Homeopathy in Perspective
A BRIEF HISTORY AND OVERVIEW OF HOMOEOPATHY
Adaptation of the article by Dr. Johan P. Prinsloo as it appeared in the winter 2000 edition of NATURAL ESSENTIALS, The Integrative Health Supplement to UPDATE, "The Journal of Continuing Education for General Practitioners". (The most popular Medical Journal in South Africa)
Homoeopathy is one of the fastest growing medical modalities in the world today. In spite of this growing interest much confusion still exists as to the true origins, scientific validity, applicability and efficacy of homoeopathy. Even in this day and age of effective mass communication, internet, journals, etc., misconception about the basis, fundamental principles and philosophy of homoeopathy exist which tend to equate homoeopathy with eastern philosophies, "natural" and traditional medicines such as herbalism and the likes. In this article we shall endeavour to present an objective factual overview of homoeopathy.
Christian Samuel Hahnemann 1755-1843
Christian Samuel Hahnemann was born on April 10, 1755 at Meissen, Saxony, near Dresden. He died in Paris on 2 July 1843. Even as a child Hahnemann had a very inquiring attitude and a tendency to original thought. This was spurred on by his father, a porcelain painter, who from the outset endeavoured to teach his son the value of reasoning and thought. He had aspirations for a classical education, which his father could not afford. A teacher, realising the potential of the young boy allowed him the opportunity to earn his tuition. Astonishingly, Hahnemann now only twelve years of age taught his classmates the fundamentals of the Greek language. At the age of 22 years, he was a master of Greek, Latin, English, Italian, Hebrew, Syriac, Arabic, Spanish, German, and some Chaldaic. In 1775 he left for Leipzig to study medicine. He earned his living by teaching German and French and by translating English books. Two years later he moved to Vienna where facilities were available for his practical studies and obtained his Medical Degree (M.D.) in 1779. (1) (2) (3)
He started his medical practice and finally settled again in Leipzig so as to be near a teaching institution. He accepted charge of an institution for mental diseases at Georgenthal. Here he drew much attention for his successes and humane approach to treatment. (1) At a time when the mentally aberrated were treated like wild animals, Hahnemann stated, "I never allow an insane person to be punished either by blows or other kind of corporal chastisement, because there is no punishment where there is no responsibility, and because these sufferers deserve only pity and are always rendered worse by such rough treatment and never improved." (3)
During this time much original work came from Hahnemann. In 1784 he published a very practical work "On the treatment of Chronic Ulcers." The work was highly praised in Medical journals and was indeed remarkable for its excellent rules on hygiene, some of which he introduced while heading the mental institution. His focus on exercise, recreation, clothing, diet, clean air, external use of cold water and hygiene were ahead of time and similar to modern day thinking. In 1789 he published his "Instruction to surgeons concerning the treatment of venereal diseases", for which he was highly applauded once again. (1) (3)
Hahnemann was by now a highly respected Medical Practitioner, Scientist and Chemist. He was spoken of as "this celebrated chemist," "One whom chemistry has to thank for many important discoveries." The leading physician of the day, Dr.Hufeland, spoke of him as "one of the most distinguished physicians of Germany, a physician of mature experience and reflections." His publications were described as "no ordinary work, but written with an unusual degree of knowledge, reflection and original thought."(1) Hahnemann's wine test first appeared in van Sande's 'Signs of The Purity and Adulterations of Drugs', of which Hahnemann wrote the greater part of the essay. Hahnemann's wine test was greatly praised in chemical and scientific journals and Trommsdorff's Journal of Pharmacy stated that 'ignorance of Hahnemann's Wine Test was damning evidence of the incompetence of many apothecaries.' (4) Hahnemann's four volume set entitled 'The Pharmaceutical Lexicon', was one of the standard pharmaceutical reference works of his day. (6)
During the period from 1777 to 1806, Hahnemann translated 24 texts from other languages into German. Of these 18 were done during the 1780's and 1790's, while he was conducting various chemical research and experiments and first formulating, through research and experimentation, the fundamentals of homeopathy. Not only did he translate these texts, but he also added annotations to them with extensive commentaries and personal suggestions. He was also renowned for his tendency to add his disagreements to specific texts where warranted. Hahnemann translated 17 books from the English, 6 from the French, 1 from the Italian, and 1 from the Latin, totalling over 9400 pages of text in 29 years, which amounts to 324 pages per year, or approximately 1 page every day for 29 years. (4)
During this same period, Hahnemann also translated numerous short papers on medicine and chemistry for publication in various journals of chemistry, science and medicine. From the titles and volume of these translations, Hahnemann was arguably one of the best read physicians, and, if one considers that from 1785 to 1789 he published more than 2200 printed pages, which included translations, some original works and essays, while he worked strenuously at his own medical profession, he must have ranked amongst the most energetic and hard working physicians, scientists and chemists of his day. (4) When reading of the symptoms of a substance, Hahnemann would ingest a small, non-lethal quantity of it so as to ascertain whether it can produce similar symptoms in himself. He acted as a human laboratory for toxicological analysis in his efforts to validate that which he was translating. Where he differed with the author he could then add comment to the effect, with conviction.
In 1790, while translating Cullen's Materia Medica Hahnemann, differing with the author, tested the claims by taking small doses of Peruvian bark, the result was the birth of Homoeopathy. Six years later in 1796 after constant study, experimentation and practical research, Hahnemann published in Hufeland's journal, the leading medical journal of his day, an essay "On a new principle for ascertaining the curative properties of drugs." This historical proclamation of his second principle, though being a physician of highest repute, a scientist no one dared question, was met with fierce opposition and criticism. (1)(4)
Here is demonstrated Hahnemann's character as a Scientist, he sets the example for all "scientists" to this day in that, to pronounce that something does not work before having tried and experimented with it first, is not only totally unscientific and unprofessional, but may be considered irrational. A scientist is someone who studies, experiments and researches without any bias or prejudice before acceptance or rejection in any manner what so ever. The code of the true scientist is :"To prove all things and hold fast that which is good" (5) ; It is to be a lateral thinker and to be open minded and receptive at all times; It is to disregard hearsay and to consider everything as neither valid nor invalid until personal investigation has equipped him to do so. Hahnemann experimented on himself in every case of doubt, he researched his findings with Peruvian bark (quinine) for six years before finally publishing.
