Introduction and Full disclosure:
Rather than have you try and tease out my biases while reading this, I’ll give them to you up front. As you may or may not know, not only was I previously a devout Catholic, I was also very much a part of the alternative health movement to the point that I completed a 4 year diploma in Classical Homeopathy. I will admit up-front to still not being entirely convinced that homeopathy is completely bogus for the simple reason that I have seen things first hand that are not easily dismissed as placebo and for which I do not have a better explanation. I am, however, strongly skeptical. But the subject of this essay is not the purported efficacy of homeopathy – there are many others who have already dealt with that subject at length and are far more qualified than I to assess it. Rather, I wish to give a basic background on what homeopathy is, from a former insider’s perspective, and explore the similarities – apparent to me soon after joining the homeopathic community – between religion and both homeopathic philosophy and the homeopathic community. If all you know about homeopathy is that it uses very dilute medicines which cannot possibly have any of the original substance remaining left in them, then you will find almost all of the information I present in this article to be completely new to you. Homeopathy is, first and foremost, a system of medicine based on an elaborate vitalistic philosophy.
Now, before I get into the meat of this essay, I also want to say unequivocally that I have never encountered a single dishonest Homeopathic practitioner and I would never call any of them quacks or charlatans as those terms imply a deliberate attempt at fraud. My fellow skeptics who have only a passing familiarity with Homeopathy often scoff dismissively and assume that homeopaths just dispense sugar pills and bottled water willy-nilly and collect the cash to get rich. Nothing could be further from the truth. Not only is the process of interviewing a patient extensive, often taking one to two hours, a homeopath – depending on their level of experience - may also spend an additional hour or more researching which remedy to administer. Very few homeopathic practitioners can even make a living at it, let alone get rich! In fact, many actually operate at a loss, spending far more on courses, books and supplies than they would ever be able to recoup from the minimal fees they charge. And since most patients do not have insurance coverage that pays for homeopathy but must pay out of pocket, many small scale practitioners end up offering their services for discounted rates or bartering them. So you can clearly see my eyes rolling when I hear an MD refer to Homeopaths as swindlers out to make a quick buck when the MD is the one who pulls in a six figure salary and would be lying if he or she claimed to not be influenced in which prescriptions they give their patients by the pharmaceutical reps and their multi-million dollar advertising and entertainment budgets. Homeopaths sincerely believe in what they do and they work hard at it, putting in an extraordinary amount of study. Regardless of how effective the remedies themselves are, to impute that all Homeopaths are frauds is rather like claiming that all Christian preachers are actually just pretending to have faith. So disagree with them and argue with them all you like, but at least have the respect to acknowledge their sincerity and good will. Homeopaths actually care about their patients.
Now, on to what this essay is actually about.
Samuel Hahnemann: The Homeopathic Prophet
Homeopathy was founded by Samuel Hahnemann (1755-1843) http://en.wikipedia.org/wiki/Samuel_Hahnemann , an admittedly brilliant physician who also made contributions to mainstream medicine through his encouragement of hygiene, clean living and good diet, and his opposition to the barbaric and dangerous treatments mainstream medical treatments of his day such as bloodletting and the use of potent toxins. Disillusioned by these harmful practices, he quit medicine to focus on translations work and it was while translating the work of a fellow physician that he first began formulating his ideas about Homeopathy after he encountered a statement that the Peruvian bark cinchona was effective against malaria because it was bitter and astringent. Hahnemann reasoned that these properties alone would not account for its effect since many other medicines that possessed those same properties were completely ineffective against malaria. So he tested the substance by administering it to himself and recording the symptoms produced. The symptoms resembled those caused by malaria itself and so Hahnemann concluded that the effect was due to their similarity. The Latin motto of homeopathy is similia similibus curentur, often phrased in English as “like cures like”. This idea that a substance which can provoke a certain set of symptoms in a healthy individual will cure those same symptoms in a sick individual is the basis of all homeopathic treatment, and the word homeopathy itself. From the Greek, Homeos = similar, Pathos = disease. The process of human experimentation whereby a substance is administered to a group of healthy individuals, and the resultant symptoms recorded to create a picture of the remedy’s supposed curative properties is called a proving. Data from accidental poisonings was also used and later anecdotal data from patients cured by these remedies was also added. It is important to note that most of the historic provings were done with physically active doses of substances, whereas modern provings tend to use homeopathic dilutions. Now, up until this point, Homeopathy was actually far more rigorously empirical and scientific than the mainstream medicine of the day, which Hahnemann called “allopathy”, a term that has taken on a pejorative connotation that many homeopaths and other alternative health practitioners still use to refer to mainstream medicine.
