Is homeopathy a healing idea whose time has come - again ?
Is homeopathy a healing idea whose time has come - again ?
This article by Kim Ridley, appeared in Ode magazine, issue: 30, and is reproduced with permission from: http://www.odemagazine.com/article.php?aID=4222
Valerie Ohanian was a graduate student at the University of Minnesota in the late 1970s when severe fatigue descended out of nowhere. Suddenly, she couldn’t stay up for more than 15 minutes at a time without feeling exhausted. Ohanian consulted several doctors, one of whom suggested she might just be depressed and referred her to a psychologist. The psychologist told her she definitely had health problems. Nothing Ohanian’s doctors prescribed alleviated her fatigue and painfully swollen glands. She suffered through the mysterious illness for two years, unable to work. “I didn’t know if I’d ever get over it,” she says. “I was really willing to try something different at that point.”
A chiropractor who gave her acupuncture provided some relief, but Ohanian always relapsed in a few days. “The chiropractor told me, ‘I think the only thing that will help you is homeopathy.’ I remembered reading about it and I contacted the only person in Minnesota at that time who was practising,” Ohanian says. “After taking mercurius vivus, the remedy this fellow gave me, I didn’t feel anything for a few days. Then one day I realized I had been up doing things for three hours and I was able to stay up all day. Within a month, I had my energy back.”
She was so moved by her experience that she became a homeopath herself at a time when few were practising in the United States. Twenty-five years later, Ohanian runs a thriving practice in Minneapolis, treating many people like herself for whom conventional medicine has failed to relieve chronic illness, as well as those seeking a deeper sense of well-being.
Ohanian’s story is set against the backdrop of a renaissance in homeopathy, a 200-year-old therapeutic system that aims to stimulate the body to heal itself. Homeopathy is based on the premise of “like cures like” or the law of similars, which posits that a substance that causes symptoms in large doses can cure the same symptoms in small doses. Homeopaths use infinitesimally diluted doses of substances derived from plants, animals and minerals to trigger the body’s natural defense mechanisms. To treat a cold accompanied by a runny nose and watery eyes, for example, a homeopath might prescribe a preparation of allium cepa: in other words, onion.
Advocates emphasize homeopathy’s gentleness - side effects are extremely rare - and holistic methods. Unlike conventional medicine, homeopathy focuses on treating the individual rather than the disease. A homeopath takes a meticulous history of each patient’s physical symptoms, emotional and mental states and overall constitution, seeking the unique aspects that will lead to the precise remedy to promote healing. This individualized approach is drawing a growing number of people fed up with an expensive, impersonal health-care system that relies on chemical drugs which sometimes end up doing more harm than good. While conventional medicine clearly saves countless lives, particularly in acute illness and emergencies, homeopathy is increasingly a choice among people with chronic health problems, the second most common reason for trips to the doctor’s office in the U.S. Homeopathy is routinely prescribed for everything from asthma, ear infections and upper respiratory infections, to high blood pressure, sprains and strains and depression. Today it is the most widely used form of alternative medicine in the world, according to the World Health Organization. Approximately 500 million people worldwide receive homeopathic treatment. Homeopathy is most common in India, where there are an estimated 300,000 homeopaths and more than 300 homeopathic hospitals. It also is popular in Europe, South Africa and Brazil. In France, approximately 40 percent of the public has used homeopathic remedies. In the Netherlands, almost half of Dutch physicians consider homeopathic remedies effective, and in Britain, visits to homeopaths are growing by nearly 40 percent a year. In the United States, the number of people using homeopathy increased by an estimated 500 percent during the 1990s.
But last August, the British medical journal The Lancet proclaimed “The End of Homeopathy” in its lead editorial (issue 366), based on a new analysis of earlier studies comparing homeopathy and conventional medicine to the use of placebos. The analysis, conducted by Aijing Shang, Matthias Egger and their colleagues at the University of Berne in Switzerland, on eight placebo-controlled trials with homeopathy and six with conventional medicine, reported that homeopathy appears to work no better than a placebo. In other words, any positive effects from homeopathy are all in people’s heads. Lancet editors concluded, “Now doctors need to be bold and honest with their patients about homeopathy’s lack of benefit, and with themselves for the failings of modern medicine to address patients’ needs for personalized care.” A number of researchers, however, contend that the editorial is slanted, inaccurate and ignores the real issues. Among them is Dr. Wayne Jonas, who published a meta-analysis incorporating a number of studies, an approach similar to Shang’s in The Lancet in 1997. After analyzing 89 studies, Jonas and his colleagues reported that homeopathy was almost 2 1/2 times more effective than a placebo. Jonas calls the recent editorial “irresponsible” and “a misuse of statistics.” He says statistics are dangerously easy to misconstrue, and in the case of homeopathy, techniques like meta-analysis can fail to accurately capture what’s happening in people’s bodies and lives, which is the real issue that needs investigating.
