The controversial cure
Kim Ridley
This article appeared in Ode issue: 30
http://www.odemagazine.com/article.php?aID=4222
Is homeopathy a healing idea whose time has come-again?
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.