I will not go into too much detail on the further development of homeopathy. You can easily find that information in other historical resources if it interests you as it very well documented, with a large body of historical documents to draw from including some interesting stories about Hahnemann and others that resemble legends. For example, the origin of succussion (the vigorous hitting of the bottle at each stage of dilution to add energy to the remedy) is said to have come about when Hahnemann noticed that the remedies he used were more effective after having ridden on horseback to see a patient.
Instead, let me just broadly paint a picture of how this system of medicine that began with such well intentioned scientific beginnings morphed into what I perceive to be a pseudo-religious movement. Hahnemann wrote a book outlining his philosophy and practice known as the Organon, which is for all intents and purposes the holy scripture of Homeopathy. The Organon went through 6 editions, with the last being published posthumously. Hahnemann was known for being very possessive of his new system and dictatorial about how he spread the practice of Homeopathy. After releasing a new edition of the Organon which would form the orthodox methods of practice for the majority of Homeopaths, Hahnemann and a few select colleagues would continue experimenting with new methods and concepts that would only later be revealed to others in the next edition. Those who deviated from orthodox practice and attempted to do their own research or try different methods were – and still are! - treated as heretics with ostracism, public criticism and condemnations. The Organon is divided into numbered verses known as aphorisms which are quoted by homeopaths very much as one would quote the bible or the koran, and often with equal if not greater weight and reverence given to these writings. Though new translations from the original German exist that some Homeopaths accept, others grant authority only to older translations much the same way some groups of Christians accept only the King James Bible as authoritative.
Vitalism and energy medicine
In the Organon – which you can read on-line at http://www.homeopathyhome.com/reference/organon/organon.html - Hahnemann claims that the body’s health is regulated by the “vital force” and that diseases that affect it are energetic states with an energetic signature which can be cancelled out by the application of a remedy which has a similar energy signature and produces a temporary artificial disease state, which, when it subsides, will leave the patient in a state of health.
Now this is a very key point. Any skeptic encountering homeopathy will learn about Avogadro’s constant (http://en.wikipedia.org/wiki/Avogadro%27s_number): the theoretical point of dilution at which no trace of the original substance remains, which is 6.02214X×1023 (You’ll note that 10-23 is the date skeptics use to protest homeopathy). The obvious questions when one learns that homeopathic remedies are diluted well beyond this point is, do these homeopaths know about this? And if so, how can someone know about this and not be a fraud? The reason that homeopaths and their patients are not disturbed by the knowledge of Avogadro’s constant is because of their faith in vitalism. I knew about the Avogadro constant before I signed up for Homeopathy school. Truth be told, I thought it was cool and I was proud of this distinctive feature of homeopathy. You see, homeopathy is often referred to as “energy medicine” alongside aromatherapy, healing crystals and others (which are inferior and more primitive forms of energy medicine, according to classical homeopaths). They believe that the process of dilution and succussion imparts an energetic signature to the remedy and that this acts as a signal that stimulates the body’s own innate healing mechanisms. In fact, in homeopathy the belief is that the greater the dilution, the more powerful the remedy is. Whereas pharmaceutical medicine and herbs operate at a clearly physical level, reacting biochemically in the body, homeopathy does not and even when physical doses are used that is not the intended method of application. At its very core, Homeopathy relies on a faith in the existence of an invisible and undetectable vital force in the body which has innate healing abilities (note that Chiropractic was founded on a similar philosophy and calls their version of this healing capability ‘the innate’, but most Chiropractors have abandoned that philosophy in favour of a more scientific and publicly palatable approach.) It also requires faith that the remedies administered have a similar undetectable vital force or energetic signature capable of interacting with the body’s vital force. The obvious assumption would be that this is a spiritual quasi-religious belief, and for many it is. But others believe that these energies and forces are very real natural energies and that one day technology will advance enough to allow them to be detected and measured. They may make reference to quantum physics being the arena where these discoveries will be made, but I have yet to meet one who actually has more than a superficial understanding of quantum physics or any sort of reasonable hypothesis as to how that area of study might relate to homeopathy.