This was the end of Hahnemann's Allopathic career and beginnings of Homoeopathy. By the end of Hahnemann's life he had completed ten volumes of Provings, which included experiments with ninety nine substances upon himself, published seventy original works on chemistry and medicine, left 54 case books containing the detailed records of all patients consulted by him from 1799 to 1843, four large volume of repertories, 1500 pages each, and numerous articles on a wide variety of subjects (1), including, "The Medicine of Experience", His "Organon" 1st to 6th edition, "Chronic Diseases", "Materia Medica Pura" and the numerous other writings. By the late 1830's Hahnemann had become the most famous physician in Europe. Poor patients were treated for free and Hahnemann charged his other patients only if a cure was achieved. Samuel Hahnemann died peacefully in his bed on July 2, 1843. The inscription on his grave reads: Non inutilis vixi (I have not lived in vain).
The Development of Homoeopathy
Homoeopathy spread rapidly. In 1825 Dr.Hans Gram moved back to the US from Holland and introduced homeopathy to their medical fraternity. By 1900 there were in the United States; seventy homeopathic general hospitals with 4829 beds, 32 special hospitals and asylums with 6592 beds, over sixty orphanages and old people's homes, more than one thousand homeopathic pharmacies, thirty four State and one hundred and sixteen local homeopathic societies, 9369 Homoeopathic Medical Practitioners and twenty two homeopathic medical schools producing between four to five hundred new graduates per annum, with a doubling of the number of homeopaths in New York every five years during the period 1829 to 1869. (6)(7) By this time there were also some two thousand homoeopathic practitioners in Europe. (7) Of the four US medical schools with the largest libraries three belonged to homoeopathic colleges and there were 29 different homoeopathic medical journals. There existed only one registration authority in the US and graduates from both Conventional Medical schools and from Homoeopathic Medical schools registered as medical doctors with this same body.
The rise of homoeopathy was not appreciated by all and the American Medical Association's (AMA) efforts to suppress homoeopathy grew increasingly more effective. In 1910 a very biased evaluation of American Medical Schools which was chaired by Abraham Flexner in conjunction with leading members of the AMA resulted in the Carnegie Foundation's publication of the infamous Flexner Report. This report led to a reduction of homoeopathic schools from twenty two in 1900 to only two in 1923, of the black medical schools less than thirty percent(<30%) remained and it contributed a thirty three percent(33%) reduction in the number of women graduating from medical schools in the US. It's publication effectively eliminated 85-90% of the health care practitioners in the US (6) By the 1930s all homeopathic medical schools had dropped the word "homeopathic" from their names as did all of the homeopathic hospitals and by the 1950s virtually all homeopathic inpatient care had ceased.
Homeopathy was kept alive in the U.S by the efforts of people like Dr. Royal Copeland, M.D., a homeopath, dean of New York Homeopathic Medical College, Health Commissioner for New York City and U.S. senator who sponsored the Pure Food and Drug Act of 1938, the bill that established the F.D.A. and which gave long-standing legal status to homeopathic medicines to this present day. Secondly, during the federal hearings in the 1960s for Medicare legislation, medicines listed in the Homeopathic Pharmacopoeia were included as drugs reimbursed under Medicare.
The demise and deliberate suppression of Homoeopathy was short-lived as radio, television, magazines and journals contributed to a restoration of the status quo and interest in homoeopathy is growing faster today than ever before. Statements from world leaders and organisations in favour of homoeopathy contribute enormously in changing the perception of homoeopathy. The World Health Organisation stated in their Journal "The World Health Forum" that "Homoeopathy seems well suited for use in rural areas where the Infrastructure, Equipment, and Drugs needed for Conventional Medicine cannot be provided." The Mahatma Gandhi said, "Homoeopathy cures a greater number of people than any other method of treatment.", President Francois Mitterand of France, and six Deans of Medical faculties, called for more research on Homoeopathy in an article in " Le Novel Observateur" one of France's leading magazines, the Editor of this magazine stated in his editorial, "It is a Fact that Homoeopathy obtains results, and sometimes spectacular results." (6)
In the early 1970's in the US there were 50 - 100 Practitioners specialising in Homoeopathy, by the Mid 1980's there were more than a thousand, with a doubling in numbers between 1980 to 1982. The were also some 1000 more practitioners from other Health Professions practising it. The FDA in a report stated that there was a 1000% growth in the sales of Homoeopathic Medicines in the US from the late 1970's to the early 1980's. From the late 1970's through the end of the millennium sales of homeopathic medicines have reportedly increased by 2000%(37). Market research has shown that sales of homeopathic remedies have grown at 25-50% per year during the past ten years(38). In 1999 the world market for supplementary/complementary medicine was estimated at US$46 billion of which an estimated $20 billion were for botanical and homeopathic sales, followed by vitamins and minerals with $17.8 billion and sports/specialty supplements at $8.8 billion(36). There is a 39% growth in the interest in Homoeopathy in Great Britain. The are more than 2000 Homoeopathic Practitioners in Argentina and an equal number in Brazil. All pharmacists in Brazil must do Homoeopathic Pharmacology to graduate. There are 120 Homoeopathic Medical Faculties, more than 100 000 Homoeopathic practitioners and more than a hundred four-and five-year Homoeopathic Medical Colleges in India(28). There are more than 11 000 French Doctors who prescribe Homoeopathic Medicines. More than 20 000 French Pharmacies now sell Homoeopathic Medicine. Degree Courses in Homoeopathy are now offered in 6 Medical Schools in France. Homoeopathy is taught in all Pharmacy Schools in France and in four Veterinary Schools.
