Homoeopaths
treat disease using very low dose preparations administered
according to the principle that "like should be cured
with like." Practitioners select a drug that would,
if given to a healthy volunteer, cause the presenting symptoms
of the patient. For example, the homoeopathic remedy Allium
cepa is derived from the common onion. Contact with raw
onions typically causes lacrimation, stinging and irritation
around the eyes and nose, and clear nasal discharge. Allium
cepa might be prescribed to patients with hay fever, especially
if both nose and eyes are affected.
Homeopaths tend to believe in such things as "vital
forces" being in harmony (health) or out of harmony
(disease). And they tend to advocate holistic medicine,
treating "vital forces," "spirits,"
"minds", etc., as well as the body. Homeopaths
like to say that they treat "persons" not "bodies"
or "diseases."
One criticism
of homeopathy is that it takes the "cookie cutter"
approach to treatment: one-size-fits-all. No matter what
ails you, treatment with a diluted like agent is the cure.
Experience teaches otherwise. For example, the treatment
for scurvy is not more scurvy but vitamin C; the treatment
for diabetes is not sugar, but insulin. There seem to be
countless examples one could come up which would contraindicate
homeopathy as a reasonable approach to the treatment of
disease. Thus, simply because it is sometimes reasonable
to treat like with like (e.g., polio vaccines), it does
not follow that it is always reasonable to treat like with
like. It is misleading, however, to compare the use of vaccines
in medicine to homeopathic remedies; for, medical vaccines
would be ineffective if they were as diluted as homeopathic
remedies.
Other common
homoeopathic medicines include those made from plants such
as belladonna, arnica, and chamomile; minerals such as mercury
and sulphur; animal products such as sepia (squid ink) and
lachesis (snake venom); and, more rarely, biochemical substances
such as histamine or human growth factor. The remedies are
prepared by a process of serial dilution and succussion
(vigorous shaking). The more times this process of dilution
and succussion is performed, the greater the "potency"
of the remedy.
Prescribing
strategies in homoeopathy vary considerably. In what is
often termed "classical" homoeopathy, practitioners
attempt to identify the single medicine that corresponds
to a patient's general "constitution"a complex
picture incorporating current illness, medical history,
personality, and behaviour. Two patients with identical
conventional diagnoses may receive very different homoeopathic
medicines.
Other practitioners
prescribe combinations of medicines ("complex homoeopathy")
or prescribe on the basis of conventional diagnosis alone.
There is currently insufficient evidence concerning the
relative benefits of the different approaches to treatment.
How can homoeopathy
work ?
It is well
known that many homoeopathic medicines are ultramolecularthat
is, they are diluted to such a degree that not even a single
molecule of the original solute is likely to be present.
As drug actions are conventionally understood in biochemical
terms, homoeopathy presents an enormous intellectual challenge,
if not a complete impasse. Many scientists have suggested
that the clinical effects of homoeopathic medicines are
solely due to the placebo effect. However, there have been
rigorous, replicated, double blind, randomised trials showing
significant differences between homoeopathic and placebo
tablets.
The response
to this has been mixed. Some people remain unconvinced by
the evidence, claiming that there must be another explanation,
such as methodological bias, for the results. Others point
out that the evidence is very strong and argue that homoeopathic
medicines must work by some, as yet undefined, biophysical
mechanism. One possible explanation, currently being investigated,
is that during serial dilution the complex interactions
between the solvent (water) molecules are permanently altered
to retain a "memory" of the original solute material.
What happens
during a treatment ?
Homoeopaths'
consultations for chronic conditions include an extremely
detailed case history. Patients are asked to describe their
medical history and current symptoms. Particular attention
is paid to the "modalities" of presenting symptoms
that is, whether they change according to the weather, time
of day, season, and so on. Information is also gathered
about mood and behaviour, likes and dislikes, responses
to stress, personality, and reactions to food. The overall
aim of the history taking is to build up a "symptom
picture" of the patient. This is matched with a "drug
picture" described in the homoeopathic Materia medica.
