.) Quin contracted cholera in 1831 while travelling in Moravia, and attributed his cure to his use of the homeopathic remedy Camphor. [15]. Quin, allegedly the illegitimate son of the Duchess of Devonshire, had excellent social connections, and homeopathy soon became the preferred treatment of the upper classes: the Dukes of Edinburgh and Beaufort were among Quin's patients, and he became physician to the Duchess of Cambridge. At its peak in the 1870s, there were large hospitals in Liverpool, Birmingham, Glasgow, London and Bristol [16]; the Bristol hospital was funded by the W.D. & H.O. Wills tobacco family, while the 'Hahnemann Hospital' in Liverpool was built by members of the Tate family of sugar importers, who also funded the Tate Gallery in London.

The primary reason that homeopathy became popular in the 19th century was the remarkable results that homeopathic physicians experienced in treating people suffering from the infectious disease epidemics that raged at the time. Epidemics of cholera, scarlet fever, typhoid, and yellow fever were rampant and killed large numbers of people who became ill with them. And yet, death rates in homeopathic hospitals were commonly one-half or even one-eighth of the death rates in the conventional medical hospitals.

From the very beginnings of homeopathy, its claims were treated with skepticism by the medical and scientific establishments. Sir John Forbes (1787-1861), physician to Queen Victoria, declared in 1861 that most cases of disease which recover under homeopathy "recover by means of the curative powers of Nature alone." He concluded that homeopathy is "one of the greatest delusions...of the healing art" and the only good it brings is by lessening "the monstrous polypharmacy which has always been the disgrace of our art - by at once diminishing the frequency of administration of drugs and lessening their dose." [17] Professor Sir James Young Simpson said, of the highly diluted drugs, that there is "no poison, however strong or powerful, the billionth or decillionth of which would in the least degree affect a man or harm a fly."

Homeopathy came to India with Dr Martin Honigberger (1795-1869) in 1829-30. India now has the largest homeopathic infrastructure in the world, with 300,000 qualified homeopaths, 180 colleges, 7500 government clinics, and 307 hospitals, and 10% of the population are estimated to use homeopathy exclusively for their medical needs.

Homeopathy was brought to the USA by Dr Hans Burch Gram (1787-1840) in 1825 and became popular there partly because of the excesses of conventional medicine, partly because of the impressive results it experienced in the treatment of infectious disease epidemics of the day, and partly by the influence of Constantine Hering (1800-1880). Hering immigrated to America in 1833 and became known as the 'father of American homeopathy' due to authoring textbooks for practicing homeopaths as well as books for the general public on how to use homeopathic medicines in home care [18]. Hering's contributions to the theory of homeopathy include his "laws" of cure. [19]. He proposed that healing proceeds (and symptoms disappear):

From above downwards.

From within outwards.

From a more important organ to a less important one.

In the reverse order of their coming.

By 1900, hardly any city in the USA with a population of more than 50,000 was without a homeopathic hospital.

Homeopathy and medicine at the turn of the 20th century

Emil Adolph von Behring (1854-1917), who won the first Nobel Prize in medicine in 1901 for discoveries that led to vaccines against tetanus and diphtheria, and who some consider to be the father of immunology, asserted that vaccination is, in part, derived from the homeopathic principle of similars.

In spite of all scientific speculations and experiments regarding smallpox vaccination, Jenner’s discovery remained an erratic blocking medicine, till the biochemically thinking Pasteur, devoid of all medical classroom knowledge, traced the origin of this therapeutic block to a principle which cannot better be characterized than by Hahnemann’s word: homeopathic.

Waning of homeopathy

In the 1930s, the popularity of homeopathy waned, partly due to the Flexner Report of 1910, which led to the closure of virtually all medical schools teaching alternative medicine, and by the 1950s, homeopathy had almost disappeared. Nevertheless, in 1995 sales of homeopathic remedies were estimated at US$201 million, and the number of homeopaths increased from less than 200 in the 1970s to about 3,000 in 1996.

Notes

• Boyd, Linn (1936), The Simile in Medicine, Boericke and Tafel