Saturday, October 11, 2008

Arguments For Homeopathy

Arguments for Homeopathy


This page is intended to counter misinformation and increase the public understanding of arguments for homeopathy. It includes explanations of some homeopathic ideas and practice, but it does not aim to explain the whole theoretical framework of this medical system. Instead it aims to point out aspects that are often overlooked or ignored by opponents. The following page looks at orthodox drug therapy.

Environment
Genetics
Health and illness
Homeostasis
Individualisation
Miasms
Placebo
Potency
Potentisation
Provings
Reactions
Science and homeopathy
Scientific development
Susceptibility
Symptoms and homeopathy
Vital force


Environment
• Homeopathic remedies need very small amounts of material for their initial production, so they have a minimal impact on global ecology.
• Homeopathic pharmacists need plants and animals for making some remedies, and these needs to be as unpolluted as possible, so they have a vested interest in reducing pollution.

• A huge number of doses of a remedy can be produced from the initial material and therefore homeopathy is both a cheap and efficient user of resources.
• Homeopathic remedies have a very long shelf life in conditions requiring no specialist equipment, again making them a cheap and efficient use of resources.

• A very low level of technology is required to produce remedies, so homeopathy’s carbon footprint is small.
• Because remedies can be de-activated by heat and sunlight, homeopathy creates no risks to the environment.

Genetics

Homeopaths recognised the fact that people are both similar and unique long before genetics explained the reason for this . They gathered information about the action of substances on people’s health from as wide a range of people as possible. In this way they could identify not only the unique general pattern of action of a remedy on human beings, but also the particular patterns resulting from differences between individuals (see Provings). This enables a specific remedy to be found for an individual’s specific symptoms (see Individualisation).

By contrast, the individuality of people’s responses creates significant problems for orthodox drup therapy when conducting drug trials (see What are randomised control trials?), whilst a reliance on general responses appears to lead to problems when prescribing drugs (see What are side effects?).

Health and illness

Homeopathy regards health and illness as processes rather than states. As a result the information taken about a patient in a consultation is oriented on understanding how the whole of the patient’s health has changed. At first this involves learning how the symptoms have developed and are developing, but subsequently it involves identifying whether treatment is changing the direction of this process to a curative one.
Dr. Samuel Hahnemann (1755-1843), the discoverer of the principles of homeopathy, recognised the main features of these processes, though it was Dr. Constantine Hering (1800-1880) who went on to formulate the Law of Cure, which is still the guiding framework for understanding the process of illness and recovery. It can be stated as follows:

In recovery symptoms move from the more vital organs to the less vital, from the interior of the body to the exterior, from the higher parts to the lower, and reappear in the reverse order from that in which they appeared. Orthodox medicine does not appear to have such a framework for relating changes in symptoms to a general view of health and illness.


Homeostasis

The body is a homeostatic system, which means that when it monitors changes that may take it outside the normal range of its function, it acts to compensate for these changes (see Symptoms and homeopathy). For example, to prevent damage to the brain the action of the heart has to continually vary to deal with the changing position of the body, such as standing up or lying down; similarly sweat glands need to be brought into action if a person is exercising to prevent overheating of the body.

Any attempt to modify this behaviour is identified as a further disruption for which corrective action is needed. Dr. Samuel Hahnemann referred to this process as in terms of primary action and secondary action, where the effect of an external change was the primary action (the hands becoming chilled by playing in snow, for example), while the body’s reaction was the secondary action (the hands becoming hotter than normal as the body responds after such play is stopped). These were the terms current at the time, but they have subsequently been absorbed into the concept of homeostasis.

It would appear that in the case of treatment with drugs, the same process may be observable. When a drug has an action opposing the existing symptoms, one would expect the new corrective action taken by the body to be in opposition to the drug and to increase those symptoms, and this appears to be the explanation for the rebound effect (see What is the rebound effect?).

In some cases this does not happen, but homeopaths dispute the view of orthodox medicine that this means that the problem has been cured. Their view is that there must be a homeostatic action of the body of some sort, and they maintain that this takes the form of new, more serious, and apparently unrelated symptoms (see Health and illness).

Similarly giving a treatment which is known to have an action almost identical to the existing symptoms also leads to a reaction, but in this case the treatment’s action and the symptoms are so similar that in acting against the treatment the body also acts against the symptoms and so removes them.

In this way homeopathy makes use of homeostasis to restore health. Evidence of this process at work can sometimes be observed in the form of the homeopathic aggravation, when the stimulus of the remedy produces a temporary worsening of symptoms before the body’s reaction takes over.

