An Introduction to Homeopathy: Part I
The first time I heard about homeopathy was when my sister asserted that she was planning to become a homeopathic doctor. As with many of my sister’s grand plans for life, this came to precisely nothing, but it got me wondering what exactly homeopathy was. The truth of it surprised me, no less so because it seems so prevalent on pharmacy shelves and so easily accepted by the average consumer. Many assume it’s simply a form of ‘natural medicine’ or ‘traditional healing’, but the facts may be surprising even to those who think they know a little about it.
Homeopathy is a product of an unusual quirk of fate. In 1790, Dr. Samuel Hahnemann was feeling deeply dissatisfied with the medical theory of his time. He was absolutely correct in believing that the medicine of his day did more harm than good - the orthodox treatments of the 18th centry are hardly what we would consider ‘medicine’ today. So disillusioned was Hahnemann that he gave up his practice entirely and retreated to the world of medical writing. It was while translating Scottish chemist William Cullen’s Materia Medica into German that Hahnemann came across an explanation he just couldn’t stomach. In line with the medical theory at the time, Cullen theorised that the success of Cinchona Bark in the treatment of intermittent fever (malaria) was as a result of a balancing of the humors - chinchona’s bitter qualities marked it as a ‘hot’ substance, which balanced fever, a known result of an overabundance of ‘cold’ temperament. Hahnemann correctly identified this as utter rubbish but not for the right reasons… today we know that it is the quinine in the bark which disrupts an enzyme in the malaria parasite, causing a lethal buildup of toxins in the invading organism that kills it, ending the symptoms of the infection. But there was no way Hahnemann could have known this, so instead he did a fateful thing in his efforts to understand how cinchona really worked – he dosed himself with the stuff to see what would happen. The results were interesting: Hahnemann began to experience languor, weakness, palpitations, fever, headache, tremors and coldness in his extremities. After ceasing the dosing, these symptoms abated. The symptoms are superficially similar to those of malaria, and thus Hahnemann’s conclusion was that quinine had produced in a healthy person the symptoms of the disease it cured. The dose that Hahnemann took was the equivalent of a normal therapeutic dose today, which only results in such drastic responses in the case of a severe allergic reaction to quinine - precisely what he appears to have experienced. Think about it: quinine and other anti-malarials is habitually used as a preventitive measure by healthy people about to enter malaria country, and the practice of tempering the bitter taste with alcohol led to the gin and tonic becoming a popular drink even outside of the colonies. So if Hahnemann’s reaction was typical, my english grandmother should have been diagnosed with malaria years ago given her penchant for a good G&T, and people departing for african holidays should be struck down with fever before they ever leave. This discrepency does not appear to have occured to Hahnemann.
Thus, from a single atypical reaction, was the theory of homeopathy born. Hahnemann coined the law of similars from this single incident. Like cures like: that which causes a symptom in a healthy individual, cures the same symptom in a sick one. This means that in homeopathic terms, caffeine cures insomnia, emetics cure vomiting, and HIV-infected blood cures AIDS.
The idea of ‘like cures like’ was in direct opposition to the reigning theory of the time, which involved balancing the four humors and temperaments with their opposite – a theory that Hahnemann referred to as ‘allopathy’ to further separate the two schools of thought (homeo = the same; allo = the opposite). Today, homeopaths incorrectly use the term to describe modern, conventional or orthodox medicine, unaware that this only makes them look ignorant of their own history.
But Hahnemann wasn’t done there. As with any theory, it’s not just enough to state that a thing happens – one must also explain why. Hahnemann ascribed the homeopathic effect to a stimulation of the vitalist energy that animated all human beings, allowing it to more strongly fight off the evil influences causing the sickness. Basically, he attributed it to the Force. You may want to laugh at Hahnemann for this, but it’s important to remember that this was before the discovery of bacteria, viruses, biochemistry and genetics. At the time, vitalism was a completely accepted means for explaining disease and cures. When it becomes silly is when people continue to use it as an explanation even after the invention of the microscope.
Hahnemann’s vitalist theories also allowed him to formulate the second law of homeopathy – that higher dilutions would be just as effective at stimulating the vital force, if not more so. This was an important leap for the apparent success of homeopathy, because most items which cause any kind of symptom in a healthy human do so because they are bad for you. A normal dose of say, arsenic, would certainly not be good for patients, so it’s a good thing that the Force can sense arsenic at even the tiniest doses. Thus, the law of dilutions was born. Hahnemann also added succussion (tapping and shaking) between each step of dilution, which woke the vital forces in the substance (he felt this step was so important for strengthening the solution that he advised his patients to avoid walking around with their remedies in their pockets in case they inadvertently potentized them to the point of toxicity). The result was a medication diluted to the point where no molecules of the original substance could possibly exist – important for patient safety, but a point which escaped Hahnemann’s notice because this was before people like Avogadro shed light on exactly what happens when you dilute things.
The final step involved dosing healthy volunteers with every available substance and checking for any resulting symptoms in order to compile a list of homeopathic remedies, in a process referred to as a ‘proving’. Hahnemann would dose someone and then require that they kept a diary for months afterward, recording all relevant health details, from which he would deduce what symptoms the substance caused. Yes, I said months, which means that pretty much all provings conducted using Hahnemann’s methods may as well be tossed out because they don’t control in any way for the possibility that recorded symptoms were caused by anything else that may have occured during these months, which the patient may have failed to mention. His only control for accuracy of the volunteer’s self-reporting of symptoms? He made them swear they had told the truth, an obviously infallible system. That said, some of the concepts introduced by Hahnemann during his provings gave rise to clinical trials as we know them today, so he at least sowed the seeds for better medical practice, even if he didn’t reap them himself.
So, given that Hahnemann invented homeopathy from whole cloth after experiencing what was likely an allergic reaction, then embellished the theory with vitalist nonsense and poorly controlled tests, how did it ever gain a foothold? Again, you need to put this all in the context of its times. In the 18th century, medicine pretty much killed you. People didn’t know anything about germs or hygiene, so even the simplest medical procedure was almost guaranteed to cause fatal infection. No one understood cancer, heart disease, cholesterol or hypertension, and the closest they got to understanding high blood pressure was inducing dangerously low blood pressure for almost any ailment. Common tonics and medications contained anything from heroin and cocaine to sulphur and mercury. Most people were better off doing absolutely nothing and leaving the immune system to do its thing. Bring onto this scene a doctor who gives his patients glorified water and tells them with all certainty that it will cure them, and you combine the power of the placebo effect with a treatment that didn’t actually harm you. On top of this, Hahneman was also a man ahead of his time in that he also encouraged his patients to eat well, live hygienically, and get moderate exercise. It is beyond doubt that his encouragement of a healthy lifestyle, while also not infecting and killing his patients, led to an apparent success that was remarkable in comparison to the failings of medicine at the time.
So it’s no wonder that homeopathy took off in the early 19th century. What is a wonder is that after all we have discovered in the fields of chemistry, biology and medicine since, some people still think it works. But we’ll save further exploration of the current-day silliness of homeopathy for Part II.