“I do not agree with the editorial that we should abandon homeopathy,” says Jonas, director of the Samueli Institute of Information Biology in Alexandria, Virginia, and a former director of both the National Institutes of Health’s Office of Alternative Medicine and the World Health Organization (WHO)’s Collaborating Center for Traditional Medicine. “We will never know whether its primary effect is due to a better application of the art of medicine, or if there’s a special effect from the remedies, unless we do research in these areas. Since the public is using homeopathy at a growing rate, then it’s really our obligation as scientists to try to find that out.” Is homeopathy a 200-year-old hoax, or a powerful paradigm for healing? The pursuit of the truth offers an intriguing glimpse into the tangled - some would say dysfunctional - relationship between the politics of medicine and the advancement of healing. Fasten your seatbelts.
A German physician named Samuel Hahnemann created homeopathy in the late 1700s. Back then, one of the worst places a sick person could wind up was a hospital, where bloodletting and purging were among the cures du jour. Disillusioned after seeing too many patients die from such barbaric practises, the young Dr. Hahnemann decided to switch careers for awhile and translate medical and scientific texts. He was translating William Cullen’s Materia Medica from English to German in 1790 when he encountered Cullen’s idea that Peruvian bark, which we now know contains quinine, cured malaria because it was bitter. The notion made no sense to Hahnemann, but he was intrigued enough that he started experimenting on himself. After taking several doses of the bark, Hahnemann developed most of the symptoms of malaria. He concluded that the bark was effective because it triggered symptoms similar to those of the disease it treated, and called this effect “the law of similars.” When he gave Peruvian bark to malaria patients to confirm his ideas, they improved. Hahnemann eventually tested more than 200 medicines of the day - diluting them to reduce toxicity - on himself, his family and a growing group of followers. He meticulously recorded his subjects’ physical, mental and emotional reactions to each substance, establishing the now-standard homeopathic process of “provings” to develop remedies.
As Hahnemann continued this research he also developed his most controversial idea: The more a substance is diluted, the more powerful its healing properties. Homeopathic remedies then, as now, are so diluted they may not contain a single molecule of the original substance. Hahnemann called this process of dilution and shaking “potentization,” which he believed extracted the “spirit-like” nature of each substance that could activate a patient’s “vital force” against disease. In 1810, Hahnemann laid out his theories and philosophy in his treatise Organon of the Rational Art of Healing. His methods had gained many followers, including European royalty, by the time he coined the term “homeopathy” (for homoios or “similar” and pathos or “suffering”) in 1826.
Homeopathy spread throughout Europe and the U.S. over the next few decades, gaining credibility during epidemics of infectious disease. Patients treated by homeopaths were reported to have had much lower mortality rates than those treated by conventional physicians during cholera epidemics in Europe and the U.S. in the 1830s and ’40s. For example, during a cholera epidemic in Cincinnati, Ohio, in 1849, only three percent of patients who received homeopathic care died, compared with up to 60 percent of patients who received the conventional medical treatment of the time.
But a backlash was brewing on both sides of the Atlantic. Homeopaths were creating serious competition for conventional physicians. Two years after homeopaths organized the American Institute of Homeopathy in 1844, the American Medical Association (AMA) was formed - in part to discredit homeopathy. In 1855, the AMA incorporated a code of ethics that included expulsion of physicians who even consulted with homeopaths or other “non-regular” practitioners. Similar events were unfolding in Europe; orthodox physicians in France also banned consultations with homeopaths. Homeopathy was outlawed in Austria.
In spite of these setbacks, homeopathy continued to flourish, drawing such admirers as Mark Twain, who wrote in Harper’s magazine in 1890, “The introduction of homeopathy forced the old-school doctor to stir around and learn something of a rational nature about his business.” By the turn of the century, more than 100 homeopathic hospitals operated in the U.S., along with 22 homeopathic medical schools and more than 1,000 homeopathic pharmacies. Interestingly, many students and practitioners were women, and the homeopathic Boston Female Medical College, founded as a school for midwives in 1848, was the first women’s medical college in the world.
