This article was published in Veterinary Times on 28th June 2004 (volume 34, issue 24, p. 12). |
PETER GREGORY, BVSc, MRCVS
speaks out in defence of homoeopathy in our occasional Your Shout column.
"The physician's highest and only calling is to make the sick healthy, to cure, as it is called." - paragraph 1 of The Organon of the Medical Art by Samuel Hahnemann.
IN 1984, after 12 years in mixed practice in the UK and Australia, I took a short-term post in Cardiff. One evening surgery I was presented with an Old English sheepdog for treatment of radiographically-confirmed arthritis of the spine. Weeks earlier he had undergone extensive surgery to the pelvic area after being hit by a train.
On attempting to move he suffered from such pain that he would scream; painkillers and anti-inflammatories would provide relief for at most five days before complete relapse, and the owner was considering euthanasia.
Having recently learned a little of homoeopathy, this seemed to be a suitable opportunity to try it out; I took the case and prescribed Rhus tox 6c tds for 10 days and at the end of the course the elated owner returned to say that after three days the symptoms had completely disappeared. There was no relapse within the six months I was able to follow the case up.
The only feasible way to explain this dramatic recovery was that the homoeopathic medicine had acted beneficially, and this experience set me to studying homoeopathy and developing my skills in its use. My professional life is now entirely taken up by practising complementary therapies, and teaching homoeopathy to vets in the UK and overseas.
Little did I realise then what I would have to put up with from a few of my veterinary colleagues for daring to use a form of medicine other than that which I was taught at university.
The principle of homoeopathy is that disease in an organism may be cured by the administration of a substance which, when given to a healthy individual, would induce similar symptoms.
In contrast much of orthodox medicine is "antipathic" (where the effects of the medicine are contrary to the symptoms) or "allopathic" (where the effect of the medicine on a healthy individual bears no relationship to the symptoms).
The Ancient Egyptians are known to have treated illness using the homoeopathic principle, and the Ancient Greeks also refer to it; Hippocrates (c.460-c.375BC) is quoted thus: "The majority of maladies may be cured by the same things that have caused them." Paracelsus (1493-1541) proposed that medicines should be prescribed on the same basis.
It was, however, not until the early 19th century that the system was fully developed, by a German physician by the name of Dr Samuel Hahnemann. A full description of the system was published as the first edition of The Organon of the Medical Art in 1810.
Generations of homoeopaths have built on Hahnemann's work, and while The Organon still remains the basis of all homoeopathy, there are modern works which are arguably more relevant, such as George Vithoulkas' The Science of Homoeopathy and Jan Scholten's Homoeopathy and the Elements, which ascribes properties of the elemental homoeopathic medicines according to their position in the periodic table.
In order to build up what we might now call a database of homoeopathic medicines, Hahnemann tested the effects of a large number of substances on healthy individuals. The collection of symptoms produced by the administration of a medicine to a healthy subject is termed a "proving" (from the German "prüfung" meaning "test").
Initially, Hahnemann used material doses, but later went on to use potentised medicines (see below). Homoeopathic provings of new medicines continue to be performed in the belief that as the diseases of man and his companion animals change, so are new medicines required to treat them.
Perhaps not surprisingly, Hahnemann found that the use of toxic medicines in the sick frequently caused a worsening of the patient's condition before the therapeutic effect appeared, and in an effort to reduce these effects he experimented with progressive dilutions of the medicines.
As might be expected, simple dilution only made the medicines weaker, but Hahnemann discovered that, if he shook the vial vigorously after each stage of dilution (a process known as "succussion") the medicines not only became safer to use but also more powerful.
The initial aggravations were considerably reduced but they were not completely eliminated, and acquiring the ability to recognise and manage these is an essential part of learning to practise homoeopathy.
Hahnemann beat the vials an a leather-bound book, but nowadays machines are often used. For the medicines to be active, a polar solvent (usually alcohol) must be used, and the process must induce vorticing of the solution. After the 12th centessimal potency (diluted in the ratio of 1:100 12 times) the chance of finding a single molecule of the original solute tends to zero and it is this issue which seems to be the basis of most of the opposition to homoeopathy.
Frequently, and crucially, those who wish to discredit homoeopathy (as in Mr Taylor's article in the 17th May issue of Veterinary Times) often ignore the process of succussion. An enormous amount of research has been performed which demonstrates the activity of potentised medicines, but as yet the exact nature of the phenomenon remains a mystery.
As we are dealing with physics at the submolecular level, it seems likely that quantum physics may reveal some answers and models have been developed to investigate this. In contrast, recent research (which have yet to peruse myself) claims to have identified the receptor sites upon which homoeopathic medicines act.
"In its analytical pursuit of the parts, science has missed the whole, and thus tended to reduce the world to dead aggregations rather than to the real living wholes which make up nature." - Jan Smuts, the originator of "holism", 1927.