It should be noted that by using a potentised remedy (see Potentisation), homeopathy actually goes further towards reducing additional disturbance, since all the remedy’s toxic chemical effects are removed, and the action is purely on the Vital force. This is another reason why homeopathic remedies do not produce any side effects (see What are side effects?).


Individualisation
Homeopathy makes use of all the symptoms of a patient, since the remedy is selected to match the specific requirements of an individual (see Genetics), rather than the common symptoms of diseases (see What are diseases?). Homeopaths also use these individual responses when gathering information about remedies in Provings.

Use of a remedy that does not meet the patient’s specific requirements may cause one of several Reactions, but if a homeopathic prescription were only a placebo, there would either be a “beneficial” effect or none at all (see Placebo).


Miasms

Homeopaths have known for 180 years that there can be predispositions to illness, and that these can be passed on. Dr. Samuel Hahnemann (1755-1843), the discoverer of the principles of homeopathy, used the term “miasm” for the living organisms that he considered to be the cause of disease, and he maintained that the suppressing of the symptoms of these diseases led to other long-lasting (chronic) conditions.

Nowadays homeopaths use the term “miasms” for these predispositions to illness, that is the tendencies to illness after diseases have been suppressed. These predispositions have their own individual patterns of symptoms, and remedies can be selected to take this larger picture into account and so treat the underlying aspects of the individual’s condition.

An important aspect of miasmatic conditions is that they do not get better without appropriate treatment, but get steadily worse throughout a person’s life The actual symptoms may change (within the limits of each miasm), and they come under the headings of a number of chronic conditions, but the degree to which they affect the body will become more severe. Within this framework there may also be acute episodes which can be fatal: asthmatic attacks, heart attacks, strokes, allergic responses, etc.
Homeopaths distinguish between emergency treatment for acute episodes, when an orthodox medical intervention may be life-saving, and treatment of the underlying miasmatic condition which predisposes to such episodes.


Placebos
It is regularly argued that homeopathy works by placebo effect, the claim being that the remedies have no active ingredient and so the patient gets better by self-delusion or some other inexplicable reason. There are several important points that are overlooked in this assertion:

• It cannot explain Provings, where specific reactions are recorded which have no relation to the subjects of the trial feeling better – indeed they usually feel worse.
• It cannot explain why different remedies produce different reactions in the same person, since the reaction should be the same for all remedies if it is solely a placebo effect. For example, it does not explain why a person immediately gets better from a burn after the correct remedy, but does not get better at all more quickly after the wrong remedy

• It cannot explain why a person may have different reactions at different times after taking the same remedy.
• It cannot explain the differences in reactions to different potencies, which can range from no reaction through beneficial reaction to unpleasant reactions.

• It cannot explain why the two different types of Potency (centesimal and decimal on the one hand, and LM on the other) need to be given in significantly different ways, because they generally produce significantly different patterns of reaction (see Reactions).

• It cannot explain the fact that the patient’s symptoms may change rather than simply get better (see Reactions). In particular it cannot explain why patients sometimes get worse as the immediate reaction before they get better (see Homeostasis).
• It cannot explain why homeopathy works on babies, toddlers and animals, since they can have no preconception of the treatment being beneficial, and so are not disposed to a placebo effect. In this case the claim is made that the benefit is only perceived by the practitioner, the parent or the owner of the animal, without there being a real improvement. Such a claim ignores the fact that the placebo effect is not a self-deception but a real modification of symptoms.

• It cannot explain why homeopathy works on people who are unconscious.
• It cannot explain the action of potentised remedies on tissue samples.

• Orthodox medicine cannot distinguish between a patient getting better after a “placebo” and one getting better after an “active” treatment. In other words, both treatments are considered equally successful, and therefore both should be considered equally “active”. The fact that the method of a so-called placebo’s action is unknown should be a reason for investigating that action further, not for denying its validity.

• Critics of homeopathy maintain that the degree of dilution involved in making remedies means that they cannot be “active” treatments, but must work by the placebo effect. However, this is a narrow view of treatment based on an approach entirely oriented to chemistry, and it ignores the application of physics to questions of effects on living organisms (see Potentisation and Vital force). It cannot be a coincidence that this narrow view is consistent with the pursuit of drug therapies.
• Critics of homeopathy also maintain that potentised remedies cannot work because homeopaths cannot explain how Potentisation works. However, they are quite happy to allege that any success is entirely due to the placebo effect without themselves being able to explain how a placebo works.