On this basis, one or more homoeopathic medicines are prescribed,
usually in pill form. Sometimes treatment consists of only
one or two doses. In other cases a regular daily dose is
used.
Two to six
weeks after the start of treatment, progress is reviewed
and alterations made to remedy or dilution. A patient's
initial symptom picture commonly matches more than one homoeopathic
remedy, and follow up allows the practitioner to make an
empirical judgment on whether a particular remedy was the
correct one to prescribe. If the patient is doing well the
practitioner may stop treatment and monitor progress. If
symptoms recur the treatment may be repeated at the same
or a higher potency. If the symptom picture has changed
at follow up a different homoeopathic prescription may be
given even though the conventional diagnosis remains unchanged.
Homoeopathic
consultations in private practice may last over an hour,
although many NHS general practitioners practise basic homoeopathy
in 10-15 minute appointments. Many homoeopaths also recommend
changes to diet and lifestyle, and some advise against vaccination
(see section on safety below).
Therapeutic
scope
Most of a typical
homoeopath's caseload consists of chronic or recurrent conditions
such as eczema, rheumatoid arthritis, fatigue disorders,
asthma, migraine, dysmenorrhoea, irritable bowel syndrome,
recurrent upper respiratory or urinary tract infections,
and mood disorders. Homoeopaths also treat a substantial
number of patients with ill defined illness that has not
been given a conventional diagnosis. Children are much more
commonly treated by homoeopaths than by other types of complementary
practitioner.
Some homoeopaths
say that few conditions are truly outside their remit, and
the homoeopathic case literature includes treatment of complaints
as diverse as tuberous sclerosis, infertility, myasthenia
gravis, fear of flying, and cystic fibrosis. That said,
opinions about what can be effectively treated by homoeopathy
differ widely, even among homoeopaths, with medically trained
practitioners generally being more conservative than non-medical
ones. It is also used, often by self prescription, to treat
various acute conditions such as the common cold, bruising,
hay fever, and joint sprains.
Research evidence
Given the difficulties in understanding how homoeopathy
may work, researchers have concentrated on establishing
whether it is a placebo treatment. Current evidence suggests
that this is probably not the case. A recent meta-analysis,
published in the Lancet, examined over 100 randomised, placebo
controlled trials and found an odds ratio of 2.45 (95% confidence
interval 2.05 to 2.93) in favour of homoeopathy. The authors
concluded that, even allowing for publication bias, "the
results of our meta-analysis are not compatible with the
hypothesis that the clinical effects of homoeopathy are
completely due to placebo."
The notorious
Benveniste affair, which involved accusations of fraud and
scientific misconduct after the publication of an in vitro
experiment in Nature, continues to dampen enthusiasm for
basic research in homoeopathy. None the less, laboratory
studies have reported biological effects of homoeopathic
medicines on animals, plants, and cellssome at ultramolecular
dilutions.
Evidence is
less clear on the effectiveness of homoeopathy as it is
generally practised for the conditions that homoeopaths
usually treat. Many trials have investigated treatment of
an acute condition with a single remedy. This makes research
easier but does not reflect the real world of homoeopathic
clinical practice. For example, in the best known UK trial
144 patients with hay fever were randomised to receive either
homoeopathically prepared grass pollen or placebo. Though
there was a significant result in favour of homoeopathy,
implications for clinical practice are unclear as most homoeopaths
do not treat hay fever with homoeopathic grass pollen alone.
There is currently
insufficient evidence that homoeopathy is clearly efficacious
for any single clinical condition. For many of the conditions
treated in homoeopathic practicesuch as depression, fatigue,
and eczemarandomised trials have not been undertaken. In
addition, few of the existing studies of homoeopathy have
been independently replicated.
Safety of homoeopathy
Serious unexpected
adverse effects of homoeopathic medicines are rare. "Aggravation
reactions," when symptoms become acutely and transiently
worse after starting homoeopathic treatment, have been described
and are said by homoeopaths to be a good prognostic factor.