The early 20th century, however, brought several blows to homeopathy. The Carnegie Foundation issued the Flexner Report in 1910, which, in collaboration with the AMA, sought to standardize medical education. The report rated all medical schools in the U.S and gave nearly all homeopathic colleges - as well as most medical colleges for blacks and women - low scores. Soon, some of these schools started closing, and far fewer graduates of homeopathic colleges were allowed to take medical licensing exams. Soon after, the Rockefeller Foundation boosted conventional medical schools with gifts in the tens of millions. Conventional medicine became the overwhelmingly dominant paradigm. By 1922, only two homeopathic colleges remained in the U.S. With the exception of India and a few scattered corners of the world, homeopathy went deep underground.
By the time Valerie Ohanian decided to study homeopathy, she couldn’t find a training program in the U.S. She read what she could and eventually found people to teach her. “I had to put things together bit by bit,” she says. In Europe, however, homeopathy was making a comeback. The person most responsible for that revival is George Vithoulkas, a Greek homeopath who started practising and teaching in the 1960s. Vithoulkas refined Hahnemann’s ideas and brought them into the new frontier of energy medicine. He says homeopathy helps a patient heal by affecting his or her electromagnetic field. In his seminal book The Science of Homeopathy, Vithoulkas offers a brief but eloquent description of the goal of any healing system. “A human being’s main and final objective is continuous and unconditional happiness,” he wrote. “Any therapeutic system should lead a person toward this goal.” Vithoulkas defined the difference between conventional medicine and homeopathy this way: “Homeopathy does not merely remove disease from the organism; it strengthens and harmonizes the very source of life and creativity in the individual.”
Vithoulkas’ teachings and writings inspired a new generation of homeopaths, including Ohanian, who studied with him in the 1980s. For his groundbreaking work, he received the Right Livelihood Award, or “alternative Nobel Prize” in 1996. In addition to being a powerful teacher, Vithoulkas is also a fearless critic of conventional medicine’s reliance on increasingly harsh and powerful drugs. Homeopaths believe conventional drugs often suppress symptoms rather than cure illness. Vithoulkas says this suppression actually drives illness deeper into the patient, eventually expressing itself as mental illness and diseases of the central and peripheral nervous system. He also contends that the medical establishment’s overemphasis on increasingly stronger drugs may be making us sicker.
“The immune systems of the Western population, through strong chemical drugs and repeated vaccinations, have broken down,” Vithoulkas told the Swedish Parliament in his acceptance speech for the Right Livelihood Award. He linked the rising rates of diseases such as asthma and cancer with “wrong intervention.” Vithoulkas told the gathering, “If conventional medicine were really curing chronic diseases, today we would have a population in the West that was healthy, mentally, emotionally and physically.”
Although such sweeping statements need to be taken with a grain of salt, they raise provocative questions. Chronic disease is the world’s leading killer, causing approximately 17 million premature deaths worldwide every year, according to WHO. While lifestyle factors like poor diet, smoking and lack of exercise can lead to chronic disease, along with environmental and genetic factors, conventional medicine typically fails to cure people once they’ve gotten sick. Prescription drugs, in fact, sometimes do more harm than good: A 1998 study by researchers at the University of Toronto found that prescription drugs were the fourth leading cause of death in the U.S.
Among the many researchers unconvinced of homeopathy’s “end” is Dr. George Lewith, director of the Complementary Medicine Research Unit at the University of Southampton in England. “People are coming to homeopaths and some are getting better,” Lewith says. “Our patients are telling us that something is going on with complementary medicine and we have to listen and understand that. This is a patient-led revolution, which gets up doctors’ noses a lot.”
Lewith, who has been studying complementary and alternative medicine for years, first prescribed homeopathy to a patient with rheumatoid arthritis 25 years ago. Within two weeks, the woman’s inflammation and arthritis disappeared. “From then on, I thought, ‘This is something very useful,’” Lewith says. “I know you shouldn’t be impressed by such things, but that’s what I found.” Lewith suspects the consultation process between the patient and the homeopath is a strong influence. He is now investigating this question in a study of rheumatoid arthritis patients in which one group receives a homeopathic remedy and a consultation and the other receives only a remedy. He’s comparing these groups with two others, one receiving a placebo with a consultation and the other receiving only a placebo. “As I’ve gone on over the last 10 years thinking about how we could research homeopathy, it’s increasingly becoming clearer to me that the process of homeopathy and the process of the consultation are probably inseparable,” he says. “I think there’s something quite therapeutic in that process which is different from the almost mechanical consultations that you get in conventional medicine.”