In South Africa the Homoeopathic Industry has been growing steadily. Sales of homoeopathic medicine in South Africa are growing at an enormous rate. The interest among our South African Allopathic Medical colleagues is evident form the number of medical practitioners attending Homoeopathic lectures, seminars and congresses. It is estimated that more than 10% of South African Allopathic Medical Practitioners advise or use Homeopathic medicines. The Alternative Medicine Market in South Africa is now more than R2billion per annum and growing rapidly. Membership of non-allopathic associations and societies are on a steady incline and so are the numerous publications which feature regular articles on these subject. Homoeopathy is recognised as being the fastest growing medical modality in the World. The perception of homoeopathy is changing and there is a growing demand to learn more about homoeopathy.
Homoeopathy as practised in South Africa
The terms Homoeopathy and Homoeopaths mean different things to different people and it is necessary to place homoeopathy in perspective for everyone to understand what it really is. In South Africa there are three groups of Primary Contact Practitioners, being Medical Practitioners, Homoeopathic Practitioners and Chiropractors. Homoeopathy became a registerable profession in 1974 and any person wanting to practice as a Homoeopathic Practitioner needs to be registered with the Allied Health Professions Council (one of the five autonomous Statutory Health Councils), established in terms of Act 63 of 1982, the other four councils being the Medical and Dental Council, Nursing Council, Pharmacy Council and Dental Technicians Council. There are currently more than 600 registered Homoeopathic Practitioners in South Africa and some 100 to 200 new intakes every year between the two official Homoeopathic Schools, in Durban and the Witwatersrand. A Post-graduate Homoeopathic course is being developed locally for Medical Practitioners. The Homoeopathic Profession has worked hard at demographic representation since the early days and today more than 30% (thirty percent) of all registered practitioners are from the previously disadvantaged population. An even better representation exists in terms services rendered in rural areas as a very large portion of practitioners live and practice in rural South Africa where health services are desperately needed. As previously mentioned, the WHO also feels that "Homoeopathy seems well suited for use in rural areas where the Infrastructure, Equipment, and Drugs needed for Conventional Medicine cannot be provided."
The fact that a person is registered as a homoeopath suggests that he/she practices pure homoeopathy, but in practice this is not necessarily the case, which sometimes causes confusion. Furthermore, numerous non-homoeopathic treatments, medicines, techniques and philosophies are confounded with homoeopathy. Registered homoeopaths may choose to practice homoeopathy in 'n number ways and these different approaches to Homoeopathic medicine can be summed up as follows;
Some Homoeopaths consider it of utmost importance that there should be strict adherence to the modern "classical" homoeopathic philosophy. This includes, among others, prescription of only a single remedy, adherence to the similimum principle(Individualisation), the totality of symptoms, the minimum or infinitesimal dose (high and ultra high potencies or dilutions). They choose to practise homoeopathy according to an approach that focuses on the constitution of the patient rather than the condition itself. The Mental or mind symptoms are considered most important in determining the medicine to be prescribed, which may include even the past history of relatives such as grand and great grandparents and as such these practitioners require at least two hours per consultation. The medicines tend to be supplied in the form of powders (of which only a certain number actually contain any medication or active substance), or small round sugar pellets called granules or pillules.
Then there is the more conventionally established approach to homeopathy. These practitioners choose to prescribe any homoeopathic remedy, single and/or complex, in any form, ampoule, suppository, ointments, tablets, capsules, drops, pillules or granules, etc. They prescribe for the condition as presented in the individual patient. They may prescribe simplex(single) higher potency medicines according to the similimum for the condition as presented in the individual patient, for specific organs or symptoms, but may often also support it with complex homoeopathic medicines for specific organs and/or systems, or to obtain specific affects. These practitioners tend to be very holistic in their approach and treat the condition, the organs involved as well as the person as a whole. They would for instance prescribe medicine specific to the condition, medicine for the constitution, medicine to assist in drainage and medicine for focal infections, etc. They treat chronic and acute conditions and quite often run busy primary contact practices. They would use any medicine, as long as it is Homoeopathically prepared, in their effort to assist in restoring their patients' health. They tend to follow 'n more modern holistic combined inter-disciplinary approach to homoeopathic treatment and also work closely with their medical and alternative / complementary counterparts.
Another group of Homoeopathic practitioners tend to follow an integrative approach. These practitioners utilise not only those treatments and medicines for which they are primarily registered, but combine a number of quite different methods, medicines, techniques and alternative disciplines in their efforts to restore patients to health. They often include treatments like Ozone therapy, Hydrogen peroxide therapy, Isotherapy, Vitamin therapy and clinical nutrition as part of their treatment program. They may even combine the conventional with the unconventional. This integrative approach to medicine is found all over the World today and is growing rapidly.
The present Scope of Practice of Homoeopathic Practitioners in South Africa is more in line with that of Medical Practitioners in SA and elsewhere and most South African Homoeopaths tend toward the last two approaches. These homoeopathic practitioners also utilise a variety of diagnostic techniques and equipment most often similar to conventional medical practitioners, but may include Iridology, Live Blood Analysis, Electro-acupuncture Devices and numerous others. Consultations are usually around 30 minutes and very cost effective.