Potency
There are three scales of homeopathic potencies, with succussion or agitation (see Potentisation) performed at each step of dilution:

• Decimal (x) scale - dilutions are made at the rate of 1:10, so 3x = 1:1,000;
• Centesimal (c) scale - dilutions are made at the rate of 1:100, so 2c = 1:10,000;
• LM scale - dilutions are made at the rate of 1:50,000, so LM2 = 1:2,500,000,000.

The decimal and centesimal potency scales perform similarly, and certain potencies have been found to be more generally effective than others. The most commonly used potencies in the UK are 3x, 6x, 6c, 12c, 30c, 200c, 1m (1,000c) and 10m(10,000c), though higher potencies and potencies in between these ones are also used on occasions. These potencies are usually given in single doses at intervals which depend on the individual’s reaction, with the interval and the possible repetition of a particular potency depending on the nature of the symptoms, the potency and other factors.
On the other hand the LM scale has a very different pattern of prescription, since a prescribed LM potency is regularly repeated, being diluted and succussed by the patient before taking each dose (see Potentisation). Prescriptions start with one potency (usually LM1) and then step up to the next (i.e. LM2, LM3, etc.) as needed. The reactions to centesimal (and decimal) and LM potencies are generally different (see Reactions).

References
1. Kent, James Tyler, 2000, New Remedies, Clinical Cases, Lesser Writings, Aphorisms and Precepts, New Delhi, B. Jain Publishers Ltd pp. 358-59.
2. Schiff, Michel, 1994, The Memory of Water: Homoeopathy and the battle of ideas in the new science, London, Thorsens pp. 25-28.)


Potentisation

The difference between potentisation and chemical dilution is enormous. In potentisation bursts of energy are put into each new solution by banging it several times (succussion) with the result that the solution has a more profound effect when used to treat people. Why this should be the case is a question physicists will one day answer (rather than chemists), but the effect is observed repeatedly, and it makes it possible to use harmful substances safely.

The fact that succussion is a significant factor in preparing a remedy is less strange when it is compared with some other activities where energy is added in a discontinuous manner. For example, the action of whipping cream is not the same as stirring it because only a part of the cream is moved with each beat leading to a reorganisation of the material; a car engine requires a spark to trigger the explosive reaction, but only at a particular time if it is to work; an iron bar will acquire the new property of becoming a magnet by repeatedly banging it while it is in a magnetic field. In each of these cases controlled inputs of energy are added and they create an important change of state.


Provings
A proving is the method used by homeopaths to test a substance so that it can be used as a remedy. The substance is first prepared by Potentisation, and then volunteers (provers) are usually given the 30c Potency (though a different one may be used on occasions) until they start to exhibit a response. The provers are not told what the remedy is, and they are not in communication with each other, and their responses are recorded by themselves and by observers. These responses are temporary and vary from person to person, but the total information has a pattern unique to that substance and is used as the basis of treatment.

By using provers with as wide a variety of differences as possible, the maximum amount of information can be gathered, enabling the fullest understanding of the general and specific properties of the substance. Other information may be gathered from reports of poisonings and from subsequent clinical use. Warning: Repeatedly taking any potentised remedy can lead to harmful results.


Reactions
Homeopathy distinguishes between a whole range of reactions to a prescribed remedy. The general types of reaction are:

• Curative reaction - the symptoms change to become more superficial, more remote from the major organs, and from further back in the patient’s medical history. Ultimately all symptoms disappear and the patient is in the best state of health achievable.
• Palliative reaction - the symptoms are alleviated but can change to others of a similar severity;
• Placebo reaction – this is not the same as a placebo reaction in orthodox medicine, but is one where the patient expresses a non-specific improvement without there being an actual curative change in the symptoms (as defined above). As such this represents the desire to feel better without the evidence of it.
• Harmful reaction - the symptoms have become more severe (and there may be new symptoms), affecting more central and significant parts of the body than before.

Additionally, Dr. James Tyler Kent (1849-1916) identified 12 patterns of aggravation and alleviation of symptoms after treatment with centesimal (and decimal) potencies which give more precise indications of the patient’s state of health. (1) These are consistent with the homeostatic nature of the body (see Homeostasis). Curative reactions to LM potencies, however, tend to involve only beneficial change until the remedy no longer needs repeating, though sometimes the reaction can be similar to that after a decimal or centesimal potency. The variations in the reactions to these different types of potency indicate that there is still a lot to be discovered about their mechanism of action.

References
1. Kent, James Tyler, 1993, Lectures on Homoeopathic Philosophy, New Delhi, B. Jain Publishers Pvt. Ltd. pp. 226-34.


