History of homeopathy

The history of homeopathy is intertwined with the history of allopathic medicine, or standard medicine. Homeopathic treatments are a type of controversial alternative medicine.

The basic idea of homeopathy is that an ill person with a set of symptoms should be administered extremely dilute doses of a substance which has been found to produce the same symptoms in healthy individuals. The doses are often so diluted that not a single molecule of the active substance remains in the dose. This approach, based on the medical similars (the idea that 'like cures like'), has its roots in the medicine of the Ancient Greeks, but flowered under the efforts of the German physician Samuel Hahnemann (1755-1843), the modern "Father of Homeopathy", in the 1800s.

Since its inception homeopathy has received criticism on scientific and medical grounds, and no scientific studies have conclusively shown its efficacy. The belief that extreme dilution makes drugs more powerful by enhancing their "spirit-like medicinal powers" is inconsistent with the laws of chemistry and physics and the observed dose-response relationships of conventional drugs. Critics of homeopathy frequently describe it as pseudoscience and quackery. Placebo-controlled clinical trials have given some mixed results, but most of those showing positive results are found to have methodological problems, and the better-quality trials (e.g. those using double-blind techniques and large numbers of people) give negative results. Several examples of publications in high ranking journals that were later withdrawn are known. Additionally, the use of homeopathic drugs to prevent malaria infection has had life-threatening consequences.

Early history

The law of similars has a long history, going back to at least the Ancient Greeks. Hippocrates believed that there are two possible types of treatment; administering "contraries" and "similars". Aulus Cornelius Celsus (fl. 1st century AD, Rome), was a Roman medical writer, and thought to rely on this same reasoning by some writers. The method of contraries would be followed a century later by Galen of Pergamum (born AD 129, died c. 199). The system of similars was described by philosophers such as Thomas Aquinas and by doctors of the vitalist school of medicine.

One of the most prominent proponents of vitalism who deserves special mention was the Renaissance physician Paracelsus (1493-1541). Paracelsus subscribed to many of the same principles as the modern founder of homeopathy, Samuel Hahnemann. Vienna physician Anton Freiherr von Störck (1731-1803) and English doctor John Brown (1735-1788) also anticipated the work of Samuel Hahnemann.

Theory of disease in the 18th century

In Hahnemann's day, the conventional theory of disease was based on the four humours. Mainstream medicine focused on restoring the balance in the humours, either by attempting to remove an excess (by such methods as bloodletting and purging, laxatives, enemas and nauseous substances that made patients vomit) or by suppressing symptoms, such as by lowering the body temperature of patients who were feverish. By contrast, Hahnemann promoted an immaterial, vitalistic view of disease, that is, that diseases had spiritual, rather than physical causes.

Vitalism was a part of mainstream science in the 18th century. In the twentieth century, medicine discarded vitalism in favour of the germ theory of disease, following the work of Louis Pasteur, Alexander Fleming, Joseph Lister and many others. Modern medicine sees bacteria and viruses as the causes of many diseases, but Kent and some modern homeopaths regard them as effects, not causes, of disease. Others have adapted to the views of modern medicine by referring to disturbances in, and stimulation of, the immune system, rather than the vital force.

Birth of the modern theory of homeopathy

Samuel Hahnemann conceived of homeopathy while translating the Materia Medica (1789) of the "Scottish Hippocrates" William Cullen into German. On reading that Cinchona bark (which contains quinine) was effective because it was bitter, Hahnemann felt this implausible because other substances were as bitter but had no therapeutic value. To understand the effects of Cinchona bark, he decided to take it himself, and saw that his reactions were similar to the symptoms of the disease it was used to treat. At least one writer has suggested that Hahnemann was hypersensitive to quinine, and that he may have had an allergic reaction.