In an attempt to explain the process of disease and its treatnent by homoeopathy, Hahnemann postulated that each individual possesses a unique "vital force" which is responsible forr homoeostasis. When this is in harmony there is health; when it is in disharmony disease ensues. In modern medical thinking, this is represented by he "Psycho-neuro-endocrineimmune axis" (PNEI), a concept well accepted within orthodox medicine.
In considering the PNEI system, it is apparent that there is an inextricable link between the mental/emotional and the physical, and if disturbance of the PNEI is indeed the basis of disease, it is reflected not by the single presenting symptom alone but by the patient's complete symptom complex.
This concept of "totality" is vital to an understanding of homoeopathy, as it sets disease in a holistic framework, and concentrates on the individual patient and his symptoms, rather than on the named disease.
A consequence of the individuality of each patient's PNEI disturbance is that it is difficult to test homoeopathy using those methods which have been derived to specifically cancel out individual variation, such as the double-blind crossover trial.
However, some such trials have been conducted, a recent example being a placebo-controlled double-blind parallel-group study on the effects of homoeopathy on patients with fibromyalgia. This showed a significant improvement in symptoms over placebo [Rheumatology (2004) 4: 577-82].
"The most common of all follies is to believe passionately in the palpably not true. It is the chief occupation of mankind." - H. L. Meneken.
"No one can act out of exclusively pure motives. The greater the contamination by dark motives, the more the (case) worker clings to his alleged objectivity." - Guggenbühl-Craig.
It should be made clear that there is no conflict between homoeopathy and veterinary medicine, but there are a few members of the profession who are violently opposed to it.
I have often tried to understand why a minority of veterinary surgeons, practising a relatively safe, well-documented and established form of medicine, should attract such violent opposition from an admittedly even smaller number of their professional colleagues. The opposition is certainly not based on science. Were it to be so, there would be more interest in the lack of science which underlies so many of the orthodox interventions in veterinary medicine; indeed, this vociferous minority would ensure that they truly understood homoeopathy before committing their ignorance of the system to print.
It seems that the "antihomoeopaths" are primarily motivated by the belief that homoeopathic medicines are inactive, despite all the evidence to the contrary. They particularly object to the inference that potentised medicines may act at the "energetic" level which they erroneously perceive as the metaphysical - somewhere they have missed out on the last 90 years of advances in physics.
In order to maintain this belief, it is necessary to adhere to the prejudices, inaccuracies and improbabilities which bolster it, and to ignore the reality. Necessary casualties include science, freedom of thought, freedom of choice, quantum physics and any notion of the non-material, and any belief in the competence and ethics of one's fellow professionals.
Indeed, latterly, perhaps in a last, desperate attempt to justify the belief, it has apparently become necessary to question the honesty of those millions of professionals, medical and veterinary, around the world, who practise homoeopathy. A look at the websites which the "anti-homoeopaths" espouse leaves one in no doubt as to the radical nature of their belief system; were they to be directed towards a religious minority they would be illegal.
The only rational explanation I can find for such behaviour is that it is motivated by fear and perpetuated by ignorance; perhaps the mystery surrounding potentisation somehow touches the fear of the unknown inherent in our Western belief system, the fear of "the occult".
Even today there are sections of the Church of England who consider homoeopathy "the work of the devil". Perhaps our society is still sufficiently steeped in mediaeval beliefs as to provide an explanation for the irrationality which we observe, but one thing is certain: it ain't scientific.
Within the veterinary profession homoeopathy has a long history. Hahnemann himself treated animals and many books on veterinary homoeopathy survive from the 19th century: in the UK, for instance, 15,000 copies of Dr Ruddock's Pocket Manual of Homoeopathic Veterinary Medicine were printed.
Homoeopathy has been an integral part of veterinary medicine since long before "modern" chemical-based drugs appeared in the mid-20th century; veterinary medicine as practised in this century is, by comparison with homoeopathy, in its infancy.
The opponents of homoeopathy would like to believe that homoeopaths operate outside the profession, but the reality is that veterinary homoeopaths operate entirely within it, either by integrating the system successfully into general practice, or as specialists taking referrals from other veterinary surgeons.
There is an increasing demand for this service, not only in small animal medicine but also in farm animals, where homoeopathy is an essential feature of organic systems.
Where orthodox therapy is unsuccessful or inappropriate, homoeopathy can provide immense benefits for our patients. Furthermore, the practice of homoeopathy requires the development of a closer relationship between client, patient and veterinarian than is necessary when orthodox medicine is used. This can be immensely rewarding for vet and client alike, and is in contrast to the disempowerment felt by many in the profession, and reflected in the increasingly impersonal way in which veterinary medicine is currently practised in the UK.
Those who learn to use homoeopathy invariably recognise an improvement in the satisfaction they derive from their work and a correspondingly higher success rate in treating their patients. Homoeopathy benefits patients, clients and veterinary surgeons alike.
This, as Pooh Bear would say, is "A Good Thing." Why anyone should be opposed to it is indeed a mystery.