Homeopathy and Science
This week’s entry† is a summary of some of the tests of homeopathy. It is a necessary prelude to a discussion of how homeopaths and their apologists promote the method. Several tenets of homeopathy lend themselves to tests. The doctrine of similia similibus curantur (“like cures like”) was tested by Hahnemann himself, as introduced in Part I of this blog. It is a special case that will be discussed further below. Hahnemann’s second doctrine, “infinitesimals,” suggests laboratory, animal, and clinical studies looking for specific effects of homeopathic preparations.
“Provings,” also called “homeopathic pathogenic trials,” suggest testing “provers” for the ability to distinguish between homeopathic preparations and placebos, and suggest asking homeopaths to identify specific remedies solely by the “symptoms” they elicit in “provers.” The homeopathic interview and prescribing scheme, gathering copious “symptoms” and matching them to the appropriate “remedy” in the Materia Medica, suggests testing homeopaths for consistency in symptom interpretations and prescriptions. The clinical practice suggests outcome studies, both of individual “conditions” (with the caveat that, strictly speaking, homeopathy does not recognize disease categories—only “symptom” complexes) and of the practice as a whole.
Several of these categories overlap. Several have been tested: the results have overwhelmingly failed to confirm homeopathy’s claims. I will mention a few of the more conspicuous examples.
Part II of this blog† introduced the homeopathic understanding of “symptoms” as they pertain both to “provings” in healthy subjects (now called “homeopathic pathogenic trials” or “HPTs”) and to histories elicited from patients. Hahnemann conflated “symptoms” and every random itch, ache, pain, sniffle, feeling, thought, dream, pimple or other sign, and anything else that might occur to a subject or a patient. This was amply demonstrated by Oliver Wendell Holmes, Sr., who seemed to doubt that such a morass would yield useful information. As unlikely as it may seem, today’s homeopaths are every bit as whimsical in their elicitation of “symptoms” as was Hahnemann.
Part I of this blog† summarized the origin of homeopathy, invented in 1790 by Samuel Christian Hahnemann. It discussed Hahnemann’s first two “homœopathic laws of nature,” similia similibus curantur (like cures like) and the “law of infinitesimals,” and showed that his rationales for each have long been refuted. Hahnemann proclaimed a third doctrine, the “law of psora” ["itch"], said by him to be “the mother of all true chronic diseases except the syphilitic and sycotic.” Oddly, it seems to have been forgotten.
Part II gives Hahnemann the opportunity to explain his assertions more thoroughly, as is his due. It considers those assertions from the vantage point of modernity, as is ours.
“Leave None of them Uncured”
According to Hahnemann, homeopathy is a panacea:
“Now, however, in all careful trials, pure experience, the sole and infallible oracle of the healing art, teaches us that actually that medicine which, in its action on the healthy human body, has demonstrated its power of producing the greatest number of symptoms similar to those observable in the case of disease under treatment, does also, in doses of suitable potency and attenuation, rapidly, radically and permanently remove the totality of the symptoms of this morbid state, that is to say, the whole disease present, and change it into health; and that all medicines cure, without exception, those diseases whose symptoms most nearly resemble their own, and leave none of them uncured.”
How might this happen?
“Either homeopathy works or controlled trials don’t!”
—Scottish homeopath David Reilly at the 2001 Harvard Medical School Complementary and Integrative Medicine Conference.
Reilly based that assertion on his own series of four small studies of homeopathic treatments of hay fever, asthma, and allergic rhinitis, the outcomes of which had been inconsistent and largely subjective. (1) Later he explained that small-minded skeptics in “conventional medicine” assume “homeopathy doesn’t work because it can’t work,” a view echoed by conference host Dr. David Eisenberg, then the Director of the Center for Alternative Medicine Research and Education at Harvard Medical School (now of the Osher Center); these comments were met with appreciative laughter from the partisan audience. If such charges were valid, it would indeed be fortunate that Harvard Medical School, several other medical schools, and the National Center for Complementary and Alternative Medicine (NCCAM) are promoting homeopathy, both as a clinical method and as a topic worthy of research.