While many like Lewith work on human studies, others are investigating homeopathy’s effects on animals, which offer further insight into the placebo question. Animals don’t make things up; they either get better or they don’t. In an intriguing set of new studies completed last summer, Liesbeth Ellinger, a homeopathic veterinarian in Apeldoorn in the Netherlands, investigated homeopathy’s effect in newborn dairy calves. Diarrhea is a common problem in dairy calves, a condition some Dutch farmers regularly treat with homeopathic remedies. Among Ellinger’s findings: On one farm, not a single calf who received a homeopathic remedy developed diarrhea, while every calf given a placebo did. She says the most difficult part of the research, done with the Louis Bolk Instituut, was persuading farmers to give a placebo instead of homeopathy “because they know homeopathy works.”
In spite of typically limited funding for research, homeopaths around the world are continuing their own investigations and publishing results in homeopathic and alternative medicine journals. They are reporting homeopathy to be particularly promising in treating illnesses and conditions including ADHD (attention deficit/hyperactivity disorder), arthritis, viral illnesses, chronic fatigue syndrome, eczema, inflammatory bowel disease, premenstrual syndrome, and post-traumatic stress, according to the American Institute of Homeopathy. In seminar rooms around the world, homeopaths tell story after story of extraordinary, improbable cures.
Among the believers is Dr. Andrew Weil, director of the Program in Integrative Medicine at the University of Arizona and author of Healthy Aging: A Lifelong Guide to Your Physical and Spiritual Well-Being. “I’ve witnessed homeopathy working in my own life and I’ve seen a great deal of clinical success with it,” he says. “I’d love to know how it works. I think there is some way in which homeopathic remedies convey information to the body and that some day it will be seen as some form of energy medicine, which is up and coming. As that develops, we may have studies that uncover the mechanisms by which homeopathy works.”
Homeopathy defies explanation by conventional science, a valid point that skeptics make over and over again. How can a remedy that might not contain a single molecule of the original substance have any effect at all? If an explanation is ever found, it may be discovered on the frontiers of quantum physics through studies that might yield great material for a sequel to What the Bleep Do We Know?! - the recent movie exploring those sorts of questions. Wayne Jonas points out that science also has yet to explain the mechanism of action of many conventional drugs. How aspirin works, of all things, has undergone four or five different explanations over the last 100 years. “There are many things we deliver in conventional medicine that we have no idea why they work, or even if they work, but we still allow them and we still continue to research them,” he says. So much of medicine, like many things that influence our lives, hinges on the “politically dominant standard” of the time, says Dr. Iris Bell, director of research for the Program in Integrative Medicine at the University of Arizona. Bell criticized the editorial in The Lancet, saying tools such as the meta-analysis are “inappropriate to the nature of the intervention that they’re evaluating.” Unlike conventional drugs, which are expected to produce basically the same effect in every person, homeopathic remedies are prescribed for each individual. In other words, three people with the same physical symptoms could easily be given different remedies based upon their unique physical, emotional and mental make-up. In short, evaluating homeopathy is likely impossible using standard methods, and extremely difficult even when using other techniques.
Bell says all medicines - complementary or conventional - should be evaluated for their broader effects on patients’ lives, as well as for safety and cost. One tool to help with such assessments is the well-designed observational study, which measures the effects of an intervention on a patient’s overall well-being, energy level and other “real-life” changes. "If homeopathy and other forms of complementary and alternative medicine were the politically dominant standard, researchers would have every right to evaluate every drug on safety, cost, and whether or not one drug can help improve a broad range of symptoms in the person as a whole - with minimal side-effects - not just an isolated symptom,” she says.
As the debate over homeopathy continues, people are streaming in to see Valerie Ohanian and into the offices of other homeopaths around the world. “I’ve seen our client base go from people at the end who have tried everything else, to people who want to get a constitutional remedy to fine-tune their health,” Ohanian says. Ohanian is now treating the grandchildren of some of her earliest clients, which she finds particularly gratifying. She talks about a client who had angrily stopped treatment when he was a teenager. Now an adult, he returned recently with his young son. “He told me, ‘I resisted you because my mom made me come. But the peace and light and energy in me went away after I stopped seeing you,’” Ohanian says. It’s becoming increasingly clear that the medicine of the future needs to focus on strengthening our own healing abilities. After all, that’s our best defense. “We know that the most powerful weapon we have against illness and suffering is our own inherent healing capacities,” Jonas says. “We wouldn’t be around if we weren’t constantly repairing ourselves and becoming more whole.” The people seeking better health through alternative forms of medicine like homeopathy just want to feel better. They’re not waiting for a paradigm shift in medicine - they’re leading it.