Miasms, suppression, and the “theory” of the origin of disease
While homeopathy is often used to treat acute concerns, which is termed therapeutics, the focus is chronic disease, especially in modern practice where many of the patients who come to a homeopath do so because they have tried and failed to find relief through conventional medicine or other more popular forms of medicine. Hahnemann’s other well known work is a book called the Chronic Diseases in which he ascribed all diseases that afflict humanity to a group of what he calls “miasms”. These miasms are a sort of inherited energetic pollution that affect the vital force and cause disease, a concept very similar to the Christian doctrine of original sin. The origin of these miasms is said to be a natural disease that was “suppressed” in the past. This notion of suppression is another pseudo religious concept you will often encounter in homeopathic philosophy and many other alternative medicines. It claims that the application of allopathic medicines – particularly the toxic poultices of the past, and the modern use of steroids – pushes the disease state further into the vital force resulting in chronic disease rather than healing. You may hear, for example, homeopaths claim that skin diseases treated with steroids can lead to asthma through this process of suppression. The flip side of this is that one aim of homeopathy is to bring these suppressed diseases to the surface, and so they will interpret new or changing symptoms as signs that the disease suppression is being lifted. This is of particular concern to medical doctors as interpreting symptoms as signs of healing (sometimes termed a healing crisis), may prevent the patient from recognizing what may in fact be serious symptoms that need attention.
The chief miasm is called Psora, said to be responsible for 7/8th of all disease, and is descended from suppressed scabies. The other ones are syphilitic (descended from syphilis), and sycotic (not to be confused with psychotic, and derived from suppressed gonorrhea). To these original three Hahnemann later added Tuberculin (descended from suppressed tuberculosis), and subsequent homeopaths have expanded this pantheon to include miasmic versions of cancer, malaria, leprosy and a host of others. Many of these new additions are of course opposed by the Hahnemannian fundamentalists who see any evolution of the philosophy beyond the canonical works of Hahnemann, Kent, Hering and a few other early pioneers to be heretical.
It was this doctrinal in-fighting that first caught my attention as a student of Homeopathy. It was everywhere. It didn’t take long to realize that most of the political tensions and personal conflicts rampant within the homeopathic community and the various small competing schools stemmed as much from differences of opinion over doctrine and practice as they did from ego and personality clashes. Coming from a background in Catholic apologetics where my favourite subject of study was the doctrinal differences between Catholicism and Protestantism I immediately saw in Homeopathy a mirror image of this religious sectarianism. Much in the same way the Protestant reformation resulted in offshoots of Protestantism centered around the teachings of particular theologians like Luther, Calvin, or Wesley, the same thing has been part of Homeopathic tradition since Hahnemann died and left no plan of succession. You have probably encountered the term “Classical Homeopathy,” which is meant to distinguish it from unorthodox versions of the practice. The basic form of Classical Homeopathy relies on a core cannon of the works of Hahnemann and some contemporaries such as Kent, who was a member of the Christian mystic movement Swedenborgianism (http://en.wikipedia.org/wiki/Swedenborgianism ) and introduced many of its concepts to Homeopathy where they continue to influence its practice. Those who practice his methods refer to them as Kentian, one of the sub-schools of practice that exist within orthodox classical homeopathy. The chief characteristic of all classical homeopathy is that only one remedy is used at a time and it is tailored specifically to the symptoms the patient presents with. This individualization is the key reason why homeopaths object to the methodologies of clinical trials published in mainstream medical journals. Those trials, by their nature, tend to minimize variables and so chose one remedy to test against one disease. In homeopathy, remedies are not chosen to suit the disease, or even the disease’s common symptoms, but to suit the patient’s individualizing symptoms. So, for example, you would not say give remedy x for headache. You may say if the headache has a sudden onset with throbbing and redness in the face, give remedy X, but if it slowly progressive and vice-like give remedy Y. 10 people with the same medical diagnosis may be prescribed 10 different remedies. In homeopathy the medical diagnosis – at least in terms of choosing the remedy – is of secondary or tertiary importance. In a very real sense for the homeopath, the remedy is the diagnosis that the practitioner is making, and the only other diagnosis that might aid in remedy selection would be the miasmatic diagnosis as certain remedies are directed towards specific miasms. Important considerations are the patient’s state of mind and any strange rare and peculiar symptoms. Remedy profiles may include hundreds of different possible symptoms with many overlaps between remedies, and practitioners may frequently disagree over which remedy best suits a particular patient.
