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On Homeopathy

The unexpected treat at medical school was that most of the people, fellow students and teachers alike, were kind, generous and intelligent. The unexpected disappointment was an absence of the concept of health; the very word “health” was never mentioned during my conventional medical training. I sat bolt upright the first day of my homeopathic training when Dr. Bill Gray suggested that we could only start our thinking with the question, “What does it mean to be healthy?” (Read to the end for the answer!)

Equally shocking was the suggested format for the homeopathic interview:  begin by letting the patient talk uninterrupted for at least five minutes, longer if they come in with a lot they want to say. 

Almost twenty years later I hold great gratitude for the exemplary kindness and curiosity of my allopathic medical professors, but I aspire to the deeper wisdom of homeopaths, nutritionists and psychologists in my interactions with patients.

 

BASIC PRINCIPLES

Already I am guilty of a conventional medical mistake:  using words that can be easily misinterpreted and poorly understood.  Allopathy?  Homeopathy?  Strictly speaking, allopathy refers to the guiding paradigm of conventional medical practice, a paradigm that is actually philosophical, though allopaths claim it to be purely scientific.  The philosophical premise of allopathy holds that the randomized, double-blind, controlled trial (RDBCT) and laboratory research findings are the best, indeed the only, means to gather information that can be used to treat illness.

(RDBCT:  Essentially, divvy up a group of people (aka “subjects”) with sufficient characteristics in common, and give them all a treatment without the subjects or the observers knowing who takes the real treatment and who takes a sugar pill or placebo.  If the real treatment wins out, package it up and stick it on the shelf.  You get your ideas of what to test based on laboratory research experiments with test tubes, animals, and then lawyers before you progress to human beings. Only kidding about that last part, but that was a popular joke in medical school.  Of course, if the real treatment doesn’t win out, … well, that is a whole story in itself. ) 

Ironically the only essential tenet of the allopathic world that cannot be subjected to the gold standard of the RDBCT is the question of whether the RDBCT itself is a valid means with which to study and answer a clinical question!  Since that tenet cannot be tested, and it is the basis of allopathic medicine, I say that it is a philosophy rather than a fact.  I would suggest further that a philosophy is in danger of becoming tyrannical when it is so intrinsic that its adherents can’t see it as an opinion or a point of view, but rather believe their point of view to be all of reality. 

What do I mean by tyranny?  I mean that when your old buddy the RDBCT turns up validating something as illogical as homeopathy, such an outcome cannot be tolerated.  So, in fact, the RDBCT can be “harnessed” to suit your needs.  If an investigation of hundreds of trials validates homeopathy, select a smaller group of trials to analyze, without revealing your criteria for selecting that group.  Certainly do not consult homeopaths to find which trials best match their true clinical methods.  When the smaller group reveals no difference between homeopathy and placebo, publish it widely and proclaim “The End of Homeopathy”.  Ignore the fact that the same journal found homeopathy effective in previously published articles.  Call your journal Lancet and the story is history. 

 

OVER THE RAINBOW

The RDBCT is indeed an interesting measure and it can be applied to homeopathic medicines as well as to the pharmaceutical company’s offerings.  However, we are comparing apples and oranges, because the purpose of such a trial is to test the power of a given single medication to diminish symptoms associated with a particular disease.  Homeopathic medicines are not actually given to diminish disease symptoms, they are seeking a different kind of target.  Homeopaths do not regard isolated symptom reduction as the proper goal of a conscientious physician.  We’ll get back to this in a bit. 

At the basis of homeopathic medicine is a completely different kind of philosophy:  the Law of Similars, or the proposition that Like Cures Like.  250 years ago this was treated as a hypothesis by Samuel Hahnemann, and he became the first homeopath to verify its usefulness in clinical practice. 

Essentially, when an individual has a complex of symptoms that match the known or discovered effects of a given substance, that substance in sub-molecular doses can stimulate the individual to heal, and the symptoms are reversed.  The question that comes to mind is “how can that work?!”, and your eyes are wide and your mind is incredulous.   Well, we don’t exactly know how.  But, frankly, neither do the allopaths know how most of their medicines work.    Your eyes are still wide, and they should be, for there is a much better answer to your question.