Internationally Homoeopathy is considered a post-graduate field of specialisation for registered Medical, Osteopathic and Naturopathic Practitioners, whereas in South Africa it is being offered at undergraduate level as it was in the United States until the 1950's. The training of homoeopaths in South Africa involves a five year Masters degree course leading to a M.Tech.(Hom)., followed by a one year internship program. Admission requirements are similar to those of the MB.ChB (medical) programs. The curriculum of the first three years are the same as for MB.ChB including dissections, but excluding surgery. As Homoeopathy follows a medicinal therapeutic approach, pharmacology takes the place of surgery. Homoeopathic students undergo dual training, meaning that they are trained both as Homoeopathic Practitioners and as Homoeopathic pharmacists. Homoeopathic Students are also required to study conventional allopathic(medical) pharmacology and undergo three years of pharmacology training, which includes homoeopharmaceutics and dispensing as part of the study of Materia Medica. The fourth and fifth years focus on clinical medicine, clinical homoeopathy, systemic pathology and the practical application of Materia Medica, applied homoeopathy as it were. The fourth and fifth years follow the same path as the MB ChB, but focus upon the homoeopathic rather than on the allopathic treatment in Cardiology, Urology, Dermatology, Gynaecology, etc. Owing to the fact that registration in South Africa demands no less than a Masters degree level qualification, allopathic (conventional) medical practitioners wishing to practice Homoeopathy in South Africa are required to do a three year post-graduate course of training in Homoeopathy and then pass the National Council Registration Examination (CRE), before being allowed to register as Homoeopathic practitioners. It is illegal for anyone (including Medical Practitioners) to prescribe Homoeopathic medicine or practice homoeopathy in South Africa without being registered with the Allied Health Professions Council of South Africa (AHPCSA) and as such dual registration with both the AHPCSA and the Health Professions Council of South Africa (HPCSA) is provided for. The Scope of Practice of Homoeopathic Practitioners is virtually the same as for Allopathic / conventional Medical practitioners, so too are the Code of Ethics, Continuing Professional Development requirements, etc. South Africa is considered the World leader in terms of Homoeopathic education and training.
An evaluation of the South African Homoeopathic training suggested that this training is of a much higher standard than the training of Medical Practitioners in many overseas countries including Germany and others. The only real difference between South African trained Homoeopathic practitioners and their medical counterparts is the surgery aspect, which is replaced by pharmacy. It is recognised that South Africa produces the best trained Homoeopathic practitioners in the World today. South Africa, through its masters degree program, also produces a vast amount of International standard scientific/clinical Homoeopathic research annually. The Masters Research Dissertations include double blind clinical trials, laboratory studies e.g. in vitro studies, etc. These studies are of the highest scientific standards and include the most advanced scientific technology and methods.
Principles and Practice of Homoeopathy
Similia similibus curentur - let likes be treated by likes, this is the primary principle of homoeopathy. Homoeopathy is most often confused with small, minute and immeasurably diluted (infinitesimal) substances, but this, in fact, is not the true meaning of homoeopathy. The encyclopaedia describes it as, "Homoeopathy is a system of medicine based on the law of similars - that like is treated or cured by like. The principle of Homoeopathy "like is cured by likes", suggests it to be a fundamental Law of science, but practitioners mostly apply the rule simply as "let likes be treated by likes", which is Homoeopathy's fundamental principle or therapeutic approach to the practice of medicine. In homeopathy a drug that produces the same symptoms as a disease (e.g., quinine given to a healthy person mimics malaria) is used in small doses to treat that disease."(9) Hahnemann demonstrates this principle to exist in nature itself, " A weaker dynamic affection is permanently extinguished in the living organism by a stronger one, if the latter (whilst differing in kind) is very similar to the former in its manifestations." (8) This explains how it applies to medicinal treatment of disease "In order for a medicine to affect a cure, it is before all things requisite that they should be capable of producing in the human body an artificial disease as similar as possible ("and somewhat stronger") to the disease to be cured"" (8) Smallpox is an excellent example of the principle of homoeopathy, especially in relation to vaccination. When the product of smallpox was used for the preparation of vaccines, patients died as consequence. Jenner utilised cow-pox, which is very similar in nature and presentation to smallpox to prepare his vaccine, which resulted in the virtual eradication of smallpox. Hahnemann says "Smallpox coming on after vaccination, as well on account of its greater strength as its great similarity, at once removes entirely the cow-pox homeopathically, and does not permit it to come to maturity; but, on the other hand, the cow-pox when near maturity does, on account of its great similarity, homeopathically diminish very much the supervening smallpox and make it much milder, as Muhry and many others testify."(8) He explains Jenner's smallpox vaccine when he says that "two similar diseases cannot exist beside each other in the same organism, or together form a double complex disease".(8) Hahnemann also quotes Jenner as having suggested that in the presence of Rachitis (Rickets), vaccination does not take effect(8), which is in agreement with Hahnemann's converse-theories once again.
Homoeopathy is a system of medical practice based on three principles ; 1) Drugs are tested on healthy human subjects, 2) The Law of Similars, 3) The Individual Disease Picture. It is not necessary that the dilution of the medicine be infinitely diluted. However, what is important in every individual case, is the homoeopathicity of the prescription. Homoeopathicity meaning that the medicine or remedy prescribed should be in accordance with the Homoeopathic principle of similimum (individualised to the condition as presented in the patient). The principle of similimum has been demonstrated even on the level of molecular biology.(16)(26) The symptomatological picture presented by a patient or disease (both, subjective and objective), should very closely compare with the Drug Picture (symptoms produced by the medicine when tested on healthy subjects). Stated otherwise, the patient's symptoms or symptoms of the disease should be matched against the symptoms produced by the drug when given to healthy human subjects. It is for this reason that Homoeopathy is considered one the most difficult medical modalities to study and practice as the average Homoeopathic Materia Medica contains some 2000 Homoeopathic substances describing between 200 and 2000 symptoms for each, which must be compared with the symptoms as presented by the patient or as existing in the disease at hand. There are almost ten thousand individual Homoeopathic substances listed with the South African Medicines Control Council plus thousands of Homoeopathic Complexes (combination formulations).
An example of a commonly prescribed Allopathic substance which concurs with the principle of likes treated by likes, is the prescribing of Colchicine in the treatment of acute gout. Massive doses of Colchicine causes "Inflammation in the big toe and heal, with great tenderness to touch", "His sufferings seem intolerable." (10) "So far as it influences healthy joints it is to cause inflammation and pain in them, and not any condition opposite to that which obtains in the gouty state." (11) Although Pharmaceutical companies give indications for Colchicine in both acute and chronic gout, as well as for prophylaxis,(12) both homoeopathic and allopathic articles tend to indicate it primarily in the acute forms. (15) It must be added though, that from a homoeopathic perspective, this is not the only condition for which Colchicine or Colchicum (the name used in Homoeopathy) is indicated as it causes a much wider range of symptoms, including the well known side-effect of diarrhoea and others.