Science and homeopathy
Science involves an interaction of evidence and theory: the theory explains the evidence, and experiments produce evidence to test the predictions of the theory. Without a theory the significance of evidence can be missed; without experimenting to gain evidence, a theory cannot be tested. Homeopathy is accused of being unscientific, but its practice involves a continual testing of the theory against the evidence. The actual Reactions of a patient to each remedy are assessed in the light of the theory, and if the reaction is unexpected then the grounds for selecting the remedy are reassessed to determine why the expectation was wrong.

A founding principle of homeopathy is the relationship of medicines to illness, which is summed up as:
A. Substances must be tested in order to discover their unique action on human beings (see Provings).
B. All the individual’s symptoms (as far as possible) must be established in order to know what must be treated (see Individualisation).
C. There must be a clear method of relating A to B, that is one set of information to the other.

Clinical evidence has shown that when the two sets of information match, the substance will successfully treat the symptoms, whereas if the two sets are opposed, relief will be brief with the symptoms returning more strongly. A prime example of the former case is centuries of use of quinine to treat malaria, since the symptoms of quinine poisoning are extremely similar to those of malaria. This was the example, in fact, which led to the discovery of the principles of homeopathy. This clinical evidence is further confirmed by the theoretical requirements of homeostasis (see Homeostasis).


Scientific development
The field of homeopathy has continued to develop and expand for over 200 years, both clinically and theoretically. Knowledge acquired in the past continues to be valid today, but it is becoming better understood and more thoroughly explored. This is exactly the process one would expect in a scientific field.


Susceptibility
Homeopaths have recognised for 180 years that while there are disease agents (living organisms that can cause illness), their ability to infect the body depends on an individual’s susceptibility. This susceptibility is increased by stresses (physical, mental or emotional), whether prolonged or sudden, and especially by miasmatic conditions (see Miasms). On the other hand the healthier and less stressed a person is, the less likely they are to become ill.


Symptoms and homeopathy
Homeopathy regards symptoms as the body’s attempt to deal with problems and to restore health (see Homeostasis), and considers that the process should not be opposed but assisted so as to more rapidly return the body to normal function. Common examples of the curative nature of acute symptoms include fever in influenza (which kills the virus), and vomiting and diarrhoea in food poisoning (which expel the toxic material). However, sometimes symptoms will persist (become chronic), and there are several reasons why this happens:

• External environmental circumstances are continually stressing the body, so that it is continually working to counteract disruption of its normal function. Homeopaths call these “maintaining causes”, and they can include poor living conditions, poor working conditions, poor diet, pollution, etc. These stresses should be removed as far as possible if the patient is to recover.

• The body is unable to restore health because its ability to heal itself is compromised, and the curative process cannot be completed unaided (see Miasms).
• Over time changes in function from miasmatic conditions may lead to tissue changes in the body, creating internal environmental stresses which disrupt normal function, such as pressure on other parts, obstruction of passages, or incorrect levels of hormone production.

Homeopathic treatment cannot change the external environment or replace organs that have atrophied or been removed, but otherwise it can help the body to repair itself more quickly.


Vital Force

The concept of the vital force (“Dynamis”) is defined by Dr. Samuel Hahnemann (1755-1843) as that aspect of a healthy organism that retains all parts in a harmonious relationship to each other. Disturbance of this aspect causes illness, and its absence death. He maintained that it was a real material force, like gravity or magnetism, rather than a wholly separate mystical entity, and he regarded it as an integral part of the organism with no independent existence.

The significance of Hahnemann’s position is noted by biographers (1), and explained by the debate in Britain in the years 1814 to 1819 between John Abernethy and William Lawrence.(2) Abernethy (a vitalist) regarded the vital force as a “superadded” aspect of living things that did not arise from the matter from which they were made. This position defended the theological idea of the soul and the political idea of people requiring external control. Lawrence (a materialist) considered that the “vital properties” arose necessarily from the organisation of matter in living things, a position which defended atheism and republicanism. For the religious Hahnemann to support the latter position but combine it with aspects of the former one is just one example of how his scientific rigour surmounted contemporary religious prejudice. Lawrence was ultimately forced to deny his views, and this helps to explain why orthodox medicine still has an approach to the body oriented on chemical aspects rather than on properties within the field of physics. As a result it still has no satisfactory explanation of how our cells know they are part of a single organism, or of what precisely changes when a living creature dies.

Homeopathy is oriented on the idea that the primary unifying aspect of the living organism is in the realm of physics without this aspect being at all divorced from the organism’s existence as matter. As a result it is not surprising that the process of Potentisation involves a similar shift of perspective from a view of substances based on chemistry to one also based on physics. In this respect homeopathy was a therapy far ahead of its time which maintained (and still maintains) a consistent approach to its understanding of health, disease, life and medical intervention.

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