In my mind as a homeopath (I’m getting to the deeper wisdom that homeopathy contains) I am much less concerned with the sub-molecular nature of the medicine or the cellular level of your disease process.  I am only interested in does it work, not how it works.  I want to know that overall the patient feels better, in the most important ways, and I am less concerned with the degree of itching in their eczema.  If their eczema is worse but they feel like they remember feeling when they were well – vital, rested, cheerful, creative, attentive – I am satisfied.  

 

A HOLOGRAM OF SYMPTOMS

Allopathic medicine sees the human body in the way I see my car, in that the interactions of the various parts are either obvious or non-existent.  Yes, the heart pumps the blood through the arteries:  they are connected.  No, the brain is not connected to the intestines, they can be treated totally separately. (Actually, allopathic medicine doesn’t believe that one anymore, both systems incorporate serotonin, but you get the idea.)  So an allopathic patient whose eczema is cured (!), but then develops asthma or depression, is just considered to have developed another problem, requiring another drug, sometimes another doctor. 

Homeopathic medicine sees the human body as a complex hologram in which all the parts are inextricably connected.  A homeopathic patient with eczema following the same path would be evaluated as worse:  they were better off with eczema rather than life-threatening asthma or depression.  Wrong treatment!  The asthma and depression did not arise spontaneously but somehow as a result or consequence of the treatment of the eczema.

Just mentioning the word eczema introduces a conceptual difference that demands attention (I am resisting the urge to compare it to an itch that must be scratched, just so you know).  When a steroid (hydrocortisone, triamcinolone, etc.; there are many) cream is able to disappear a rash, many possibilities follow.  Either the rash stays away, and no apparent other effects are noted; or the rash returns; or the rash stays away … and over some period of time some other symptom emerges affecting a different organ of the body.  Usually it’s asthma.  Could be migraines.  What has happened?

Allopathically, in the first case, it appears to be a cure.  It could even be listed as a positive outcome in a RDBCT.  In the second case, it was a temporary suspension of symptoms.  So now reach for a stronger cream!  In the third instance, allopaths believe that if it’s asthma, the patient was destined to have them both all along (atopy is what they call it:  allergic hypersensitivity) but if it’s migraines, they would say they’re absolutely not related, separate issue, turn to another chapter of the pharmacy formulary, find a new drug, perhaps see my colleague down the hall.

Homeopaths would agree that the first instance appears to be a cure, but won’t really believe it.   Rather, I await either a return of the symptoms (if the body is pretty sturdy and won’t give up on the rash), or the appearance of a more threatening symptom if the rash has been suppressed and the body has had to find a less appealing way of dealing with the fact that something was amiss inside.

Which or course is where we get out of the auto mechanics school of allopathy and visit the vitalistic school of thought.  Vitalists, which include homeopaths, believe that the being, the body and mind and emotions and … spirit (!?), has a force of its own.  A vitality.  A vital force.  An essence.  The vital force is a health-tending organism which meets dis-ease, or ill-at-ease, or challenges to health, and will manifest particular symptoms in an attempt to return to health. 

The whole world will now agree that a moderate fever serves this purpose in viral infections.  Homeopaths take it further and try to see the work of the vital force in each presentation of illness or pain.   We rely on the specific and comprehensive picture of symptoms to select a medicine that can cause the same picture, then give that medication to the patient, in the hope that the vital force can be helped along in its healing process

The vital force, the body if you will, is wiser than I am.  Wiser than you, wiser than all of us put together.  Who can do what the body does?  Who can grow a blade of grass from scratch, let alone grow a whole human organism.  I am repeatedly astounded by the genius of biological processes, and the comparable (and disrespectful) idiocy of casual attempts to manipulate those processes. 

Does Vital Force sound like a crazy? antiquated? heretical? concept to you?  I would venture that to most non-scientists it sounds fairly normal, perhaps even an assumption that hasn’t asked to be examined.  To scientists, it is all of those problems (crazy, rooted in the past, counter to scientific observation:  where exactly does this Vital Force show up on the MRI?) and more.  It represents a completely different level of experience that falls outside the allopathic paradigm.  Completely outside.  Perhaps it belongs in church, but not in the medical consulting room.

No -- it belongs in the homeopath’s office:  Homeopathy is actually a method of practicing medicine within a worldview of Vitalism. 