The Drug Picture or Drug Action is obtained from ; Provings, Toxicology and Pharmacology, Clinical use, and Veterinary use. (2) The term Proving implies that a "healthy" human subject would under controlled and supervised conditions take samples of a substance for the purpose of invoking symptoms, peculiar to the substance, in himself. This "may" be compared to a toxicological study of drug action, but much more in-depth and detailed, and covering a much wider spectrum of effects, changes signs and symptom notation. The symptoms and signs are carefully observed and documented in terms of severity, duration, primary and secondary symptoms, factors which influence the state and severity produced in the, Mind, Head, Eyes, Ears, Nose, Throat, and so forth. In earlier times the substances taken were crude substances, and the provings were, in many cases, continued for prolonged periods, but stopped before becoming lethal. (10) The later provings were performed with diluted or potentized substances. The purpose of the proving then is to ascertain the symptom range and "picture", of the action of the substance as produced in the healthy. The first rule of any scientific experiment, is that it should be reproducible. The reproducibility of the provings are especially important. Numerous re-provings of drugs have been conducted over the years to determine just that. The positive results of re-provings have led many to conclude that it unnecessary and that provings should rather be conducted on new substances to add the Homoeopathic Materia Medica. In some cases, results of gross poisonings and toxicology act as indispensable sources of information regarding the action of substances. It must be realised that the symptoms of poisoning and the side-effects of drugs and substances are (from a homoeopathic perspective) provings of the drugs/substances. Much of the symptomatological data contained in homoeopathic Materia Medica's stem from poisonings and toxicological records. The drug picture is further enhanced and confirmed by clinical experience and findings from practitioners, researchers and training institutions. The same applies to results obtained from veterinary practice and experiments. (10)
Substances used in homoeopathy have their origin from plants, chemicals, minerals and other. There are also other classes of homoeopathic medicine;
Nosodes are derived from pathological organs or tissues, causative agents such as bacteria, fungi, ova, parasites, virus particles, yeast or disease products or excretions.
Allersodes are derived from antigens, i.e., substances which under suitable conditions can induce the formation of antibodies. Antigens include toxins, ferments, precipitogens, agglutinogens, opsonogens, lysogens, venins, agglutinins, complements, opsonins, amboceptors, precipitins, and most native proteins.
Isodes are derived from botanical, biological, chemical or synthetic substances, or drugs, including excipients or binders, which have been ingested or otherwise absorbed by the body and are believed to have produced a disease or disorder which interferes with homeostasis.
Sarcodes are derived from wholesome organs or tissues obtained from healthy animals. (17)*
The preparation or manufacture of Homoeopathic medicine requires a process which Hahnemann termed dynamization or potentization. The process begins with the preparation of a homoeopathic mother tincture (Ø) or tincture for short. The tincture is prepared according to the rules as set out in the Homoeopathic Pharmacopoeia. The medicine is then potentized according to the decimal scale (1:10 indicated by "D" or "X") or the centesimal scale (1:100 indicated by "C" or "CH"). Depending on which scale is used or required, one part of the tincture is diluted with either nine ("x") or ninety nine ("CH") parts of alcohol and is then succussed (shaken vigorously). This would be the first potency and is designated either 1x or 1CH respectively. The next potency, the 2x or 2CH potency is obtained by repeating the process in either 1:10 or 1:100 dilution respectively. This process of successive dilution and succussion is repeated until the desired potency is obtained.
The greatest obstacle to acceptance of homoeopathy lies in the potencies or dilutions employed. As mentioned before, it is not the dilution or potency which is of most importance, but the homoeopathicity. The vast majority of Homoeopathic complex medicines contain substances with potencies ranging from the mother tincture (1:9) to the 6x (1:1,000,000) decimal potency. In the case of Colchicine, one finds it prescribed in strengths of 1mg which can be compared to a 3x potency. (12) Alprazolam is prescribed in doses as small as 0.25mg per dose. (12) If fluoride in drinking water exceeds 0.7mg/l which amounts to less than 1ppm (parts per million), supplementation is not recommended. (13) 1ppm can be compared to a 6x potency. A more chemical example is that of a swimming pool in which a level of 3ppm of chlorine is considered the ideal concentration to maintain a healthy state of the water, this is equal to ± 6x potency. A physiological response can be obtained with the pituitary hormone in dilutions of 1:100,000,000 and adrenaline may act at dilutions three times greater. One day's production of prostaglandins in the body, weigh as little as one tenth of one milligram and is sufficient to the need.(14) It has also been demonstrated that substances in potencies as high as 14x (1:10-14 ) contain enough of the active ingredients to cause physiological stimulation of macrophages/monocytes to produce 5 to 15 chain amino acids (called "motifs"). In terms of these studies, concentrations or dilutions ranging from the undiluted to the 14x dilution are considered to have a biochemical action, and dilutions higher than 14x are considered to function energetically.(16)(26) It has been shown that the formation of Th3 cells are induced by substances only in the potency/dilutions 1x to 14x (plus minus 1 to 10µg per day per kg body weight), while higher concentrations of the same proteins inhibit such cell formation. This means that certain therapeutic effects on the cytokine level can only be achieved through substances at these low concentrations.(26) It would seem that, on average, the potencies or dilutions used in homoeopathy are not all that different from conventional medicine, or inconceivably high. While in many instances the strength of Homoeopathic dilutions may perhaps exceed those of conventional Medicine, the physiological effect of low concentration homoeopathic medicines can be demonstrated scientifically.
