Homeopathy: placebo's freind

It seems I am not the only one expressing recent concerns that pseudoscientific therapies are creeping their way into science based realms. Orac, Dr R.W., and retired doc have very interesting reviews of a 2005 study regarding homeopathy and its use in intensive care units. They do an excellent job dismantling the pseudo legitimacy and getting straight to the quackery.

Homeopathy has yet to be discussed in detail on this blog, mainly because so many have done such a great job discussing it already. However it seems fitting to put together a brief introduction and review of homeopathy as a backdrop to these posts.

Homeopathy

Christian Friedrich Samuel Hahnemann, the founder of homeopathy, was born in 1775 in Meissen, Germany. His father, a porcelain painter, worked to give his children the best education possible with the goal that they become “Selbstdenker”- or self-thinkers, and in fact Samuel Hahnenmann became a very inquisitive student. Through his life as a student he sustained himself by translating publications acquiring along the way, a wealth of chemistry knowledge.

He received an MD degree in 1779 and pursued an interest in chemistry. For instance, he introduced a method to unmask the sweetening of wine with lead and published a report on arsenic poisoning. By 1789, Hahnemann left medical practice and dedicated himself to research and writing and by 1805 had published 5,500 pages in books, articles, and translations. From 1811 to 1821 he lectured on his homeopathy theory in Leipzig, and in 1821 was forced to leave due to the “the hostilities of the apothecaries.” He eventually moved to Paris, where he became a very popular medical practitioner until he died in 1843.

During this point in the history of medicine a variety of archaic, mostly damaging modalities were still in use. For example blood letting, leeching, and purging were common medical therapies. Amongst these primitive and unproductive therapies Hahnemann developed an understandable disdain for this medical reality and yearned for a better way.

The problem, however is that he relied more on speculative techniques to create his homeopathic system. Dr Rijnberk (The end of homeopathy) states: “In his search for other approaches the Newtonian empiricism did not play an important role. The role model was rather the Renaissance astrologist Paracelsus, who pioneered the use of chemicals and minerals in medicine. Hahnemann always emphasized the empiric character of his method, but he had a strong passion for speculation and ontological system building.”

This is reminiscent of the Traditional Chinese Medicine pre-enlightenment period where practitioners moved away from true empiricism and moved backwards towards divination.

Simila Theory

The basic tenant of “like cures like” has a very interesting origin that illustrates the non empirical formulation of homeopathy. When translating William Cullen’s Lectures on the Materia medica into German Hahnemann disagreed with the author regarding quinine in malaria patients. Cullen thought that quinine strengthened the stomach. Hahnemann ingested quinine and experienced symptoms similar to the actual disease of malaria. He basically had an “epiphany” or occurrence that led to the subsequent formulation of the Materia medica. According to Rijnberk “This observation led him to assert the theory that “likes are cured by likes”, similia similibus curentur. Diseases are cured (or should be treated) by those drugs that produce in healthy persons symptoms similar to the disease. His work, Organon der rationellen (Orgenon of rational medicine) Heilkunst contains an exposition of his system, which he called Homoopathie.”

Potentiation

From these rather tenuous beginnings, Hahnemann continued to build his paper tiger. Rijnberk notes “Hahnemann increasingly tended to believe in dynamic rather than corpuscular interpretations of the action of drugs. He described the action of highly dilutes solutions as “dynamic”. He compared the action of drugs with warmth, magnetism, and electricity.” Through the years, he increased the dilutions; finally favoring dilutions up to C30 (100³⁰=10⁶⁰) Knowing that little of the original substance remained in these fluids, Hahnemann believed that by shaking these fluids through each dilution step, he could facilitate the “release of intrinsic curing forces.”

These remedies experienced a period of popularity as they were less harmful than many of the other archaic practices being utilized at the time. By the turn of the 20^th century, its popularity began to diminish dramatically with the introduction of the far more demonstrably efficacious science based medicine. However, the practice of homeopathy has continued to smolder and seems to have gained popularity in today’s seemingly more favorable public environment. Its effects are largely a combination of placebo effects, confirmation bias, and misinterpreting natural variations during the history of a disease process.

Ref: Rijnberk, AD, DDr.hc. The end of homeopathy. Worlds Small Animal Veterinary Association World Congress, .2006