They may cause concern, especially if patients and doctors
are not adequately forewarned.
A potentially
more serious issue is the belief of some practitioners that
conventional drugs reduce the efficacy of homoeopathy. Serious
adverse events have resulted from patients failing to comply
with essential conventional treatments while using homoeopathy.
Some, mainly non-medical, homoeopaths are also strongly
against vaccination, although the official policy of the
Society of Homoeopaths is to give patients information and
choice and not to pressurise against immunisation. Homoeopaths
may offer alternatives to vaccination. These have not been
subjected to clinical trials and cannot therefore be recommended
as an effective substitute.
HOMEOPATHY
AND ALLOPATHY:
It was Hippocrates who gave us the concepts of what Samuel
Hahnemann would name "allopathy" and "homeopathy."
Hippocrates
said that there were two concepts of healing. To ways to
approach the symptoms of disease. And that he could best
illustrate them by thinking of them as two streams that
flowed side by side in opposite directions. Those two streams
are homeopathy and allopathy.
The term "allopathy"
is taken from two greek words "allos," which means
"other" and "pathos," which means suffering.
The idea here is that the symptoms that the patient associates
with pain are bad things, they are things that must be struggled
with and worked against. The doctor who practices allopathy
will give a patient medicines that will work against the
symptoms that are in place, or will simply mask the symptoms.
Therefore, the patient who has a cold which has left him
with a runny nose and tearing eyes will receive a medicine
that has the power to dry up both eyes and noses. And the
patient who has a headache will be given a medicine that
will interrupt their ability to feel the headache pain.
In neither case will the medicine acutally work with the
actual cause of the symptoms. The cold medicine will have
no effect on the cold itself, nor will the pain medicine
actually put an end to the headache. Bottom line: the allopath
depends upon the body to ultimately heal itself and creates
an environment in which that healing can take place with
as much comfort as possible.
Homeopathy,
on the other hand, is something very different. The term
"homeopathy" is also taken from two Greek words,
"homios," or "similar" and "pathos,"
or "suffering."
For the homeopath,
illness is not an invader of any sort, but is, instead,
the beings response to some trauma or crisis that
has sent the patient into a tailspin. The symptoms, therefore,
tell you more about the patients reaction to circumstances
than they do about the circumstances themselves. First,
they tell you that the patient was susceptible to the trauma
that they suffered. They were in a state in which they were
resonating with the illness enough for it to take hold.
This may have been caused by exhaustion, depression, or
any of many other causes, but the homeopath recogizes that
there was a reason that the patient became ill in the first
place.
Because the
symptoms associated with the illness are not invaders, but
a part of the patient himself, they must be respected as
such and worked with and not against.
The homeopath
will, in fact, give the patient a remedy that would, in
a healthy person, create the very symptoms that are in place
naturally within the patients being. He does this
with the knowledge that as the Patients Vital Force
rises up to move against the effects of the remedy, it will
move against the illness as well and restore the patient
to health.
It is important
that Hippocrates states that these two streams of medicine
flow side by side and that they flow in opposite directions.
They are, in many ways, in close proximity with one another.
They almost touch, and yet, there is never truly a meeting
point. Because they flow in opposite directions, and have
opposite impacts upon the being--one suppressive and the
other expressive--they never can be united as one.
For the purposes
of this site, the concepts of homeopathy and allopathy transcend
the practices of these specific schools of treatment. When
we use the term "homeopathy," we refer to any
school of treatment that is, in its action and philosophy,
homeopathic. Therefore, acupuncture, chiropractic and naturopathy
are, for our purposes, homeopathic.
The same might
be said about allopathy. For our purposes, it is a form
of treatment that involves the use of substances to control
symptoms in a suppressive manner. Therefore, for our purposes,
herbal medicines would be considered as allopathic a modern
chemical medicines