Homoeopathic medicines can be prescribed either patient specific, as is the case when prescribing in accordance with the similimum of the patient or disease, or it can be prescribed symptom specific, as in the case of Colchicum for the specific symptom of pain in gout. In the latter case the results are not always equally effective in every case which applies equally to both homoeopathy and allopathy. Some articles / authors state that Homoeopathic medicines are patient specific and homoeopathic complex medicines are symptom specific, while it is in fact not true. This notion stems from a modern day misinterpretation of the principles of homoeopathic prescribing. Any Homoeopathic medicine can be prescribed for any specific symptom, any specific organ, any specific patient or for any specific disease. Various homoeopathic medicines are described in the most authoritative homoeopathic literature as being specific to certain organs, symptoms, disease, etc. Was it not for this fact, complex homoeopathic medicines could barely have been developed, as most complexes are formulated by virtue of these specific indications of the individual simplexes contained therein. The difference between patient specific and symptom specific prescribing lies in the application or therapeutic approach. Homoeopathic complex medicines can also be prescribed either symptom specific or in a more general sense, disease specific. In fact some homoeopathic companies produce complexes for patient specific application in accordance with the various constitutional type classifications. Homoeopathic Complexes tend to be more specifically aimed at specific organs or tissues, or at specific functional states. Complex homoeopathic formulae are usually prescribed according to their indications. The efficacy of many complexes are supported by clinical trials and most homoeopathic pharmaceutical companies have ongoing programs to research and validate the efficacy of claims and indications.
Scientific Evidence and Validation of Homoeopathy
There are ± 30,000 biomedical journals in the world, growing by 7% per annum since the 17th century, yet only about 15% of medical interventions are supported by solid scientific evidence. This is partly because only 1% of the articles in medical journals are scientifically sound and partly because many treatments have never been assessed at all. One x-ray in five is taken unnecessarily. Based on autopsy findings, errors in diagnosis are now just as prevalent as in the past (around 50%) despite enormous technological advances. Errors in medication supplied in hospitals occur once every 6.5 administrations (either in medications or dosage given), while between 50 and 80% of adults swallow prescription medication every 24 to 36 hours. According to figures in the USA only 2% of special investigative test results actually influence subsequent treatment decisions. 12% of all surgery is said to be unnecessary, with caesarean section averaging 23% of all deliveries in the US.(18)
(Read the latest article with shocking evidence "Modern Health Care System is the Leading Cause of Death)
A.D. Speransky states in his book "A Basis for the Theory of Medicine":
"It must be frankly admitted that contemporary medicine does not owe its success in the sphere of treatment to science alone. Scores of its methods and procedures rest on empiricism and even on chance. Only in the sphere of infection, of mechanical therapy and of hygiene are its achievements connected with a really scientific analysis of the phenomena. For the rest, anarchy prevails, here and there connected by separate facts and practical comparison. We have an infinite number of medical theories, but we have not had, and do not have a theory of medicine, a theory capable of embracing all the data and directing them into channels where they can be most actively utilized."(39)
Homeopathy has a wonderful advantage over other disciplines since it has a codified set of 294 principles contained in The Organon. These principles are not mere theories or conjecture, but are based upon repeatable, verifiable scientific experimentation and investigation as prescribed in the Organon and documented for practical application in the Materia Medica. Homoeopathy is one of the very few (if not the only) health disciplines that is based upon and practised according to a specific and detailed philosophy. If practised in accordance and with strict adherence to the rules and guidelines contained in the Organon specific outcomes can be expected for it is based upon proven cause and effect in terms of the provings of each and every homoeopathic medicine. The advances in quantum physics are verifying the principles of homeopathy and World-wide vast amounts of research are conducted in Homoeopathy. According to research in Germany and Europe, we can already scan a remedy and graph it's unique electromagnetic signature as a waveform (Energy pattern). We can do the same thing using one remedy at different potencies, with each potency producing a unique electromagnetic signature or waveform. This effectively proves the existence of physical substance within homoeopathic medicines to at least the 30CH potency. Each and every homoeopathic medicine correctly prescribed will act safely and predictably in accordance with the symptomatological guidelines as contained in the Materia Medica. The same results can be expected in every individual prescription of every homoeopathic remedy every time for it is based upon fact and repeatable experimentation.
Contrary to general belief, vast amounts of research (including double blind clinical trials) in homoeopathy have been conducted over the past two hundred years. Scientists regard double blind clinical studies as the "gold standard" and this evidence for homoeopathy, is not lacking. A state of the art meta analysis reviewed 186 studies, 89 of which fit pre-defined criteria, showed that patients taking homeopathic medicines were 2.45 times more likely to experience a positive therapeutic effect than placebo.(19) Another meta-analysis reviewed 107 studies of homeopathic medicines, 81 of which (77%) showed positive effect. Of the best 22 studies, 15 showed efficacy. The researchers concluded: "The evidence presented in this review would probably be sufficient for establishing homeopathy as a regular treatment for certain indications." Further, "The amount of positive evidence even among the best studies came as a surprise to us." (20) Homoeopathy has been shown in numerous controlled studies to be superior to placebo.(21) (22) A meta-analysis of 105 studies in toxicology showed that homeopathic medicines may be useful in treating toxic exposures(23). An acclaimed controlled study concluded that Homoeopathic medicine may be an effective alternative in the treatment of hypertension having demonstrated its effectiveness in reducing both blood pressure and pulse pressure in subjects.(27) Studies have demonstrated homoeopathy to be effective in: vertigo;29 pollinosis;21,30 postoperative ileus;31 upper respiratory tract infection and otitis media;32,33 and depression and anxiety34 to quote but a few. A meta-analysis of placebo-controlled trials published in the Lancet concluded that the results were "not compatible with the hypothesis that the clinical effects of homoeopathy are completely due to placebo".19 An earlier study also published in the Lancet also indicated that the evidence for homoeopathy is reproducible.22 As stated by Dr. Gaby, "While statistically significant results will occasionally occur by chance, it is extremely improbable that a worthless treatment would repeatedly produce statistically significant benefits."35
Numerous studies have also shown the cost effectiveness of Homoeopathy. A study of 130,000 prescriptions confirmed the benefit and savings to homeopathic treatment. The number of paid sick leave days by patients under homeopathic physicians were 3.5 times less (598 days/year) than patients under general medical care (2,017 days/year). Homeopathic medicines represent 5% of all medicines prescribed in France, but represent only 1.2% of all drug reimbursements due to their lower cost per prescription. (Homeopathic medicines are fully reimbursable under the French health care system) (24). A study showed that homeopathic care for infertility was 30 times (30x) cheaper per successful delivery than the comparison group given conventional care (25). Unfortunately South African Medical schemes generally place very little value on the cost-effectiveness and efficacy of Homoeopathic treatment and reimbursements are negligible, notwithstanding the fact that South Africa leads the field in Homoeopathic training (being equal to Medical training and state funded) and that Homoeopathic practitioners have a scope of practice similar to that of medical practitioners.