 

ASIDE

I write this as a homeopath, and hope that you have some idea of homeopathy:  like cures like, we use tiny doses of medicines, we consider the whole patient.  There are many other forms of alternative medical paradigms that might be suggested here – acupuncture, herbalism, ayurvedic medicine – and questioned, do they represent yet more paradigms of medical philosophy?

Not having fully studied any of those areas, my impression is that any of those modalities can be practiced either allopathically or, like homeopathy, within a vitalist paradigm.  I invite comments on that impression from practitioners of any of these specialties.

 

HOW DO THESE DIFFERENCES PLAY OUT?

There are numerous other philosophical differences between the two approaches to medicine, but for now let’s ponder how daily medical practice reveals the difference between the points of view of the allopath and the homeopath. 

Are you a randomized double blind controlled study?  No, I didn’t think so.  Yet you might feel the effects. 

The current system of medicine directs doctors to treat individual patients with a collection of “wisdom” or “insights” gathered from the RDBCT source material.  One comes to see the world through that viewpoint and to forget that it is only one viewpoint.   Such a viewpoint facilitates the industrialization of medicine, where a patient complaint triggers an algorithm of appropriate tests, treatments, referrals and scheduled follow-ups.  Follow-ups become a juggling act of medication efficacy and side effects, resulting in dosage manipulation and compensatory second and third prescriptions.

Algorithms are not, by definition, individualized.  Efficient, yes, personal, no.

Homeopaths cherish the individuality of each patient.  I don’t mean that in a solemn way, no, rather we are pleading for an individualizing symptom.  Please tell me how your experience of strep throat differs from the three other people I’ve seen this week with strep throat.  Please tell me how your menopausal symptoms are affecting you.

Homeopaths make time for their patients.  The most reliable information comes spontaneously, so we like to ask open-ended questions, particularly if they take us somewhere very unexpected.  An apparently wild detour will often lead to a deeper understanding of the patient’s situation. 

And I delight in the individuality of each remedy.  There are over 2000 remedies and any one of them could be used for your strep throat or your menopausal symptoms, IF the picture of the remedy matches your picture.  There are no “standard” responses to any particular condition or illness. 

Stephanie Sides , who contributes her own experience of medical intervention to this issue of EAP, bumped headlong into a conventional medical horror of individualized treatment:  if the medication is made up by or even FOR an individual, it could fail standardized testing!  So even in a non-HMO setting, should the physician have ample time to spend with the patient, modern medicine strives to codify, calibrate, regulate medicines so that they fit into the RDBCT model.  And she rightly points out the physician’s 1. connections to pharmaceutical funding (even refusing pharmaceutical gifts, they fund the research which creates the store of knowledge upon which they base their practice) 2.  readiness to add new prescriptions as patients learn about and request new drugs, and 3.  the corporate-driven cost of and selection of medications.   Bio-identical hormones cannot be patented:  there is no wealth to be made from their manufacture or sale.  You might be able to guess how many large scale RDBCT’s have been funded to test their efficacy and safety.  Zero!

 

CONCLUSION

Reining in my conspiracy theory attitude, I return to the topic at hand, the homeopathic point of view.  Another aspect of the homeopath’s approach is to ensure that there are no obstacles to cure and that the patient’s general surroundings, as much as possible, support the organism’s self-healing.    Titrating in a tiny (nano-dosage) amount of a well-selected remedy will ideally change the organism’s direction away from suffering and towards healing. 

Just as the homeopathic interview (often 90-120 minutes or more) allows time and space and respect for the entire organism and all its vagaries of complaint, struggle and delight, so must the response to treatment address all aspects of the individual.  As a homeopath I am not satisfied with single symptom reduction or elimination.  Rather I am curious if the whole organism, on every level the patient wishes to address, is responding in a healthful way. 

And what did I learn of health from my homeopathic instructors?

What does it mean to be healthy?

Health is freedom:  not absence of symptoms, but freedom from those symptoms.  To follow an earlier example, if you still have your eczema, and it does still itch you, I want to know more.  If you’re miserable with it, I must keep looking.  I look either for a remedy that is a better choice, or for more information about you:  if your whole life is better, worse, or the same, that information outweighs the information about your eczema. 

If you laugh, and say that life is really good, you are thriving, and that eczema is only a minor problem you can easily live with, I can relax with you, and enjoy a moment of health and freedom.