In sharp contrast to this extremely complex process of individualization, the remedies you buy in drug-stores generally consist of combinations of ingredients of varying low potencies labelled as a treatment for a specific condition. This shotgun approach to throwing a range of remedies at symptoms instead of a single targeted remedy is anathema to classical homeopathy and will often be dismissed as not homeopathic at all. You may be surprised to learn that these drug-store homeopathic remedies that are the bread and butter of sales for the remedy makers are generally frowned upon by homeopaths themselves, not for the obvious financial reason that OTC homeopathic remedy use allows consumers to bypass the practitioner, but because they are heretical to basic homeopathic dogma.
Many practitioners of Classical Homeopathy are what I would term fundamentalists, who will not deviate from the original cannon and generally restrict the remedies they use to the well known ones described in the old Materia Medicas (their compendiums of remedy indications.) Other homeopaths have moved far beyond the original scope of homeopathy and pursue new remedies and new doctrines. One such common doctrine that forms the foundation of the work of popular contemporary homeopaths Jan Scholten and Rajan Sankaran, is the doctrine of signatures. This doctrine states that the natural form of a remedy relates in some way to its function. A classic example would be Pulsatilla, a type of buttercup flower that is very delicate, easily damaged, easily swayed in the wind, etc. and whose symptom profile includes weepiness, changeability of symptoms, etc. Patients needing Lachesis Muta derived from the venom of the bushmaster snake are said to have snake-like personality traits, feel as if they have a lump in their throat like a snake swallowing prey, and so on. Where most classical homeopaths would choose a remedy based primarily on which remedy best matches the symptoms, regardless of the source of the remedy, those subscribing to this doctrine might first attempt to classify their patient as a plant, animal or mineral, and further narrow down from there into subcategories. Though these practitioners still fall under the umbrella of “classical” homeopathy, they are nevertheless considered heretics by the fundamentalist camps. The fireworks in the clashes between proponents of different methods of practice are really quite something to observe and have resulted in schisms forming within schools such as my own.
As with religion, there is a mainstream orthodoxy; in this case classical homeopathy and its subsets that still fall under that umbrella. There are also numerous unorthodox interpretations of homeopathy. The type of homeopathy employed by naturopaths alongside herbs and other treatment modalities is generally classical, but often limited in use and tends towards the therapeutic. Some New Age energy healers may use homeopathic remedies chosen through forms of augury like applied kinesiology, a dowsing pendulum, astrology, intuitive interpretations of energy sensing or aura visualizing, or forms of Kirlian photography or other imaging techniques that purport to create a visual representation of the patient’s aura. All of these methods are shunned by classical homeopathy and often considered mere quackery. Other practitioners use classical homeopathy as a basis for further experimentation and work with limited combination remedies and other methods of symptom based remedy selection that they perceive as a natural evolution in homeopathic thought and do not regard Hahnemann’s doctrines as immutable. Still others seek to use historical research into Hahnemann’s unpublished work, and new translations and interpretations of the Organon and Chronic Diseases to gain a new understanding of what Hahnemann’s newest vision for homeopathy was just before he died.
Homeopathy shares many traits in common with religions: A founder who put forth new doctrines about the unseen and the impossible to verify. A body of stories about him and other important characters in its history, generally regarded with reverence. A cannon of orthodox literature written long ago that is studied and interpreted and provides the doctrinal and philosophical foundations for its practice. It relies on unverifiable supernatural or quasi supernatural explanations for natural phenomena. And, of course, its adherents can’t agree on many points and fight ongoing battles of words over their differences.