In South Africa some thirty clinical trials and research dissertations are conducted and published annually by graduates of Technikon Witwatersrand and the Durban Institute of Technology. Numerous trials are also conducted at Universities and by Manufacturers and distributors of Homoeopathic Medicine in South Africa. Clinical trials formed the basis of homoeopathy from the outset and thousands of research projects and controlled clinical trials have been conducted over the past two centuries. A meta-analysis is presently underway to evaluate the past research conducted at Technikon Witwatersrand School of Homoeopathy.
Homoeopathy is based on sound principles and scientific guidelines, it is supported by vast amounts of research, which is growing by the day, done with the help of the most advanced scientific and clinical technology, by some of the World's foremost scientists, also supported and used by leading international scientists, including Nobel Laureates, growing faster than any other health modality, having withstood the "test of time" over some two hundred years in spite of the most severe attempts to suppress and discredit it, used in paediatrics, adult and geriatric medicine, veterinary medicine, acute and chronic disease, in fact every field of medicine, with great success.
Modalities, Techniques and Medicines often linked to or confounded with Homoeopathy
In South Africa, many unrelated medicines, techniques, modalities and therapeutics are confounded or equated with homoeopathy. Homoeopathy is often linked to so-called "natural" medicines, including herbalism / phytotherapy, chinese medicine and acupuncture, iridology, ayurveda, and various other modern and traditional integrative medicines and therapeutics. Although some aspects or medicines are sometimes used, applied or advised by individual homoeopathic practitioners, these have nothing in common with Homoeopathy and are not related to or part of homoeopathy. Two centuries ago when Hahnemann founded Homoeopathy, medical practice consisted largely of herbal and crude un-adultered natural substances. It was exactly due the side-effects of these "natural" substances that Hahnemann experimented with potentisation in an effort to produce safer yet effective medicines. Most of the substances used in Homoeopathy are the same as those used in conventional medicine and herbalism/phytotherapy. The difference is that in homoeopathy these substances are not used in their pure/crude natural form, but rather far from it. Many conventional medicines still contain pure natural substances, but these are used under very controlled conditions. Conventional medicine is fully researched and the side-effects, interactions, contraindications and working is well researched, documented and published. Conventional medicine, although dangerous in some instances are used very responsibly under very controlled and specific instructions. Unfortunately very few "natural" medicines are researched at all and in many instances are used in accordance with traditional use and unsubstantiated theories without any knowledge of possible side-effects, interactions or contraindications often refusing to admit to the existence thereof. Homoeopathic substances are well researched in terms of its philosophy, documented in Materia Medica's and Pharmacopoeia and prescribed accordingly. In homoeopathy, as in conventional medicine, every fine detail of every substance has to be obtained from experimentation, human trials (including provings in the case of homoeopathy), toxicology, veterinary science, interactions and contraindications. In the case of Homoeopathy these studies include detailed mental symptoms produced and every possible affect on every organ and system. Homoeopathy does however have the added advantage that very few side-effects, interactions and contraindications exist owing to it not being used in crude natural form. The same can unfortunately not be said of most "natural" traditional medicines. Homoeopathy moved away from crude natural substances, while "natural" traditional and conventional medicine continued along the path of crude natural substances, but while conventional medicine did so under very strictly controlled and responsible conditions, "natural" traditional medicine did not.
Owing to the variety of different approaches some homoeopaths may perhaps find some fault with some of the statements made in this article, but it was not written for homoeopaths. Instead, it was written for the Allopathic Medical Practitioners and other Health Professionals who show interest in homoeopathy and who would like to understand what homoeopathy is. It is by no means a detailed or scientific research paper on the subject of homoeopathy. It is hoped, however, that it explains and abrogates some of the misconceptions about homoeopathy, which existed until now. There is nothing mystical or esoteric about homoeopathy. Homoeopathy does not use unknown substances or mere placebos. Most homoeopathic substances were, or are still used in allopathic medicine. The difference lies in the manufacturing process, the direction of indications, in some instances the strengths or dilutions and, perhaps, the paradigm. The proof of the pudding is in the eating and as stated by the honourable Dr.E.B.Nash :"Prove all things and hold fast that which is good". There is no validity or rational in acceptance or rejection of anything until tried and tested by oneself. The information provided from such an article has no substance or value, which is worth more than the cost of the ink and paper, unless is it put to the test practically. Only once the information is put to the test in practical application and the results weighed, does it materialise in value and therapeutic applicability. Homoeopathy is safe and undoubtedly effective, proven by the tremendous world-wide support and interest of patients and health professionals.
Homoeopathy originated from conventional western medical science and is a true Alternative Medicine. It was founded by a Western Medical Genius as an alternative to conventional allopathic medicine. It has been further developed and enhanced by the efforts of brilliant homoeopathic medical doctors over the past two hundred years. Homoeopathy is a complete medical science as it treats any medical condition in any human being of any age and is supported by scientific research and clinical trials.
the twenty first century,
Homoeopathy is the Best Known, Safest, and Most Effective Wholistic Healing Art in the World.
(1) A compend of the Principles of Homoeopathy for Students of Medicine, Garth Boericke, M.D. B.Jain, New Delhi, India; p137-143
(2) The Handbook of Homoeopathy. Its Principles and Practice; Gerhard Koehler, Healing Arts Press, Rochester, Vermont; p18-21
(3) Homoeopathy. The Potent Force of the Minimum Dose, Keith A. Scott, M.B., Ch.B., M.F.Hom. & Linda A. McCourt M.A.(Oxon), Thorsons; p16-19
(4) Peter Morrell, A Guide To Hahnemann's Translations
(5) Leaders in Homoeopathic Therapeutics, E.B.Nash MD Sett Dey &co, Calcutta 1959; p372
(6) A Condensed History of Homeopathy Discovering Homeopathy: Medicine for the 21st Century, Dana Ullman, M.P.H., Berkeley: North Atlantic, 1991.