Yet, this experiment by Hahnemann was by no means unique, as others before him had tried the same approach. For example, Anton von Störck (1731-1803), "in the 1760’s, who advocated treatment by cautious use of poisons." Indeed, Hahnemann had studied briefly in Vienna (1777) where Störck eventually became head of the University. The proving idea had also been recommended by the great Swiss medical botanist, Albrecht von Haller, (1708-77), who Hahnemann admired, and whose Materia Medica he translated in 1806. It might be said the proving experiment came to Hahnemann from several previous sources.

He adopted a reclusive lifestyle while residing in Koethen and his new inclination towards metaphysical pursuits may explain his sudden adoption of [olfaction] (inhaling the remedy), which he continued to use until his death in Paris in 1843. Olfaction might derive from Arabian medicine and the art of perfumery.

The first such homeopathic repertory was George Jahr's "Repertory", published in 1835.

Hahnemann tested many substances commonly used as medicines in his time, such as antimony and rhubarb, and also poisons like arsenic, mercury and belladonna. Hahnemann recorded his first provings of 27 preparations in his book Fragmenta de viribus in 1805. Later, Hahnemann published Materia Medica Pura, which contained provings of a further 65 preparations. He was most heavily engaged in proving in the 1790s and early 1800s, but he never abandoned these experiments. Hahnemann was involved in another phase of proving in preparation for the publication of his books, "Miasm Theory" and "The Chronic Diseases, their Peculiar Nature and their Homœopathic Cure",. Miasma Theory and The Chronic Diseases were published in 1828 and contained provings of 48 further preparations.

James Kent's Lectures on Homoeopathic Materia Medica (1905) lists 217 remedies, and new substances are continually added to contemporary versions. Homeopathy uses many animal, plant, mineral, and synthetic substances. Examples include natrum muriaticum (sodium chloride or table salt), lachesis muta (the venom of the bushmaster snake), opium, and thyroidinum (thyroid hormone).

The term "homeopathy" was coined by Christian Friedrich Samuel Hahnemann (1755–1843) and first appeared in print in 1807, although he began outlining his theories of 'medical similars' in a series of articles and monographs in 1796. Hahnemann's main opus was the book, The Organon of Medicine. Hahnemann published six editions of this work between 1810 and 1842.

For Hahnemann, the whole body and spirit was the focus of therapy, not just localised disease. Hahnemann spent a lot of time with his patients, asking them not only about their symptoms or illness, but also about their daily lives. This gentle approach contrasted with the violent forms of heroic medicine common at the time, which included techniques such as bleeding as a matter of course.

Nearly as important as Hahnemann to the development of homeopathy was James Tyler Kent (1849 – 1921). Kent's influence in the USA was limited, but in the UK, his ideas became the homeopathic orthodoxy by the end of the First World War. His most important contribution may be his repertory, which is still used today. Kent's attempt to rescue an idealized pure homeopathy from what he saw as its degenerate mongrel forms was authoritarian, as he sought to re-emphasize the metaphysical and clinical aspects of Hahnemann's teachings, in particular:

• insistence on the core doctrines of miasm and vital force;
• emphasis on case totality rather than rote prescribing for 'named diseases'
• emphasis on psychological symptoms (to supplement physical pathology) in prescribing; and
• regular use of very high potencies.

Influenced by Swedenborgianism, Kent reputedly emphasized 'spiritual factors' as the root cause of disease.

"...for it goes to the very primitive wrong of the human race, the very first sickness of the human race that is the spiritual sickness... which in turn laid the foundation for other diseases."

Homeopathy history around the world

There are estimated to be more than 100,000 practitioners of homeopathy worldwide, with an estimated 500 million people receiving treatment. More than 12,000 medical doctors and licensed health care practitioners administer homeopathic treatment in the UK, France, and Germany. Homeopathy was regulated by the European Union in 2001, by Directive 2001/83/EC.

Britain

Homeopathy was first established in Britain by Dr Frederick Quin around 1827, though two Italian homeopathic doctors (Drs Romani and Roberta) had been employed two years previously by the Earl of Shrewsbury based at Alton Towers in North Staffordshire; however, they soon returned to Naples as they could not tolerate the cool damp English climate. Homeopathy in the UK quickly became popular with the aristocracy, and Quin counted among his patients, the Dukes of Edinburgh and Beaufort and the Duchess of Cambridge.

At its peak in the 1870s Britain had numerous homeopathic dispensaries and small hospitals as well as large busy hospitals in Liverpool, Birmingham, Glasgow, London and Bristol, almost exclusively funded and run by members of the local gentry.

In Britain, homeopathic remedies are sold over the counter. Today Britain has five homeopathic hospitals, funded by the National Health Service, which together with many regional clinics make free homeopathic treatment available on the health service. Homeopathy is not practised by most of the medical profession, but it enjoys support from the Prince of Wales and many other members of the royal family.

The largest organisation of homeopaths in Britain, the Society of Homeopaths[1], was founded in 1978 and has been growing steadily since then; it now has 1300 members, an increasing proportion of whom are women. Homeopaths in Britain are represented by the Faculty of Homeopathy, incorporated by an Act of Parliament in 1950, and based in London.

India

Homeopathy arrived in India with Dr John Martin Honigberger (1795-1869) in Lahore, in 1829-30, and is officially recognized. "The first doctor who brought homeopathy to India was Dr. Martin Honigburger, who first came to the Punjab...in 1829." India has the largest homeopathic infrastructure in the world, with 300,000 qualified homeopaths, 180 colleges, 7500 government clinics, and 307 hospitals. The Association of Qualified Homoeopaths in India (IHK) is the largest of its kind.

USA

Homeopathy was first practiced in the USA by Dr Hans Burch Gram in 1825 and rapidly gained popularity, partly because the lack of availability of conventional medicine, and partly due to the efforts of Dr Constantine Hering, who immigrated to the US in 1833, and was later called "the father of American homeopathy". By the early 1840s homeopathy enjoyed considerable influence and prestige, and in the period 1880 - 1900 reached the height of its popularity. Use of homeopathy has since declined in the US, and as of 2002 about 1.7% of people polled reported having sought homeopathic treatment.

Waning of popularity

In the 1930s homeopathy's popularity waned, especially in the USA and Europe, due in part due to advances in conventional medicine, skepticism, and the active advocacy against homeopathy by the American Medical Association. This led to the closure of virtually all medical schools teaching alternative medicine in the USA.

Homeopathy reached a peak of popularity in 1865–1885 and thereafter declined due partly to recognition by the establishment of the dangers of large doses of drugs and bleeding, and via dissent between different schools of homeopathy. The Carnegie Foundation issued the Flexner Report sponsored by the American Medical Association in 1910 that supported conventional medical schools while condemning homeopathic schools.

The Federation of State Medical Boards voluntarily agreed to base its accreditation policies for all medical schools on academic standards determined by the AMA's Council on Medical Education[2]. Consequently, the CME's decisions "came to have the force of law." By the 1930s, the combined efforts of state licensing boards, philanthropic foundations, and the AMA's CME resulted in the eradication of America's proprietary medical colleges including homeopathic schools.

Classical versus non-classical homeopathy

Hahnemann's formulation of homeopathy is often referred to as classical homeopathy. Classical homeopaths use one remedy at a time, and base their prescription also on incidental or constitutional symptoms. However, homeopathic remedies are often used both by practitioners and by the public based on formulations marketed for specific medical conditions. Some formulations use a 'shotgun' approach of the most commonly indicated single remedies in mixture form, while others, such as those by Heel and Reckeweg, are proprietary mixtures marketed for specific diagnostic criteria based on various systems. Many members of the public are unfamiliar with classical homeopathy, and equate these practices with homeopathy; others are familiar with the classical approach but regard these as legitimate variants; while others consider it a misuse of the term. Use of non-classical approaches is confined mainly to places where over-the-counter preparations are popular and where many doctors use natural medicines in a conventional clinical setting.