(7) The Principles and Practice of Homoeopathy, Richard Hughes LRCP, MRCS, MD(Hon); B.Jain New Delhi; p177
(8) Organon of Medicine Samuel Hahnemann 6th ed. transl.W.Boericke MD, Roy Publ.House., Calcutta, 1972 p107 § 26, p111 § 34, p127 § 48, § 46, § 44, § 36
(9) Concise Columbia Encyclopaedia 1995 Columbia University Press. MS Bookshelf 1996-97
(10) A Manual of Homoeo-Therapeutics Edwin A.Neatby MD and Thomas Gearge Stonham MD, 3rd ed. Staples Press Ltd. 1948; p4-20, Colchicum p389
(11) A Manual of Pharmacodynamics reprint 6th ed. Richard Hughes LRCP, B.Jain Publishers New Delhi, 1999; p427
(12) MIMS Medical Specialities.vol 40 no.1 January 2000 p76, p6
(13) MIMS Desk Reference vol 34, 1999, p876
(14) Our Sciences Ruled by Human Prejudice D.G.Garan Ph.D., J.U.D., LL.D. p98
(15) MIMS Prescribing Power vol.3 no. 1, March 1998 Gout - Prevention and Management K.R.L. Huddle FCP(SA) p21-23
(16) Homotoxicologie en Biotherapie een Integratieve Visie op Gezondheid en wetenschap, Bruno van Brandt DSc. Auralia-Verlag, Badeb-Baden, 1998 p59-61
(17)* Homoeopathic Pharmacopoeia of the United States 8th ed. 1st suppl. Published by the Homoeopathic Pharmacopoeia Convention of the US ; Quoted verbatim from p65, 66, 67, 68
(18) The Journal of the Chiropractic Academy of Homeopathy, Towle, Daniel P. Article Title : Why Homeopathy? Volume 6; Number. 2 Page : p. 25 & various articles from the Journal of Alternative and Complementary Medicine
(19) Lancet, September 20, 1997, 350:834-843, Lancet. 351(9097): Jan 1998 K. Linde, N. Clausius, G. Ramirez, et al., Are the Clinical Effects of Homeopathy Placebo Effects? A Meta-analysis of Placebo-Controlled Trials
(20) British Medical Journal, February 9, 1991, 302:316-323, J. Kleijnen, P. Knipschild, G. ter Riet, Clinical Trials of Homeopathy
(21) Lancet, October 18, 1986, 881-86., D. Reilly, M. Taylor, C. McSherry, Is Homeopathy a Placebo Response? Controlled Trial of Homeopathic Potency with Pollen in Hayfever as Model.
(22) Lancet, December 10, 1994, 344:1601-6., D. Reilly, M. Taylor, N. Beattie, et al., Is Evidence for Homoeopathy Reproducible?
(23) Human and Experimental Toxicology, 1994, 13:481-92., K. Linde, W.B. Jonas, D. Melchart, D., et al., Critical Review and Meta-Analysis of Serial Agitated Dilutions in Experimental Toxicology
(24) Caisse Nationale de l'Assurance Maladie des Travailleurs Salaris, 1996
(25) Therapeutikon. 1991;7:309-315, Gerhard, I, G. Reimers, C. Keller, and M. Schmuck, Weibliche fertiltitasstorungen. Vergleich homoopathischer einzelmittel--mit konventioneller hormontherapie
(26) Biomedical Therapy, Vol. XVII, No. 4 of 1999, Helmut Heine, Ph.D., The Working Mechanisms of Antihomotoxic Potentized Preparations. (Reprinted from Biologische Medizin (1999 February): 19-23) p.117-120
(27) Research report to Faculty of Health Sciences Technikon Witwatersrand, in fulfilment of degree Master of Technology Homoeopathy, Manfred Nikolaus Leibenguth, 2000, "The treatment of Essential Hypertension amongst the black African population using simplex homoeopathic medicines"
(28) The Present Status of Homoeopathy internationally, 1995, Dana Ulman
(29) Weiser M, Strosser W and Klein P. Homeopathic vs conventional treatment of vertigo: a randomized double-blind controlled clinical study. Arch Otolaryngol Head Neck Surg. 124(8): 879-85. Aug 1998.
(30) Ludtke R and Wiesenauer M. A meta-analysis of homoeopathic treatment of pollinosis with Galphimia glauca. Wien Med Wochenschr. 147(14): 323-7. 1997.
(31) Barnes J, Resch KL and Ernst E. Homeopathy for postoperative ileus? A meta-analysis. J Clin Gastroenterol. 25(4): 628-33. Dec 1997.
(32) Friese KH, Kruse S, Ludtke R and Moeller H. The homoeopathic treatment of otitis media in children â€“ comparisons with conventional therapy. Int J Clin Pharmacol Ther. 35(7): 296-301. Jul 1997.
(33) Lewith GT. Upper respiratory tract infections and otitis media. Complement Ther Med. 5: 99-100. 1997.
(34) Davidson JR, Morrison RM, Shore J, Davidson RT and Bedayn G. Homeopathic treatment of depression and anxiety. Altern Ther Health Med. 3(1): 46-9. Jan 1997.
(35) Gaby AR. Editorial. Townsend Letter. 195:13-14. Oct 1999.
(36) Sarah A. Laird and Alan R. Pierce; Promoting Sustainable and Ethical Botanicals: Strategies to Improve Commercial Raw Material Sourcing; Results from the Sustainable Botanicals Pilot Project Industry Surveys, Case Studies, and Standards Collection; May 2002 Final Report
(38) http://www.mmyerowitz.com/hom.html ; where is homeopathy popular?
(39) A. D. Speransky. A Basis for the Theory of Medicine, International Publishers, 1943